Version 3.19 Update - Professional Services and Supplies Charge Table,,,,,,,,,,,,,,,,,,,,,,,,,
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Item Code,Code Type,Description,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 Date,,,
00100,CPT,ANESTHESIA SALIVARY GLANDS WITH BIOPSY,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00102,CPT,ANESTHESIA CLEFT LIP INVOLVING PLASTIC REPAIR,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00103,CPT,ANESTHESIA EYELID RECONSTRUCTIVE PROCEDURE,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00104,CPT,ANESTHESIA ELECTROCONVULSIVE THERAPY,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00120,CPT,ANESTHESIA EXTERNAL MIDDLE & INNER EAR W/BX NOS,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00124,CPT,ANES EXTERNAL MIDDLE & INNER EAR W/BX OTOSCOPY,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00126,CPT,ANES XTRNL MID & INNER EAR W/BX TYMPANOTOMY,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00140,CPT,ANESTHESIA EYE NOT OTHERWISE SPECIFIED,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00142,CPT,ANESTHESIA EYE LENS SURGERY,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00144,CPT,ANESTHESIA EYE CORNEAL TRANSPLANT,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00145,CPT,ANESTHESIA EYE VITREORETINAL SURGERY,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00147,CPT,ANESTHESIA EYE IRIDECTOMY,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00148,CPT,ANESTHESIA EYE OPHTHALMOSCOPY,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00160,CPT,ANESTHESIA NOSE & ACCESSORY SINUSES NOS,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00162,CPT,ANES NOSE & ACCESSORY SINUSES RADICAL SURGERY,,,3,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00164,CPT,ANES NOSE & ACCESSORY SINUSES BIOPSY SOFT TISSUE,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00170,CPT,ANESTHESIA INTRAORAL WITH BIOPSY NOS,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00172,CPT,ANES INTRAORAL W/BIOPSY REPAIR CLEFT PALATE,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00174,CPT,ANES INTRAORAL W/BX EXC RETROPHARYNGEAL TUMOR,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00176,CPT,ANESTHESIA INTRAORAL W/BIOPSY RADICAL SURGERY,,,3,,Anesth,,,,,7.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00190,CPT,ANESTHESIA FACIAL BONES OR SKULL NOS,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00192,CPT,ANES FACIAL BONES/SKULL RAD SURG W/PROGNATHISM,,,3,,Anesth,,,,,7.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00210,CPT,ANESTHESIA INTRACRANIAL PROCEDURE NOS,,,3,,Anesth,,,,,11.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00211,CPT,ANES INTRACRANIAL CRANIOTOMY/CRANIECTOMY HMTMA,,,3,,Anesth,,,,,10.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00212,CPT,ANESTHESIA INTRACRANIAL PROCEDURE SUBDURAL TAPS,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00214,CPT,ANES INTRACRANIAL BURR HOLES W/VENTRICULOGRAPHY,,,3,,Anesth,,,,,9.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00215,CPT,ANES INTRACRANIAL/ELEVATION DEPRSD SKULL FX XDRL,,,3,,Anesth,,,,,9.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00216,CPT,ANESTHESIA INTRACRANIAL VASCULAR PROCEDURE,,,3,,Anesth,,,,,15.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00218,CPT,ANES INTRACRANIAL PROCEDURE IN SITTING POSITION,,,3,,Anesth,,,,,13.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00220,CPT,ANES INTRACRANIAL CEREBROSPINAL FLUID SHUNTING,,,3,,Anesth,,,,,10.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00222,CPT,ANES INTRACRANIAL ELECTROCOAGULATION ICRA NERVE,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00300,CPT,ANES INTEG MUSC & NRV HEAD NECK&POSTERIOR TRUNK,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00320,CPT,ANES ESOPH THYRD LARYNX TRACH & LYMPH NECK 1YR,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00322,CPT,ANES ESOPH THYRD LARX TRACH & LYMPH NCK BX THYRD,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00326,CPT,ANESTHESIA LARYNX & TRACHEA CHILDREN <1 YEAR,,,3,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00350,CPT,ANESTHESIA MAJOR VESSELS NECK NOS,,,3,,Anesth,,,,,10.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00352,CPT,ANESTHESIA MAJOR VESSELS NECK SIMPLE LIGATION,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00400,CPT,ANES INTEG EXTREMITIES ANT TRUNK & PERINEUM NOS,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00402,CPT,ANESTHESIA RECONSTRUCTION BREAST,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00404,CPT,ANESTHESIA RADICAL/MODIFIED RADICAL BREAST,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00406,CPT,ANES RADICAL/MODIFIED RADICAL BREAST W/NODES,,,3,,Anesth,,,,,13.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00410,CPT,ANES INTEG SYS ELEC CONVERSION ARRHYTHMIAS,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00450,CPT,ANESTHESIA CLAVICLE AND SCAPULA NOS,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00454,CPT,ANESTHESIA CLAVICLE & SCAPULA BIOPSY CLAVICLE,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00470,CPT,ANESTHESIA PARTIAL RIB RESECTION NOS,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00472,CPT,ANESTHESIA PARTIAL RIB RESECTION THORACOPLASTY,,,3,,Anesth,,,,,10.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00474,CPT,ANESTHESIA PARTIAL RIB RESECTION RADICAL,,,3,,Anesth,,,,,13.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00500,CPT,ANESTHESIA ESOPHAGUS,,,3,,Anesth,,,,,15.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00520,CPT,ANESTHESIA CLOSED CHEST W/BRONCHOSCOPY NOS,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00522,CPT,ANESTHESIA CLOSED CHEST NEEDLE BIOPSY PLEURA,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00524,CPT,ANESTHESIA CLOSED CHEST PNEUMOCENTESIS,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00528,CPT,ANES MEDIASTINOSCOPY&THORACSCOPY W/O 1 LUNG VNTJ,,,3,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00529,CPT,ANES MEDIASTINOSCOPY&THORACOSCOPY W/1 LUNG VNT,,,3,,Anesth,,,,,11.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00530,CPT,ANES PERMANENT TRANSVENOUS PACEMAKER INSERTION,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00532,CPT,ANESTHESIA ACCESS CENTRAL VENOUS CIRCULATION,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00534,CPT,ANES TRANSVENOUS INSJ/REPLACEMENT PACING CVDFB,,,3,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00537,CPT,ANES CARDIAC ELECTROPHYSIOL STDY W/RF ABLATION,,,3,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00539,CPT,ANESTHESIA TRACHEOBRONCHIAL RECONSTRUCTION,,,3,,Anesth,,,,,18.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00540,CPT,ANES THORACOTOMY & THORACOSCOPY NOS,,,3,,Anesth,,,,,12.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00541,CPT,ANES THORACOTOMY & THORACOSCOPY W/1 LUNG VNTJ,,,3,,Anesth,,,,,15.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00542,CPT,ANES THORACOTOMY & THORACOSCOPY DECORTICATION,,,3,,Anesth,,,,,15.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00546,CPT,ANES THORACOTOMY & THORACOSCOPY PULMONARY RESC,,,3,,Anesth,,,,,15.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00548,CPT,ANES THORACOTOMY &THORACSCOPY TRACHEA & BRONCHI,,,3,,Anesth,,,,,17.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00550,CPT,ANESTHESIA FOR STERNAL DEBRIDEMENT,,,3,,Anesth,,,,,10.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00560,CPT,ANES HRT PERICARDIAL SAC& GRT VESLS W/O PMP OXT,,,3,,Anesth,,,,,15.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00561,CPT,ANES HRT PERICARD SAC&GREAT VSLS W/PMP OXTJ <1YR,,,3,,Anesth,,,,,25.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00562,CPT,ANES HRT PERICRD SAC&GRT VSLS W/PMP OXTJ >1MO PO,,,3,,Anesth,,,,,20.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00563,CPT,ANES HRT PRCRD SAC & GREAT VSL W/PUMP OXTJ HYPTH,,,3,,Anesth,,,,,25.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00566,CPT,ANES DIRECT CABG W/O PUMP OXYGENATOR,,,3,,Anesth,,,,,25.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00567,CPT,ANES DIRECT CABG W/PUMP OXYGENATOR,,,3,,Anesth,,,,,18.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00580,CPT,ANES HEART TRANSPLANT/HEART/LUNG TRANSPLANT,,,3,,Anesth,,,,,20.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00600,CPT,ANESTHESIA CERVICAL SPINE & CORD NOS,,,3,,Anesth,,,,,10.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00604,CPT,ANES CERVICAL SPINE & CORD W/PATIENT SITTING,,,3,,Anesth,,,,,13.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00620,CPT,ANESTHESIA THORACIC SPINE & CORD NOS,,,3,,Anesth,,,,,10.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00625,CPT,ANES THRC SPINE & CORD ANT APPR W/O 1 LUNG VENTJ,,,3,,Anesth,,,,,13.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00626,CPT,ANES THORACIC SPINE & CORD ANT APPR W/1 LNG VENT,,,3,,Anesth,,,,,15.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00630,CPT,ANESTHESIA LUMBAR REGION NOS,,,3,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00632,CPT,ANESTHESIA LUMBAR REGION LUMBAR SYMPATHECTOMY,,,3,,Anesth,,,,,7.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00635,CPT,ANES DIAGNOSTIC/THERAPEUTIC LUMBAR PUNCTURE,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00640,CPT,ANES MANIPULATE SPINE/CLSD CRV THORC/LUMBR SPINE,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00670,CPT,ANESTHESIA EXTENSIVE SPINE & SPINAL CORD,,,3,,Anesth,,,,,13.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00700,CPT,ANESTHESIA UPPER ANTERIOR ABDOMINAL WALL NOS,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00702,CPT,ANES UPR ANT ABDL WALL PERCUTANEOUS LIVER BX,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00730,CPT,ANESTHESIA UPPER POSTERIOR ABDOMINAL WALL,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00740,CPT,ANES UPPER GI ENDOSCOPY PROXIMAL TO DUODENUM,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00750,CPT,ANESTHESIA HERNIA REPAIR UPPER ABDOMEN NOS,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00752,CPT,ANES HRNA RPR UPR ABD LMBR&VENTRAL HERNIA&DEHISC,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00754,CPT,ANES HERNIA REPAIR UPPER ABDOMEN OMPHALOCELE,,,3,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00756,CPT,ANES HRNA REPAIR UPR ABD TABDL RPR DIPHRG HRNA,,,3,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00770,CPT,ANESTHESIA MAJOR ABDOMINAL BLOOD VESSELS,,,3,,Anesth,,,,,15.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00790,CPT,ANES INTRAPERITONEAL UPPER ABDOMEN W/LAPS NOS,,,3,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00792,CPT,ANES LAPS PARTIAL HEPATECTOMY W/MGMT LIVER HEMOR,,,3,,Anesth,,,,,13.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00794,CPT,ANES LAPAROSCOPIC PARTIAL/TOTAL PANCREATECTOMY,,,3,,Anesth,,,,,8.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00796,CPT,ANES LAPAROSCOPIC LIVER TRANSPLANT,,,3,,Anesth,,,,,30.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00797,CPT,ANES IPR UPPER ABDOMEN LAPS GASTRIC RSTCV MO,,,3,,Anesth,,,,,11.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00800,CPT,ANESTHESIA LOWER ANTERIOR ABDOMINAL WALL NOS,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00802,CPT,ANES LOWER ANT ABDOMINAL WALL PANNICULECTOMY,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00810,CPT,ANES LOWER INTESTINE ENDOSCOPY DISTAL DUODENUM,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00820,CPT,ANESTHESIA LOWER POSTERIOR ABDOMINAL WALL,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00830,CPT,ANESTHESIA HERNIA REPAIR LOWER ABDOMEN NOS,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00832,CPT,ANES LWR ABD VENTRAL & INCISIONAL HERNIA REPAIR,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00834,CPT,ANES HERNIA REPAIR LOWER ABDOMEN NOS & 1YR AGE,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00836,CPT,ANES HRNA RPR LWR ABD NOS INFTS <37WK BRTH/50WK,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00840,CPT,ANESTHESIA INTRAPERITONEAL LOWER ABD W/LAPS NOS,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00842,CPT,ANES IPER LOWER ABDOMEN W/LAPS AMNIOCENTESIS,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00844,CPT,ANES IPER LOWER ABD W/LAPS ABDOMINOPRNL RESCJ,,,3,,Anesth,,,,,7.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00846,CPT,ANES IPER LOWER ABD W/LAPS RAD HYSTERECTOMY,,,3,,Anesth,,,,,8.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00848,CPT,ANES IPER LOWER ABD W/LAPS PELVIC EXENTERATION,,,3,,Anesth,,,,,8.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00851,CPT,ANES IPER LWR ABD W/LAPS TUBAL LIGATION/TRANSECT,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00860,CPT,ANES EXTRAPERITONEAL LWR ABD W/URINARY TRACT NOS,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00862,CPT,ANES XTRPRTL LOWER ABD UR TRACT RENAL DON NFRCT,,,3,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00864,CPT,ANES XTRPRTL LWER ABD W/URINARY TRACT TOT CYSTEC,,,3,,Anesth,,,,,8.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00865,CPT,ANES XTRPRTL LWR ABD W/URINARY TRACT RAD PRSTECT,,,3,,Anesth,,,,,7.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00866,CPT,ANES XTRPRTL LOWER ABD W/URIN TRACT ADRENLECTOMY,,,3,,Anesth,,,,,10.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00868,CPT,ANES XTRPRTL LWR ABD W/URIN TRACT RENAL TRANSPL,,,3,,Anesth,,,,,10.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00870,CPT,ANES XTRPRTL LWR ABD W/URIN TRACT CSTOLITHOTOMY,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00872,CPT,ANES LITHOTRP XTRCORP SHOCK WAVE W/WATER BATH,,,3,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00873,CPT,ANES LITHOTRP XTRCORP SHOCK WAVE W/O WATER BATH,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00880,CPT,ANESTHESIA MAJOR LOWER ABDOMINAL VESSELS NOS,,,3,,Anesth,,,,,15.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00882,CPT,ANES MAJOR LOWER ABDOMINAL VESSELS IVC LIGATION,,,3,,Anesth,,,,,10.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00902,CPT,ANESTHESIA ANORECTAL PROCEDURE,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00904,CPT,ANESTHESIA RADICAL PERINEAL PROCEDURE,,,3,,Anesth,,,,,7.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00906,CPT,ANESTHESIA VULVECTOMY,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00908,CPT,ANESTHESIA PERINEAL PROSTATECTOMY,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00910,CPT,ANES TRANSURETHRAL W/URETHROCYSTOSCOPY NOS,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00912,CPT,ANES TRANSURETHRAL RESECTION OF BLADDER TUMOR,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00914,CPT,ANESTHESIA TRANSURETHRAL RESECTION OF PROSTATE,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00916,CPT,ANES TRURL POST-TRURL RESECTION BLEEDING,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00918,CPT,ANES TRURL FRAGMNTJ MANJ&/RMVL URETERAL CALCULUS,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00920,CPT,ANESTHESIA MALE GENITALIA INCL OPEN URETHRAL PX,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00921,CPT,ANES VASECTOMY UNI/BI INCL OPEN URETHRAL PX,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00922,CPT,ANES SEMINAL VESICLES INCL OPEN URETHRAL PX,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00924,CPT,ANES UNDSCND TESTIS UNI/BI INCL OPEN URTL PX,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00926,CPT,ANES RAD ORCHIECTOMY INGUN INCL OPEN URTL PX,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00928,CPT,ANES RAD ORCHIECTOMY ABDOMINAL INCL OPN URTL,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00930,CPT,ANES ORCHIOPEXY UNI/BI INCL OPEN URETHRAL PX,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00932,CPT,ANES COMPLETE AMPUTATION PENIS INCL OPEN URTL,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00934,CPT,ANES RAD AMP PENIS W/BI INGUINAL LYMPH NODE RMVL,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00936,CPT,ANES RAD AMP PENIS W/BI INGUNL&ILIAC LYMPH RMOVL,,,3,,Anesth,,,,,8.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00938,CPT,ANES INSJ PENILE PROSTH PRNL INCL OPEN URTL,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00940,CPT,ANESTHESIA VAGINAL PROCEDURE W/BIOPSY NOS,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00942,CPT,ANES COLPTMY VAGNC COLPRPHY INCL BX W/OPN URTL,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00944,CPT,ANESTHESIA VAGINAL HYSTERECTOMY INCL BIOPSY,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
00948,CPT,ANESTHESIA CERVICAL CERCLAGE INCLUDING BIOPSY,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00950,CPT,ANESTHESIA CULDOSCOPY INCLUDING BIOPSY,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
00952,CPT,ANES HYSTEROSCOPY&/HYSTEROSALPINGOGRAPHY W/BX,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01112,CPT,ANES BONE MARROW ASPIR&/BX ANT/PST ILIAC CREST,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01120,CPT,ANESTHESIA ON BONY PELVIS,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01130,CPT,ANESTHESIA BODY CAST APPLICATION OR REVISION,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01140,CPT,ANESTHESIA INTERPELVI ABDOMINAL AMPUTATION,,,3,,Anesth,,,,,15.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
01150,CPT,ANES RADICAL TUMOR PELVIS XCP HINDQUARTER AMP,,,3,,Anesth,,,,,10.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
01160,CPT,ANES CLOSED SYMPHYSIS PUBIS/SACROILIAC JOINT,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01170,CPT,ANES OPEN SYMPHYSIS PUBIS/SACROILIAC JOINT,,,3,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01173,CPT,ANES OPN RPR DISRPJ PELVIS/COLUMN FX ACETABULUM,,,3,,Anesth,,,,,12.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01180,CPT,ANESTHESIA OBTURATOR NEURECTOMY EXTRAPELVIC,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01190,CPT,ANESTHESIA OBTURATOR NEURECTOMY INTRAPELVIC,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01200,CPT,ANESTHESIA CLOSED HIP JOINT PROCEDURE,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01202,CPT,ANESTHESIA ARTHROSCOPIC HIP JOINT PROCEDURE,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01210,CPT,ANESTHESIA OPEN HIP JOINT PROCEDURE NOS,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01212,CPT,ANESTHESIA OPEN HIP JOINT DISARTICULATION,,,3,,Anesth,,,,,10.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
01214,CPT,ANESTHESIA OPEN TOTAL HIP ARTHROPLASTY,,,3,,Anesth,,,,,8.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
01215,CPT,ANESTHESIA OPEN REVISION TOTAL HIP ARTHROPLASTY,,,3,,Anesth,,,,,10.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01220,CPT,ANESTHESIA CLOSED PROCEDURES UPPER 2/3 FEMUR,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01230,CPT,ANESTHESIA OPEN PROCEDURES UPPER 2/3 FEMUR NOS,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01232,CPT,ANESTHESIA UPPER 2/3 FEMUR AMPUTATION,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
01234,CPT,ANES UPPER 2/3 FEMUR RADICAL RESCECTION,,,3,,Anesth,,,,,8.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
01250,CPT,ANES NERVE MUSC TENDON FASCIA & BURSAE UPPER LEG,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01260,CPT,ANES VEINS OF UPPER LEG INCLUDING EXPLORATION,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01270,CPT,ANESTHESIA ARTERIES UPPER LEG INCL BYPASS GRAFT,,,3,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01272,CPT,ANES ART UPPER LEG W/BYPASS GRAFT FEM ART LIG,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
01274,CPT,ANES UPPER LEG W/BYPASS GRFT FEM ART EMBOLECTOMY,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
01320,CPT,ANES NERVE MUSC TENDON FASCIA&BURSA KNEE&/POPLT,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01340,CPT,ANESTHESIA CLOSED PROCEDURES LOWER 1/3 FEMUR,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01360,CPT,ANESTHESIA OPEN PROCEDURES LOWER 1/3 FEMUR,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01380,CPT,ANESTHESIA CLOSED PROCEDURES KNEE JOINT,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01382,CPT,ANESTH DIAGNOSTIC ARTHROSCOPIC PROC KNEE JOINT,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01390,CPT,ANES CLOSED PROC UPPER END TIBIA FIBULA/PATELLA,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01392,CPT,ANES OPEN PROC UPPER ENDS TIBIA FIBULA&/PATELLA,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01400,CPT,ANES OPEN/SURG ARTHROSCOPIC PROC KNEE JOINT NOS,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01402,CPT,ANESTH OPEN/SURG ARTHRS TOTAL KNEE ARTHROPLASTY,,,3,,Anesth,,,,,7.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
01404,CPT,ANESTH OPEN/SURG ARTHRS KNEE DISARTICULATION,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
01420,CPT,ANES CAST APPLICATION REMOVAL/REPAIR KNEE JOINT,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01430,CPT,ANESTHESIA VEINS KNEE & POPLITEAL AREA NOS,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01432,CPT,ANES KNEE & POPLITEAL ARTERY VEIN FISTULA NOS,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01440,CPT,ANES ARTERIES OF KNEE & POPLITEAL AREA NOS,,,3,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01442,CPT,ANES ART KNEE POPLITEAL TEAEC W/WO PATCH GRAFT,,,3,,Anesth,,,,,8.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
01444,CPT,ANES ART KNEE POPLITEAL EXC&GRF/RPR OCCLS/ARYS,,,3,,Anesth,,,,,8.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
01462,CPT,ANESTHESIA CLOSED PROC LOWER LEG ANKLE & FOOT,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01464,CPT,ANESTHESIA ARTHROSCOPIC PROCEDURE ANKLE & FOOT,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01470,CPT,ANES NRV/MUS/TND/FASC LOWER LEG/ANKLE/FOOT NOS,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01472,CPT,ANES RPR RUPTURED ACHILLES TENDON W/WO GRAFT,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01474,CPT,ANESTHESIA GASTROCNEMIUS RECESSION,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01480,CPT,ANES OPEN PROC BONES LOWER LEG/ANKLE/FOOT NOS,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01482,CPT,ANES RADICAL RESECJ INCL BELOW KNEE AMPUTATION,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01484,CPT,ANES OPEN OSTEOTOMY/OSTEOPLASTY TIBIA&/FIBULA,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01486,CPT,ANESTHESIA OPEN TOTAL ANKLE REPLACEMENT,,,3,,Anesth,,,,,7.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
01490,CPT,ANES LOWER LEG CAST APPLICATION REMOVAL/REPAIR,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01500,CPT,ANESTHESIA ARTERIES LOWER LEG W/BYPASS GRAFT NOS,,,3,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01502,CPT,ANES ART LOWER LEG W/BYP GRAFT EMBLC DIR/W/CATH,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
01520,CPT,ANESTHESIA VEINS OF LOWER LEG NOS,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01522,CPT,ANES VEINS LOWER LEG VENOUS THRMBC DIR/W/CATH,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01610,CPT,ANES NRV MUSC TNDN FSCIA BURSA SHOULDER & AXILLA,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01620,CPT,ANES CLOSED HUMRL H/N STRNCLAV JOINT& SHO JOINT,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01622,CPT,ANES DIAG ARTHROSCOPIC SHOULDER JOINT PROC NOS,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01630,CPT,ANES ARTHRS HUMERAL H/N STRNCLAV & SHOULDER NOS,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01634,CPT,ANESTHESIA ARTHROSCOPIC SHOULDER DISARTICULATION,,,3,,Anesth,,,,,9.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
01636,CPT,ANES ARTHRS INTERTHORACOSCAPULAR AMPUTATION,,,3,,Anesth,,,,,15.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
01638,CPT,ANES ARTHROSCOPIC TOTAL SHOULDER REPLACEMENT,,,3,,Anesth,,,,,10.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
01650,CPT,ANESTHESIA ARTERIES SHOULDER & AXILLA NOS,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01652,CPT,ANESTHESIA AXILLARY-BRACHIAL ANEURYSM,,,3,,Anesth,,,,,10.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
01654,CPT,ANES ARTERIES SHOULDER & AXILLA BYPASS GRAFT,,,3,,Anesth,,,,,8.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
01656,CPT,ANESTHESIA AXILLARY-FEMORAL BYPASS GRAFT,,,3,,Anesth,,,,,10.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
01670,CPT,ANESTHESIA VEINS SHOULDER & AXILLA,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01680,CPT,ANES SHOULDER CAST APPL REMOVAL/REPAIR NOS,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01682,CPT,ANES SHOULDER SPICA APPLICATION REMOVAL/REPAIR,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01710,CPT,ANES NRV MUSC TDN FSCA&BRS UPR ARM/ELBOW NOS,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01712,CPT,ANESTHESIA OPEN TENOTOMY ELBOW TO SHOULDER,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01714,CPT,ANESTHESIA TENOPLASTY ELBOW TO SHOULDER,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01716,CPT,ANESTHESIA BICEPS TENODESIS RUPTURE LONG TENDON,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01730,CPT,ANESTHESIA CLOSED PROCEDURES HUMERUS & ELBOW,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01732,CPT,ANESTHESIA ELBOW JOINT DIAGNOSTIC ARTHROSCOPIC,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01740,CPT,ANES OPEN/SURG ARTHROSCOPIC ELBOW PROC NOS,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01742,CPT,ANESTHESIA OPEN/SURG ARTHRS OSTEOTOMY HUMERUS,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01744,CPT,ANES OPEN/SURG ARTHRS REPRS NON/MALUNION HUMERUS,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01756,CPT,ANESTHESIA OPEN/SURG ARTHRS RADICAL PROC ELBOW,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
01758,CPT,ANESTH OPEN/SURG ARTHRS EXC CYST/TUMOR HUMERUS,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01760,CPT,ANESTH OPEN/SURG ARTHRS TOTAL ELBOW REPLACEMENT,,,3,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01770,CPT,ANESTHESIA ARTERIES UPPER ARM & ELBOW NOS,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01772,CPT,ANESTHESIA ARTERIES UPPER ARM&ELBOW EMBOLECTOM,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01780,CPT,ANESTH CLOSED PROC RADIUS ULNA WRIST/HAND BONES,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01782,CPT,ANESTHESIA VEINS UPPER ARM & ELBOW PHLEBORRHAPHY,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01810,CPT,ANES NERVE MUSCLE TDN FASCIA&BURSA FOREARM WRIST,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01820,CPT,ANES RADIUS ULNA WRIST/HAND BONES CLOSED PX,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01829,CPT,ANESTHESIA DIAGNOSTIC ARTHROSCOPIC PROC WRIST,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01830,CPT,ANES ARTHRS/ENDSCPY DSTL RADIUS ULNA/WRIST/HAND,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01832,CPT,ANESTHESIA ARTHRS/ENDOSCPIC TOTAL WRIST REPLCMT,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01840,CPT,ANESTHESIA ARTERIES FOREARM WRIST & HAND NOS,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01842,CPT,ANES ARTERIES FOREARM WRIST & HAND EMBOLECTOMY,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01844,CPT,ANESTHESIA VASCULAR SHUNT/SHUNT REVISION,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01850,CPT,ANESTHESIA VEINS FOREARM WRIST & HAND NOS,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01852,CPT,ANES VEINS FOREARM WRIST & HAND PHLEBORRHAPHY,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01860,CPT,ANES FOREARM WRIST/HAND CAST APPL RMVL/REPAIR,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01916,CPT,ANESTHESIA DIAGNOSTIC ARTERIOGRAPHY/VENOGRAPH,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01920,CPT,ANES C-CATHJ W/C ANGIOGRAPHY & VENTRICULOGRAPHY,,,3,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01922,CPT,ANES NON-INVASIVE IMAGING/RADIATION THERAPY,,,3,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01924,CPT,ANESTHESIA THER IVNTL RADIOLOGICAL ARTERIAL,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01925,CPT,ANESTHESIA CAROTID/CORONARY THER IVNTL RAD,,,3,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01926,CPT,ANES ICRA ICAR/AORTIC THER IVNTL RAD ARTL,,,3,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01930,CPT,ANES VENOUS/LYMPHATIC NOS THER IVNTL RAD NOS,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01931,CPT,ANESTHESIA INTRAHEPATIC/PORTAL THER IVNTL RAD,,,3,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01932,CPT,ANESTHESIA INTRATHORACIC/JUGULAR THER IVNTL RAD,,,3,,Anesth,,,,,6.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01933,CPT,ANES INTRACRANIAL THER IVNTL RAD VENS/LYMPHTC,,,3,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01935,CPT,ANESTHESIA PERQ IMAGE GUIDED SPINE DIAGNOSTIC,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01936,CPT,ANESTHESIA PERQ IMAGE GUIDED SPINE THERAPEUTIC,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01951,CPT,ANES 2/3 DGR BRN EXC/DBRDMT W/WO GRFT 4 % TBSA,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01952,CPT,ANES 2/3 DGR BRN EXC/DBRDMT W/WO GRFT 4-9 % TBSA,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01953,CPT,ANES 2/3 DGR BRN EXC/DBRDMT W/WO GRF EA 9% TBS,,,3,,Anesth,,,,,1.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01958,CPT,ANESTHESIA EXTERNAL CEPHALIC VERSION,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01960,CPT,ANESTHESIA VAGINAL DELIVERY ONLY,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01961,CPT,ANESTHESIA CESAREAN DELIVERY ONLY,,,3,,Anesth,,,,,7.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01962,CPT,ANES URGENT HYSTERECTOMY FOLLOWING DELIVERY,,,3,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01963,CPT,ANESTHESIA C HYST W/O ANY LABOR ANALG/ANES CARE,,,3,,Anesth,,,,,8.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01965,CPT,ANESTHESIA INCOMPLETE/MISSED ABORTION,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01966,CPT,ANESTHESIA INDUCED ABORTION,,,3,,Anesth,,,,,4.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01967,CPT,NEURAXIAL LABOR ANALG/ANES PLND VAGINAL DELIVERY,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01968,CPT,ANES CESARN DLVR FLWG NEURAXIAL LABOR ANALG/ANES,,,3,,Anesth,,,,,2.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01969,CPT,ANES CESARN HYST FLWG NEURAXIAL LABOR ANALG/ANES,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01990,CPT,PHYSIOL SUPPORT HARVEST ORGAN FROM BRAIN-DEAD PT,,,3,,Anesth,,,,,7.0,$1.00,$0.00,3,0,0,1,1,1,20161001,,,,
01991,CPT,ANES DX/THER NRV BLK/NJX OTH/THN PRONE POS,,,3,,Anesth,,,,,3.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01992,CPT,ANES DX/THER NERVE BLOCK/INJECTION PRONE POS,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
01996,CPT,DAILY HOSP MGMT EDRL/SARACH CONT DRUG ADMN,,,3,,TotalUnits,,,,2.62 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
01999,CPT,UNLISTED ANESTHESIA PROCEDURE,,,3,,Anesth,,,,,5.0,$1.00,$0.00,3,0,1,1,1,1,20161001,,,,
10021,CPT,FINE NEEDLE ASPIRATION W/O IMAGING GUIDANCE,,,21,,RBRVS,1.27 ,0.55 ,2.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
10022,CPT,FINE NEEDLE ASPIRATION WITH IMAGING GUIDANCE,,,21,,RBRVS,1.27 ,0.48 ,2.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
10030,CPT,IMAGE-GUIDED CATHETER FLUID COLLECTION DRAINAGE,,,21,,RBRVS,3.00 ,1.17 ,18.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
10035,CPT,PERQ SFT TISS LOC DEVICE PLMT 1ST LES W/GDNCE,,,21,,RBRVS,1.70 ,0.63 ,13.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
10036,CPT,PERQ SFT TISS LOC DEVICE PLMT ADD LES W/GDNCE,,,21,,RBRVS,0.85 ,0.32 ,12.25 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
10040,CPT,ACNE SURGERY,,,21,,RBRVS,1.21 ,1.14 ,1.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
10060,CPT,INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE,,,21,,RBRVS,1.22 ,1.42 ,1.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
10061,CPT,INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE,,,21,,RBRVS,2.45 ,2.38 ,3.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
10080,CPT,INCISION & DRAINAGE PILONIDAL CYST SIMPLE,,,21,,RBRVS,1.22 ,1.55 ,3.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
10081,CPT,INCISION & DRAINAGE PILONIDAL CYST COMPLICATED,,,21,,RBRVS,2.50 ,2.01 ,4.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
10120,CPT,INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE,,,21,,RBRVS,1.22 ,1.59 ,2.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
10121,CPT,INCISION & REMOVAL FOREIGN BODY SUBQ TISS COMPL,,,21,,RBRVS,2.74 ,2.17 ,4.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
10140,CPT,I&D HEMATOMA SEROMA/FLUID COLLECTION,,,21,,RBRVS,1.58 ,1.61 ,2.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
10160,CPT,PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,,,21,,RBRVS,1.25 ,1.33 ,2.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
10180,CPT,INCISION & DRAINAGE COMPLEX PO WOUND INFECTION,,,21,,RBRVS,2.30 ,2.33 ,4.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11000,CPT,DBRDMT EXTENSV ECZEMA/INFECT SKN UP 10% BDY SURF,,,21,,RBRVS,0.60 ,0.17 ,0.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11001,CPT,DBRDMT EXTNSVE ECZEMA/INFECT SKN EA 10% BDY SURF,,,21,,RBRVS,0.30 ,0.08 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11004,CPT,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT&PR,,,21,,RBRVS,10.80 ,3.91 ,3.91 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
11005,CPT,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ ABDL WALL,,,21,,RBRVS,14.24 ,5.21 ,5.21 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
11006,CPT,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT/ABDL,,,21,,RBRVS,13.10 ,4.68 ,4.68 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
11008,CPT,REMOVAL PROSTHETIC MATRL ABDL WALL FOR INFECTION,,,21,,RBRVS,5.00 ,1.83 ,1.83 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
11010,CPT,DBRDMT W/RMVL FM FX&/DISLC SKIN&SUBQ TISSUS,,,21,,RBRVS,4.19 ,3.11 ,9.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11011,CPT,DBRDMT W/RMVL FM FX&/DISLC SKN SUBQ T/M/F MUSC,,,21,,RBRVS,4.94 ,2.68 ,9.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11012,CPT,DBRDMT FX&/DISLC SUBQ T/M/F BONE,,,21,,RBRVS,6.87 ,3.99 ,11.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11042,CPT,DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<,,,21,,RBRVS,1.01 ,0.64 ,2.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11043,CPT,DEBRIDEMENT MUSCLE & FASCIA 20 SQ CM/<,,,21,,RBRVS,2.70 ,1.37 ,3.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11044,CPT,DEBRIDEMENT BONE MUSCLE &/FASCIA 20 SQ CM/<,,,21,,RBRVS,4.10 ,1.91 ,4.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11045,CPT,DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM,,,21,,RBRVS,0.50 ,0.18 ,0.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11046,CPT,DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM,,,21,,RBRVS,1.03 ,0.40 ,0.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11047,CPT,DEBRIDEMENT BONE EACH ADDITIONAL 20 SQ CM,,,21,,RBRVS,1.80 ,0.72 ,1.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11055,CPT,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1,,,21,,RBRVS,0.35 ,0.09 ,0.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11056,CPT,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-4,,,21,,RBRVS,0.50 ,0.12 ,1.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11057,CPT,PARING/CUTTING BENIGN HYPERKERATOTIC LESION >4,,,21,,RBRVS,0.65 ,0.16 ,1.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11100,CPT,BX SKIN SUBCUTANEOUS&/MUCOUS MEMBRANE 1 LESION,,,21,,RBRVS,0.81 ,0.48 ,2.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11101,CPT,BIOPSY SKIN SUBQ&/MUCOUS MEMBRANE EA ADDL LESN,,,21,,RBRVS,0.41 ,0.25 ,0.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11200,CPT,REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15,,,21,,RBRVS,0.82 ,1.17 ,1.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11201,CPT,REMOVAL SK TGS MLT FIBRQ TAGS ANY AREA EA 10,,,21,,RBRVS,0.29 ,0.15 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11300,CPT,SHAVING SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.5CM/<,,,21,,RBRVS,0.60 ,0.33 ,2.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11301,CPT,SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM,,,21,,RBRVS,0.90 ,0.52 ,2.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11302,CPT,SHVG SKN LESION 1 TRUNK/ARM/LEG DIAM 1.1-2.0 CM,,,21,,RBRVS,1.05 ,0.61 ,2.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11303,CPT,SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM,,,21,,RBRVS,1.25 ,0.71 ,2.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11305,CPT,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<,,,21,,RBRVS,0.80 ,0.25 ,1.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11306,CPT,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.6-1.0 CM,,,21,,RBRVS,0.96 ,0.42 ,2.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11307,CPT,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM,,,21,,RBRVS,1.20 ,0.56 ,2.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11308,CPT,SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM,,,21,,RBRVS,1.46 ,0.51 ,2.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11310,CPT,SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM 0.5 CM/<,,,21,,RBRVS,0.80 ,0.45 ,2.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11311,CPT,SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 0.6-1.0 CM,,,21,,RBRVS,1.10 ,0.64 ,1.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11312,CPT,SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 1.1-2.0 CM,,,21,,RBRVS,1.30 ,0.76 ,3.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11313,CPT,SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM >2.0 CM,,,21,,RBRVS,1.68 ,0.96 ,3.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11400,CPT,EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<,,,21,,RBRVS,0.90 ,1.27 ,2.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11401,CPT,EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM,,,21,,RBRVS,1.28 ,1.50 ,2.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11402,CPT,EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM,,,21,,RBRVS,1.45 ,1.59 ,3.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11403,CPT,EXC B9 LESION MRGN XCP SK TG T/A/L 2.1-3.0 CM/<,,,21,,RBRVS,1.84 ,2.07 ,3.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11404,CPT,EXC B9 LESION MRGN XCP SK TG T/A/L 3.1-4.0 CM,,,21,,RBRVS,2.11 ,2.16 ,3.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11406,CPT,EXC B9 LESION MRGN XCP SK TG T/A/L >4.0 CM,,,21,,RBRVS,3.52 ,2.85 ,4.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11420,CPT,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.5 CM/<,,,21,,RBRVS,1.03 ,1.18 ,2.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11421,CPT,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM,,,21,,RBRVS,1.47 ,1.48 ,2.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11422,CPT,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM,,,21,,RBRVS,1.68 ,1.95 ,3.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11423,CPT,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM,,,21,,RBRVS,2.06 ,2.13 ,3.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11424,CPT,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM,,,21,,RBRVS,2.48 ,2.27 ,3.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11426,CPT,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM,,,21,,RBRVS,4.09 ,3.05 ,4.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11440,CPT,EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<,,,21,,RBRVS,1.05 ,1.76 ,2.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11441,CPT,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.6-1.0CM,,,21,,RBRVS,1.53 ,2.01 ,3.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11442,CPT,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 1.1-2.0CM,,,21,,RBRVS,1.77 ,2.12 ,3.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11443,CPT,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 2.1-3.0CM,,,21,,RBRVS,2.34 ,2.40 ,3.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11444,CPT,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 3.1-4.0CM,,,21,,RBRVS,3.19 ,2.82 ,4.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11446,CPT,EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M > 4.0CM,,,21,,RBRVS,4.80 ,3.74 ,5.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11450,CPT,EXCISION HIDRADENITIS AXILLARY SMPL/INTRM RPR,,,21,,RBRVS,3.22 ,3.31 ,6.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11451,CPT,EXCISION HIDRADENITIS AXILLARY COMPLEX REPAIR,,,21,,RBRVS,4.43 ,3.91 ,8.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11462,CPT,EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR,,,21,,RBRVS,3.00 ,3.24 ,6.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11463,CPT,EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR,,,21,,RBRVS,4.43 ,4.00 ,8.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11470,CPT,EXCISION H/P/P/U SIMPLE/INTERMEDIATE REPAIR,,,21,,RBRVS,3.74 ,3.52 ,7.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11471,CPT,EXCISION H/P/P/U COMPLEX REPAIR,,,21,,RBRVS,4.89 ,4.12 ,8.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11600,CPT,EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<,,,21,,RBRVS,1.63 ,1.56 ,3.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11601,CPT,EXCISION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM,,,21,,RBRVS,2.07 ,1.90 ,4.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11602,CPT,EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM,,,21,,RBRVS,2.27 ,2.09 ,4.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11603,CPT,EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM/<,,,21,,RBRVS,2.82 ,2.37 ,4.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11604,CPT,EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM,,,21,,RBRVS,3.17 ,2.51 ,5.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11606,CPT,EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM,,,21,,RBRVS,5.02 ,3.28 ,6.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11620,CPT,EXCISION MALIGNANT LESION S/N/H/F/G 0.5 CM/<,,,21,,RBRVS,1.64 ,1.58 ,3.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11621,CPT,EXCISION MALIGNANT LESION S/N/H/F/G 0.6-1.0 CM,,,21,,RBRVS,2.08 ,1.92 ,4.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11622,CPT,EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM,,,21,,RBRVS,2.41 ,2.16 ,4.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11623,CPT,EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM/<,,,21,,RBRVS,3.11 ,2.51 ,4.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11624,CPT,EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM,,,21,,RBRVS,3.62 ,2.70 ,5.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11626,CPT,EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM,,,21,,RBRVS,4.61 ,3.07 ,6.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11640,CPT,EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<,,,21,,RBRVS,1.67 ,1.67 ,3.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11641,CPT,EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM,,,21,,RBRVS,2.17 ,1.99 ,4.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11642,CPT,EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM,,,21,,RBRVS,2.62 ,2.28 ,4.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11643,CPT,EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM,,,21,,RBRVS,3.42 ,2.68 ,5.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11644,CPT,EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM,,,21,,RBRVS,4.34 ,3.15 ,6.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11646,CPT,EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM,,,21,,RBRVS,6.26 ,4.09 ,7.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11719,CPT,TRIMMING NONDYSTROPHIC NAILS ANY NUMBER,,,21,,RBRVS,0.17 ,0.04 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11720,CPT,DEBRIDEMENT NAIL ANY METHOD 1-5,,,21,,RBRVS,0.32 ,0.08 ,0.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11721,CPT,DEBRIDEMENT NAIL ANY METHOD 6/>,,,21,,RBRVS,0.54 ,0.13 ,0.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11730,CPT,AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1,,,21,,RBRVS,1.10 ,0.27 ,1.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11732,CPT,AVULSION NAIL PLATE PARTIAL/COMP SIMPLE EA ADDL,,,21,,RBRVS,0.44 ,0.11 ,0.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11740,CPT,EVACUATION SUBUNGUAL HEMATOMA,,,21,,RBRVS,0.37 ,0.53 ,1.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11750,CPT,EXCISION NAIL MATRIX PERMANENT REMOVAL,,,21,,RBRVS,2.50 ,2.26 ,3.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11752,CPT,EXC NAIL MATRIX PRM RMVL W/AMP TUFT DSTL PHALANX,,,21,,RBRVS,3.63 ,3.45 ,5.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11755,CPT,BIOPSY NAIL UNIT SEPARATE PROCEDURE,,,21,,RBRVS,1.31 ,0.81 ,2.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11760,CPT,REPAIR NAIL BED,,,21,,RBRVS,1.63 ,1.91 ,4.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11762,CPT,RECONSTRUCTION NAIL BED W/GRAFT,,,21,,RBRVS,2.94 ,2.08 ,4.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11765,CPT,WEDGE EXCISION SKIN NAIL FOLD,,,21,,RBRVS,1.22 ,1.37 ,3.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11770,CPT,EXCISION PILONIDAL CYST/SINUS SIMPLE,,,21,,RBRVS,2.66 ,2.09 ,4.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11771,CPT,EXCISION PILONIDAL CYST/SINUS EXTENSIVE,,,21,,RBRVS,6.09 ,5.00 ,8.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11772,CPT,EXCISION PILONIDAL CYST/SINUS COMPLICATED,,,21,,RBRVS,7.35 ,7.58 ,10.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11900,CPT,INJECTION INTRALESIONAL UP TO & INCLUD 7 LESIONS,,,21,,RBRVS,0.52 ,0.31 ,0.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11901,CPT,INJECTION INTRALESIONAL >7 LESIONS,,,21,,RBRVS,0.80 ,0.48 ,1.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11920,CPT,TATTOOING INCL MICROPIGMENTATION 6.0 CM/<,,,21,,RBRVS,1.61 ,1.40 ,2.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11921,CPT,TATTOOING INCL MICROPIGMENTATION 6.1-20.0 CM,,,21,,RBRVS,1.93 ,1.61 ,3.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11922,CPT,TATTOOING INCL MICROPIGMENTATION EA 20.0 CM,,,21,,RBRVS,0.49 ,0.29 ,1.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11950,CPT,SUBCUTANEOUS INJECTION FILLING MATERIAL 1 CC/<,,,21,,RBRVS,0.84 ,0.55 ,1.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11951,CPT,SUBCUTANEOUS INJECTION FILLING MATRL 1.1-5.0 CC,,,21,,RBRVS,1.19 ,0.75 ,1.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11952,CPT,SUBCUTANEOUS INJECTION FILLING MATRL 5.1-10.0CC,,,21,,RBRVS,1.69 ,0.80 ,1.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11954,CPT,SUBCUTANEOUS INJECTION FILLING MATRL >10.0 CC,,,21,,RBRVS,1.85 ,1.15 ,2.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11960,CPT,INSERTION TISSUE EXPANDER INCL SBSQ XPNSJ,,,21,,RBRVS,11.49 ,13.55 ,13.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11970,CPT,REPLACEMENT TISS EXPANDER PERMANENT PROSTHESIS,,,21,,RBRVS,8.01 ,8.04 ,8.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11971,CPT,REMOVAL TISS EXPANDER W/O INSERTION PROSTHESIS,,,21,,RBRVS,3.41 ,5.12 ,9.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11976,CPT,REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES,,,21,,RBRVS,1.78 ,0.70 ,2.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11980,CPT,SUBCUTANEOUS HORMONE PELLET IMPLANTATION,,,21,,RBRVS,1.10 ,0.39 ,1.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11981,CPT,INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,,,21,,RBRVS,1.48 ,0.64 ,2.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11982,CPT,REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,,,21,,RBRVS,1.78 ,0.80 ,2.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
11983,CPT,RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT,,,21,,RBRVS,3.30 ,1.26 ,2.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12001,CPT,SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<,,,21,,RBRVS,0.84 ,0.32 ,1.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12002,CPT,SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM,,,21,,RBRVS,1.14 ,0.38 ,1.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12004,CPT,SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM,,,21,,RBRVS,1.44 ,0.45 ,1.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12005,CPT,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM,,,21,,RBRVS,1.97 ,0.58 ,2.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12006,CPT,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 20.1-30.0CM,,,21,,RBRVS,2.39 ,0.71 ,2.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12007,CPT,SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM,,,21,,RBRVS,2.90 ,0.93 ,3.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12011,CPT,SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<,,,21,,RBRVS,1.07 ,0.36 ,1.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12013,CPT,SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM,,,21,,RBRVS,1.22 ,0.39 ,2.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12014,CPT,SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM,,,21,,RBRVS,1.57 ,0.46 ,2.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12015,CPT,SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM,,,21,,RBRVS,1.98 ,0.55 ,2.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12016,CPT,SIMPLE REPAIR F/E/E/N/L/M 12.6CM-20.0 CM,,,21,,RBRVS,2.68 ,0.74 ,2.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12017,CPT,SIMPLE REPAIR F/E/E/N/L/M 20.1CM-30.0 CM,,,21,,RBRVS,3.18 ,0.71 ,0.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12018,CPT,SIMPLE REPAIR F/E/E/N/L/M >30.0 CM,,,21,,RBRVS,3.61 ,0.79 ,0.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12020,CPT,TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE,,,21,,RBRVS,2.67 ,2.33 ,4.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12021,CPT,TX SUPERFICIAL WOUND DEHISCENCE W/PACKING,,,21,,RBRVS,1.89 ,1.78 ,2.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12031,CPT,REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<,,,21,,RBRVS,2.00 ,2.09 ,4.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12032,CPT,REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM,,,21,,RBRVS,2.52 ,2.71 ,5.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12034,CPT,REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM,,,21,,RBRVS,2.97 ,2.50 ,5.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12035,CPT,REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM,,,21,,RBRVS,3.50 ,2.81 ,6.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12036,CPT,REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM,,,21,,RBRVS,4.23 ,2.99 ,6.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12037,CPT,REPAIR INTERMEDIATE S/A/T/E >30.0 CM,,,21,,RBRVS,5.00 ,3.50 ,7.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12041,CPT,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM/<,,,21,,RBRVS,2.10 ,2.09 ,4.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12042,CPT,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM,,,21,,RBRVS,2.79 ,2.56 ,4.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12044,CPT,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM,,,21,,RBRVS,3.19 ,2.52 ,6.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12045,CPT,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 12.6-20 CM,,,21,,RBRVS,3.75 ,3.45 ,7.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12046,CPT,RPR INTERMEDIATE N/H/F/XTRNL GENT 20.1-30.0 CM,,,21,,RBRVS,4.30 ,3.62 ,8.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12047,CPT,REPAIR INTERMEDIATE N/H/F/XTRNL GENT >30.0 CM,,,21,,RBRVS,4.95 ,5.01 ,10.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12051,CPT,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.5 CM/<,,,21,,RBRVS,2.33 ,2.25 ,4.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12052,CPT,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5.0 CM,,,21,,RBRVS,2.87 ,2.57 ,5.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12053,CPT,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 5.1-7.5 CM,,,21,,RBRVS,3.17 ,2.61 ,6.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12054,CPT,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 7.6-12.5 CM,,,21,,RBRVS,3.50 ,2.51 ,6.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12055,CPT,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 12.6-20.0CM,,,21,,RBRVS,4.50 ,3.45 ,8.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12056,CPT,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 20.1-30.0CM,,,21,,RBRVS,5.30 ,3.83 ,7.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
12057,CPT,REPAIR INTERMEDIATE F/E/E/N/L&/MUC >30.0 CM,,,21,,RBRVS,6.00 ,3.85 ,9.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
13100,CPT,REPAIR COMPLEX TRUNK 1.1-2.5 CM,,,21,,RBRVS,3.00 ,2.48 ,6.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
13101,CPT,REPAIR COMPLEX TRUNK 2.6-7.5 CM,,,21,,RBRVS,3.50 ,3.25 ,7.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
13102,CPT,REPAIR COMPLEX TRUNK EACH ADDITIONAL 5 CM/<,,,21,,RBRVS,1.24 ,0.69 ,2.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
13120,CPT,REPAIR COMPLEX SCALP/ARM/LEG 1.1-2.5 CM,,,21,,RBRVS,3.23 ,3.08 ,6.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
13121,CPT,REPAIR COMPLEX SCALP/ARM/LEG 2.6-7.5 CM,,,21,,RBRVS,4.00 ,3.11 ,7.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
13122,CPT,REPAIR COMPLEX SCALP/ARM/LEG EA ADDL 5 CM/<,,,21,,RBRVS,1.44 ,0.79 ,2.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
13131,CPT,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 1.1-2.5 CM,,,21,,RBRVS,3.73 ,2.92 ,6.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
13132,CPT,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM,,,21,,RBRVS,4.78 ,3.56 ,8.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
13133,CPT,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F EA ADDL 5 CM/<,,,21,,RBRVS,2.19 ,1.26 ,2.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
13151,CPT,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM,,,21,,RBRVS,4.34 ,3.27 ,6.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
13152,CPT,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM,,,21,,RBRVS,5.34 ,3.88 ,8.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
13153,CPT,REPAIR COMPLX EYELID/NOSE/EAR/LIP EA ADDL 5 CM/<,,,21,,RBRVS,2.38 ,1.33 ,2.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
13160,CPT,SECONDARY CLOSURE SURG WOUND/DEHSN EXTSV/COMPLIC,,,21,,RBRVS,12.04 ,8.91 ,8.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
14000,CPT,ADJACENT TISSUE TRANSFER/REARGMT TRUNK 10 SQCM/<,,,21,,RBRVS,6.37 ,6.95 ,10.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
14001,CPT,ADJNT TIS TRANSFR/REARRANGE TRUNK 10.1-30.0 SQCM,,,21,,RBRVS,8.78 ,8.44 ,12.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
14020,CPT,ADJT TIS TRNSFR/REARGMT SCALP/ARM/LEG 10 SQ CM/<,,,21,,RBRVS,7.22 ,7.93 ,11.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
14021,CPT,ADJT/REARRGMT SCALP/ARM/LEG 10.1-30.0 SQ CM,,,21,,RBRVS,9.72 ,9.38 ,13.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
14040,CPT,ADJT TIS TRNS/REARGMT F/C/C/M/N/A/G/H/F 10SQCM/<,,,21,,RBRVS,8.60 ,8.28 ,11.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
14041,CPT,ADJT/REARGMT F/C/C/M/N/AX/G/H/F 10.1-30.0 SQ CM,,,21,,RBRVS,10.83 ,9.89 ,14.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
14060,CPT,ADJT TIS TRNSFR/REARRGMT E/N/E/L DFCT 10 SQ CM/<,,,21,,RBRVS,9.23 ,8.75 ,11.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
14061,CPT,ADJT TIS REARGMT EYE/NOSE/EAR/LIP 10.1-30.0 SQCM,,,21,,RBRVS,11.48 ,10.71 ,15.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
14301,CPT,ADJNT TIS TRNSFR/REARGMT ANY AREA 30.1-60 SQ CM,,,21,,RBRVS,12.65 ,10.66 ,15.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
14302,CPT,ADJT TIS TRNSFR/REARGMT DEFEC EA ADDL 30 SQCM/<,,,21,,RBRVS,3.73 ,2.01 ,2.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
14350,CPT,FILLETED FINGER/TOE FLAP W/PREPJ RECIPIENT SITE,,,21,,RBRVS,11.05 ,7.59 ,7.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15002,CPT,PREP SITE TRUNK/ARM/LEG 1ST 100 SQ CM/1PCT,,,21,,RBRVS,3.65 ,2.25 ,5.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15003,CPT,PREP SITE TRUNK/ARM/LEG ADDL 100 SQ CM/1PCT,,,21,,RBRVS,0.80 ,0.37 ,1.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15004,CPT,PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT,,,21,,RBRVS,4.58 ,2.60 ,6.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15005,CPT,PREP SITE F/S/N/H/F/G/M/D GT ADDL 100 SQ CM/1PCT,,,21,,RBRVS,1.60 ,0.74 ,1.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15040,CPT,HARVEST SKIN TISSUE CLTR SKIN AGRFT 100 CM/<,,,21,,RBRVS,2.00 ,1.29 ,4.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15050,CPT,PINCH GRAFT 1/MLT SM ULCER TIP/OTH AREA 2CM,,,21,,RBRVS,5.57 ,6.40 ,9.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15100,CPT,SPLIT AGRFT T/A/L 1ST 100 CM/&/1% BDY INFT/CHLD,,,21,,RBRVS,9.90 ,8.78 ,12.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15101,CPT,SPLIT AGRFT T/A/L EA 100 CM/EA 1% BDY INFT/CHLD,,,21,,RBRVS,1.72 ,1.13 ,3.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15110,CPT,EPIDRM AGRFT T/A/L 1ST 100 CM/&/1% BDY INFT/CHLD,,,21,,RBRVS,10.97 ,7.51 ,10.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15111,CPT,EPIDRM AGRFT T/A/L EA 100 CM/EA 1% BDY INFT/CHLD,,,21,,RBRVS,1.85 ,0.72 ,1.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15115,CPT,EPIDERMAL AGRFT F/S/N/H/F/G/M/D GT 1ST 100 CM/<,,,21,,RBRVS,11.28 ,7.67 ,10.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15116,CPT,EPIDERMAL AGRFT F/S/N/H/F/G/M/D GT EA 100 CM,,,21,,RBRVS,2.50 ,1.46 ,1.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15120,CPT,SPLIT AGRFT F/S/N/H/F/G/M/D GT 1ST 100 CM/</1 %,,,21,,RBRVS,10.15 ,8.21 ,12.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15121,CPT,SPLIT AGRFT F/S/N/H/F/G/M/D GT EA 100 CM/EA 1 %,,,21,,RBRVS,2.00 ,1.45 ,3.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15130,CPT,DERMAL AUTOGRAFT TRUNK/ARM/LEG 1ST 100 CM,,,21,,RBRVS,7.53 ,7.38 ,10.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15131,CPT,DERMAL AUTOGRAFT TRUNK/ARM/LEG EA 100 CM/EA,,,21,,RBRVS,1.50 ,0.54 ,0.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15135,CPT,DERMAL AUTOGRAFT F/S/N/H/F/G/M/D GT 1ST 100,,,21,,RBRVS,11.03 ,8.55 ,11.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15136,CPT,DERMAL AGRFT F/S/N/H/F/G/M/D GT EA 100 CM/EA,,,21,,RBRVS,1.50 ,0.78 ,0.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15150,CPT,CLTR SKIN AUTOGRAFT T/A/L 1ST 25 CM/<,,,21,,RBRVS,9.39 ,6.59 ,8.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15151,CPT,CLTR SKIN AGRFT T/A/L ADDL 1 CM-75 CM,,,21,,RBRVS,2.00 ,0.72 ,0.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15152,CPT,CLTR SKIN AGRFT T/A/L EA 100 CM/EA 1%BODY AREA,,,21,,RBRVS,2.50 ,0.90 ,1.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15155,CPT,CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT 1ST 25CM/<,,,21,,RBRVS,10.14 ,7.30 ,8.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15156,CPT,CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT ADDL 1-75CM,,,21,,RBRVS,2.75 ,1.00 ,1.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15157,CPT,CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT EA 100 EA,,,21,,RBRVS,3.00 ,0.94 ,1.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15200,CPT,FTH/GFT FREE W/DIRECT CLOSURE TRUNK 20 CM/<,,,21,,RBRVS,9.15 ,8.55 ,12.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15201,CPT,FTH/GFT FR W/DIR CLSR TRNK EA ADDL 20 CM/<,,,21,,RBRVS,1.32 ,0.71 ,2.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15220,CPT,FTH/GFT FREE W/DIRECT CLOSURE S/A/L 20 CM/<,,,21,,RBRVS,8.09 ,8.25 ,12.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15221,CPT,FTH/GFT FR W/DIR CLSR S/A/L EA ADDL 20 CM/<,,,21,,RBRVS,1.19 ,0.66 ,2.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15240,CPT,FTH/GFT FR W/DIR CLSR F/C/C/M/N/AX/G/H/F 20 CM/<,,,21,,RBRVS,10.41 ,10.93 ,14.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15241,CPT,FTH/GT FR W/DIR CLSR F/C/C/M/N/AX/G/H/F EA20CM/<,,,21,,RBRVS,1.86 ,1.05 ,3.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15260,CPT,FTH/GFT FREE W/DIRECT CLOSURE N/E/E/L 20 SQ CM/<,,,21,,RBRVS,11.64 ,11.34 ,15.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15261,CPT,FTH/GFT FREE W/DIR CLSR N/E/E/L EA 20 SQ CM/<,,,21,,RBRVS,2.23 ,1.47 ,3.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15271,CPT,APP SKN SUB GRFT T/A/L AREA/100SQ CM /<1ST 25,,,21,,RBRVS,1.50 ,0.72 ,2.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15272,CPT,APP SKN SUB GRFT T/A/L AREA/100SQ CM EA ADL 25SC,,,21,,RBRVS,0.33 ,0.12 ,0.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15273,CPT,APP SKN SUBGRFT T/A/L AREA/100SQ CM 1ST 100SQ CM,,,21,,RBRVS,3.50 ,1.71 ,4.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15274,CPT,APP SKN SUB GRFT T/A/L AREA>/=100SCM ADL 100SQCM,,,21,,RBRVS,0.80 ,0.36 ,1.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15275,CPT,SUB GRFT F/S/N/H/F/G/M/D <100SQ CM 1ST 25 SQ CM,,,21,,RBRVS,1.83 ,0.75 ,2.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15276,CPT,SUB GRFT F/S/N/H/F/G/M/D<100SQ CM EA ADDL25SQ CM,,,21,,RBRVS,0.50 ,0.16 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15277,CPT,SUB GRFT F/S/N/H/F/G/M/D >/= 100SCM 1ST 100SQ CM,,,21,,RBRVS,4.00 ,1.84 ,4.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15278,CPT,SUB GRFT F/S/N/H/F/G/M/D >/= 100SCM ADL 100SQ CM,,,21,,RBRVS,1.00 ,0.46 ,1.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15570,CPT,FRMJ DIRECT/TUBED PEDICLE W/WO TRANSFER TRUNK,,,21,,RBRVS,10.21 ,9.07 ,13.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15572,CPT,FRMJ DIRECT/TUBE PEDICLE W/WO TR SCALP ARMS/LEGS,,,21,,RBRVS,10.12 ,9.58 ,13.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15574,CPT,FRMJ DIR/TUBE PEDCL W/WOTR FH/CH/CH/M/N/AX/G/H/F,,,21,,RBRVS,10.70 ,9.63 ,13.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15576,CPT,FRMJ DIRECT/TUBED PEDICLE W/WOTR E/N/E/L/NTRORAL,,,21,,RBRVS,9.37 ,8.52 ,12.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15600,CPT,DELAY FLAP/SECTIONING FLAP TRUNK,,,21,,RBRVS,2.01 ,3.58 ,6.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15610,CPT,DELAY FLAP/SECTIONING FLAP SCALP ARMS/LEGS,,,21,,RBRVS,2.52 ,3.97 ,7.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15620,CPT,DELAY FLAP/SECTIONING FLAP F/C/C/N/AX/G/H/F,,,21,,RBRVS,3.75 ,4.98 ,8.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15630,CPT,DELAY FLAP/SCTJ FLAP EYELIDS NOSE EARS/LIPS,,,21,,RBRVS,4.08 ,5.22 ,8.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15650,CPT,TRANSFER ANY PEDICLE FLAP ANY LOCATION,,,21,,RBRVS,4.77 ,5.46 ,8.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15731,CPT,FOREHEAD FLAP W/PRESERVATION VASCULAR PEDICLE,,,21,,RBRVS,14.38 ,12.35 ,15.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15732,CPT,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP HEAD&NC,,,21,,RBRVS,16.38 ,13.44 ,17.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15734,CPT,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP TRUNK,,,21,,RBRVS,19.86 ,14.15 ,19.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15736,CPT,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP UXTR,,,21,,RBRVS,17.04 ,12.58 ,17.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15738,CPT,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP LXTR,,,21,,RBRVS,19.04 ,12.90 ,17.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15740,CPT,FLAP ISLAND PEDICLE ANATOMIC NAMED AXIAL ARTERY,,,21,,RBRVS,11.80 ,10.93 ,15.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15750,CPT,FLAP NEUROVASCULAR PEDICLE,,,21,,RBRVS,12.96 ,11.20 ,11.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15756,CPT,FREE MUSCLE/MYOCUTANEOUS FLAP W/MVASC ANAST,,,21,,RBRVS,36.94 ,23.85 ,23.85 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
15757,CPT,FREE SKIN FLAP W/MICROVASCULAR ANASTOMOSIS,,,21,,RBRVS,37.15 ,23.31 ,23.31 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
15758,CPT,FREE FASCIAL FLAP W/MICROVASCULAR ANASTOMOSIS,,,21,,RBRVS,36.90 ,23.35 ,23.35 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
15760,CPT,GRAFT COMPOSITE W/PRIMARY CLOSURE DONOR AREA,,,21,,RBRVS,9.86 ,9.08 ,13.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15770,CPT,GRAFT DERMA-FAT-FASCIA,,,21,,RBRVS,8.96 ,8.76 ,8.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15775,CPT,PUNCH GRAFT HAIR TRANSPLANT 1-15 PUNCH GRAFTS,,,21,,RBRVS,3.95 ,1.93 ,4.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15776,CPT,PUNCH GRAFT HAIR TRANSPLANT >15 PUNCH GRAFTS,,,21,,RBRVS,5.53 ,3.43 ,7.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15777,CPT,IMPLNT BIO IMPLNT FOR SOFT TISSUE REINFORCEMENT,,,21,,RBRVS,3.65 ,1.83 ,1.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15780,CPT,DERMABRASION TOTAL FACE,,,21,,RBRVS,8.73 ,8.37 ,14.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15781,CPT,DERMABRASION SEGMENTAL FACE,,,21,,RBRVS,5.02 ,6.53 ,9.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15782,CPT,DERMABRASION REGIONAL OTHER THAN FACE,,,21,,RBRVS,4.44 ,7.68 ,12.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15783,CPT,DERMABRASION SUPERFICIAL ANY SITE,,,21,,RBRVS,4.41 ,5.67 ,8.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15786,CPT,ABRASION 1 LESION,,,21,,RBRVS,2.08 ,1.55 ,4.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15787,CPT,ABRASION EACH ADDITIONAL 4 LESIONS OR LESS,,,21,,RBRVS,0.33 ,0.14 ,1.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15788,CPT,CHEMICAL PEEL FACIAL EPIDERMAL,,,21,,RBRVS,2.09 ,4.65 ,10.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15789,CPT,CHEMICAL PEEL FACIAL DERMAL,,,21,,RBRVS,4.91 ,6.53 ,10.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15792,CPT,CHEMICAL PEEL NONFACIAL EPIDERMAL,,,21,,RBRVS,1.86 ,5.17 ,10.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15793,CPT,CHEMICAL PEEL NONFACIAL DERMAL,,,21,,RBRVS,3.96 ,5.95 ,9.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15819,CPT,CERVICOPLASTY,,,21,,RBRVS,10.65 ,10.21 ,10.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15820,CPT,BLEPHAROPLASTY LOWER EYELID,,,21,,RBRVS,6.27 ,7.78 ,9.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15821,CPT,BLEPHAROPLASTY LOWER EYELID HERNIATED FAT PAD,,,21,,RBRVS,6.84 ,7.92 ,9.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15822,CPT,BLEPHAROPLASTY UPPER EYELID,,,21,,RBRVS,4.62 ,5.97 ,7.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15823,CPT,BLEPHAROPLASTY UPPER EYELID W/EXCESSIVE SKIN,,,21,,RBRVS,6.81 ,8.05 ,9.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15824,CPT,RHYTIDECTOMY FOREHEAD,,,21,,RBRVS,15.47 ,13.13 ,13.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15825,CPT,RHYTIDECTOMY NECK W/PLATYSMAL TIGHTENING,,,21,,RBRVS,17.41 ,14.77 ,14.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15826,CPT,RHYTIDECTOMY GLABELLAR FROWN LINES,,,21,,RBRVS,12.57 ,10.67 ,10.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15828,CPT,RHYTIDECTOMY CHEEK CHIN & NECK,,,21,,RBRVS,32.88 ,27.90 ,27.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15829,CPT,RHYTIDECTOMY SMAS FLAP,,,21,,RBRVS,36.75 ,31.19 ,31.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15830,CPT,EXCISION SKIN ABD INFRAUMBILICAL PANNICULECTOMY,,,21,,RBRVS,17.11 ,13.41 ,13.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15832,CPT,EXCISION EXCESSIVE SKIN & SUBQ TISSUE THIGH,,,21,,RBRVS,12.85 ,11.14 ,11.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15833,CPT,EXCISION EXCESSIVE SKIN & SUBQ TISSUE LEG,,,21,,RBRVS,11.90 ,11.04 ,11.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15834,CPT,EXCISION EXCESSIVE SKIN & SUBQ TISSUE HIP,,,21,,RBRVS,12.17 ,11.19 ,11.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15835,CPT,EXCISION EXCESSIVE SKIN & SUBQ TISSUE BUTTOCK,,,21,,RBRVS,12.99 ,11.65 ,11.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15836,CPT,EXCISION EXCESSIVE SKIN & SUBQ TISSUE ARM,,,21,,RBRVS,10.61 ,10.18 ,10.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15837,CPT,EXC EXCESSIVE SKIN &SUBQ TISSUE FOREARM/HAND,,,21,,RBRVS,9.55 ,9.46 ,13.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15838,CPT,EXC EXCSV SKIN & SUBQ TISSUE SUBMENTAL FAT PAD,,,21,,RBRVS,8.25 ,6.89 ,6.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15839,CPT,EXCISION EXCESSIVE SKIN & SUBQ TISSUE OTHER AREA,,,21,,RBRVS,10.50 ,8.82 ,12.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15840,CPT,GRAFT FACIAL NERVE PARALYSIS FREE FASCIAL GRAFT,,,21,,RBRVS,14.99 ,11.63 ,11.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15841,CPT,GRAFT FACIAL NERVE PARALYSIS FREE MUSCLE GRAFT,,,21,,RBRVS,25.99 ,16.20 ,16.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15842,CPT,GRF FACIAL NRV PALYSS FR MUSCLE FLAP MICROSURG,,,21,,RBRVS,41.01 ,23.25 ,23.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15845,CPT,GRF FACIAL NERVE PARALYSIS REGIONAL MUSCLE TR,,,21,,RBRVS,14.32 ,12.97 ,12.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15847,CPT,EXCISION EXCESSIVE SKIN & SUBQ TISSUE ABDOMEN,,,21,,TotalUnits,,,,9.18 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15850,CPT,REMOVAL SUTURES UNDER ANESTHESIA SAME SURGEON,,,21,,RBRVS,0.78 ,0.30 ,1.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15851,CPT,REMOVAL SUTURES UNDER ANESTHESIA OTHER SURGEON,,,21,,RBRVS,0.86 ,0.36 ,1.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15852,CPT,DRESSING CHANGE UNDER ANESTHESIA,,,21,,RBRVS,0.86 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15860,CPT,IV INJECTION TEST VASCULAR FLOW FLAP/GRAFT,,,21,,RBRVS,1.95 ,0.90 ,0.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15876,CPT,SUCTION ASSISTED LIPECTOMY HEAD & NECK,,,21,,TotalUnits,,,,21.15 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15877,CPT,SUCTION ASSISTED LIPECTOMY TRUNK,,,21,,TotalUnits,,,,11.22 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15878,CPT,SUCTION ASSISTED LIPECTOMY UPPER EXTREMITY,,,21,,TotalUnits,,,,13.00 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15879,CPT,SUCTION ASSISTED LIPECTOMY LOWER EXTREMITY,,,21,,TotalUnits,,,,3.25 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15920,CPT,EXC COCCYGEAL PR ULC W/COCCYGECTOMY W/PRIM SUTR,,,21,,RBRVS,8.29 ,7.17 ,7.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15922,CPT,EXC COCCYGEAL PR ULC W/COCCYGECTOMY W/FLAP CLSR,,,21,,RBRVS,10.38 ,10.21 ,10.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15931,CPT,EXCISION SACRAL PRESSURE ULCER W/PRIMARY SUTURE,,,21,,RBRVS,10.07 ,7.40 ,7.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15933,CPT,EXC SACRAL PRESSURE ULC W/PRIM SUTR W/OSTECTOMY,,,21,,RBRVS,11.77 ,10.12 ,10.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15934,CPT,EXCISION SACRAL PRESSURE ULCER W/SKIN FLAP CLSR,,,21,,RBRVS,13.68 ,10.21 ,10.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15935,CPT,EXC SACRAL PR ULCER W/SKN FLAP CLSR W/OSTECTOMY,,,21,,RBRVS,15.78 ,12.62 ,12.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15936,CPT,EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF CLSR,,,21,,RBRVS,13.16 ,9.67 ,9.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15937,CPT,EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF OSTC,,,21,,RBRVS,15.14 ,11.37 ,11.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15940,CPT,EXC ISCHIAL PRESSURE ULCER W/PRIMARY SUTURE,,,21,,RBRVS,10.20 ,7.76 ,7.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15941,CPT,EXC ISCHIAL PR ULC W/PRIM SUTR W/OSTC ISCHIECT,,,21,,RBRVS,12.41 ,11.06 ,11.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15944,CPT,EXC ISCHIAL PRESSURE ULCER W/SKIN FLAP CLOSURE,,,21,,RBRVS,12.44 ,11.00 ,11.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15945,CPT,EXC ISCHIAL PR ULC W/SKN FLAP CLSR W/OSTECTOMY,,,21,,RBRVS,13.75 ,11.88 ,11.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15946,CPT,EXC ISCHIAL PR ULCER W/OSTC MUSC/MYOQ FLAP/SKIN,,,21,,RBRVS,24.12 ,18.29 ,18.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15950,CPT,EXC TROCHANTERIC PRESSURE ULCER W/PRIMARY SUTR,,,21,,RBRVS,8.03 ,7.18 ,7.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15951,CPT,EXC TRCHNTRIC PR ULCER W/PRIM SUTR W/OSTECTOMY,,,21,,RBRVS,11.58 ,11.59 ,11.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15952,CPT,EXC TROCHANTERIC PR ULCER W/SKIN FLAP CLOSURE,,,21,,RBRVS,12.31 ,11.46 ,11.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15953,CPT,EXC TRCHNTRIC PR ULC W/SKN FLAP CLSR W/OSTECTOMY,,,21,,RBRVS,13.57 ,12.60 ,12.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15956,CPT,EXC TROCHANTERIC PR ULCER MUSC/MYOQ FLAP/SKIN,,,21,,RBRVS,16.79 ,13.01 ,13.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15958,CPT,EXC TRCHNTRIC PR ULC MUSC/MYOQ FLAP/SKIN W/OSTC,,,21,,RBRVS,16.75 ,13.82 ,13.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
15999,CPT,UNLISTED PROCEDURE EXCISION PRESSURE ULCER,,,21,,TotalUnits,,,,23.47 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
16000,CPT,INITIAL TX 1ST DEGREE BURN LOCAL TX,,,21,,RBRVS,0.89 ,0.32 ,0.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
16020,CPT,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL,,,21,,RBRVS,0.71 ,0.75 ,1.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
16025,CPT,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM,,,21,,RBRVS,1.74 ,1.20 ,2.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
16030,CPT,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ LARGE,,,21,,RBRVS,2.08 ,1.37 ,2.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
16035,CPT,ESCHAROTOMY FIRST INCISION,,,21,,RBRVS,3.74 ,1.32 ,1.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
16036,CPT,ESCHAROTOMY EACH ADDITIONAL INCISION,,,21,,RBRVS,1.50 ,0.57 ,0.57 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
17000,CPT,DESTRUCTION PREMALIGNANT LESION 1ST,,,21,,RBRVS,0.61 ,0.82 ,1.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17003,CPT,DESTRUCTION PREMALIGNANT LESION 2-14 EA,,,21,,RBRVS,0.04 ,0.02 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17004,CPT,DESTRUCTION PREMALIGNANT LESION 15/>,,,21,,RBRVS,1.37 ,1.29 ,2.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17106,CPT,DESTRUCTION CUTANEOUS VASC PROLIFERATIVE <10CM,,,21,,RBRVS,3.69 ,3.69 ,5.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17107,CPT,DSTRJ CUTANEOUS VASCULAR LESIONS 10.0-50.0 SQ CM,,,21,,RBRVS,4.79 ,4.40 ,6.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17108,CPT,DSTRJ CUTANEOUS VASCULAR LESIONS >50.0 SQ CM,,,21,,RBRVS,7.49 ,6.47 ,9.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17110,CPT,DESTRUCTION BENIGN LESIONS UP TO 14,,,21,,RBRVS,0.70 ,1.20 ,2.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17111,CPT,DESTRUCTION BENIGN LESIONS 15/>,,,21,,RBRVS,0.97 ,1.35 ,2.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17250,CPT,CHEMICAL CAUTERIZATION GRANULATION TISSUE,,,21,,RBRVS,0.50 ,0.49 ,1.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17260,CPT,DESTRUCTION MALIGNANT LESION T/A/L 0.5 CM/<,,,21,,RBRVS,0.96 ,0.91 ,1.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17261,CPT,DESTRUCTION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM,,,21,,RBRVS,1.22 ,1.23 ,2.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17262,CPT,DESTRUCTION MAL LESION TRUNK/ARM/LEG 1.1-2.0CM,,,21,,RBRVS,1.63 ,1.48 ,3.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17263,CPT,DESTRUCTION MAL LESION TRUNK/ARM/LEG 2.1-3.0CM,,,21,,RBRVS,1.84 ,1.60 ,3.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17264,CPT,DESTRUCTION MAL LESION TRUNK/ARM/LEG 3.1-4.0CM,,,21,,RBRVS,1.99 ,1.68 ,3.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17266,CPT,DESTRUCTION MAL LESION TRUNK/ARM/LEG > 4.0 CM,,,21,,RBRVS,2.39 ,1.92 ,3.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17270,CPT,DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.5 CM/>,,,21,,RBRVS,1.37 ,1.30 ,2.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17271,CPT,DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.6-1.0CM,,,21,,RBRVS,1.54 ,1.42 ,2.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17272,CPT,DESTRUCTION MALIGNANT LESION S/N/H/F/G 1.1-2.0CM,,,21,,RBRVS,1.82 ,1.59 ,3.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17273,CPT,DESTRUCTION MALIGNANT LESION S/N/H/F/G 2.1-3.0CM,,,21,,RBRVS,2.10 ,1.75 ,3.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17274,CPT,DESTRUCTION MALIGNANT LESION S/N/H/F/G 3.1-4.0CM,,,21,,RBRVS,2.64 ,2.05 ,3.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17276,CPT,DSTRJ MAL LESION S/N/H/F/G LESION DIAM > 4.0 CM,,,21,,RBRVS,3.25 ,2.37 ,4.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17280,CPT,DESTRUCTION MALIGNANT LESION F/E/E/N/L/M 0.5CM/<,,,21,,RBRVS,1.22 ,1.21 ,2.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17281,CPT,DESTRUCTION MAL LESION F/E/E/N/L/M 0.6-1.0CM,,,21,,RBRVS,1.77 ,1.56 ,3.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17282,CPT,DESTRUCTION MAL LESION F/E/E/N/L/M 1.1-2.0CM,,,21,,RBRVS,2.09 ,1.75 ,3.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17283,CPT,DESTRUCTION MAL LESION F/E/E/N/L/M 2.1-3.0CM,,,21,,RBRVS,2.69 ,2.09 ,3.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17284,CPT,DESTRUCTION MAL LESION F/E/E/N/L/M 3.1-4.0CM,,,21,,RBRVS,3.20 ,2.38 ,4.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17286,CPT,DESTRUCTION MAL LESION F/E/E/N/L/M >4.0 CM,,,21,,RBRVS,4.48 ,2.99 ,5.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17311,CPT,MOHS MICROGRAPHIC H/N/H/F/G 1ST STAGE 5 BLOCKS,,,21,,RBRVS,6.20 ,3.75 ,11.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17312,CPT,MOHS MICROGRAPHIC H/N/H/F/G EACH ADDL STAGE,,,21,,RBRVS,3.30 ,2.01 ,7.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17313,CPT,MOHS TRUNK/ARM/LEG 1ST STAGE 5 BLOCKS,,,21,,RBRVS,5.56 ,3.37 ,11.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17314,CPT,MOHS TRUNK/ARM/LEG EA STAGE AFTER 1ST STAGE,,,21,,RBRVS,3.06 ,1.86 ,7.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17315,CPT,MOHS TRUNK/ARM/LEG EA ADDL BLOCK ANY STAGE,,,21,,RBRVS,0.87 ,0.53 ,1.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17340,CPT,CRYOTHERAPY CO2 SLUSH LIQUID N2 ACNE,,,21,,RBRVS,0.77 ,0.54 ,0.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17360,CPT,CHEMICAL EXFOLIATION ACNE,,,21,,RBRVS,1.46 ,1.15 ,1.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17380,CPT,ELECTROLYSIS EPILATION EACH 30 MINUTES,,,21,,TotalUnits,,,,0.90 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
17999,CPT,UNLISTED PX SKIN MUC MEMBRANE & SUBQ TISSUE,,,21,,TotalUnits,,,,1.44 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19000,CPT,PUNCTURE ASPIRATION CYST BREAST,,,21,,RBRVS,0.84 ,0.31 ,2.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19001,CPT,PUNCTURE ASPIRATION BREAST EACH ADDITIONAL CYST,,,21,,RBRVS,0.42 ,0.16 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19020,CPT,MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP,,,21,,RBRVS,3.83 ,4.05 ,8.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19030,CPT,INJECTION MAMMARY DUCTOGRAM/GALACTOGRAM,,,21,,RBRVS,1.53 ,0.57 ,3.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19081,CPT,BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID,,,21,,RBRVS,3.29 ,1.22 ,15.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19082,CPT,BX BREAST W/DEVICE ADDL LESION STEREOTACT GUID,,,21,,RBRVS,1.65 ,0.61 ,13.65 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
19083,CPT,BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID,,,21,,RBRVS,3.10 ,1.15 ,14.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19084,CPT,BX BREAST W/DEVICE ADDL LESION ULTRASOUND GUID,,,21,,RBRVS,1.55 ,0.58 ,13.18 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
19085,CPT,BX BREAST W/DEVICE 1ST LESION MAGNETIC RES GUID,,,21,,RBRVS,3.64 ,1.35 ,24.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19086,CPT,BX BREAST W/DEVICE ADDL LESION MAGNET RES GUID,,,21,,RBRVS,1.82 ,0.68 ,21.21 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
19100,CPT,BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX,,,21,,RBRVS,1.27 ,0.46 ,2.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19101,CPT,BIOPSY BREAST OPEN INCISIONAL,,,21,,RBRVS,3.23 ,2.41 ,5.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19105,CPT,ABLTJ CRYOSURGICAL W/US GID EA FIBROADENOMA,,,21,,RBRVS,3.69 ,1.69 ,66.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19110,CPT,NIPPLE EXPLORATION,,,21,,RBRVS,4.44 ,4.30 ,8.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19112,CPT,EXCISION LACTIFEROUS DUCT FISTULA,,,21,,RBRVS,3.81 ,4.23 ,8.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19120,CPT,EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION,,,21,,RBRVS,5.92 ,4.55 ,6.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19125,CPT,EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES,,,21,,RBRVS,6.69 ,4.89 ,7.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19126,CPT,EXC BRST LES PREOP PLMT RAD MARKER OPN EA ADDL,,,21,,RBRVS,2.93 ,1.05 ,1.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19260,CPT,EXCISION CHEST WALL TUMOR INCLUDING RIBS,,,21,,RBRVS,17.78 ,12.74 ,12.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19271,CPT,EXC CHEST TUMOR W/RCNSTJ W/O MEDSTNL LMPHADEC,,,21,,RBRVS,22.19 ,19.53 ,19.53 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
19272,CPT,EXC CHEST TUMOR W/RCNSTJ W/MEDSTNL LMPHADEC,,,21,,RBRVS,25.17 ,20.49 ,20.49 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
19281,CPT,PERQ DEVICE PLACEMENT BREAST LOC 1ST LES W/GDNCE,,,21,,RBRVS,2.00 ,0.75 ,4.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19282,CPT,PERQ DEVICE PLACEMT BREAST LOC EA LESION W/GDNCE,,,21,,RBRVS,1.00 ,0.37 ,3.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
19283,CPT,PERQ BREAST LOC DEVICE PLACEMT 1ST STRTCTC GDNCE,,,21,,RBRVS,2.00 ,0.76 ,5.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19284,CPT,PERQ BREAST LOC DEVICE PLACEMT EA LESION STRTCTC,,,21,,RBRVS,1.00 ,0.38 ,4.61 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
19285,CPT,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO US IMAG,,,21,,RBRVS,1.70 ,0.65 ,10.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19286,CPT,PERQ BREAST LOC DEVICE PLACEMT EACH LES US IMAGE,,,21,,RBRVS,0.85 ,0.32 ,9.79 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
19287,CPT,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO MR GUID,,,21,,RBRVS,2.55 ,0.97 ,21.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19288,CPT,PERQ BREAST LOC DEVICE PLACEMT ADD LESIO MR GUID,,,21,,RBRVS,1.28 ,0.49 ,18.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
19296,CPT,PLMT EXPANDABLE CATH BRST FOLLOWING PRTL MAST,,,21,,RBRVS,3.63 ,1.62 ,106.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19297,CPT,PLMT EXPANDABLE CATH BRST CONCURRENT PRTL MAST,,,21,,RBRVS,1.72 ,0.62 ,0.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19298,CPT,PLMT RADTHX BRACHYTX BRST FOLLOWING PRTL MAST,,,21,,RBRVS,6.00 ,2.53 ,22.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19300,CPT,MASTECTOMY GYNECOMASTIA,,,21,,RBRVS,5.31 ,5.33 ,8.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19301,CPT,MASTECTOMY PARTIAL,,,21,,RBRVS,10.13 ,6.25 ,6.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19302,CPT,MASTECTOMY PARTIAL W/AXILLARY LYMPHADENECTOMY,,,21,,RBRVS,13.99 ,8.58 ,8.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19303,CPT,MASTECTOMY SIMPLE COMPLETE,,,21,,RBRVS,15.85 ,9.47 ,9.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19304,CPT,MASTECTOMY SUBCUTANEOUS,,,21,,RBRVS,7.95 ,6.70 ,6.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19305,CPT,MAST RAD W/PECTORAL MUSCLES AXILLARY LYMPH NODES,,,21,,RBRVS,17.46 ,10.87 ,10.87 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
19306,CPT,MAST RAD W/PECTORAL MUSC AX INT MAM LYMPH NODES,,,21,,RBRVS,18.13 ,11.95 ,11.95 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
19307,CPT,MAST MODF RAD W/AX LYMPH NOD W/WO PECT/ALIS MIN,,,21,,RBRVS,18.23 ,11.86 ,11.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19316,CPT,MASTOPEXY,,,21,,RBRVS,11.09 ,9.00 ,9.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19318,CPT,REDUCTION MAMMAPLASTY,,,21,,RBRVS,16.03 ,12.87 ,12.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19324,CPT,MAMMAPLASTY AUGMENTATION W/O PROSTHETIC IMPLANT,,,21,,RBRVS,6.80 ,5.64 ,5.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19325,CPT,MAMMAPLASTY AUGMENTATION W/PROSTHETIC IMPLANT,,,21,,RBRVS,8.64 ,8.31 ,8.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19328,CPT,REMOVAL INTACT MAMMARY IMPLANT,,,21,,RBRVS,6.48 ,6.55 ,6.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19330,CPT,REMOVAL MAMMARY IMPLANT MATERIAL,,,21,,RBRVS,8.54 ,8.11 ,8.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19340,CPT,IMMT INSJ BRST PROSTH FLWG MASTOPEXY MAST/RCNSTJ,,,21,,RBRVS,13.99 ,12.39 ,12.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19342,CPT,DLYD INSJ BRST PROSTH FLWG MASTOPEXY MAST/RCNSTJ,,,21,,RBRVS,12.63 ,11.71 ,11.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19350,CPT,NIPPLE/AREOLA RECONSTRUCTION,,,21,,RBRVS,9.11 ,8.62 ,12.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19355,CPT,CORRECTION INVERTED NIPPLES,,,21,,RBRVS,8.52 ,5.85 ,9.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19357,CPT,BRST RCNSTJ IMMT/DLYD W/TISS EXPANDER SBSQ XPNSJ,,,21,,RBRVS,18.50 ,21.47 ,21.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19361,CPT,BRST RCNSTJ W/LATSMS D/SI FLAP WO PRSTHC IMPL,,,21,,RBRVS,23.36 ,17.86 ,17.86 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
19364,CPT,BREAST RECONSTRUCTION FREE FLAP,,,21,,RBRVS,42.58 ,29.37 ,29.37 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
19366,CPT,BREAST RECONSTRUCTION OTHER TECHNIQUE,,,21,,RBRVS,21.84 ,14.55 ,14.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19367,CPT,BREAST RECONSTRUCTION TRAM FLAP 1 PEDICLE,,,21,,RBRVS,26.80 ,20.15 ,20.15 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
19368,CPT,BREAST RECONSTRUCTION TRAM 1 PEDCL MVASC ANAST,,,21,,RBRVS,33.90 ,23.63 ,23.63 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
19369,CPT,BREAST RECONSTRUCTION TRAM FLAP DOUBLE PEDICLE,,,21,,RBRVS,31.31 ,22.10 ,22.10 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
19370,CPT,OPEN PERIPROSTHETIC CAPSULOTOMY BREAST,,,21,,RBRVS,9.17 ,8.90 ,8.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19371,CPT,PERIPROSTHETIC CAPSULECTOMY BREAST,,,21,,RBRVS,10.62 ,10.02 ,10.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19380,CPT,REVISION RECONSTRUCTED BREAST,,,21,,RBRVS,10.41 ,9.95 ,9.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19396,CPT,PREPARATION MOULAGE CUSTOM BREAST IMPLANT,,,21,,RBRVS,2.17 ,1.66 ,5.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
19499,CPT,UNLISTED PROCEDURE BREAST,,,21,,TotalUnits,,,,6.33 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20005,CPT,I&D SOFT TISSUE ABSCESS SUBFASC,,,21,,RBRVS,3.58 ,2.56 ,4.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20100,CPT,EXPLORATION PENETRATING WOUND SPX NECK,,,21,,RBRVS,10.38 ,5.04 ,5.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20101,CPT,EXPLORATION PENETRATING WOUND SPX CHEST,,,21,,RBRVS,3.23 ,2.03 ,8.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20102,CPT,EXPL PENETRATING WOUND SPX ABDOMEN/FLANK/BACK,,,21,,RBRVS,3.98 ,2.49 ,9.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20103,CPT,EXPLORATION PENETRATING WOUND SPX EXTREMITY,,,21,,RBRVS,5.34 ,3.71 ,10.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20150,CPT,EXCISION EPIPHYSEAL BAR,,,21,,RBRVS,14.75 ,10.26 ,10.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20200,CPT,BIOPSY MUSCLE SUPERFICIAL,,,21,,RBRVS,1.46 ,0.93 ,4.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20205,CPT,BIOPSY MUSCLE DEEP,,,21,,RBRVS,2.35 ,1.52 ,5.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20206,CPT,BIOPSY MUSCLE PERCUTANEOUS NEEDLE,,,21,,RBRVS,0.99 ,0.62 ,5.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20220,CPT,BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL,,,21,,RBRVS,1.27 ,0.71 ,3.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20225,CPT,BIOPSY BONE TROCAR/NEEDLE DEEP,,,21,,RBRVS,1.87 ,1.08 ,12.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20240,CPT,BIOPSY BONE OPEN SUPERFICIAL,,,21,,RBRVS,3.28 ,2.46 ,2.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20245,CPT,BIOPSY BONE OPEN DEEP,,,21,,RBRVS,8.95 ,7.21 ,7.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20250,CPT,BIOPSY VERTEBRAL BODY OPEN THORACIC,,,21,,RBRVS,5.19 ,4.71 ,4.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20251,CPT,BIOPSY VERTEBRAL BODY OPEN LUMBAR/CERVICAL,,,21,,RBRVS,5.72 ,4.88 ,4.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20500,CPT,INJECTION SINUS TRACT THERAPEUTIC SEPARATE PROC,,,21,,RBRVS,1.28 ,1.02 ,1.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20501,CPT,INJECTION SINUS TRACT DIAGNOSTIC,,,21,,RBRVS,0.76 ,0.27 ,2.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20520,CPT,REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE,,,21,,RBRVS,1.90 ,2.03 ,3.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20525,CPT,RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP,,,21,,RBRVS,3.54 ,2.98 ,9.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20526,CPT,INJECTION THERAPEUTIC CARPAL TUNNEL,,,21,,RBRVS,0.94 ,0.56 ,1.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20527,CPT,INJECTION ENZYME PALMAR FASCIAL CORD,,,21,,RBRVS,1.00 ,0.73 ,1.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20550,CPT,INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS,,,21,,RBRVS,0.75 ,0.36 ,0.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20551,CPT,INJECTION SINGLE TENDON ORIGIN/INSERTION,,,21,,RBRVS,0.75 ,0.39 ,0.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20552,CPT,INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES,,,21,,RBRVS,0.66 ,0.36 ,0.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20553,CPT,INJECTION SINGLE/MLT TRIGGER POINT 3/> MUSCLES,,,21,,RBRVS,0.75 ,0.41 ,0.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20555,CPT,PLACEMENT NEEDLES MUSCLE SUBSEQUENT RADIOELEMENT,,,21,,RBRVS,6.00 ,2.80 ,2.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20600,CPT,ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US,,,21,,RBRVS,0.66 ,0.29 ,0.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20604,CPT,ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT,,,21,,RBRVS,0.89 ,0.33 ,1.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20605,CPT,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US,,,21,,RBRVS,0.68 ,0.31 ,0.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20606,CPT,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US,,,21,,RBRVS,1.00 ,0.39 ,1.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20610,CPT,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,,,21,,RBRVS,0.79 ,0.42 ,0.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20611,CPT,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US,,,21,,RBRVS,1.10 ,0.51 ,1.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20612,CPT,ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ,,,21,,RBRVS,0.70 ,0.41 ,0.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20615,CPT,ASPIRATION & INJECTION TREATMENT BONE CYST,,,21,,RBRVS,2.33 ,2.09 ,4.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20650,CPT,INSERTION WIRE/PIN W/APPL SKELETAL TRACTION SPX,,,21,,RBRVS,2.28 ,1.89 ,3.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20660,CPT,APPL CRANIAL TONG/STRTCTC FRAME W/REMOVAL SPX,,,21,,RBRVS,4.00 ,1.86 ,1.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20661,CPT,APPLICATION HALO CRANIAL INCLUDING REMOVAL,,,21,,RBRVS,5.26 ,7.47 ,7.47 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
20662,CPT,APPLICATION HALO PELVIC INCLUDING REMOVAL,,,21,,RBRVS,6.38 ,5.63 ,5.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20663,CPT,APPLICATION HALO FEMORAL INCLUDING REMOVAL,,,21,,RBRVS,5.74 ,4.77 ,4.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20664,CPT,APPL HALO 6/> PINS THIN SKULL OSTEOLOGY,,,21,,RBRVS,10.06 ,11.17 ,11.17 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
20665,CPT,REMOVAL TONG/HALO APPLIED BY ANOTHER INDIVIDUAL,,,21,,RBRVS,1.36 ,1.10 ,1.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20670,CPT,REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE,,,21,,RBRVS,1.79 ,2.16 ,8.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20680,CPT,REMOVAL IMPLANT DEEP,,,21,,RBRVS,5.96 ,5.19 ,10.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20690,CPT,APPLICATION UNIPLANE EXTERNAL FIXATION SYSTEM,,,21,,RBRVS,8.78 ,6.63 ,6.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20692,CPT,APPLICATION MULTIPLANE EXTERNAL FIXATION SYSTEM,,,21,,RBRVS,16.27 ,13.04 ,13.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20693,CPT,ADJUSTMENT/REVJ XTRNL FIXATION SYSTEM REQ ANES,,,21,,RBRVS,6.06 ,5.76 ,5.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20694,CPT,REMOVAL EXTERNAL FIXATION SYSTEM UNDER ANES,,,21,,RBRVS,4.28 ,4.62 ,7.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20696,CPT,XTRNL FIXJ W/STEREOTACTIC ADJUSTMENT 1ST & SUBQ,,,21,,RBRVS,17.56 ,13.80 ,13.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20697,CPT,XTRNL FIXJ W/STRTCTC ADJUSTMENT EXCHANGE STRUT,,TC,21,,RBRVS,,59.97 ,59.97 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
20802,CPT,REPLANTATION ARM COMPLETE AMPUTATION,,,21,,RBRVS,42.62 ,28.24 ,28.24 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
20805,CPT,REPLANTATION FOREARM COMPLETE AMPUTATION,,,21,,RBRVS,51.46 ,35.17 ,35.17 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
20808,CPT,REPLANTATION HAND COMPLETE AMPUTATION,,,21,,RBRVS,63.09 ,41.68 ,41.68 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
20816,CPT,RPLJ DGT EXCEPT THMB MTCARPHLNGL JT COMPL AMP,,,21,,RBRVS,31.95 ,23.18 ,23.18 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
20822,CPT,RPLJ DGT EXCLUDING THMB SUBLIMIS TDN COMPL AMP,,,21,,RBRVS,26.66 ,20.58 ,20.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20824,CPT,RPLJ THMB CARP/MTCRPL JT MP JT COMPL AMPUTATION,,,21,,RBRVS,31.95 ,21.27 ,21.27 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
20827,CPT,RPLJ THUMB DISTAL TIP MP JOINT COMPL AMPUTATION,,,21,,RBRVS,27.48 ,21.06 ,21.06 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
20838,CPT,REPLANTATION FOOT COMPLETE AMPUTATION,,,21,,RBRVS,42.88 ,17.73 ,17.73 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
20900,CPT,BONE GRAFT ANY DONOR AREA MINOR/SMALL,,,21,,RBRVS,3.00 ,1.94 ,8.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20902,CPT,BONE GRAFT ANY DONOR AREA MAJOR/LARGE,,,21,,RBRVS,4.58 ,2.82 ,2.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20910,CPT,CARTILAGE GRAFT COSTOCHONDRAL,,,21,,RBRVS,5.53 ,6.65 ,6.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20912,CPT,CARTILAGE GRAFT NASAL SEPTUM,,,21,,RBRVS,6.54 ,6.22 ,6.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20920,CPT,FASCIA LATA GRAFT BY STRIPPER,,,21,,RBRVS,5.51 ,4.99 ,4.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20922,CPT,FASCIA LATA GRAFT INCISION & AREA EXPOSURE,,,21,,RBRVS,6.93 ,5.79 ,8.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20924,CPT,TENDON GRAFT FROM A DISTANCE,,,21,,RBRVS,6.68 ,6.65 ,6.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20926,CPT,TISSUE GRAFTS OTHER,,,21,,RBRVS,5.79 ,5.49 ,5.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20930,CPT,ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED,,,21,,TotalUnits,,,,4.23 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20931,CPT,ALLOGRAFT FOR SPINE SURGERY ONLY STRUCTURAL,,,21,,RBRVS,1.81 ,0.87 ,0.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20936,CPT,AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION,,,21,,TotalUnits,,,,5.22 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
20937,CPT,AUTOGRAFT SPINE SURGERY MORSELIZED SEP INCISION,,,21,,RBRVS,2.79 ,1.38 ,1.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
20938,CPT,AUTOGRAFT SPINE SURGERY BICORT/TRICORT SEP INC,,,21,,RBRVS,3.02 ,1.46 ,1.46 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
20950,CPT,MNTR INTERSTITIAL FLUID PRESSURE CMPRT SYNDROME,,,21,,RBRVS,1.26 ,1.12 ,5.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20955,CPT,BONE GRAFT MICROVASCULAR ANASTOMOSIS FIBULA,,,21,,RBRVS,40.26 ,25.85 ,25.85 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
20956,CPT,BONE GRAFT MICROVASCULAR ANAST ILIAC CREST,,,21,,RBRVS,41.18 ,26.93 ,26.93 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
20957,CPT,BONE GRAFT MICROVASCULAR ANAST METATARSAL,,,21,,RBRVS,42.61 ,14.96 ,14.96 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
20962,CPT,BONE GRF W/MVASC ANAST OTH/THN ILIAC CREST/METAR,,,21,,RBRVS,39.21 ,16.31 ,16.31 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
20969,CPT,FREE OSTQ FLAP W/MVASC ANAST METAR/GREAT TOE,,,21,,RBRVS,45.43 ,27.08 ,27.08 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
20970,CPT,FREE OSTQ FLAP W/MVASC ANASTOMOSIS ILIAC CREST,,,21,,RBRVS,44.58 ,29.08 ,29.08 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
20972,CPT,FREE OSTQ FLAP W/MVASC ANASTOMOSIS METATARSAL,,,21,,RBRVS,44.51 ,18.34 ,18.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20973,CPT,FR OSTQ FLAP W/MVASC ANAST GRT TOE W/WEB SPACE,,,21,,RBRVS,47.27 ,22.35 ,22.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20974,CPT,ELECTRICAL STIMULATION BONE HEALING NONINVASIVE,,,21,,RBRVS,0.62 ,0.69 ,1.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20975,CPT,ELECTRICAL STIMULATION BONE HEALING INVASIVE,,,21,,RBRVS,2.60 ,1.91 ,1.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20979,CPT,LOW INTENSITY US STIMJ BONE HEALING NONINVASIVE,,,21,,RBRVS,0.62 ,0.23 ,0.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20982,CPT,ABLATION BONE TUMOR RF PERQ W/IMG GDN WHEN DONE,,,21,,RBRVS,7.27 ,2.90 ,98.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20983,CPT,ABLATJ BONE TUMOR CRYO PERQ W/IMG GDN WHEN PRFMD,,,21,,RBRVS,7.13 ,3.44 ,188.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20985,CPT,CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS,,,21,,RBRVS,2.50 ,1.26 ,1.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
20999,CPT,UNLISTED PROCEDURE MUSCSKELETAL SYSTEM GENERAL,,,21,,TotalUnits,,,,1.58 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21010,CPT,ARTHROTOMY TEMPOROMANDIBULAR JOINT,,,21,,RBRVS,11.04 ,9.03 ,9.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21011,CPT,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ <2CM,,,21,,RBRVS,2.99 ,3.90 ,6.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21012,CPT,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2 CM/>,,,21,,RBRVS,4.45 ,4.37 ,4.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21013,CPT,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL <2CM,,,21,,RBRVS,5.42 ,5.16 ,8.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21014,CPT,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>,,,21,,RBRVS,7.13 ,6.49 ,6.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21015,CPT,RAD RESECTION TUMOR SOFT TISS FACE/SCALP < 2CM,,,21,,RBRVS,9.89 ,8.63 ,8.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21016,CPT,RAD RESECTION TUMOR SOFT TISS FACE/SCALP 2 CM/>,,,21,,RBRVS,15.26 ,11.38 ,11.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21025,CPT,EXCISION BONE MANDIBLE,,,21,,RBRVS,10.03 ,10.12 ,14.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21026,CPT,EXCISION FACIAL BONE,,,21,,RBRVS,5.70 ,7.82 ,11.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21029,CPT,REMOVAL CONTOURING BENIGN TUMOR FACIAL BONE,,,21,,RBRVS,8.39 ,8.64 ,12.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21030,CPT,EXC BENIGN TUMOR/CYST MAXL/ZYGOMA ENCL & CURTG,,,21,,RBRVS,4.91 ,6.37 ,9.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21031,CPT,EXCISION TORUS MANDIBULARIS,,,21,,RBRVS,3.30 ,4.71 ,7.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21032,CPT,EXCISION MAXILLARY TORUS PALATINUS,,,21,,RBRVS,3.34 ,4.57 ,7.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21034,CPT,EXCISION MALIGNANT TUMOR MAXILLA/ZYGOMA,,,21,,RBRVS,17.38 ,13.47 ,17.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21040,CPT,EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL & CURT,,,21,,RBRVS,4.91 ,6.41 ,9.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21044,CPT,EXCISION MALIGNANT TUMOR MANDIBLE,,,21,,RBRVS,12.80 ,10.61 ,10.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21045,CPT,EXCISION MALIGNANT TUMOR MANDIBLE RADICAL,,,21,,RBRVS,18.37 ,14.17 ,14.17 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21046,CPT,EXC BENIGN TUMOR/CYST MNDBL INTRA-ORAL OSTEOT,,,21,,RBRVS,14.21 ,15.86 ,15.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21047,CPT,EXC B9 TUM/CST MNDBL XTR-ORAL OSTEOT&PRTL MNDB,,,21,,RBRVS,20.07 ,14.93 ,14.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21048,CPT,EXC BENIGN TUMOR/CYST MAXL INTRA-ORAL OSTEOT,,,21,,RBRVS,14.71 ,16.16 ,16.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21049,CPT,EXC B9 TUM/CST MAXL XTR-ORAL OSTEOT&PRTL MAXLC,,,21,,RBRVS,19.32 ,12.84 ,12.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21050,CPT,CONDYLECTOMY TEMPOROMANDIBULAR JOINT SPX,,,21,,RBRVS,11.76 ,10.55 ,10.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21060,CPT,MENISCECTOMY PRTL/COMPL TEMPOROMANDIBULAR JT SPX,,,21,,RBRVS,11.07 ,10.52 ,10.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21070,CPT,CORONOIDECTOMY SEPARATE PROCEDURE,,,21,,RBRVS,8.62 ,7.73 ,7.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21073,CPT,MANIPULATION TMJ THERAPEUTIC REQUIRE ANESTHESIA,,,21,,RBRVS,3.45 ,3.32 ,7.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21076,CPT,IMPRESSION&PREPARATION SURG OBTURATOR PROSTHES,,,21,,RBRVS,13.40 ,8.77 ,13.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21077,CPT,IMPRESSION & PREPARATION ORBITAL PROSTHESIS,,,21,,RBRVS,33.70 ,22.28 ,33.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21079,CPT,IMPRESSION & PREPARATION INTERIM OBTURATOR PROST,,,21,,RBRVS,22.31 ,14.76 ,23.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21080,CPT,IMPRESSION & PREPJ DEFINITIVE OBTURATOR PROSTHES,,,21,,RBRVS,25.06 ,16.12 ,25.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21081,CPT,IMPRESSION & PREPJ MANDIBULAR RESECTION PROSTHES,,,21,,RBRVS,22.85 ,15.13 ,24.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21082,CPT,IMPRESSION & PREPJ PALATAL AUGMENTATION PROSTHES,,,21,,RBRVS,20.84 ,14.99 ,23.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21083,CPT,IMPRESSION & PREPARATION PALATAL LIFT PROSTHESIS,,,21,,RBRVS,19.27 ,14.01 ,23.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21084,CPT,IMPRESSION & PREPARATION SPEECH AID PROSTHESIS,,,21,,RBRVS,22.48 ,15.99 ,26.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21085,CPT,IMPRESSION & PREPARATION ORAL SURGICAL SPLINT,,,21,,RBRVS,8.99 ,6.06 ,11.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21086,CPT,IMPRESSION & PREPARATION AURICULAR PROSTHESIS,,,21,,RBRVS,24.88 ,16.40 ,25.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21087,CPT,IMPRESSION & PREPARATION NASAL PROSTHESIS,,,21,,RBRVS,24.88 ,16.40 ,25.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21088,CPT,IMPRESSION & PREPARATION FACIAL PROSTHESIS,,,21,,TotalUnits,,,,37.96 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21089,CPT,UNLISTED MAXILLOFACIAL PROSTHETIC PROCEDURE,,,21,,TotalUnits,,,,44.76 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21100,CPT,APPL HALO APPLIANCE MAXILLOFACIAL FIXATION SPX,,,21,,RBRVS,4.73 ,9.35 ,27.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21110,CPT,APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC,,,21,,RBRVS,5.99 ,12.56 ,16.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21116,CPT,INJECTION TEMPOROMANDIBULAR JOINT ARTHROGRAPHY,,,21,,RBRVS,0.81 ,0.36 ,3.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21120,CPT,GENIOPLASTY AUGMENTATION,,,21,,RBRVS,5.10 ,7.85 ,11.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21121,CPT,GENIOPLASTY SLIDING OSTEOTOMY SINGLE PIECE,,,21,,RBRVS,7.81 ,10.13 ,13.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21122,CPT,GENIOPLASTY 2/> SLIDING OSTEOTOMIES,,,21,,RBRVS,8.71 ,9.10 ,9.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21123,CPT,GENIOP SLIDING AGMNTJ W/INTERPOSAL BONE GRAFTS,,,21,,RBRVS,11.34 ,10.09 ,10.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21125,CPT,AGMNTJ MNDBLR BODY/ANGLE PROSTHETIC MATERIAL,,,21,,RBRVS,10.80 ,8.54 ,77.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21127,CPT,AGMNTJ MNDBLR BDY/ANGL W/GRF ONLAY/INTERPOSAL,,,21,,RBRVS,12.44 ,11.05 ,109.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21137,CPT,REDUCTION FOREHEAD CONTOURING ONLY,,,21,,RBRVS,10.24 ,7.25 ,7.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21138,CPT,RDCTJ FHD CNTRG & PROSTHETIC MATRL/BONE GRAFT,,,21,,RBRVS,12.87 ,11.49 ,11.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21139,CPT,RDCTJ FHD CNTRG & SETBACK ANT FRONTAL SINUS WALL,,,21,,RBRVS,15.02 ,14.81 ,14.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21141,CPT,RCNSTJ MIDFACE LEFORT I 1 PIECE W/O BONE GRAFT,,,21,,RBRVS,19.57 ,16.12 ,16.12 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21142,CPT,RCNSTJ MIDFACE LEFORT I 2 PIECES W/O BONE GRAFT,,,21,,RBRVS,20.28 ,18.00 ,18.00 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21143,CPT,RCNSTJ MIDFACE LEFORT I 3/> PIECE W/O BONE GRAFT,,,21,,RBRVS,21.05 ,17.47 ,17.47 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21145,CPT,RCNSTJ MIDFACE LEFORT I 1 PIECE W/BONE GRAFTS,,,21,,RBRVS,23.94 ,19.28 ,19.28 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21146,CPT,RCNSTJ MIDFACE LEFORT I 2 PIECES W/BONE GRAFTS,,,21,,RBRVS,24.87 ,20.16 ,20.16 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21147,CPT,RCNSTJ MIDFACE LEFORT I 3/> PIECE W/BONE GRAFTS,,,21,,RBRVS,26.47 ,21.08 ,21.08 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21150,CPT,RCNSTJ MIDFACE LEFORT II ANTERIOR INTRUSION,,,21,,RBRVS,25.96 ,18.71 ,18.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21151,CPT,RCNSTJ MIDFACE LEFORT II W/BONE GRAFTS,,,21,,RBRVS,29.02 ,25.40 ,25.40 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21154,CPT,RCNSTJ MIDFACE LEFORT III W/O LEFORT I,,,21,,RBRVS,31.29 ,27.23 ,27.23 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21155,CPT,RCNSTJ MIDFACE LEFORT III W/LEFORT I,,,21,,RBRVS,35.22 ,30.05 ,30.05 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21159,CPT,RCNSTJ MIDFACE LEFORT III W/FHD W/O LEFORT I,,,21,,RBRVS,43.14 ,23.25 ,23.25 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21160,CPT,RCNSTJ MIDFACE LEFORT III W/FHD W/LEFORT I,,,21,,RBRVS,47.19 ,24.80 ,24.80 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21172,CPT,RCNSTJ SUPERIOR-LATERAL ORBITAL RIM & LOWER FHD,,,21,,RBRVS,28.20 ,20.65 ,20.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21175,CPT,RCNSTJ BIFRONTAL SUPERIOR-LAT ORB RIMS & LWR FHD,,,21,,RBRVS,33.56 ,18.87 ,18.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21179,CPT,RCNSTJ FOREHEAD &/ SUPRAORB RIMS W/ALGRF/PROSTC,,,21,,RBRVS,22.65 ,13.38 ,13.38 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21180,CPT,RCNSTJ FOREHEAD &/ SUPRAORBITAL RIMS W/AUTOGRAFT,,,21,,RBRVS,25.58 ,14.77 ,14.77 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21181,CPT,RCNSTJ CONTOURING BENIGN TUMOR CRNL BONES XTRC,,,21,,RBRVS,10.28 ,9.25 ,9.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21182,CPT,RCNSTJ ORBIT/FHD/NASETHMD EXCBONE TUM GRF<40SQCM,,,21,,RBRVS,32.58 ,17.82 ,17.82 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21183,CPT,RCNSTJ ORBIT/FHD/NASETHMD EXC BONE GRF>40 <80,,,21,,RBRVS,35.70 ,25.84 ,25.84 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21184,CPT,RCNSTJ ORBIT/FHD/NASETHMD EXC BONE TUM GRF>80SQ,,,21,,RBRVS,38.62 ,24.25 ,24.25 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21188,CPT,RCNSTJ MDFC OTH/THN LEFORT OSTEOT & BONE GRAFTS,,,21,,RBRVS,23.15 ,18.54 ,18.54 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21193,CPT,RCNSTJ MNDBLR RAMI HRZNTL/VER/C/L OSTEOT W/O GRF,,,21,,RBRVS,18.90 ,12.58 ,12.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21194,CPT,RCNSTJ MNDBLR RAMI HRZNTL/VER/C/L OSTEOT W/GRAFT,,,21,,RBRVS,21.82 ,17.76 ,17.76 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21195,CPT,RCNSTJ MNDBLR RAMI&/BODY SGTL SPLT W/O INT RGD,,,21,,RBRVS,19.16 ,16.33 ,16.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21196,CPT,RCNSTJ MNDBLR RAMI&/BDY SGTL SPLT W/INT RGD FI,,,21,,RBRVS,20.83 ,18.77 ,18.77 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21198,CPT,OSTEOTOMY MANDIBLE SEGMENTAL,,,21,,RBRVS,15.71 ,15.46 ,15.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21199,CPT,OSTEOTOMY MANDIBLE SGMTL W/GENIOGLOSSUS ADVMNT,,,21,,RBRVS,16.73 ,9.79 ,9.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21206,CPT,OSTEOTOMY MAXILLA SEGMENTAL,,,21,,RBRVS,15.59 ,17.51 ,17.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21208,CPT,OSTEOPLASTY FACIAL BONES AUGMENTATION,,,21,,RBRVS,11.42 ,11.06 ,41.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21209,CPT,OSTEOPLASTY FACIAL BONES REDUCTION,,,21,,RBRVS,7.82 ,8.79 ,14.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21210,CPT,GRAFT BONE NASAL/MAXILLARY/MALAR AREAS,,,21,,RBRVS,11.69 ,11.55 ,52.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21215,CPT,GRAFT BONE MANDIBLE,,,21,,RBRVS,12.23 ,11.87 ,103.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21230,CPT,GRAFT RIB CRTLG AUTOGENOUS FACE/CHIN/NOSE/EAR,,,21,,RBRVS,11.17 ,8.88 ,8.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21235,CPT,GRAFT EAR CRTLG AUTOGENOUS NOSE/EAR,,,21,,RBRVS,7.50 ,7.70 ,12.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21240,CPT,ARTHRP TEMPOROMANDIBULAR JOINT W/WO AUTOGRAFT,,,21,,RBRVS,16.07 ,13.68 ,13.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21242,CPT,ARTHROPLASTY TEMPOROMANDIBULAR JT W/ALLOGRAFT,,,21,,RBRVS,14.59 ,12.68 ,12.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21243,CPT,ARTHRP TMPRMAND JOINT W/PROSTHETIC REPLACEMENT,,,21,,RBRVS,24.53 ,20.61 ,20.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21244,CPT,RCNSTJ MNDBL XTRORAL W/TRANSOSTEAL BONE PLATE,,,21,,RBRVS,13.62 ,15.03 ,15.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21245,CPT,RCNSTJ MNDBL/MAXL SUBPRIOSTEAL IMPLANT PARTIAL,,,21,,RBRVS,13.12 ,10.41 ,16.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21246,CPT,RCNSTJ MNDBL/MAXL SUBPRIOSTEAL IMPLANT COMPLETE,,,21,,RBRVS,12.92 ,10.86 ,10.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21247,CPT,RCNSTJ MNDBLR CONDYLE W/BONE CARTLG AUTOGRAFTS,,,21,,RBRVS,24.37 ,16.01 ,16.01 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21248,CPT,RCNSTJ MANDIBLE/MAXL ENDOSTEAL IMPLANT PARTIAL,,,21,,RBRVS,12.74 ,11.47 ,17.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21249,CPT,RCNSTJ MANDIBLE/MAXL ENDOSTEAL IMPLANT COMPLETE,,,21,,RBRVS,18.77 ,15.61 ,22.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21255,CPT,RCNSTJ ZYGMTC ARCH/GLENOID FOSSA W/BONE CARTLG,,,21,,RBRVS,18.46 ,16.79 ,16.79 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21256,CPT,RECONSTRUCTION ORBIT W/OSTEOTOMIES & BONE GRAFTS,,,21,,RBRVS,17.66 ,15.38 ,15.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21260,CPT,PERIORBITAL OSTEOTOMIES BONE GRAFTS EXTRACRANIAL,,,21,,RBRVS,17.90 ,13.80 ,13.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21261,CPT,PERIORBITAL OSTEOTOMIES W/BONE GRAFTS ICRA & XTR,,,21,,RBRVS,34.07 ,22.04 ,22.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21263,CPT,PERIORBITAL OSTEOTOMIES W/BONE GRAFTS W/FOREHEAD,,,21,,RBRVS,31.01 ,20.89 ,20.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21267,CPT,ORBITAL REPOSITIONING W/BONE GRAFTS EXTRACRANIAL,,,21,,RBRVS,20.69 ,23.03 ,23.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21268,CPT,ORBITAL REPOSITIONING W/BONE GRAFTS ICRA & XTRC,,,21,,RBRVS,27.07 ,22.09 ,22.09 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21270,CPT,MALAR AUGMENTATION PROSTHETIC MATERIAL,,,21,,RBRVS,10.63 ,9.36 ,16.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21275,CPT,SECONDARY REVISION ORBITOCRANIOFACIAL RCNSTJ,,,21,,RBRVS,11.76 ,10.30 ,10.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21280,CPT,MEDIAL CANTHOPEXY SEPARATE PROCEDURE,,,21,,RBRVS,7.13 ,8.44 ,8.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21282,CPT,LATERAL CANTHOPEXY,,,21,,RBRVS,4.27 ,6.07 ,6.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21295,CPT,REDUCTION MASSETER MUSCLE & BONE EXTRAORAL,,,21,,RBRVS,1.90 ,3.23 ,3.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21296,CPT,REDUCTION MASSETER MUSCLE & BONE INTRAORAL,,,21,,RBRVS,4.78 ,6.57 ,6.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21299,CPT,UNLISTED CRANIOFACIAL & MAXILLOFACIAL PROCEDURE,,,21,,TotalUnits,,,,15.60 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21310,CPT,CLOSED TREATMENT NASAL FRACTURE W/O MANIPULATION,,,21,,RBRVS,0.58 ,0.12 ,3.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21315,CPT,CLOSED TX NASAL FRACTURE W/O STABILIZATION,,,21,,RBRVS,1.83 ,2.27 ,5.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21320,CPT,CLOSED TREATMENT NASAL FRACTURE W/STABILIZATION,,,21,,RBRVS,1.88 ,1.73 ,5.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21325,CPT,OPEN TREATMENT NASAL FRACTURE UNCOMPLICATED,,,21,,RBRVS,4.18 ,8.85 ,8.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21330,CPT,OPEN TX NASAL FX COMP W/INT&/XTRNL SKELETAL FI,,,21,,RBRVS,5.79 ,9.70 ,9.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21335,CPT,OPEN TX NASAL FX W/CONCOMITANT OPTX FXD SEPTUM,,,21,,RBRVS,9.02 ,10.49 ,10.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21336,CPT,OPEN TX NASAL SEPTAL FRACTURE W/WO STABILIZATION,,,21,,RBRVS,6.77 ,10.71 ,10.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21337,CPT,CLOSED TX NASAL SEPTAL FRACT W/WO STABILIZATION,,,21,,RBRVS,3.39 ,4.59 ,7.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21338,CPT,OPEN TX NASOETHMOID FX W/O EXTERNAL FIXATION,,,21,,RBRVS,6.87 ,13.58 ,13.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21339,CPT,OPEN TX NASOETHMOID FX W/EXTERNAL FIXATION,,,21,,RBRVS,8.50 ,14.54 ,14.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21340,CPT,PERCUTANEOUS TX NASOETHMOID COMPLEX FRACTURE,,,21,,RBRVS,11.49 ,10.63 ,10.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21343,CPT,OPEN TX DEPRESSED FRONTAL SINUS FRACTURE,,,21,,RBRVS,14.32 ,18.21 ,18.21 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21344,CPT,OPEN TX COMPLICATED FRONTAL SINUS FRACTURE,,,21,,RBRVS,21.57 ,15.32 ,15.32 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21345,CPT,CLOSED TX NASOMAXILLARY COMPLEX FRACTURE,,,21,,RBRVS,9.06 ,7.68 ,12.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21346,CPT,OPTX NASOMAX CPLX FX LEFT II TYPE W/WIRG & FXJ,,,21,,RBRVS,11.45 ,12.88 ,12.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21347,CPT,OPTX NASOMAX CPLX FX LEFT II TYPE REQ MLT OPN,,,21,,RBRVS,13.53 ,16.91 ,16.91 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21348,CPT,OPTX NASOMAX CPLX FX LEFT II TYPE W/BONE GRAFT,,,21,,RBRVS,17.52 ,14.27 ,14.27 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21355,CPT,PERCUTANEOUS TX MALAR AREA FRACTURE,,,21,,RBRVS,4.45 ,5.10 ,8.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21356,CPT,OPEN TX DEPRESSED ZYGOMATIC ARCH FRACTURE,,,21,,RBRVS,4.83 ,5.29 ,8.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21360,CPT,OPEN TX DEPRESSED MALAR FRACTURE,,,21,,RBRVS,7.19 ,7.22 ,7.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21365,CPT,OPEN TX COMP FX MALAR W/INTERNAL FX&MULT SURG,,,21,,RBRVS,16.77 ,12.60 ,12.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21366,CPT,OPEN TX COMP FRACTURE MALAR AREA W/BONE GRAFT,,,21,,RBRVS,18.60 ,11.66 ,11.66 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21385,CPT,OPEN TX ORBITAL FLOOR BLOWOUT FX TRANSANTRAL,,,21,,RBRVS,9.57 ,8.65 ,8.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21386,CPT,OPEN TX ORBITAL FLOOR BLOWOUT FX PERIORBITAL,,,21,,RBRVS,9.57 ,8.82 ,8.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21387,CPT,OPEN TX ORBITAL FLOOR BLOWOUT FX COMBINED APPR,,,21,,RBRVS,10.11 ,8.87 ,8.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21390,CPT,OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/ALLPLSTC,,,21,,RBRVS,11.23 ,10.06 ,10.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21395,CPT,OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/BONE GRF,,,21,,RBRVS,14.70 ,11.80 ,11.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21400,CPT,CLSD TX FX ORBIT EXCEPT BLOWOUT W/O MANIPULATION,,,21,,RBRVS,1.50 ,2.78 ,3.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21401,CPT,CLOSED TX FX ORBIT EXCEPT BLOWOUT W/MANIPULATION,,,21,,RBRVS,3.68 ,4.52 ,9.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21406,CPT,OPEN TX FX ORBIT EXCEPT BLOWOUT W/O IMPLANT,,,21,,RBRVS,7.42 ,7.77 ,7.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21407,CPT,OPEN TX FX ORBIT EXCEPT BLOWOUT W/IMPLANT,,,21,,RBRVS,9.02 ,8.29 ,8.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21408,CPT,OPEN TX FX ORBIT EXCEPT BLOWOUT W/BONE GRAFT,,,21,,RBRVS,12.78 ,10.92 ,10.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21421,CPT,CLOSED TX PALATAL/MAXILLARY FX W/FIXATION/SPLINT,,,21,,RBRVS,6.02 ,13.01 ,17.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21422,CPT,OPEN TREATMENT PALATAL/MAXILLARY FRACTURE,,,21,,RBRVS,8.73 ,9.32 ,9.32 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21423,CPT,OPEN TX PALATAL/MAXILLARY FX COMP MULTIPLE APPR,,,21,,RBRVS,10.85 ,10.11 ,10.11 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21431,CPT,CLOSED TX CRANIOFACIAL SEPARATION,,,21,,RBRVS,7.90 ,13.46 ,13.46 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21432,CPT,OPEN TX CRANIOFACIAL SEP W/WIRING&/INT FIXJ,,,21,,RBRVS,8.82 ,8.33 ,8.33 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21433,CPT,OPEN TX CRANIOFACIAL SEP COMPLICATED MLT APPR,,,21,,RBRVS,26.29 ,19.35 ,19.35 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21435,CPT,OPEN TX CRANIOFACIAL SEP COMP W/INT&/XTRNL FIX,,,21,,RBRVS,20.26 ,13.11 ,13.11 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21436,CPT,OPTX CRNFCL SEP LFT III TYP COMP INT FIXJ W/BONE,,,21,,RBRVS,30.30 ,23.35 ,23.35 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21440,CPT,CLTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX,,,21,,RBRVS,3.44 ,9.52 ,12.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21445,CPT,OPTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX,,,21,,RBRVS,6.26 ,10.88 ,15.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21450,CPT,CLOSED TX MANDIBULAR FRACTURE W/O MANIPULATION,,,21,,RBRVS,3.71 ,10.07 ,13.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21451,CPT,CLOSED TX MANDIBULAR FRACTURE W/MANIPULATION,,,21,,RBRVS,5.65 ,12.96 ,17.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21452,CPT,PERCUTANEOUS TX MANDIBULAR FX W/EXTERNAL FIXJ,,,21,,RBRVS,2.40 ,7.00 ,13.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21453,CPT,CLOSED TX MANDIBULAR FX W/INTERDENTAL FIXATION,,,21,,RBRVS,6.64 ,14.94 ,18.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21454,CPT,OPEN TX MANDIBULAR FX W/EXTERNAL FIXATION,,,21,,RBRVS,7.36 ,7.99 ,7.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21461,CPT,OPEN TX MANDIBULAR FX W/O INTERDENTAL FIXATION,,,21,,RBRVS,9.31 ,16.33 ,50.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21462,CPT,OPEN TX MANDIBULAR FX W/INTERDENTAL FIXATION,,,21,,RBRVS,11.01 ,17.44 ,52.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21465,CPT,OPEN TREATMENT MANDIBULAR CONDYLAR FRACTURE,,,21,,RBRVS,13.12 ,11.65 ,11.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21470,CPT,OPTX COMP MANDIBULAR FX MLT APPR W/INT FIXATION,,,21,,RBRVS,17.54 ,14.49 ,14.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21480,CPT,CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ,,,21,,RBRVS,0.61 ,0.22 ,2.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21485,CPT,CLOSED TX TEMPOROMANDIBULAR DISLC COMP 1ST/SBSQ,,,21,,RBRVS,4.77 ,11.45 ,14.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21490,CPT,OPEN TREATMENT TEMPOROMANDIBULAR DISLOCATION,,,21,,RBRVS,12.95 ,11.49 ,11.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21495,CPT,OPEN TREATMENT HYOID FRACTURE,,,21,,RBRVS,6.79 ,11.11 ,11.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21497,CPT,INTERDENTAL WIRING OTHER THAN FRACTURE,,,21,,RBRVS,4.64 ,12.24 ,15.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21499,CPT,UNLISTED MUSCULOSKELETAL PROCEDURE HEAD,,,21,,TotalUnits,,,,15.60 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21501,CPT,I&D DEEP ABSC/HMTMA SOFT TISSUE NECK/THORAX,,,21,,RBRVS,3.98 ,4.44 ,8.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21502,CPT,I&D DP ABSC/HMTMA SOFT TISS NCK/THORAX PRTL RI,,,21,,RBRVS,7.55 ,5.28 ,5.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21510,CPT,INCISION DEEP OPENING BONE CORTEX THORAX,,,21,,RBRVS,6.20 ,5.01 ,5.01 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21550,CPT,BIOPSY SOFT TISSUE NECK/THORAX,,,21,,RBRVS,2.11 ,2.11 ,5.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21552,CPT,EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>,,,21,,RBRVS,6.49 ,4.91 ,4.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21554,CPT,EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>,,,21,,RBRVS,11.13 ,7.63 ,7.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21555,CPT,EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM,,,21,,RBRVS,3.96 ,4.03 ,7.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21556,CPT,EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM,,,21,,RBRVS,7.66 ,6.11 ,6.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21557,CPT,RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX <5CM,,,21,,RBRVS,14.75 ,9.97 ,9.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21558,CPT,RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX 5CM/>,,,21,,RBRVS,21.58 ,12.83 ,12.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21600,CPT,EXCISION RIB PARTIAL,,,21,,RBRVS,7.26 ,7.26 ,7.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21610,CPT,COSTOTRANSVERSECTOMY SEPARATE PROCEDURE,,,21,,RBRVS,15.91 ,12.75 ,12.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21615,CPT,EXCISION 1ST &/CERVICAL RIB,,,21,,RBRVS,10.45 ,5.24 ,5.24 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21616,CPT,EXCISION 1ST &/CERVICAL RIB W/SYMPATHECTOMY,,,21,,RBRVS,12.69 ,5.45 ,5.45 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21620,CPT,OSTECTOMY STERNUM PARTIAL,,,21,,RBRVS,7.28 ,5.66 ,5.66 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21627,CPT,STERNAL DEBRIDEMENT,,,21,,RBRVS,7.30 ,6.76 ,6.76 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21630,CPT,RADICAL RESECTION STERNUM,,,21,,RBRVS,19.18 ,12.27 ,12.27 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21632,CPT,RADICAL RESECTION STERNUM W/MEDSTNL LMPHADEC,,,21,,RBRVS,19.68 ,10.44 ,10.44 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21685,CPT,HYOID MYOTOMY & SUSPENSION,,,21,,RBRVS,15.26 ,11.13 ,11.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21700,CPT,DIVISION SCALENUS ANTICUS W/O RESCJ CERVICAL RIB,,,21,,RBRVS,6.31 ,2.82 ,2.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21705,CPT,DIVISION SCALENUS ANTICUS RESECTION CERVICAL RIB,,,21,,RBRVS,9.92 ,3.59 ,3.59 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21720,CPT,DIVISION STERNOCLEIDOMASTOID OPEN W/O CAST,,,21,,RBRVS,5.80 ,7.06 ,7.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21725,CPT,DIVISION STERNOCLEIDOMASTOID OPEN W/CAST,,,21,,RBRVS,7.19 ,6.87 ,6.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21740,CPT,REPAIR PECTUS EXCAVATUM/CARINATUM OPEN,,,21,,RBRVS,17.57 ,8.11 ,8.11 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21742,CPT,REPAIR PECTUS EXCAVATM/CARINATM MINLY W/O THRSC,,,21,,TotalUnits,,,,30.52 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21743,CPT,REPAIR PECTUS EXCAVATM/CARINATM MINLY W/THRSC,,,21,,TotalUnits,,,,40.16 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21750,CPT,CLOSE MEDIAN STERNOTOMY SEP W/WO DEBRIDEMENT SPX,,,21,,RBRVS,11.40 ,5.79 ,5.79 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21811,CPT,OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 1-3 RIBS,,,21,,RBRVS,10.79 ,4.37 ,4.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21812,CPT,OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 4-6 RIBS,,,21,,RBRVS,13.00 ,5.16 ,5.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21813,CPT,OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 7+ RIBS,,,21,,RBRVS,17.61 ,7.13 ,7.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21820,CPT,CLOSED TREATMENT STERNUM FRACTURE,,,21,,RBRVS,1.36 ,2.55 ,2.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21825,CPT,OPEN TX STERNUM FRACTURE W/WO SKELETAL FIXATION,,,21,,RBRVS,7.76 ,6.08 ,6.08 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
21899,CPT,UNLISTED PROCEDURE NECK/THORAX,,,21,,TotalUnits,,,,11.40 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21920,CPT,BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL,,,21,,RBRVS,2.11 ,2.16 ,4.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21925,CPT,BIOPSY SOFT TISSUE BACK/FLANK DEEP,,,21,,RBRVS,4.63 ,4.61 ,7.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21930,CPT,EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM,,,21,,RBRVS,4.94 ,4.48 ,7.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21931,CPT,EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>,,,21,,RBRVS,6.88 ,5.09 ,5.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21932,CPT,EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM,,,21,,RBRVS,9.82 ,7.02 ,7.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21933,CPT,EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>,,,21,,RBRVS,11.13 ,7.67 ,7.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21935,CPT,RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK <5CM,,,21,,RBRVS,15.72 ,10.45 ,10.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
21936,CPT,RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK 5CM/>,,,21,,RBRVS,22.55 ,13.28 ,13.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22010,CPT,I&D DEEP ABSCESS PST SPINE CRV THRC/CERVICOTHR,,,21,,RBRVS,12.75 ,11.19 ,11.19 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22015,CPT,I&D DEEP ABSCESS PST SPINE LUMBAR SAC/LUMBOSAC,,,21,,RBRVS,12.64 ,10.30 ,10.30 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22100,CPT,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM CRV,,,21,,RBRVS,11.00 ,11.49 ,11.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22101,CPT,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM THRC,,,21,,RBRVS,11.08 ,10.38 ,10.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22102,CPT,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM LMBR,,,21,,RBRVS,11.08 ,9.48 ,9.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22103,CPT,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM EA,,,21,,RBRVS,2.34 ,1.13 ,1.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22110,CPT,PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM CRV,,,21,,RBRVS,14.00 ,12.05 ,12.05 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22112,CPT,PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM THRC,,,21,,RBRVS,14.07 ,12.93 ,12.93 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22114,CPT,PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM LMBR,,,21,,RBRVS,14.07 ,11.73 ,11.73 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22116,CPT,PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM EA,,,21,,RBRVS,2.32 ,1.12 ,1.12 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22206,CPT,OSTEOTOMY SPINE POSTERIOR 3 COLUMN THORACIC,,,21,,RBRVS,37.18 ,23.32 ,23.32 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22207,CPT,OSTEOTOMY SPINE POSTERIOR 3 COLUMN LUMBAR,,,21,,RBRVS,36.68 ,23.07 ,23.07 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22208,CPT,OSTEOTOMY SPINE POSTERIOR 3 COLUMN EA ADDL SGM,,,21,,RBRVS,9.66 ,4.75 ,4.75 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22210,CPT,OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM CRV,,,21,,RBRVS,25.38 ,18.83 ,18.83 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22212,CPT,OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM THRC,,,21,,RBRVS,20.99 ,16.48 ,16.48 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22214,CPT,OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM LMBR,,,21,,RBRVS,21.02 ,16.49 ,16.49 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22216,CPT,OSTEOT SPI PST/PSTLAT APPR 1 VRT SGM EA VRT SGM,,,21,,RBRVS,6.03 ,2.97 ,2.97 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22220,CPT,OSTEOTOMY SPINE W/DSKC ANT APPR 1 VRT SGM CRV,,,21,,RBRVS,22.94 ,17.04 ,17.04 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22222,CPT,OSTEOTOMY SPINE W/DSKC ANT APPR 1 VRT SGM THRC,,,21,,RBRVS,23.09 ,17.32 ,17.32 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22224,CPT,OSTEOTOMY SPINE W/DSKC ANT APPR 1 VRT SGM LMBR,,,21,,RBRVS,23.09 ,17.11 ,17.11 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22226,CPT,OSTEOT SPI W/DSKC ANT APPR 1 VRT SGM EA VRT SGM,,,21,,RBRVS,6.03 ,2.95 ,2.95 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22305,CPT,CLOSED TX VERTEBRAL PROCESS FRACTURE,,,21,,RBRVS,2.13 ,2.43 ,2.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22310,CPT,CLTX VRT BDY FX W/O MANJ REQ&W/CSTING/BRACING,,,21,,RBRVS,3.89 ,3.42 ,4.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22315,CPT,CLTX VRT FX&/DISLC CSTING/BRACING MANJ/TRCJ,,,21,,RBRVS,10.11 ,9.61 ,12.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22318,CPT,OPTX&/RDCTJ ODNTD FX&/DISLC ANT FIXJ W/O GRAFT,,,21,,RBRVS,22.72 ,16.52 ,16.52 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22319,CPT,OPTX&/RDCTJ ODNTD FX&/DISLC ANT W/INT FIXJ,,,21,,RBRVS,25.33 ,17.94 ,17.94 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22325,CPT,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM LM,,,21,,RBRVS,19.87 ,15.81 ,15.81 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22326,CPT,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM CR,,,21,,RBRVS,20.84 ,15.66 ,15.66 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22327,CPT,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM TH,,,21,,RBRVS,20.77 ,16.36 ,16.36 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22328,CPT,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM EA,,,21,,RBRVS,4.60 ,2.22 ,2.22 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22505,CPT,MANIPULATION SPINE REQUIRING ANESTHESIA,,,21,,RBRVS,1.87 ,1.58 ,1.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22510,CPT,PERQ VERTEBROPLASTY UNI/BI INJX CERVICOTHORACIC,,,21,,RBRVS,8.15 ,3.92 ,40.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22511,CPT,PERQ VERTEBROPLASTY UNI/BI INJECTION LUMBOSACRAL,,,21,,RBRVS,7.58 ,3.74 ,41.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22512,CPT,VERTEBROPLASTY EACH ADDL CERVICOTHOR/LUMBOSACRAL,,,21,,RBRVS,4.00 ,1.50 ,23.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22513,CPT,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULATION,,,21,,RBRVS,8.90 ,4.98 ,197.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22514,CPT,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ LMBR,,,21,,RBRVS,8.24 ,4.71 ,197.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22515,CPT,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ EACH,,,21,,RBRVS,4.00 ,1.75 ,121.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22526,CPT,PERQ INTRDSCL ELECTROTHRM ANNULOPLASTY 1 LEVEL,,,21,,RBRVS,6.10 ,3.16 ,60.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22527,CPT,PERQ INTRDSCL ELECTROTHRM ANNULOPLASTY ADDL LVL,,,21,,RBRVS,3.03 ,1.16 ,52.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22532,CPT,ARTHRODESIS LATERAL EXTRACAVITARY THORACIC,,,21,,RBRVS,25.99 ,17.97 ,17.97 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22533,CPT,ARTHRODESIS LATERAL EXTRACAVITARY LUMBAR,,,21,,RBRVS,24.79 ,17.15 ,17.15 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22534,CPT,ARTHRODESIS LAT EXTRACAVITARY EA ADDL THRC/LMBR,,,21,,RBRVS,5.99 ,2.91 ,2.91 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22548,CPT,ARTHRD ANT TRANSORL/XTRORAL C1-C2 W/WO EXC ODNTD,,,21,,RBRVS,27.06 ,19.50 ,19.50 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22551,CPT,ARTHRD ANT INTERBODY DECOMPRESS CERVICAL BELW C2,,,21,,RBRVS,25.00 ,16.83 ,16.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22552,CPT,ARTHRD ANT INTERDY CERVCL BELW C2 EA ADDL NTRSPC,,,21,,RBRVS,6.50 ,3.12 ,3.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
22554,CPT,ARTHRD ANT MIN DISCECT INTERBODY CERV BELOW C2,,,21,,RBRVS,17.69 ,13.38 ,13.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22556,CPT,ARTHRD ANT MIN DISCECTOMY INTERBODY THORACIC,,,21,,RBRVS,24.70 ,16.64 ,16.64 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22558,CPT,ARTHRODESIS ANTERIOR INTERBODY LUMBAR,,,21,,RBRVS,23.53 ,15.16 ,15.16 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22585,CPT,ARTHRODESIS ANTERIOR INTERBODY EA ADDL NTRSPC,,,21,,RBRVS,5.52 ,2.57 ,2.57 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22586,CPT,ARTHRODESIS PRESACRAL INTRBDY W/INSTRUMENT L5-S1,,,21,,RBRVS,28.12 ,18.93 ,18.93 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22590,CPT,ARTHRODESIS POSTERIOR CRANIOCERVICAL,,,21,,RBRVS,21.76 ,16.56 ,16.56 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22595,CPT,ARTHRODESIS POSTERIOR ATLAS-AXIS C1-C2,,,21,,RBRVS,20.64 ,16.06 ,16.06 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22600,CPT,ARTHRODESIS PST/PSTLAT CERVICAL BELW C2 SGM,,,21,,RBRVS,17.40 ,14.38 ,14.38 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22610,CPT,ARTHRODESIS POSTERIOR/POSTEROLATERAL THORACIC,,,21,,RBRVS,17.28 ,14.15 ,14.15 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22612,CPT,ARTHRODESIS POSTERIOR/POSTEROLATERAL LUMBAR,,,21,,RBRVS,23.53 ,16.19 ,16.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22614,CPT,ARTHRODESIS POSTERIOR/POSTEROLATERAL EA ADDL,,,21,,RBRVS,6.43 ,3.12 ,3.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22630,CPT,ARTHRODESIS POSTERIOR INTERBODY LUMBAR,,,21,,RBRVS,22.09 ,16.29 ,16.29 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22632,CPT,ARTHRODESIS POSTERIOR INTERBODY EA ADDL,,,21,,RBRVS,5.22 ,2.52 ,2.52 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22633,CPT,ARTHDSIS POST/POSTEROLATRL/POSTINTERBODY LUMBAR,,,21,,RBRVS,27.75 ,18.07 ,18.07 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22634,CPT,ARTHDSIS POST/POSTERLATRL/POSTINTRBDYADL SPC/SEG,,,21,,RBRVS,8.16 ,3.93 ,3.93 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22800,CPT,ARTHRODESIS POSTERIOR SPINAL DFRM UP 6 VRT SEG,,,21,,RBRVS,19.50 ,14.67 ,14.67 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22802,CPT,ARTHRODESIS POSTERIOR SPINAL DFRM 7-12 VRT SEG,,,21,,RBRVS,32.11 ,20.88 ,20.88 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22804,CPT,ARTHRODESIS POSTERIOR SPINAL DFRM 13/> VRT SEG,,,21,,RBRVS,37.50 ,23.44 ,23.44 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22808,CPT,ARTHRODESIS ANTERIOR SPINAL DFRM 2-3 VRT SEG,,,21,,RBRVS,27.51 ,18.16 ,18.16 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22810,CPT,ARTHRODESIS ANTERIOR SPINAL DFRM 4-7 VRT SEG,,,21,,RBRVS,31.50 ,18.84 ,18.84 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22812,CPT,ARTHRODESIS POSTERIOR SPINAL DFRM 8/> VRT SEG,,,21,,RBRVS,34.25 ,22.75 ,22.75 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22818,CPT,KYPHECTOMY SINGLE OR TWO SEGMENTS,,,21,,RBRVS,34.33 ,21.54 ,21.54 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22819,CPT,KYPHECTOMY 3 OR MORE SEGMENTS,,,21,,RBRVS,39.38 ,25.26 ,25.26 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22830,CPT,EXPLORATION SPINAL FUSION,,,21,,RBRVS,11.22 ,9.27 ,9.27 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22840,CPT,POSTERIOR NON-SEGMENTAL INSTRUMENTATION,,,21,,RBRVS,12.52 ,6.06 ,6.06 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22841,CPT,INTERNAL SPINAL FIXATION WIRING SPINOUS PROCESS,,,21,,TotalUnits,,,,15.20 ,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22842,CPT,POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG,,,21,,RBRVS,12.56 ,6.08 ,6.08 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22843,CPT,POSTERIOR SEGMENTAL INSTRUMENTATION 7-12 VRT SEG,,,21,,RBRVS,13.44 ,6.52 ,6.52 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22844,CPT,POSTERIOR SEGMENTAL INSTRUMENTATION 13/> VRT SE,,,21,,RBRVS,16.42 ,8.06 ,8.06 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22845,CPT,ANTERIOR INSTRUMENTATION 2-3 VERTEBRAL SEGMENTS,,,21,,RBRVS,11.94 ,5.71 ,5.71 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22846,CPT,ANTERIOR INSTRUMENTATION 4-7 VERTEBRAL SEGMENTS,,,21,,RBRVS,12.40 ,5.94 ,5.94 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22847,CPT,ANTERIOR INSTRUMENTATION 8/> VERTEBRAL SEGMENTS,,,21,,RBRVS,13.78 ,6.70 ,6.70 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22848,CPT,PELVIC FIXATION OTHER THAN SACRUM,,,21,,RBRVS,5.99 ,2.96 ,2.96 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22849,CPT,REINSERTION SPINAL FIXATION DEVICE,,,21,,RBRVS,19.17 ,13.21 ,13.21 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22850,CPT,REMOVAL POSTERIOR NONSEGMENTAL INSTRUMENTATION,,,21,,RBRVS,9.82 ,8.39 ,8.39 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22851,CPT,APPLICATION INTERVERTEBRAL BIOMECHANICAL DEVICE,,,21,,RBRVS,6.70 ,3.22 ,3.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22852,CPT,REMOVAL POSTERIOR SEGMENTAL INSTRUMENTATION,,,21,,RBRVS,9.37 ,8.14 ,8.14 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22855,CPT,REMOVAL ANTERIOR INSTRUMENTATION,,,21,,RBRVS,15.86 ,11.55 ,11.55 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22856,CPT,TOT DISC ARTHRP ART DISC ANT APPRO 1 NTRSPC CRV,,,21,,RBRVS,24.05 ,15.25 ,15.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22857,CPT,TOT DISC ARTHRP ART DISC ANT APPRO 1 NTRSPC LMBR,,,21,,RBRVS,27.13 ,18.73 ,18.73 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22858,CPT,TOT DISC ARTHRP ANT APPR DISC 2ND LEVEL CERVICAL,,,21,,RBRVS,8.40 ,3.62 ,3.62 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22861,CPT,REVJ RPLCMT DISC ARTHROPLASTY ANT 1 NTRSPC CRV,,,21,,RBRVS,33.36 ,15.58 ,15.58 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22862,CPT,REVJ RPLCMT DISC ARTHROPLASTY ANT 1 NTRSPC LMBR,,,21,,RBRVS,32.63 ,15.81 ,15.81 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22864,CPT,RMVL DISC ARTHROPLASTY ANT 1 INTERSPACE CERVICAL,,,21,,RBRVS,29.40 ,19.61 ,19.61 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22865,CPT,RMVL DISC ARTHROPLASTY ANT 1 INTERSPACE LUMBAR,,,21,,RBRVS,31.75 ,21.07 ,21.07 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
22899,CPT,UNLISTED PROCEDURE SPINE,,,21,,TotalUnits,,,,18.34 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22900,CPT,EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM,,,21,,RBRVS,8.32 ,6.03 ,6.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22901,CPT,EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5CM/>,,,21,,RBRVS,10.11 ,6.73 ,6.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22902,CPT,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM,,,21,,RBRVS,4.42 ,4.09 ,7.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22903,CPT,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>,,,21,,RBRVS,6.39 ,4.78 ,4.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22904,CPT,RAD RESECTION TUMOR SOFT TISSUE ABDL WALL <5CM,,,21,,RBRVS,16.69 ,9.94 ,9.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22905,CPT,RAD RESECTION TUMOR SOFT TISSUE ABDL WALL 5 CM/>,,,21,,RBRVS,21.58 ,11.97 ,11.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
22999,CPT,UNLISTED PX ABDOMEN MUSCULOSKELETAL SYSTEM,,,21,,TotalUnits,,,,11.17 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23000,CPT,REMOVAL SUBDELTOID CALCAREOUS DEPOSITS OPEN,,,21,,RBRVS,4.48 ,5.29 ,11.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23020,CPT,CAPSULAR CONTRACTURE RELEASE,,,21,,RBRVS,9.36 ,8.60 ,8.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23030,CPT,I&D SHOULDER DEEP ABSCESS/HEMATOMA,,,21,,RBRVS,3.47 ,3.17 ,8.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23031,CPT,I&D SHOULDER INFECTED BURSA,,,21,,RBRVS,2.79 ,3.00 ,8.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23035,CPT,INCISION BONE CORTEX SHOULDER AREA,,,21,,RBRVS,9.16 ,8.56 ,8.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23040,CPT,ARTHROTOMY GLENOHUMERAL JT EXPL/DRG/RMVL FB,,,21,,RBRVS,9.75 ,8.97 ,8.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23044,CPT,ARTHRT ACROMCLAV STRNCLAV JT EXPL/DRG/RMVL FB,,,21,,RBRVS,7.59 ,7.27 ,7.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23065,CPT,BIOPSY SOFT TISSUE SHOULDER SUPERFICIAL,,,21,,RBRVS,2.30 ,2.13 ,3.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23066,CPT,BIOPSY SOFT TISSUE SHOULDER DEEP,,,21,,RBRVS,4.30 ,5.03 ,10.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23071,CPT,EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3 CM/>,,,21,,RBRVS,5.91 ,4.82 ,4.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23073,CPT,EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>,,,21,,RBRVS,10.13 ,7.64 ,7.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23075,CPT,EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM,,,21,,RBRVS,4.21 ,4.24 ,8.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23076,CPT,EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM,,,21,,RBRVS,7.41 ,6.47 ,6.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23077,CPT,RAD RESECTION TUMOR SOFT TISSUE SHOULDER <5CM,,,21,,RBRVS,17.66 ,11.40 ,11.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23078,CPT,RAD RESECTION TUMOR SOFT TISSUE SHOULDER 5 CM/>,,,21,,RBRVS,22.55 ,13.89 ,13.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23100,CPT,ARTHROTOMY GLENOHUMERAL JOINT W/BIOPSY,,,21,,RBRVS,6.20 ,6.89 ,6.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23101,CPT,ARTHRT ACROMCLAV/STRNCLAV JT W/BX&/EXC CRTLG,,,21,,RBRVS,5.72 ,5.99 ,5.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23105,CPT,ARTHRT GLENOHUMRL JT W/SYNOVECTOMY W/WO BIOPSY,,,21,,RBRVS,8.48 ,8.14 ,8.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23106,CPT,ARTHRT GLENOHUMRL JT STRNCLAV JT W/SYNVCT W/WOBX,,,21,,RBRVS,6.13 ,6.86 ,6.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23107,CPT,ARTHRT GLENOHMRL JT W/JT EXPL W/WO RMVL LOOSE/FB,,,21,,RBRVS,8.87 ,8.33 ,8.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23120,CPT,CLAVICULECTOMY PARTIAL,,,21,,RBRVS,7.39 ,7.93 ,7.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23125,CPT,CLAVICULECTOMY TOTAL,,,21,,RBRVS,9.64 ,8.78 ,8.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23130,CPT,PARTIAL REPAIR OR REMOVAL OF SHOULDER BONE,,,21,,RBRVS,7.77 ,8.16 ,8.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23140,CPT,EXC/CURTG BONE CYST/BENIGN TUMOR CLAV/SCAPULA,,,21,,RBRVS,7.12 ,6.56 ,6.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23145,CPT,EXC/CURTG BONE CST/B9 TUM CLAV/SCAPULA W/AGRFT,,,21,,RBRVS,9.40 ,8.66 ,8.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23146,CPT,EXC/CURTG BONE CST/B9 TUM CLAV/SCAPULA W/ALGRFT,,,21,,RBRVS,8.08 ,8.11 ,8.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23150,CPT,EXC/CURTG BONE CYST/BENIGN TUMOR PROX HUMERUS,,,21,,RBRVS,8.91 ,8.29 ,8.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23155,CPT,EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/AGRFT,,,21,,RBRVS,10.86 ,9.72 ,9.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23156,CPT,EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/ALGRFT,,,21,,RBRVS,9.11 ,8.51 ,8.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23170,CPT,SEQUESTRECTOMY CLAVICLE,,,21,,RBRVS,7.21 ,7.40 ,7.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23172,CPT,SEQUESTRECTOMY SCAPULA,,,21,,RBRVS,7.31 ,7.45 ,7.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23174,CPT,SEQUESTRECTOMY HUMERAL HEAD SURGERY NECK,,,21,,RBRVS,10.05 ,9.68 ,9.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23180,CPT,PARTIAL EXCISION BONE CLAVICLE,,,21,,RBRVS,8.99 ,8.32 ,8.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23182,CPT,PARTIAL EXCISION BONE SCAPULA,,,21,,RBRVS,8.61 ,8.56 ,8.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23184,CPT,PARTIAL EXCISION BONE PROXIMAL HUMERUS,,,21,,RBRVS,9.90 ,9.24 ,9.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23190,CPT,OSTECTOMY SCAPULA PARTIAL,,,21,,RBRVS,7.47 ,7.42 ,7.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23195,CPT,RESECTION HUMERAL HEAD,,,21,,RBRVS,10.36 ,9.26 ,9.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23200,CPT,RADICAL RESECTION TUMOR CLAVICLE,,,21,,RBRVS,22.71 ,16.39 ,16.39 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
23210,CPT,RADICAL RESECTION TUMOR SCAPULA,,,21,,RBRVS,27.21 ,18.66 ,18.66 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
23220,CPT,RADICAL RESECTION BONE TUMOR PROXIMAL HUMERUS,,,21,,RBRVS,30.21 ,19.99 ,19.99 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
23330,CPT,REMOVAL FOREIGN BODY SHOULDER SUBCUTANEOUS,,,21,,RBRVS,1.90 ,2.10 ,4.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23333,CPT,REMOVAL SHOULDER FOREIGN BODY DEEP SUBFASCIAL/IM,,,21,,RBRVS,6.00 ,5.92 ,5.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23334,CPT,PROSTHESIS REMOVAL HUMERAL/GLENOID COMPONENT,,,21,,RBRVS,15.50 ,12.36 ,12.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23335,CPT,PROSTHESIS REMOVAL HUMERAL AND GLENOID COMPONENT,,,21,,RBRVS,19.00 ,14.08 ,14.08 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
23350,CPT,INJECTION SHOULDER ARTHROGRAPHY/ CT/MRI ARTHG,,,21,,RBRVS,1.00 ,0.38 ,2.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23395,CPT,MUSCLE TRANSFER SHOULDER/UPPER ARM SINGLE,,,21,,RBRVS,18.54 ,14.86 ,14.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23397,CPT,MUSCLE TRANSFER SHOULDER/UPPER ARM MULTIPLE,,,21,,RBRVS,16.76 ,12.70 ,12.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23400,CPT,SCAPULOPEXY,,,21,,RBRVS,13.87 ,11.23 ,11.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23405,CPT,TENOTOMY SHOULDER AREA 1 TENDON,,,21,,RBRVS,8.54 ,7.77 ,7.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23406,CPT,TENOTOMY SHOULDER MULTIPLE THRU SAME INCISION,,,21,,RBRVS,11.01 ,9.02 ,9.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23410,CPT,OPEN REPAIR OF ROTATOR CUFF ACUTE,,,21,,RBRVS,11.39 ,9.98 ,9.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23412,CPT,OPEN REPAIR OF ROTATOR CUFF CHRONIC,,,21,,RBRVS,11.93 ,10.23 ,10.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23415,CPT,CORACOACROMIAL LIGAMENT RELEAS W/WOACROMIOPLASTY,,,21,,RBRVS,9.23 ,8.93 ,8.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23420,CPT,RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC,,,21,,RBRVS,13.54 ,11.64 ,11.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23430,CPT,TENODESIS LONG TENDON BICEPS,,,21,,RBRVS,10.17 ,9.32 ,9.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23440,CPT,RESECTION/TRANSPLANTATION LONG TENDON BICEPS,,,21,,RBRVS,10.64 ,9.01 ,9.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23450,CPT,CAPSULORRHAPHY ANTERIOR PUTTI-PLATT/MAGNUSON,,,21,,RBRVS,13.70 ,10.81 ,10.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23455,CPT,CAPSULORRHAPHY ANTERIOR W/LABRAL REPAIR,,,21,,RBRVS,14.67 ,11.27 ,11.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23460,CPT,CAPSULORRHAPHY ANTERIOR WITH BONE BLOCK,,,21,,RBRVS,15.82 ,12.33 ,12.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23462,CPT,CAPSULORRHAPHY ANTERIOR W/CORACOID PROCESS TR,,,21,,RBRVS,15.72 ,11.72 ,11.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23465,CPT,CAPSULORRHAPHY GLENOHUMERAL JT PST W/WO BONE BLK,,,21,,RBRVS,16.30 ,12.63 ,12.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23466,CPT,CAPSULORRHAPHY GLENOHUMRL JT MULTI-DIRIONAL INS,,,21,,RBRVS,15.80 ,13.27 ,13.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23470,CPT,ARTHROPLASTY GLENOHUMRL JT HEMIARTHROPLASTY,,,21,,RBRVS,17.89 ,13.27 ,13.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23472,CPT,ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER,,,21,,RBRVS,22.13 ,15.60 ,15.60 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
23473,CPT,REVIS SHOULDER ARTHRPLSTY HUMERAL/GLENOID COMPNT,,,21,,RBRVS,25.00 ,17.06 ,17.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23474,CPT,REVIS SHOULDER ARTHRPLSTY HUMERAL&GLENOID COMPNT,,,21,,RBRVS,27.21 ,18.24 ,18.24 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
23480,CPT,OSTEOTOMY CLAVICLE W/WO INTERNAL FIXATION,,,21,,RBRVS,11.54 ,9.72 ,9.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23485,CPT,OSTEOTOMY CLAV W/WO INT FIXJ W/BONE GRF NON/MAL,,,21,,RBRVS,13.91 ,10.77 ,10.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23490,CPT,PROPH TX W/WO METHYLMETHACRYLATE CLAVICLE,,,21,,RBRVS,12.16 ,10.16 ,10.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23491,CPT,PROPH TX W/WO METHYLMETHACRYLATE PROX HUMERUS,,,21,,RBRVS,14.54 ,11.62 ,11.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23500,CPT,CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION,,,21,,RBRVS,2.21 ,3.71 ,3.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23505,CPT,CLSD TX CLAVICULAR FRACTURE W/MANIPULATION,,,21,,RBRVS,3.83 ,4.93 ,5.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23515,CPT,OPEN TX CLAVICULAR FRACTURE INTERNAL FIXATION,,,21,,RBRVS,9.69 ,9.09 ,9.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23520,CPT,CLSD TX STERNOCLAVICULAR DISLC W/O MANIPULATION,,,21,,RBRVS,2.29 ,3.93 ,3.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23525,CPT,CLOSED TX STERNOCLAVICULAR DISLC W/MANIPULATION,,,21,,RBRVS,3.79 ,5.60 ,6.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23530,CPT,OPEN TX STERNOCLAVICULAR DISLC ACUTE/CHRONIC,,,21,,RBRVS,7.48 ,7.43 ,7.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23532,CPT,OPTX STRNCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF,,,21,,RBRVS,8.20 ,8.05 ,8.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23540,CPT,CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION,,,21,,RBRVS,2.36 ,3.74 ,3.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23545,CPT,CLSD TX ACROMIOCLAVICULAR DISLC W/MANIPULATION,,,21,,RBRVS,3.43 ,4.80 ,5.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23550,CPT,OPEN TX ACROMIOCLAVICULAR DISLC ACUTE/CHRONIC,,,21,,RBRVS,7.59 ,7.24 ,7.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23552,CPT,OPTX ACROMCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF,,,21,,RBRVS,8.82 ,8.24 ,8.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23570,CPT,CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION,,,21,,RBRVS,2.36 ,4.00 ,3.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23575,CPT,CLTX SCAPULAR FX W/MANJ W/WO SKELETAL TRACTION,,,21,,RBRVS,4.23 ,5.64 ,6.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23585,CPT,OPEN TX SCAPULAR FX W/INTERNAL FIXATION IF PFRMD,,,21,,RBRVS,14.23 ,11.19 ,11.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23600,CPT,CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION,,,21,,RBRVS,3.00 ,5.19 ,5.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23605,CPT,CLTX PROX HUMRL FX W/MANJ W/WO SKELETAL TRACJ,,,21,,RBRVS,5.06 ,6.10 ,7.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23615,CPT,OPEN TREATMENT PROXIMAL HUMERAL FRACTURE,,,21,,RBRVS,12.30 ,10.71 ,10.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23616,CPT,OPEN PROX HUMERAL FRACTURE PROSTHETIC RPLCMT,,,21,,RBRVS,18.37 ,13.78 ,13.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23620,CPT,CLTX GREATER HUMERAL TUBEROSITY FX W/O MANJ,,,21,,RBRVS,2.55 ,4.28 ,4.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23625,CPT,CLTX GRTER HUMERAL TUBEROSITY FX W/MANIPULATION,,,21,,RBRVS,4.10 ,5.21 ,5.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23630,CPT,OPEN TREATMENT GRTER HUMERAL TUBEROSITY FRACTURE,,,21,,RBRVS,10.57 ,9.81 ,9.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23650,CPT,CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES,,,21,,RBRVS,3.53 ,4.10 ,4.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23655,CPT,CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES,,,21,,RBRVS,4.76 ,5.79 ,5.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23660,CPT,OPEN TX ACUTE SHOULDER DISLOCATION,,,21,,RBRVS,7.66 ,7.49 ,7.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23665,CPT,CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MANJ,,,21,,RBRVS,4.66 ,5.74 ,6.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23670,CPT,OPEN TX SHOULDER DISLC W/HUMERAL TUBEROSITY FX,,,21,,RBRVS,12.28 ,10.52 ,10.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23675,CPT,CLTX SHOULDER DISLC W/SURG/ANTMCL NECK FX W/MANJ,,,21,,RBRVS,6.27 ,6.89 ,8.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23680,CPT,OPEN TX SHOULDER DISLOCATION W/NECK FRACTURE,,,21,,RBRVS,13.15 ,10.96 ,10.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23700,CPT,MANJ W/ANES SHOULDER JOINT W/FIXATION APPARATUS,,,21,,RBRVS,2.57 ,2.57 ,2.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23800,CPT,ARTHRODESIS GLENOHUMERAL JOINT,,,21,,RBRVS,14.73 ,11.78 ,11.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23802,CPT,ARTHRODESIS GLENOHUMERAL JT W/AUTOGENOUS GRAFT,,,21,,RBRVS,18.42 ,14.82 ,14.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23900,CPT,INTERTHORACOSCAPULAR AMPUTATION,,,21,,RBRVS,20.72 ,15.08 ,15.08 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
23920,CPT,DISARTICULATION SHOULDER,,,21,,RBRVS,16.23 ,12.93 ,12.93 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
23921,CPT,DISRTCJ SHOULDER SECONDARY CLSR/SCAR REVISION,,,21,,RBRVS,5.72 ,6.51 ,6.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23929,CPT,UNLISTED PROCEDURE SHOULDER,,,21,,TotalUnits,,,,16.31 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23930,CPT,I&D UPPER ARM/ELBOW DEEP ABSCESS/HEMATOMA,,,21,,RBRVS,2.99 ,2.57 ,6.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23931,CPT,INCISION&DRAINAGE UPPER ARM/ELBOW BURSA,,,21,,RBRVS,1.84 ,2.41 ,5.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
23935,CPT,INC DEEP W/OPENING BONE CORTEX HUMERUS/ELBOW,,,21,,RBRVS,6.38 ,6.88 ,6.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24000,CPT,ARTHRT ELBOW W/EXPLORATION DRAINAGE/REMOVAL FB,,,21,,RBRVS,6.08 ,6.43 ,6.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24006,CPT,ARTHRT ELBOW CAPSULAR EXCISION CAPSULAR RLS SPX,,,21,,RBRVS,9.74 ,8.88 ,8.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24065,CPT,BIOPSY SOFT TISSUE UPPER ARM/ELBOW SUPERFICIAL,,,21,,RBRVS,2.13 ,2.35 ,4.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24066,CPT,BIOPSY SOFT TISSUE UPPER ARM/ELBOW AREA DEEP,,,21,,RBRVS,5.35 ,5.40 ,11.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24071,CPT,EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>,,,21,,RBRVS,5.70 ,4.69 ,4.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24073,CPT,EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>,,,21,,RBRVS,10.13 ,7.73 ,7.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24075,CPT,EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM,,,21,,RBRVS,4.24 ,4.31 ,8.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24076,CPT,EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM,,,21,,RBRVS,7.41 ,6.59 ,6.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24077,CPT,RAD RESECT TUMOR SOFT TISS UPPER ARM/ELBOW <5CM,,,21,,RBRVS,15.72 ,10.66 ,10.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24079,CPT,RAD RESECT TUMOR SOFT TISS UPPER ARM/ELBOW 5CM/>,,,21,,RBRVS,20.61 ,13.24 ,13.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24100,CPT,ARTHROTOMY ELBOW W/SYNOVIAL BIOPSY ONLY,,,21,,RBRVS,5.07 ,5.87 ,5.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24101,CPT,ARTHRT ELBOW W/JNT EXPL W/WOBX W/WORMVL LOOSE/FB,,,21,,RBRVS,6.30 ,6.82 ,6.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24102,CPT,ARTHROTOMY ELBOW W/SYNOVECTOMY,,,21,,RBRVS,8.26 ,7.81 ,7.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24105,CPT,EXCISION OLECRANON BURSA,,,21,,RBRVS,3.78 ,5.48 ,5.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24110,CPT,EXCISION/CURTG BONE CYST/BENIGN TUMOR HUMERUS,,,21,,RBRVS,7.58 ,7.74 ,7.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24115,CPT,EXC/CURTG BONE CYST/BENIGN TUMOR HUMERUS W/AGRFT,,,21,,RBRVS,10.12 ,9.02 ,9.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24116,CPT,EXC/CURTG BONE CYST/BENIGN TUM HUMERUS W/ALGRFT,,,21,,RBRVS,12.23 ,10.07 ,10.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24120,CPT,EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN,,,21,,RBRVS,6.82 ,7.01 ,7.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24125,CPT,EXC/CURTG BONE CST/B9 TUM H/N RDS/OLECRN W/AGRFT,,,21,,RBRVS,8.14 ,8.02 ,8.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24126,CPT,EXC/CURTG BONE CST/B9 TUM H/N RDS/OLECRN W/ALGRT,,,21,,RBRVS,8.62 ,8.26 ,8.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24130,CPT,EXCISION RADIAL HEAD,,,21,,RBRVS,6.42 ,6.86 ,6.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24134,CPT,SEQUESTRECTOMY SHAFT/DISTAL HUMERUS,,,21,,RBRVS,10.22 ,9.19 ,9.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24136,CPT,SEQUESTRECTOMY RADIAL HEAD OR NECK,,,21,,RBRVS,8.40 ,6.24 ,6.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24138,CPT,SEQUESTRECTOMY OLECRANON PROCESS,,,21,,RBRVS,8.50 ,9.15 ,9.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24140,CPT,PARTIAL EXCISION BONE HUMERUS,,,21,,RBRVS,9.55 ,8.77 ,8.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24145,CPT,PARTIAL EXCISION BONE RADIAL HEAD/NECK,,,21,,RBRVS,7.81 ,7.59 ,7.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24147,CPT,PARTIAL EXCISION BONE OLECRANON PROCESS,,,21,,RBRVS,7.84 ,8.48 ,8.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24149,CPT,RAD RESCJ CAPSL TISS&HTRTPC BONE ELBW CONTRCT,,,21,,RBRVS,16.22 ,14.48 ,14.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24150,CPT,RADICAL RESECTION TUMOR SHAFT/DISTAL HUMERUS,,,21,,RBRVS,23.46 ,16.66 ,16.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24152,CPT,RADICAL RESECTION TUMOR RADIAL HEAD/NECK,,,21,,RBRVS,19.99 ,14.92 ,14.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24155,CPT,RESECTION ELBOW JOINT ARTHRECTOMY,,,21,,RBRVS,12.09 ,9.99 ,9.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24160,CPT,PROSTHESIS REMOVAL HUMERAL AND ULNAR COMPONENTS,,,21,,RBRVS,18.63 ,14.11 ,14.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24164,CPT,PROSTHESIS REMOVAL RADIAL HEAD,,,21,,RBRVS,10.00 ,8.97 ,8.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24200,CPT,RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS,,,21,,RBRVS,1.81 ,1.91 ,3.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24201,CPT,REMOVAL FOREIGN BODY UPPER ARM/ELBOW DEEP,,,21,,RBRVS,4.70 ,4.84 ,10.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24220,CPT,INJECTION ELBOW ARTHROGRAPHY,,,21,,RBRVS,1.31 ,0.54 ,3.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24300,CPT,MANIPULATION ELBOW UNDER ANESTHESIA,,,21,,RBRVS,4.04 ,7.15 ,7.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24301,CPT,MUSCLE/TENDON TRANSFER UPPER ARM/ELBOW SINGLE,,,21,,RBRVS,10.38 ,9.16 ,9.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24305,CPT,TENDON LENGTHENING UPPER ARM/ELBOW EA TENDON,,,21,,RBRVS,7.62 ,7.53 ,7.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24310,CPT,TENOTOMY OPEN ELBOW TO SHOULDER EACH TENDON,,,21,,RBRVS,6.12 ,6.33 ,6.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24320,CPT,TENOPLASTY ELBOW TO SHOULDER SINGLE,,,21,,RBRVS,10.86 ,9.37 ,9.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24330,CPT,FLEXOR-PLASTY ELBOW,,,21,,RBRVS,9.79 ,8.85 ,8.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24331,CPT,FLEXOR-PLASTY ELBOW W/EXTENSOR ADVANCEMENT,,,21,,RBRVS,10.95 ,9.42 ,9.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24332,CPT,TENOLYSIS TRICEPS,,,21,,RBRVS,7.91 ,8.07 ,8.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24340,CPT,TENODESIS BICEPS TENDON ELBOW SEPARATE PROCEDURE,,,21,,RBRVS,8.08 ,7.91 ,7.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24341,CPT,REPAIR TENDON/MUSCLE UPPER ARM/ELBOW EA,,,21,,RBRVS,9.49 ,10.07 ,10.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24342,CPT,RINSJ RPTD BICEPS/TRICEPS TDN DSTL W/WO TDN GRF,,,21,,RBRVS,10.86 ,9.35 ,9.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24343,CPT,REPAIR LATERAL COLLATERAL LIGAMENT ELBOW,,,21,,RBRVS,9.16 ,9.35 ,9.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24344,CPT,RCNSTJ LAT COLTRL LIGM ELBOW W/TENDON GRAFT,,,21,,RBRVS,15.21 ,13.29 ,13.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24345,CPT,REPAIR MEDIAL COLLATERAL LIGAMENT ELBOW,,,21,,RBRVS,9.16 ,9.31 ,9.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24346,CPT,RCNSTJ MEDIAL COLTRL LIGM ELBW W/TDN GRF,,,21,,RBRVS,15.21 ,13.29 ,13.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24357,CPT,TENOTOMY ELBOW LATERAL/MEDIAL PERCUTANEOUS,,,21,,RBRVS,5.44 ,6.01 ,6.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24358,CPT,TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN,,,21,,RBRVS,6.66 ,7.07 ,7.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24359,CPT,TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR,,,21,,RBRVS,8.98 ,8.25 ,8.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24360,CPT,ARTHROPLASTY ELBOW W/MEMBRANE,,,21,,RBRVS,12.67 ,10.62 ,10.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24361,CPT,ARTHROPLASTY ELBOW W/DISTAL HUMRL PROSTC RPLCMT,,,21,,RBRVS,14.41 ,11.60 ,11.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24362,CPT,ARTHRP ELBOW W/IMPLT&FSCA LATA LIGAMENT RCNSTJ,,,21,,RBRVS,15.32 ,12.06 ,12.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24363,CPT,ARTHRP ELBOW W/DISTAL HUM&PROX UR PROSTC RPLCM,,,21,,RBRVS,22.00 ,15.78 ,15.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24365,CPT,ARTHROPLASTY RADIAL HEAD,,,21,,RBRVS,8.62 ,7.99 ,7.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24366,CPT,ARTHROPLASTY RADIAL HEAD W/IMPLANT,,,21,,RBRVS,9.36 ,8.39 ,8.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24370,CPT,REVIS ELBOW ARTHRPLSTY HUMERAL/ULNA COMPNT,,,21,,RBRVS,23.55 ,16.70 ,16.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24371,CPT,REVIS ELBOW ARTHRPLSTY HUMERAL&ULNA COMPNT,,,21,,RBRVS,27.50 ,18.62 ,18.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24400,CPT,OSTEOTOMY HUMERUS W/WO INTERNAL FIXATION,,,21,,RBRVS,11.33 ,9.94 ,9.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24410,CPT,MLT OSTEOT W/RELIGNMT IMED ROD HUMERAL SHAFT,,,21,,RBRVS,15.11 ,12.23 ,12.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24420,CPT,OSTEOPLASTY HUMERUS,,,21,,RBRVS,13.73 ,12.03 ,12.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24430,CPT,REPAIR NON/MALUNION HUMERUS W/O GRAFT,,,21,,RBRVS,15.25 ,12.19 ,12.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24435,CPT,REPAIR NON/MALUNION HUMERUS W/ILIAC/OTH AGRFT,,,21,,RBRVS,14.99 ,13.09 ,13.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24470,CPT,HEMIEPIPHYSEAL ARREST,,,21,,RBRVS,8.93 ,8.53 ,8.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24495,CPT,DECOMPRESSION FASCT F/ARM W/BRACH ART EXPL,,,21,,RBRVS,8.41 ,5.05 ,5.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24498,CPT,PROPH TX W/WO METHYLMETHACRYLATE HUMERAL SHAFT,,,21,,RBRVS,12.28 ,10.17 ,10.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24500,CPT,CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION,,,21,,RBRVS,3.41 ,5.25 ,6.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24505,CPT,CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ,,,21,,RBRVS,5.39 ,6.47 ,7.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24515,CPT,OPTX HUMERAL SHFT FX W/PLATE/SCREWS W/WOCERCLAGE,,,21,,RBRVS,12.12 ,10.67 ,10.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24516,CPT,TX HUMRAL SHAFT FX W/INSJ IMED IMPLT W/W CERCLGE,,,21,,RBRVS,12.19 ,10.12 ,10.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24530,CPT,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/WO MANJ,,,21,,RBRVS,3.69 ,5.42 ,6.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24535,CPT,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MANJ,,,21,,RBRVS,7.11 ,7.70 ,9.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24538,CPT,PRQ SKEL FIXJ SPRCNDYLR/TRANSCNDYLR HUMERAL FX,,,21,,RBRVS,9.77 ,9.59 ,9.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24545,CPT,OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/O XTN,,,21,,RBRVS,13.15 ,10.99 ,10.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24546,CPT,OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/XTN,,,21,,RBRVS,14.91 ,12.06 ,12.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24560,CPT,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ,,,21,,RBRVS,2.98 ,4.66 ,5.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24565,CPT,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/MANJ,,,21,,RBRVS,5.78 ,7.03 ,8.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24566,CPT,PRQ SKEL FIXJ HUMRL EPCNDYLR FX MEDIAL/LAT MANJ,,,21,,RBRVS,9.06 ,9.67 ,9.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24575,CPT,OPEN TX HUMERAL EPICONDYLAR FRACTURE,,,21,,RBRVS,9.71 ,9.44 ,9.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24576,CPT,CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ,,,21,,RBRVS,3.06 ,5.10 ,6.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24577,CPT,CLTX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/MANJ,,,21,,RBRVS,6.01 ,7.15 ,8.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24579,CPT,OPEN TREATMENT HUMERAL CONDYLAR FRACTURE,,,21,,RBRVS,11.44 ,10.33 ,10.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24582,CPT,PRQ SKEL FIXJ HUMRL CNDYLR FX MEDIAL/LAT W/MANJ,,,21,,RBRVS,10.14 ,10.99 ,10.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24586,CPT,OPTX PERIARTICULAR FRACTURE &/DISLOCATION ELBO,,,21,,RBRVS,15.78 ,12.34 ,12.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24587,CPT,OPTX PRIARTICULAR FX&/DISLC ELBW W/IMPLT ARTHR,,,21,,RBRVS,15.79 ,12.31 ,12.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24600,CPT,TREATMENT CLOSED ELBOW DISLOCATION W/O ANES,,,21,,RBRVS,4.37 ,4.40 ,5.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24605,CPT,TREATMENT CLOSED ELBOW DISLOCATION REQ ANES,,,21,,RBRVS,5.64 ,6.70 ,6.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24615,CPT,OPEN TX ACUTE/CHRONIC ELBOW DISLOCATION,,,21,,RBRVS,9.83 ,8.67 ,8.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24620,CPT,CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MANJ,,,21,,RBRVS,7.22 ,7.07 ,7.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24635,CPT,OPEN TX MONTEGGIA FRACTURE DISLOCATION ELBOW,,,21,,RBRVS,8.80 ,8.80 ,8.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24640,CPT,CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MANJ,,,21,,RBRVS,1.25 ,1.23 ,2.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24650,CPT,CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION,,,21,,RBRVS,2.31 ,4.10 ,4.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24655,CPT,CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION,,,21,,RBRVS,4.62 ,5.83 ,6.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24665,CPT,OPEN TX RADIAL HEAD/NECK FRACTURE,,,21,,RBRVS,8.36 ,8.72 ,8.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24666,CPT,OPEN TX RADIAL HEAD/NECK FRACTURE PROSTHETIC,,,21,,RBRVS,9.86 ,9.29 ,9.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24670,CPT,CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MANJ,,,21,,RBRVS,2.69 ,4.29 ,5.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24675,CPT,CLOSED TX ULNAR FRACTURE PROXIMAL END W/MANJ,,,21,,RBRVS,4.91 ,6.03 ,7.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24685,CPT,OPEN TREATMENT ULNAR FRACTURE PROXIMAL END,,,21,,RBRVS,8.37 ,8.76 ,8.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24800,CPT,ARTHRODESIS ELBOW JOINT LOCAL,,,21,,RBRVS,11.41 ,10.10 ,10.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24802,CPT,ARTHRODESIS ELBOW JOINT W/AUTOGENOUS GRAFT,,,21,,RBRVS,14.32 ,11.57 ,11.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24900,CPT,AMPUTATION ARM THRU HUMERUS W/PRIMARY CLOSURE,,,21,,RBRVS,10.18 ,8.54 ,8.54 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
24920,CPT,AMPUTATION ARM THRU HUMERUS OPEN CIRCULAR,,,21,,RBRVS,10.13 ,8.87 ,8.87 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
24925,CPT,AMP ARM THRU HUMERUS SECONDARY CLSR/SCAR REVJ,,,21,,RBRVS,7.30 ,5.84 ,5.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24930,CPT,AMPUTATION ARM THRU HUMERUS RE-AMPUTATION,,,21,,RBRVS,10.83 ,9.23 ,9.23 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
24931,CPT,AMPUTATION ARM THRU HUMERUS W/IMPLANT,,,21,,RBRVS,13.44 ,7.74 ,7.74 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
24935,CPT,STUMP ELONGATION UPPER EXTREMITY,,,21,,RBRVS,16.45 ,5.72 ,5.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
24940,CPT,CINEPLASTY UPPER EXTREMITY COMPLETE PROCEDURE,,,21,,RBRVS,14.69 ,12.46 ,12.46 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
24999,CPT,UNLISTED PROCEDURE HUMERUS/ELBOW,,,21,,TotalUnits,,,,14.00 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25000,CPT,INCISION EXTENSOR TENDON SHEATH WRIST,,,21,,RBRVS,3.55 ,5.38 ,5.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25001,CPT,INCISION FLEXOR TENDON SHEATH WRIST,,,21,,RBRVS,3.79 ,5.34 ,5.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25020,CPT,DCMPRN FASCT F/ARM&WRST FLXR/XTNSR W/O DBRDMT,,,21,,RBRVS,6.06 ,9.19 ,9.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25023,CPT,DCMPRN FASCT F/ARM&/WRST FLXR/XTNSR W/DBRDMT,,,21,,RBRVS,13.83 ,15.09 ,15.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25024,CPT,DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR W/O DB,,,21,,RBRVS,10.79 ,9.42 ,9.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25025,CPT,DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR DBRDMT,,,21,,RBRVS,17.94 ,13.73 ,13.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25028,CPT,I&D FOREARM&/WRIST DEEP ABSCESS/HEMATOMA,,,21,,RBRVS,5.39 ,8.49 ,8.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25031,CPT,INCISION & DRAINAGE FOREARM&/WRIST BURSA,,,21,,RBRVS,4.26 ,5.31 ,5.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25035,CPT,INCISION DEEP BONE CORTEX FOREARM&/WRIST,,,21,,RBRVS,7.65 ,7.59 ,7.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25040,CPT,ARTHRT RDCRPL/MIDCARPL JT W/EXPL DRG/RMVL FB,,,21,,RBRVS,7.50 ,7.24 ,7.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25065,CPT,BIOPSY SOFT TISSUE FOREARM&/WRIST SUPERFICIAL,,,21,,RBRVS,2.04 ,2.35 ,4.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25066,CPT,BIOPSY SOFT TISSUE FOREARM&/WRIST DEEP,,,21,,RBRVS,4.27 ,5.19 ,5.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25071,CPT,EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3CM/>,,,21,,RBRVS,5.91 ,5.05 ,5.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25073,CPT,EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>,,,21,,RBRVS,7.13 ,6.73 ,6.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25075,CPT,EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM,,,21,,RBRVS,3.96 ,4.28 ,8.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25076,CPT,EXC TUMOR SOFT TISS FOREARM&/WRIST SUBFASC <3CM,,,21,,RBRVS,6.74 ,6.74 ,6.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25077,CPT,RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM,,,21,,RBRVS,12.93 ,9.84 ,9.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25078,CPT,RAD RESCJ TUM SOFT TISSUE FOREARM&/WRIST 3 CM/>,,,21,,RBRVS,17.69 ,12.15 ,12.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25085,CPT,CAPSULOTOMY WRIST,,,21,,RBRVS,5.64 ,6.12 ,6.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25100,CPT,ARTHROTOMY WRIST JOINT WITH BIOPSY,,,21,,RBRVS,4.02 ,5.06 ,5.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25101,CPT,ARTHRT WRST W/JT EXPL W/WO BX W/WO RMVL LOOSE/FB,,,21,,RBRVS,4.83 ,5.80 ,5.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25105,CPT,ARTHROTOMY WRIST JOINT WITH SYNOVECTOMY,,,21,,RBRVS,6.02 ,6.67 ,6.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25107,CPT,ARTHROTOMY DSTL RADIOULNAR JOINT RPR CARTILAGE,,,21,,RBRVS,7.70 ,8.54 ,8.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25109,CPT,EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA,,,21,,RBRVS,6.94 ,7.22 ,7.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25110,CPT,EXCISION LESION TENDON SHEATH FOREARM&/WRIST,,,21,,RBRVS,4.04 ,4.92 ,4.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25111,CPT,EXCISION GANGLION WRIST DORSAL/VOLAR PRIMARY,,,21,,RBRVS,3.53 ,4.93 ,4.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25112,CPT,EXCISION GANGLION WRIST DORSAL/VOLAR RECURRENT,,,21,,RBRVS,4.67 ,5.46 ,5.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25115,CPT,RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS FLXRS,,,21,,RBRVS,10.09 ,9.79 ,9.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25116,CPT,RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS XTNSRS,,,21,,RBRVS,7.56 ,8.23 ,8.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25118,CPT,SYNOVECTOMY EXTENSOR TENDON SHTH WRIST 1 CMPRT,,,21,,RBRVS,4.51 ,5.54 ,5.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25119,CPT,SYNVCT XTNSR TDN SHTH WRST 1 RESCJ DSTL ULNA,,,21,,RBRVS,6.21 ,6.79 ,6.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25120,CPT,EXCISION/CURETTAGE CYST/TUMOR RADIUS/ULNA,,,21,,RBRVS,6.27 ,6.77 ,6.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25125,CPT,EXC/CURTG CYST/TUMOR RADIUS/ULNA W/AUTOGRAFT,,,21,,RBRVS,7.67 ,7.93 ,7.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25126,CPT,EXC/CURTG CYST/TUMOR RADIUS/ULNA W/ALLOGRAFT,,,21,,RBRVS,7.74 ,7.82 ,7.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25130,CPT,EXCISION/CURETTAGE CYST/TUMOR CARPAL BONES,,,21,,RBRVS,5.43 ,6.34 ,6.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25135,CPT,EXC/CURTG CYST/TUMOR CARPAL BONES W/AUTOGRAFT,,,21,,RBRVS,7.08 ,7.48 ,7.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25136,CPT,EXC/CURTG CYST/TUMOR CARPAL BONES W/ALLOGRAFT,,,21,,RBRVS,6.14 ,6.74 ,6.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25145,CPT,SEQUESTRECTOMY FOREARM &/WRIST,,,21,,RBRVS,6.54 ,6.95 ,6.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25150,CPT,PARTIAL EXCISION BONE ULNA,,,21,,RBRVS,7.38 ,7.38 ,7.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25151,CPT,PARTIAL EXCISION BONE RADIUS,,,21,,RBRVS,7.68 ,7.59 ,7.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25170,CPT,RADICAL RESECTION TUMOR RADIUS OR ULNA,,,21,,RBRVS,22.21 ,15.91 ,15.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25210,CPT,CARPECTOMY 1 BONE,,,21,,RBRVS,6.12 ,6.73 ,6.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25215,CPT,CARPECTOMY ALL BONES PROXIMAL ROW,,,21,,RBRVS,8.14 ,8.07 ,8.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25230,CPT,RADICAL STYLOIDECTOMY SEPARATE PROCEDURE,,,21,,RBRVS,5.37 ,6.01 ,6.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25240,CPT,EXCISION DISTAL ULNA PARTIAL/COMPLETE,,,21,,RBRVS,5.31 ,5.98 ,5.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25246,CPT,INJECTION WRIST ARTHROGRAPHY,,,21,,RBRVS,1.45 ,0.58 ,3.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25248,CPT,EXPL W/REMOVAL DEEP FOREIGN BODY FOREARM/WRIST,,,21,,RBRVS,5.31 ,5.45 ,5.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25250,CPT,REMOVAL WRIST PROSTHESIS SEPARATE PROCEDURE,,,21,,RBRVS,6.77 ,7.05 ,7.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25251,CPT,REMOVAL WRIST PROSTH COMPLICATED W/TOTAL WRIST,,,21,,RBRVS,9.82 ,8.85 ,8.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25259,CPT,MANIPULATION WRIST UNDER ANESTHESIA,,,21,,RBRVS,4.04 ,7.12 ,7.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25260,CPT,RPR TDN/MUSC FLXR F/ARM&/WRST PRIM 1 EA TDN/MU,,,21,,RBRVS,8.04 ,8.52 ,8.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25263,CPT,RPR TDN/MUSC FLXR F/ARM&/WRIST SEC 1 EA TDN/MUS,,,21,,RBRVS,8.04 ,8.31 ,8.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25265,CPT,RPR TDN/MUSC FLXR F/ARM&/WRISTSEC FR GRF EA,,,21,,RBRVS,10.10 ,9.35 ,9.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25270,CPT,RPR TDN/MUSC XTNSR F/ARM&/WRIST PRIM 1 EA TDN,,,21,,RBRVS,6.17 ,6.73 ,6.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25272,CPT,RPR TDN/MUSC XTNSR F/ARM&/WRIST SEC 1 EA TDN/MU,,,21,,RBRVS,7.21 ,7.21 ,7.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25274,CPT,RPR TDN/MUSC XTNSR F/ARM&/WRST SEC FR GRF EA TDN,,,21,,RBRVS,8.94 ,8.50 ,8.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25275,CPT,RPR TENDON SHEATH EXTENSOR F/ARM&/WRIST W/GRAFT,,,21,,RBRVS,8.96 ,8.63 ,8.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25280,CPT,LNGTH/SHRT FLXR/XTNSR TDN F/ARM&/WRIST 1 EA TDN,,,21,,RBRVS,7.39 ,7.42 ,7.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25290,CPT,TNOT FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA,,,21,,RBRVS,5.43 ,6.05 ,6.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25295,CPT,TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA,,,21,,RBRVS,6.72 ,7.00 ,7.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25300,CPT,TENODESIS WRIST FLEXORS FINGERS,,,21,,RBRVS,9.02 ,8.80 ,8.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25301,CPT,TENODESIS WRIST EXTENSORS FINGERS,,,21,,RBRVS,8.59 ,8.24 ,8.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25310,CPT,TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1 EA TDN,,,21,,RBRVS,8.08 ,8.19 ,8.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25312,CPT,TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1/TDN GR,,,21,,RBRVS,9.82 ,8.95 ,8.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25315,CPT,FLEXOR ORIGIN SLIDE FOREARM &/WRIST,,,21,,RBRVS,10.68 ,9.30 ,9.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25316,CPT,FLEXOR ORIGIN SLIDE F/ARM&/WRST TENDON TRANSFE,,,21,,RBRVS,12.90 ,10.73 ,10.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25320,CPT,CAPSL-RHPHY/RCNSTJ WRST OPN CARPL INS,,,21,,RBRVS,12.75 ,13.17 ,13.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25332,CPT,ARTHRP WRST W/WO INTERPOS W/WO XTRNL/INT FIXJ,,,21,,RBRVS,11.74 ,10.24 ,10.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25335,CPT,CENTRALIZATION WRST ULNA,,,21,,RBRVS,13.39 ,10.98 ,10.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25337,CPT,RCNSTJ STABLJ DSTL U/DSTL JT 2 SOFT TISS STABLJ,,,21,,RBRVS,11.73 ,11.59 ,11.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25350,CPT,OSTEOTOMY RADIUS DISTAL THIRD,,,21,,RBRVS,9.09 ,8.58 ,8.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25355,CPT,OSTEOTOMY RADIUS MIDDLE/PROXIMAL THIRD,,,21,,RBRVS,10.53 ,9.35 ,9.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25360,CPT,OSTEOTOMY ULNA,,,21,,RBRVS,8.74 ,8.35 ,8.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25365,CPT,OSTEOTOMY RADIUS & ULNA,,,21,,RBRVS,12.91 ,10.75 ,10.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25370,CPT,MLT OSTEOTOMIES W/RELIGNMT IMED ROD RADIUS/ULNA,,,21,,RBRVS,14.10 ,11.95 ,11.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25375,CPT,MLT OSTEOTOMIES W/RELIGNMT IMED ROD RADIUS&ULNA,,,21,,RBRVS,13.55 ,11.07 ,11.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25390,CPT,OSTEOPLASTY RADIUS/ULNA SHORTENING,,,21,,RBRVS,10.70 ,9.42 ,9.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25391,CPT,OSTEOPLASTY RADIUS/ULNA LENGTHENING W/AUTOGRAFT,,,21,,RBRVS,14.28 ,11.44 ,11.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25392,CPT,OSTEOPLASTY RADIUS & ULNA SHORTENING,,,21,,RBRVS,14.58 ,12.10 ,12.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25393,CPT,OSTEOPLASTY RADIUS&ULNA LENGTHENING W/AUTOGRAF,,,21,,RBRVS,16.56 ,13.21 ,13.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25394,CPT,OSTEOPLASTY CARPAL BONE SHORTENING,,,21,,RBRVS,10.85 ,9.77 ,9.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25400,CPT,RPR NONUNION/MALUNION RADIUS/ULNA W/O AUTOGRAFT,,,21,,RBRVS,11.28 ,9.65 ,9.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25405,CPT,RPR NONUNION/MALUNION RADIUS/ULNA W/AUTOGRAFT,,,21,,RBRVS,15.01 ,11.89 ,11.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25415,CPT,RPR NONUNION/MALUNION RADIUS&ULNA W/O AUTOGRAF,,,21,,RBRVS,13.80 ,11.20 ,11.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25420,CPT,RPR NONUNION/MALUNION RADIUS&ULNA W/AUTOGRAFT,,,21,,RBRVS,17.04 ,13.10 ,13.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25425,CPT,REPAIR DEFECT W/AUTOGRAFT RADIUS/ULNA,,,21,,RBRVS,13.72 ,11.16 ,11.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25426,CPT,REPAIR DEFECT W/AUTOGRAFT RADIUS&ULNA,,,21,,RBRVS,16.45 ,12.54 ,12.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25430,CPT,INSERTION VASCULAR PEDICLE CARPAL BONE,,,21,,RBRVS,9.71 ,9.32 ,9.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25431,CPT,REPAIR NONUNION CARPAL BONE EACH BONE,,,21,,RBRVS,10.89 ,9.87 ,9.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25440,CPT,RPR NONUNION SCAPHOID CARPAL BNE W/WO RDL STYLEC,,,21,,RBRVS,10.68 ,9.41 ,9.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25441,CPT,ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL RADIUS,,,21,,RBRVS,13.29 ,11.36 ,11.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25442,CPT,ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL ULNA,,,21,,RBRVS,11.12 ,9.99 ,9.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25443,CPT,ARTHROPLASTY W/PROSTHETIC RPLCMT SCAPHOID CARPAL,,,21,,RBRVS,10.66 ,9.60 ,9.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25444,CPT,ARTHROPLASTY W/PROSTHETIC REPLACEMENT LUNATE,,,21,,RBRVS,11.42 ,9.98 ,9.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25445,CPT,ARTHROPLASTY W/PROSTHETIC REPLACEMENT TRAPEZIUM,,,21,,RBRVS,9.88 ,8.93 ,8.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25446,CPT,ARTHRP W/PROSTC RPLCMT DSTL RDS&PRTL/CARPUS,,,21,,RBRVS,17.30 ,13.20 ,13.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25447,CPT,ARTHRP INTERPOS INTERCARPAL/METACARPAL JOINTS,,,21,,RBRVS,11.14 ,10.55 ,10.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25449,CPT,REVJ ARTHRP W/REMOVAL IMPLANT WRIST JOINT,,,21,,RBRVS,14.94 ,12.01 ,12.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25450,CPT,EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS/U,,,21,,RBRVS,8.06 ,5.68 ,5.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25455,CPT,EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS&ULNA,,,21,,RBRVS,9.71 ,6.54 ,6.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25490,CPT,PROPH TX N/P/PLTWR W/WO METHYLACRYLATE RADIUS,,,21,,RBRVS,9.73 ,7.32 ,7.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25491,CPT,PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE ULNA,,,21,,RBRVS,10.15 ,9.04 ,9.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25492,CPT,PROPH TX N/P/PLTWR W/WO METHYLMECRYLATE RAD&UL,,,21,,RBRVS,12.66 ,10.73 ,10.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25500,CPT,CLOSED TX RADIAL SHAFT FRACTURE W/O MANIPULATION,,,21,,RBRVS,2.60 ,4.06 ,4.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25505,CPT,CLOSED TX RADIAL SHAFT FRACTURE W/MANIPULATION,,,21,,RBRVS,5.45 ,6.70 ,7.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25515,CPT,OPEN TREATMENT RADIAL SHAFT FRACTURE,,,21,,RBRVS,8.80 ,8.70 ,8.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25520,CPT,CLTX RDL SHFT FX&CLTX DISLC DSTL RAD/ULN JT,,,21,,RBRVS,6.50 ,7.58 ,8.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25525,CPT,OPEN RDL SHAFT FX CLOSED RAD/ULN JT DISLOCATE,,,21,,RBRVS,10.55 ,9.93 ,9.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25526,CPT,OPEN RDL SHAFT FX OPEN RAD/ULN JT DISLOCATE,,,21,,RBRVS,13.15 ,11.64 ,11.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25530,CPT,CLOSED TX ULNAR SHAFT FRACTURE W/O MANIPULATION,,,21,,RBRVS,2.24 ,4.09 ,4.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25535,CPT,CLOSED TX ULNAR SHAFT FRACTURE W/MANIPULATION,,,21,,RBRVS,5.36 ,6.55 ,7.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25545,CPT,OPEN TREATMENT OF ULNAR SHAFT FRACTURE,,,21,,RBRVS,7.94 ,8.40 ,8.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25560,CPT,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/O MAN,,,21,,RBRVS,2.59 ,4.10 ,4.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25565,CPT,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ,,,21,,RBRVS,5.85 ,6.50 ,7.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25574,CPT,OPEN TX RADIAL&ULNAR SHAFT FX W/FIXJ RADIUS/ULNA,,,21,,RBRVS,8.80 ,8.81 ,8.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25575,CPT,OPEN TX RADIAL&ULNAR SHAFT FX W/FIXJ RADIUS&ULNA,,,21,,RBRVS,12.29 ,11.14 ,11.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25600,CPT,CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ,,,21,,RBRVS,2.78 ,5.54 ,6.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25605,CPT,CLTX DSTL RDL FX/EPIPHYSL SEP W/MANJ WHEN PERF,,,21,,RBRVS,6.25 ,7.25 ,8.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25606,CPT,PERQ SKEL FIXJ DISTAL RADIAL FX/EPIPHYSL SEP,,,21,,RBRVS,8.31 ,9.03 ,9.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25607,CPT,OPTX DSTL RADL X-ARTIC FX/EPIPHYSL SEP,,,21,,RBRVS,9.56 ,9.66 ,9.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25608,CPT,OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SEP 2 FRAG,,,21,,RBRVS,11.07 ,10.44 ,10.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25609,CPT,OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SEP 3 FRAG,,,21,,RBRVS,14.38 ,12.93 ,12.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25622,CPT,CLOSED TX CARPAL SCAPHOID FRACTURE W/O MANJ,,,21,,RBRVS,2.79 ,4.59 ,5.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25624,CPT,CLOSED TX CARPAL SCAPHOID FRACTURE W/MANJ,,,21,,RBRVS,4.77 ,6.70 ,7.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25628,CPT,OPEN TX CARPAL SCAPHOID NAVICULAR FRACTURE,,,21,,RBRVS,9.67 ,9.19 ,9.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25630,CPT,CLTX CARPAL BONE FX W/O MANJ EACH BONE,,,21,,RBRVS,3.03 ,4.41 ,5.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25635,CPT,CLTX CARPAL BONE FX W/MANJ EACH BONE,,,21,,RBRVS,4.61 ,5.77 ,7.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25645,CPT,OPEN TX CARPAL BONE FRACTURE OTH/THN SCAPHOID EA,,,21,,RBRVS,7.42 ,7.42 ,7.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25650,CPT,CLOSED TREATMENT ULNAR STYLOID FRACTURE,,,21,,RBRVS,3.23 ,4.75 ,5.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25651,CPT,PRQ SKELETAL FIXATION ULNAR STYLOID FRACTURE,,,21,,RBRVS,5.82 ,6.98 ,6.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25652,CPT,OPEN TREATMENT ULNAR STYLOID FRACTURE,,,21,,RBRVS,8.06 ,8.24 ,8.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25660,CPT,CLTX RDCRPL/INTERCARPL DISLC 1/> BONES W/MANJ,,,21,,RBRVS,4.98 ,5.87 ,5.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25670,CPT,OPEN TX RADIOCARPAL/INTERCARPAL DISLC 1/> BONES,,,21,,RBRVS,8.09 ,7.74 ,7.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25671,CPT,PRQ SKELETAL FIXJ DISTAL RADIOULNAR DISLOCATION,,,21,,RBRVS,6.46 ,7.41 ,7.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25675,CPT,CLOSED TX DISTAL RADIOULNAR DISLOCATION W/MANJ,,,21,,RBRVS,4.89 ,5.65 ,6.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25676,CPT,OPEN TX DISTAL RADIOULNAR DISLC ACUTE/CHRONIC,,,21,,RBRVS,8.29 ,8.06 ,8.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25680,CPT,CLTX TRANS-SCAPHOPRILUNAR TYP FX DISLC W/MANJ,,,21,,RBRVS,6.23 ,6.14 ,6.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25685,CPT,OPEN TX TRANS-SCAPHOPERILUNAR FRACTURE DISLC,,,21,,RBRVS,10.09 ,9.00 ,9.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25690,CPT,CLOSED TX LUNATE DISLOCATION W/MANIPULATION,,,21,,RBRVS,5.72 ,6.88 ,6.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25695,CPT,OPEN TREATMENT LUNATE DISLOCATION,,,21,,RBRVS,8.51 ,7.94 ,7.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25800,CPT,ARTHRODESIS WRIST COMPLETE W/O BONE GRAFT,,,21,,RBRVS,10.07 ,9.07 ,9.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25805,CPT,ARTHRODESIS WRIST W/SLIDING GRAFT,,,21,,RBRVS,11.73 ,10.15 ,10.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25810,CPT,ARTHRODESIS WRIST W/ILIAC/OTHER AUTOGRAFT,,,21,,RBRVS,11.95 ,10.76 ,10.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25820,CPT,ARTHRODESIS WRIST LIMITED W/O BONE GRAFT,,,21,,RBRVS,7.64 ,8.58 ,8.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25825,CPT,ARTHRODESIS WRIST LIMITED W/AUTOGRAFT,,,21,,RBRVS,9.69 ,10.24 ,10.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25830,CPT,ARTHRD DSTL RAD/ULN JT SGMTL RSCJ ULNA W/WO BONE,,,21,,RBRVS,10.88 ,14.18 ,14.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25900,CPT,AMPUTATION FOREARM THROUGH RADIUS & ULNA,,,21,,RBRVS,9.61 ,8.76 ,8.76 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
25905,CPT,AMP FOREARM THRU RADIUS & ULNA OPEN CIRCULAR,,,21,,RBRVS,9.59 ,8.61 ,8.61 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
25907,CPT,AMP F/ARM THRU RADIUS&ULNA SEC CLOSURE/SCAR RE,,,21,,RBRVS,8.09 ,7.85 ,7.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25909,CPT,AMP FOREARM THRU RADIUS&ULNA RE-AMPUTATION,,,21,,RBRVS,9.31 ,8.47 ,8.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25915,CPT,KRUKENBERG PROCEDURE,,,21,,RBRVS,17.52 ,9.25 ,9.25 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
25920,CPT,DISARTICULATION THROUGH WRIST,,,21,,RBRVS,9.03 ,9.13 ,9.13 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
25922,CPT,DISARTICULATION THRU WRIST SEC CLOSURE/SCAR REVJ,,,21,,RBRVS,7.65 ,8.32 ,8.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25924,CPT,DISARTICULATION THRU WRIST RE-AMPUTATION,,,21,,RBRVS,8.81 ,8.91 ,8.91 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
25927,CPT,TRANSMETACARPAL AMPUTATION,,,21,,RBRVS,9.09 ,12.28 ,12.28 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
25929,CPT,TRANSMETACARPAL AMPUTATION SEC CLOSURE/SCAR REVJ,,,21,,RBRVS,7.82 ,6.02 ,6.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25931,CPT,TRANSMETACARPAL AMPUTATION RE-AMPUTATION,,,21,,RBRVS,8.04 ,11.64 ,11.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
25999,CPT,UNLISTED PROCEDURE FOREARM/WRIST,,,21,,TotalUnits,,,,16.21 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26010,CPT,DRAINAGE FINGER ABSCESS SIMPLE,,,21,,RBRVS,1.59 ,2.10 ,5.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26011,CPT,DRAINAGE FINGER ABSCESS COMPLICATED,,,21,,RBRVS,2.24 ,2.66 ,8.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26020,CPT,DRAINAGE TENDON SHEATH DIGIT&/PALM EACH,,,21,,RBRVS,5.08 ,6.36 ,6.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26025,CPT,DRAINAGE OF PALMAR BURSA SINGLE BURSA,,,21,,RBRVS,5.08 ,6.07 ,6.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26030,CPT,DRAINAGE OF PALMAR BURSA MULTIPLE BURSA,,,21,,RBRVS,6.25 ,6.70 ,6.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26034,CPT,INCISION BONE CORTEX HAND/FINGER,,,21,,RBRVS,6.63 ,7.52 ,7.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26035,CPT,DECOMPRESSION FINGERS&/HAND INJECTION INJURY,,,21,,RBRVS,11.37 ,10.93 ,10.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26037,CPT,DECOMPRESSIVE FASCIOTOMY HAND,,,21,,RBRVS,7.57 ,7.22 ,7.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26040,CPT,FASCIOTOMY PALMAR PERCUTANEOUS,,,21,,RBRVS,3.46 ,4.80 ,4.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26045,CPT,FASCIOTOMY PALMAR OPEN PARTIAL,,,21,,RBRVS,5.73 ,6.53 ,6.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26055,CPT,TENDON SHEATH INCISION,,,21,,RBRVS,3.11 ,5.15 ,12.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26060,CPT,TENOTOMY PERCUTANEOUS SINGLE EACH DIGIT,,,21,,RBRVS,2.91 ,4.06 ,4.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26070,CPT,ARTHRT EXPL DRG/RMVL LOOSE/FB CARP/MTCRPL JT,,,21,,RBRVS,3.81 ,4.56 ,4.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26075,CPT,ARTHRT EXPL DRG/RMVL LOOSE/FB MTCARPHLNGL JT EA,,,21,,RBRVS,3.91 ,4.91 ,4.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26080,CPT,ARTHRT EXPL DRG/RMVL LOOSE/FB IPHAL JT EA,,,21,,RBRVS,4.47 ,5.84 ,5.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26100,CPT,ARTHROTOMY BIOPSY CARP/MTCRPL JOINT EACH,,,21,,RBRVS,3.79 ,5.02 ,5.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26105,CPT,ARTHROTOMY BIOPSY MTCARPHLNGL JOINT EACH,,,21,,RBRVS,3.83 ,5.04 ,5.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26110,CPT,ARTHROTOMY BIOPSY INTERPHALANGEAL JOINT EACH,,,21,,RBRVS,3.65 ,4.85 ,4.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26111,CPT,EX TUM/VASC MALF SFT TISS HAND/FNGR SUBQ 1.5CM/>,,,21,,RBRVS,5.42 ,5.54 ,5.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26113,CPT,EX TUM/VASC MAL SFT TIS HAND/FNGR SUBFSC 1.5CM/>,,,21,,RBRVS,7.13 ,7.25 ,7.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26115,CPT,EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM,,,21,,RBRVS,3.96 ,4.81 ,9.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26116,CPT,EXC TUM/VAS MAL SFT TIS HAND/FNGR SUBFASC<1.5CM,,,21,,RBRVS,6.74 ,7.09 ,7.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26117,CPT,RAD RESECT TUMOR SOFT TISSUE HAND/FINGER <3CM,,,21,,RBRVS,10.13 ,9.36 ,9.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26118,CPT,RAD RESCJ TUM SOFT TISSUE HAND/FINGER 3 CM/>,,,21,,RBRVS,14.81 ,12.77 ,12.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26121,CPT,FASCT PALM W/WO Z-PLASTY TISSUE REARGMT/SKN GRFT,,,21,,RBRVS,7.73 ,7.92 ,7.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26123,CPT,FASCT PRTL PALMAR 1 DGT PROX IPHAL JT W/WO RPR,,,21,,RBRVS,10.88 ,10.97 ,10.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26125,CPT,FASCT PRTL PALMR ADDL DGT PROX IPHAL JT W/WO RPR,,,21,,RBRVS,4.60 ,2.47 ,2.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26130,CPT,SYNOVECTOMY CARPOMETACARPAL JOINT,,,21,,RBRVS,5.59 ,6.51 ,6.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26135,CPT,SYNVCT MTCARPHLNGL JT W/INTRNSC RLS&XTNSR HOOD,,,21,,RBRVS,7.13 ,7.31 ,7.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26140,CPT,SYNVCT PROX IPHAL JT W/XTNSR RCNSTJ EA IPHAL JT,,,21,,RBRVS,6.34 ,6.91 ,6.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26145,CPT,SYNVCT TDN SHTH RAD FLXR TDN PALM&/FNGR EA TDN,,,21,,RBRVS,6.49 ,6.94 ,6.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26160,CPT,EXC LESION TDN SHTH/JT CAPSL HAND/FNGR,,,21,,RBRVS,3.57 ,5.28 ,12.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26170,CPT,EXCISION TENDON PALM FLEXOR/EXTENSOR SINGLE EACH,,,21,,RBRVS,4.91 ,5.83 ,5.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26180,CPT,EXCISION TENDON FINGER FLEXOR/EXTENSOR EACH,,,21,,RBRVS,5.35 ,6.39 ,6.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26185,CPT,SESAMOIDECTOMY THUMB/FINGER SEPARATE PROCEDURE,,,21,,RBRVS,6.52 ,7.97 ,7.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26200,CPT,EXCISION/CURETTAGE CYST/TUMOR METACARPAL,,,21,,RBRVS,5.65 ,6.14 ,6.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26205,CPT,EXC/CURETTAGE CYST/TUMOR METACARPAL W/AUTOGRAFT,,,21,,RBRVS,7.93 ,7.73 ,7.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26210,CPT,EXCISION/CURETTAGE CYST/TUMOR PHALANX FINGER,,,21,,RBRVS,5.32 ,6.33 ,6.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26215,CPT,EXC/CURETTAGE CYST/TUMOR PHALANX FINGER W/AGRAFT,,,21,,RBRVS,7.27 ,7.39 ,7.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26230,CPT,PARTIAL EXCISION BONE METACARPAL,,,21,,RBRVS,6.47 ,6.68 ,6.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26235,CPT,PARTIAL EXCISION PROXIMAL/MIDDLE PHALANX FINGER,,,21,,RBRVS,6.33 ,6.63 ,6.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26236,CPT,PARTIAL EXCISION DISTAL PHALANX FINGER,,,21,,RBRVS,5.46 ,6.12 ,6.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26250,CPT,RADICAL RESECTION TUMOR METACARPAL,,,21,,RBRVS,15.21 ,13.13 ,13.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26260,CPT,RAD RESECTION TUMOR PROX/MIDDLE PHALANX FINGER,,,21,,RBRVS,11.16 ,9.67 ,9.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26262,CPT,RADICAL RESECTION TUMOR DISTAL PHALANX FINGER,,,21,,RBRVS,8.29 ,8.23 ,8.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26320,CPT,REMOVAL IMPLANT FROM FINGER/HAND,,,21,,RBRVS,4.10 ,5.05 ,5.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26340,CPT,MANIPULATION FINGER JOINT UNDER ANES EACH JOINT,,,21,,RBRVS,2.80 ,6.18 ,6.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26341,CPT,MANIPLATN PALAR FASCIAL CRD POST INJ SINGLE CORD,,,21,,RBRVS,0.91 ,1.07 ,1.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26350,CPT,RPR/ADVMNT FLXR TDN N/Z/2 W/O FR GRAFT EA TENDON,,,21,,RBRVS,6.21 ,12.67 ,12.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26352,CPT,RPR/ADVMNT FLXR TDN N/Z/2 W/FR GRAFT EA TENDON,,,21,,RBRVS,7.87 ,13.37 ,13.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26356,CPT,RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON,,,21,,RBRVS,10.62 ,18.31 ,18.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26357,CPT,RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON,,,21,,RBRVS,8.77 ,14.08 ,14.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26358,CPT,RPR/ADVMNT FLXR TDN ZONE 2 W/FR GRAFT EA TENDON,,,21,,RBRVS,9.36 ,14.53 ,14.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26370,CPT,RPR/ADVMNT TDN W/NTC SUPFCIS TDN PRIM EA TDN,,,21,,RBRVS,7.28 ,12.78 ,12.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26372,CPT,RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/FREE GRAFT EA,,,21,,RBRVS,9.01 ,14.20 ,14.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26373,CPT,RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/O FREE GRF EA,,,21,,RBRVS,8.41 ,13.68 ,13.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26390,CPT,EXC FLXR TDN W/IMPLTJ SYNTH ROD DLYD TDN GRF H/F,,,21,,RBRVS,9.43 ,12.34 ,12.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26392,CPT,RMVL SYNTH ROD & INSJ FLXR TDN GRF H/F EA ROD,,,21,,RBRVS,10.50 ,14.96 ,14.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26410,CPT,REPAIR EXTENSOR TENDON HAND W/O GRAFT EACH,,,21,,RBRVS,4.77 ,10.20 ,10.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26412,CPT,REPAIR EXTENSOR TENDON HAND W/GRAFT EACH,,,21,,RBRVS,6.48 ,11.75 ,11.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26415,CPT,EXC XTNSR TDN W/IMPLTJ SYNTH ROD DLYD GRF H/F EA,,,21,,RBRVS,8.51 ,10.16 ,10.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26416,CPT,RMVL SYNTH ROD & INSJ XTNSR TDN GRF H/F EA ROD,,,21,,RBRVS,9.56 ,13.58 ,13.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26418,CPT,REPAIR EXTENSOR TENDON FINGER W/O GRAFT EACH,,,21,,RBRVS,4.47 ,10.92 ,10.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26420,CPT,REPAIR EXTENSOR TENDON FINGER W/GRAFT EACH,,,21,,RBRVS,6.94 ,11.72 ,11.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26426,CPT,RPR XTNSR TDN CNTRL SLIP TISS W/LAT BAND EA FNGR,,,21,,RBRVS,6.32 ,6.82 ,6.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26428,CPT,RPR XTNSR TDN CNTRL SLIP SEC W/FR GRFT EA FINGER,,,21,,RBRVS,7.40 ,12.27 ,12.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26432,CPT,CLTX DSTL XTNSR TDN INSJ W/WO PERCUTAN PINNING,,,21,,RBRVS,4.16 ,9.12 ,9.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26433,CPT,REPAIR EXTENSOR TENDON DISTAL INSERTION W/O GRF,,,21,,RBRVS,4.70 ,9.37 ,9.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26434,CPT,REPAIR EXTENSOR TENDON DISTAL INSERTION W/GRAFT,,,21,,RBRVS,6.26 ,10.74 ,10.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26437,CPT,REALIGNMENT EXTENSOR TENDON HAND EACH TENDON,,,21,,RBRVS,5.99 ,10.43 ,10.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26440,CPT,TENOLYSIS FLEXOR TENDON PALM/FINGER EACH TENDON,,,21,,RBRVS,5.16 ,11.30 ,11.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26442,CPT,TENOLYSIS FLEXOR TENDON PALM&FINGER EACH TENDO,,,21,,RBRVS,9.75 ,15.66 ,15.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26445,CPT,TENOLYSIS EXTENSOR TENDON HAND/FINGER EACH,,,21,,RBRVS,4.45 ,10.89 ,10.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26449,CPT,TENOLYSIS CPLX XTNSR TENDON FINGER W/FOREARM EA,,,21,,RBRVS,8.59 ,9.76 ,9.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26450,CPT,TENOTOMY FLEXOR PALM OPEN EACH TENDON,,,21,,RBRVS,3.79 ,6.98 ,6.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26455,CPT,TENOTOMY FLEXOR FINGER OPEN EACH TENDON,,,21,,RBRVS,3.76 ,6.95 ,6.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26460,CPT,TENOTOMY EXTENSOR HAND/FINGER OPEN EACH TENDON,,,21,,RBRVS,3.58 ,6.81 ,6.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26471,CPT,TENODESIS PROXIMAL INTERPHALANGEAL JOINT EACH,,,21,,RBRVS,5.90 ,10.32 ,10.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26474,CPT,TENODESIS DISTAL JOINT EACH,,,21,,RBRVS,5.49 ,10.36 ,10.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26476,CPT,LENGTHENING TENDON EXTENSOR HAND/FINGER EACH,,,21,,RBRVS,5.35 ,10.04 ,10.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26477,CPT,SHORTENING TENDON EXTENSOR HAND/FINGER EACH,,,21,,RBRVS,5.32 ,10.05 ,10.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26478,CPT,LENGTHENING TENDON FLEXOR HAND/FINGER EACH,,,21,,RBRVS,5.97 ,10.35 ,10.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26479,CPT,SHORTENING TENDON FLEXOR HAND/FINGER EACH,,,21,,RBRVS,5.91 ,10.36 ,10.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26480,CPT,TR/TRNSPL TDN CARP/MTCRPL HAND W/O FR GRF EA TDN,,,21,,RBRVS,6.90 ,13.06 ,13.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26483,CPT,TENDON TRANSFER TRANSPLANT CARP/MTCRPL GRAFT,,,21,,RBRVS,8.48 ,13.68 ,13.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26485,CPT,TRANSFER/TRANSPLANT TENDON PALMAR W/O GRAFT EACH,,,21,,RBRVS,7.89 ,13.43 ,13.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26489,CPT,TRANSFER/TRANSPLANT TENDON PALMAR W/GRAFT EACH,,,21,,RBRVS,9.86 ,14.63 ,14.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26490,CPT,OPPONENSPLASTY SUPFCIS TDN TR TYP EA TDN,,,21,,RBRVS,8.60 ,12.18 ,12.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26492,CPT,OPPONENSPLASTY TDN TR W/GRF EA TDN,,,21,,RBRVS,9.84 ,13.15 ,13.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26494,CPT,OPPONENSPLASTY HYPOTHENAR MUSC TR,,,21,,RBRVS,8.66 ,11.86 ,11.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26496,CPT,OPPONENSPLASTY OTHER METHODS,,,21,,RBRVS,9.78 ,12.76 ,12.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26497,CPT,TR TDN RESTORE INTRNSC FUNCJ RING&SM FNGR,,,21,,RBRVS,9.76 ,12.77 ,12.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26498,CPT,TR TDN RESTORE INTRNSC FUNCJ ALL 4 FNGRS,,,21,,RBRVS,14.21 ,15.57 ,15.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26499,CPT,CORRECTION CLAW FINGER OTHER METHODS,,,21,,RBRVS,9.17 ,12.42 ,12.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26500,CPT,RCNSTJ TENDON PULLEY EACH W/LOCAL TISSUES SPX,,,21,,RBRVS,6.13 ,10.29 ,10.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26502,CPT,RCNSTJ TDN PULLEY EA TDN W/TDN/FSCAL GRF SPX,,,21,,RBRVS,7.31 ,11.27 ,11.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26508,CPT,RELEASE THENAR MUSCLE,,,21,,RBRVS,6.18 ,10.30 ,10.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26510,CPT,CROSS INTRINSIC TRANSFER EACH TENDON,,,21,,RBRVS,5.60 ,10.17 ,10.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26516,CPT,CAPSULODESIS MTCARPHLNGL JOINT SINGLE DIGIT,,,21,,RBRVS,7.32 ,11.12 ,11.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26517,CPT,CAPSULODESIS MTCARPHLNGL JOINT 2 DIGITS,,,21,,RBRVS,9.08 ,12.43 ,12.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26518,CPT,CAPSULODESIS MTCARPHLNGL JOINT 3/4 DIGITS,,,21,,RBRVS,9.27 ,12.48 ,12.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26520,CPT,CAPSULECTOMY/CAPSULOTOMY MTCARPHLNGL JOINT EACH,,,21,,RBRVS,5.47 ,11.81 ,11.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26525,CPT,CAPSULECTOMY/CAPSULOTOMY IPHAL JOINT EACH,,,21,,RBRVS,5.50 ,11.79 ,11.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26530,CPT,ARTHROPLASTY METACARPOPHALANGEAL JOINT EACH,,,21,,RBRVS,6.88 ,7.23 ,7.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26531,CPT,ARTHRP MTCARPHLNGL JT W/PROSTC IMPLT EA JT,,,21,,RBRVS,8.13 ,8.24 ,8.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26535,CPT,ARTHROPLASTY INTERPHALANGEAL JOINT EACH,,,21,,RBRVS,5.41 ,5.74 ,5.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26536,CPT,ARTHROPLASTY INTERPHALANGEAL JT W/PROSTHETIC EA,,,21,,RBRVS,6.56 ,12.31 ,12.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26540,CPT,RPR COLTRL LIGM MTCARPHLNGL/IPHAL JT,,,21,,RBRVS,6.60 ,10.68 ,10.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26541,CPT,RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/TDN/FSCAL GRF,,,21,,RBRVS,8.81 ,12.17 ,12.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26542,CPT,RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/LOCAL TISS,,,21,,RBRVS,6.95 ,10.93 ,10.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26545,CPT,RCNSTJ COLTRL LIGM IPHAL JT 1 W/GRF EA JT,,,21,,RBRVS,7.11 ,11.43 ,11.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26546,CPT,RPR NON-UNION MTCRPL/PHALANX,,,21,,RBRVS,10.83 ,15.31 ,15.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26548,CPT,RPR & RCNSTJ FINGER VOLAR PLATE INTERPHALANGEAL,,,21,,RBRVS,8.22 ,11.72 ,11.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26550,CPT,POLLICIZATION DIGIT,,,21,,RBRVS,21.68 ,20.77 ,20.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26551,CPT,TR TOE-TO-HAND W/MVASC ANAST GRT TOE WRP/ARND,,,21,,RBRVS,48.48 ,36.21 ,36.21 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
26553,CPT,TR TOE-TO-HAND W/MVASC ANAST OTH/THN GRT TOE 1,,,21,,RBRVS,48.17 ,26.16 ,26.16 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
26554,CPT,TR TOE-TO-HAND W/MVASC ANAST OTH/THN GRT TOE 2,,,21,,RBRVS,57.01 ,29.92 ,29.92 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
26555,CPT,TR FNGR AXH POS W/O MVASC ANAST,,,21,,RBRVS,17.08 ,18.44 ,18.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26556,CPT,TRANSFER FREE TOE JOINT W/MVASC ANASTOMOSIS,,,21,,RBRVS,49.75 ,20.95 ,20.95 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
26560,CPT,REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS,,,21,,RBRVS,5.52 ,10.03 ,10.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26561,CPT,REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS&GRAFT,,,21,,RBRVS,11.10 ,13.30 ,13.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26562,CPT,REPAIR SYNDACTYLY EACH SPACE COMPLEX,,,21,,RBRVS,16.68 ,18.17 ,18.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26565,CPT,OSTEOTOMY METACARPAL EACH,,,21,,RBRVS,6.91 ,10.83 ,10.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26567,CPT,OSTEOTOMY PHALANX FINGER EACH,,,21,,RBRVS,6.99 ,10.88 ,10.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26568,CPT,OSTEOPLASTY LENGTHENING METACARPAL/PHALANX,,,21,,RBRVS,9.27 ,14.33 ,14.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26580,CPT,REPAIR CLEFT HAND,,,21,,RBRVS,19.75 ,19.30 ,19.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26587,CPT,RCNSTJ POLYDACTYLOUS DIGIT SOFT TISSUE & BONE,,,21,,RBRVS,14.50 ,9.54 ,9.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26590,CPT,REPAIR MACRODACTYLIA EACH DIGIT,,,21,,RBRVS,18.67 ,17.62 ,17.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26591,CPT,REPAIR INTRINSIC MUSCLES HAND EACH MUSCLE,,,21,,RBRVS,3.38 ,8.22 ,8.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26593,CPT,RELEASE INTRINSIC MUSCLES HAND EACH MUSCLE,,,21,,RBRVS,5.50 ,10.39 ,10.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26596,CPT,EXC CONSTRICTING RING FNGR W/MLT Z-PLASTIES,,,21,,RBRVS,9.14 ,10.72 ,10.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26600,CPT,CLTX METACARPAL FX W/O MANIPULATION EACH BONE,,,21,,RBRVS,2.60 ,4.81 ,5.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26605,CPT,CLTX METACARPAL FX W/MANIPULATION EACH BONE,,,21,,RBRVS,3.03 ,4.76 ,5.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26607,CPT,CLTX METACARPAL FX W/MANJ W/XTRNL FIXJ EA BONE,,,21,,RBRVS,5.48 ,6.48 ,6.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26608,CPT,PRQ SKELETAL FIXJ METACARPAL FX EACH BONE,,,21,,RBRVS,5.55 ,7.01 ,7.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26615,CPT,OPEN TX METACARPAL FRACTURE SINGLE EA BONE,,,21,,RBRVS,7.07 ,8.09 ,8.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26641,CPT,CLTX CARPO/METACARPAL DISLOCATION THUMB W/MANJ,,,21,,RBRVS,4.13 ,4.95 ,5.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26645,CPT,CLTX CARPO/METACARPAL FX DISLC THUMB W/MANJ,,,21,,RBRVS,4.58 ,5.70 ,6.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26650,CPT,PRQ SKELETAL FIX CARPO/METACARPAL FX DISLC THUMB,,,21,,RBRVS,5.35 ,7.29 ,7.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26665,CPT,OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB,,,21,,RBRVS,7.94 ,8.56 ,8.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26670,CPT,CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES,,,21,,RBRVS,3.83 ,4.27 ,5.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26675,CPT,CLTX CARPO/MTCRPL DISLC THUMB MANJ EA JT W/ANES,,,21,,RBRVS,4.83 ,6.12 ,7.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26676,CPT,PRQ SKEL FIXJ CARPO/MTCRPL DISLC THMB MANJ EA JT,,,21,,RBRVS,5.74 ,7.47 ,7.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26685,CPT,OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB,,,21,,RBRVS,7.07 ,8.10 ,8.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26686,CPT,OPTX CARP/MTCRPL DISLC THMB CPLX MLT/DLYD RDCTJ,,,21,,RBRVS,8.17 ,8.06 ,8.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26700,CPT,CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES,,,21,,RBRVS,3.83 ,4.15 ,4.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26705,CPT,CLTX METACARPOPHALANGEAL DISLC W/MANJ W/ANES,,,21,,RBRVS,4.38 ,5.59 ,6.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26706,CPT,PRQ SKEL FIXJ METACARPOPHALANGEAL DISLC W/MANJ,,,21,,RBRVS,5.31 ,6.31 ,6.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26715,CPT,OPEN TREATMENT METACARPOPHALANGEAL DISLOCATION,,,21,,RBRVS,7.03 ,8.05 ,8.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26720,CPT,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA,,,21,,RBRVS,1.76 ,3.18 ,3.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26725,CPT,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA,,,21,,RBRVS,3.48 ,4.54 ,5.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26727,CPT,PRQ SKEL FIXJ PHLNGL SHFT FX PROX/MIDDLE PX/F/T,,,21,,RBRVS,5.42 ,6.95 ,6.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26735,CPT,OPEN TX PHALANGEAL SHAFT FRACTURE PROX/MIDDLE EA,,,21,,RBRVS,7.42 ,8.27 ,8.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26740,CPT,CLTX ARTCLR FX INVG MTCRPHLNGL/IPHAL JT W/O MANJ,,,21,,RBRVS,2.07 ,3.68 ,4.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26742,CPT,CLTX ARTCLR FX INVG MTCARPHLNGL/IPHAL JT W/MANJ,,,21,,RBRVS,3.99 ,4.75 ,5.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26746,CPT,OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA,,,21,,RBRVS,9.80 ,9.63 ,9.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26750,CPT,CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA,,,21,,RBRVS,1.80 ,3.15 ,3.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26755,CPT,CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA,,,21,,RBRVS,3.23 ,3.99 ,5.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26756,CPT,PRQ SKEL FIXJ DSTL PHLNGL FX FNGR/THMB EA,,,21,,RBRVS,4.58 ,6.47 ,6.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26765,CPT,OPEN TX DISTAL PHALANGEAL FRACTURE EACH,,,21,,RBRVS,5.86 ,7.37 ,7.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26770,CPT,CLTX IPHAL JT DISLC W/MANJ W/O ANES,,,21,,RBRVS,3.15 ,3.62 ,4.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26775,CPT,CLTX IPHAL JT DISLC W/MANJ REQ ANES,,,21,,RBRVS,3.90 ,5.29 ,6.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26776,CPT,PRQ SKEL FIXJ IPHAL JT DISLC W/MANJ,,,21,,RBRVS,4.99 ,6.69 ,6.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26785,CPT,OPEN TX INTERPHALANGEAL JOINT DISLOCATION,,,21,,RBRVS,6.60 ,7.80 ,7.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26820,CPT,FUSION OPPOSITION THUMB W/AUTOGENOUS GRAFT,,,21,,RBRVS,8.45 ,12.11 ,12.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26841,CPT,ARTHRD CARPO/METACARPAL JT THUMB W/WO INT FIXJ,,,21,,RBRVS,7.35 ,11.76 ,11.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26842,CPT,ARTHRD CRP/MTACRPL JT THMB W/WO INT FIXJ W/AGRFT,,,21,,RBRVS,8.49 ,12.03 ,12.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26843,CPT,ARTHRD CARP/MTCRPL JT DGT OTHER THAN THUMB EACH,,,21,,RBRVS,7.78 ,11.51 ,11.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26844,CPT,ARTHRD CARP/MTCRPL JT DGT OTH/THN THMB W/AGRFT,,,21,,RBRVS,8.98 ,12.38 ,12.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26850,CPT,ARTHRODESIS METACARPOPHALANGEAL JT W/WO INT FIXJ,,,21,,RBRVS,7.14 ,11.05 ,11.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26852,CPT,ARTHRODESIS MTCRPL JT W/WO INT FIXJ W/AUTOGRAFT,,,21,,RBRVS,8.71 ,12.12 ,12.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26860,CPT,ARTHRODESIS INTERPHALANGEAL JT W/WO INT FIXJ,,,21,,RBRVS,4.88 ,10.09 ,10.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26861,CPT,ARTHRODESIS IPHAL JT W/WO INT FIXJ EA IPHAL JT,,,21,,RBRVS,1.74 ,0.93 ,0.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26862,CPT,ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AUTOGRAFT,,,21,,RBRVS,7.56 ,11.52 ,11.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26863,CPT,ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AGRFT EA JT,,,21,,RBRVS,3.89 ,2.11 ,2.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26910,CPT,AMP MTCRPL W/FINGER/THUMB W/WO INTEROSS TRANSFER,,,21,,RBRVS,7.79 ,10.91 ,10.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26951,CPT,AMP F/TH 1/2 JT/PHALANX W/NEURECT W/DIR CLSR,,,21,,RBRVS,6.04 ,11.18 ,11.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26952,CPT,AMP F/TH 1/2 JT/PHALANX W/NEURECT LOCAL FLAP,,,21,,RBRVS,6.48 ,10.48 ,10.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26989,CPT,UNLISTED PROCEDURE HANDS/FINGERS,,,21,,TotalUnits,,,,10.96 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26990,CPT,I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA,,,21,,RBRVS,7.95 ,8.37 ,8.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26991,CPT,I&D PELVIS/HIP JOINT AREA INFECTED BURSA,,,21,,RBRVS,7.06 ,6.52 ,11.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
26992,CPT,INCISION BONE CORTEX PELVIS&/HIP JOINT,,,21,,RBRVS,13.48 ,11.55 ,11.55 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27000,CPT,TENOTOMY ADDUCTOR HIP PERCUTANEOUS SPX,,,21,,RBRVS,5.74 ,5.20 ,5.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27001,CPT,TENOTOMY ADDUCTOR HIP OPEN,,,21,,RBRVS,7.14 ,6.93 ,6.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27003,CPT,TX ADDUXOR SUBQ OPN W/OBTURATOR NEURECTOMY,,,21,,RBRVS,7.81 ,7.71 ,7.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27005,CPT,TENOTOMY HIP FLEXOR OPEN SEPARATE PROCEDURE,,,21,,RBRVS,10.07 ,8.80 ,8.80 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27006,CPT,TENOTOMY ABDUCTORS&/EXTENSOR HIP OPEN SPX,,,21,,RBRVS,10.11 ,9.06 ,9.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27025,CPT,FASCIOTOMY HIP/THIGH ANY TYPE,,,21,,RBRVS,12.89 ,10.88 ,10.88 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27027,CPT,DECOMPRESSION FASCIOTOMY PELVIC COMPARTMENT UNI,,,21,,RBRVS,13.04 ,10.01 ,10.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27030,CPT,ARTHROTOMY HIP W/DRAINAGE,,,21,,RBRVS,13.65 ,10.61 ,10.61 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27033,CPT,ARTHROTOMY HIP EXPLORATION/REMOVAL FOREIGN BODY,,,21,,RBRVS,14.11 ,11.04 ,11.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27035,CPT,DNRVTJ HIP JT INTRAPEL/XTRPEL INTRA-ARTCLR BRNCH,,,21,,RBRVS,17.37 ,12.09 ,12.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27036,CPT,CAPSLCTOMY/CAPSUL HIP W/RLS HIP FLXR MUSC,,,21,,RBRVS,14.38 ,11.89 ,11.89 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27040,CPT,BIOPSY SOFT TISSUE PELVIS&HIP AREA SUPERFICIAL,,,21,,RBRVS,2.92 ,2.35 ,6.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27041,CPT,BIOPSY SOFT TISSUE PELVIS&HIP DEEP/SUBFSCAL/IM,,,21,,RBRVS,10.18 ,7.66 ,7.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27043,CPT,EXCISION TUMOR SOFT TISSUE PELVIS&HIP SUBQ 3CM/>,,,21,,RBRVS,6.88 ,5.07 ,5.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27045,CPT,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC 5CM/>,,,21,,RBRVS,11.13 ,8.09 ,8.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27047,CPT,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBQ <3CM,,,21,,RBRVS,4.94 ,4.44 ,7.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27048,CPT,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM,,,21,,RBRVS,8.85 ,6.76 ,6.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27049,CPT,RAD RESECT TUMOR SOFT TISSUE PELVIS & HIP <5 CM,,,21,,RBRVS,21.55 ,12.59 ,12.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27050,CPT,ARTHROTOMY W/BIOPSY SACROILIAC JOINT,,,21,,RBRVS,4.74 ,5.81 ,5.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27052,CPT,ARTHROTOMY W/BIOPSY HIP JOINT,,,21,,RBRVS,7.42 ,7.71 ,7.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27054,CPT,ARTHROTOMY W/SYNOVECTOMY HIP JOINT,,,21,,RBRVS,9.21 ,8.64 ,8.64 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27057,CPT,DCMPRN FASCIOTOMY PELVIC CMPRT DBRDMT MUSCLE UNI,,,21,,RBRVS,14.91 ,11.25 ,11.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27059,CPT,RAD RESECTION TUMOR SOFT TISS PELVIS&HIP 5 CM/>,,,21,,RBRVS,29.35 ,17.18 ,17.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27060,CPT,EXCISION ISCHIAL BURSA,,,21,,RBRVS,5.87 ,6.27 ,6.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27062,CPT,EXCISION TROCHANTERIC BURSA/CALCIFICATION,,,21,,RBRVS,5.75 ,6.18 ,6.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27065,CPT,EXCISION BONE CYST/BNIGN TUMOR SUPERFICIAL,,,21,,RBRVS,6.55 ,7.04 ,7.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27066,CPT,EXCISION BONE CYST/BENIGN TUMOR DEEP,,,21,,RBRVS,11.20 ,9.94 ,9.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27067,CPT,EXC B1 CST/B9 TUM W/AGRFT REQ SEP INC,,,21,,RBRVS,14.72 ,12.04 ,12.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27070,CPT,PARTIAL EXCISION SUPERFICIAL PELVIS,,,21,,RBRVS,11.56 ,10.53 ,10.53 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27071,CPT,PARTIAL EXCISION DEEP PELVIS,,,21,,RBRVS,12.39 ,11.39 ,11.39 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27075,CPT,RAD RESCT TUMOR WING OF ILIUM 1 PUBIC/ISCHIAL,,,21,,RBRVS,32.71 ,21.33 ,21.33 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27076,CPT,RAD RESCT TUMOR ILIUM ACETABULUM BOTH PUBIC,,,21,,RBRVS,40.21 ,25.10 ,25.10 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27077,CPT,RADICAL RESCTION TUMOR INNOMINATE BONE TOTAL,,,21,,RBRVS,45.21 ,27.63 ,27.63 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27078,CPT,RAD RESCT TUMOR ISCHIAL TUBEROSITY&GRT TRCHNTR,,,21,,RBRVS,32.21 ,21.08 ,21.08 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27080,CPT,COCCYGECTOMY PRIMARY,,,21,,RBRVS,6.89 ,6.35 ,6.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27086,CPT,RMVL FOREIGN BODY PELVIS/HIP SUBCUTANEOUS TISS,,,21,,RBRVS,1.92 ,2.52 ,6.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27087,CPT,REMOVAL FOREIGN BODY PELVIS/HIP DEEP,,,21,,RBRVS,8.83 ,7.39 ,7.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27090,CPT,REMOVAL HIP PROSTHESIS SEPARATE PROCEDURE,,,21,,RBRVS,11.69 ,9.79 ,9.79 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27091,CPT,RMVL HIP PROSTH COMP W/TOT HIP PROSTH MMA,,,21,,RBRVS,24.35 ,16.92 ,16.92 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27093,CPT,INJECTION HIP ARTHROGRAPHY W/O ANESTHESIA,,,21,,RBRVS,1.30 ,0.58 ,3.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27095,CPT,INJECTION HIP ARTHROGRAPHY W/ANESTHESIA,,,21,,RBRVS,1.50 ,0.70 ,5.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27096,CPT,INJECT SI JOINT ARTHRGRPHY&/ANES/STEROID W/IMA,,,21,,RBRVS,1.48 ,0.82 ,2.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27097,CPT,RELEASE/RECESSION HAMSTRING PROXIMAL,,,21,,RBRVS,9.27 ,8.44 ,8.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27098,CPT,TRANSFER ADDUCTOR ISCHIUM,,,21,,RBRVS,9.32 ,8.73 ,8.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27100,CPT,TR XTRNL OBLQ MUSC TRCHNTR W/FSCAL/TDN XTN GRF,,,21,,RBRVS,11.35 ,10.07 ,10.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27105,CPT,TR PARASPI MUSC HIP FASC/TDN XTN GRF,,,21,,RBRVS,12.04 ,10.42 ,10.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27110,CPT,TRANSFER ILIOPSOAS GREATER TROCHANTER FEMUR,,,21,,RBRVS,13.77 ,11.29 ,11.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27111,CPT,TRANSFER ILIOPSOAS FEMORAL NECK,,,21,,RBRVS,12.60 ,10.70 ,10.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27120,CPT,ACETABULOPLASTY,,,21,,RBRVS,19.25 ,14.31 ,14.31 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27122,CPT,ACETABULOPLASTY RESECTION FEMORAL HEAD,,,21,,RBRVS,16.09 ,12.35 ,12.35 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27125,CPT,HEMIARTHROPLASTY HIP PARTIAL,,,21,,RBRVS,16.64 ,12.71 ,12.71 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27130,CPT,ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT,,,21,,RBRVS,20.72 ,14.36 ,14.36 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27132,CPT,CONV PREV HIP TOT HIP ARTHRP W/WO AGRFT/ALGRFT,,,21,,RBRVS,25.69 ,17.62 ,17.62 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27134,CPT,REVJ TOT HIP ARTHRP BTH W/WO AGRFT/ALGRFT,,,21,,RBRVS,30.28 ,19.14 ,19.14 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27137,CPT,REVJ TOT HIP ARTHRP ACTBLR W/WO AGRFT/ALGRFT,,,21,,RBRVS,22.70 ,15.38 ,15.38 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27138,CPT,REVJ TOT HIP ARTHRP FEM ONLY W/WO ALGRFT,,,21,,RBRVS,23.70 ,15.84 ,15.84 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27140,CPT,OSTEOTOMY&TRANSFER GREATER TROCHANTER SPX,,,21,,RBRVS,12.78 ,10.42 ,10.42 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27146,CPT,OSTEOTOMY ILIAC ACETABULAR/INNOMINATE BONE,,,21,,RBRVS,18.92 ,14.16 ,14.16 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27147,CPT,OSTEOTOMY ILIAC ACETABULAR/INNOMINATE HIP RDCTJ,,,21,,RBRVS,22.07 ,15.85 ,15.85 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27151,CPT,OSTEOTOMY ILIAC ACETABULAR/INNOMINATE FEM OSTEOT,,,21,,RBRVS,24.12 ,16.89 ,16.89 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27156,CPT,OSTEOT ILIAC ACTBLR/INNOMINATE BONE OSTEOT RDCTJ,,,21,,RBRVS,26.23 ,17.95 ,17.95 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27158,CPT,OSTEOTOMY PELVIS BILATERAL,,,21,,RBRVS,21.04 ,15.12 ,15.12 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27161,CPT,OSTEOTOMY FEMORAL NECK SEPARATE PROCEDURE,,,21,,RBRVS,17.89 ,13.60 ,13.60 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27165,CPT,OSTEOT INTERTRCHNTRIC/SUBTRCHNTRIC W/INT/XTRNL,,,21,,RBRVS,20.29 ,15.31 ,15.31 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27170,CPT,B1 GRF FEM H/N INTERTRCHNTRIC/SUBTRCHNTRIC AREA,,,21,,RBRVS,17.61 ,12.83 ,12.83 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27175,CPT,TX SLP FEMORAL EPIPHYSIS TRCJ W/O REDUCTION,,,21,,RBRVS,9.38 ,7.90 ,7.90 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27176,CPT,TX SLP FEM EPIPHYSIS SINGLE/MULTIPL PINNING SITU,,,21,,RBRVS,12.92 ,10.86 ,10.86 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27177,CPT,OPTX SLP FEM EPIPHYSIS SINGLE/MULT PIN/BONE GRFT,,,21,,RBRVS,16.09 ,12.72 ,12.72 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27178,CPT,OPTX SLP FEM EPIPHYSIS CLSD MANJ SINGL/MLTPL PIN,,,21,,RBRVS,12.92 ,10.86 ,10.86 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27179,CPT,OPTX SLP FEM EPIPHYSIS OSTPL FEM NCK HEYMAN PX,,,21,,RBRVS,13.97 ,11.28 ,11.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27181,CPT,OPTX SLP FEM EPIPHYSIS OSTEOT&INT FIXJ,,,21,,RBRVS,16.18 ,12.89 ,12.89 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27185,CPT,EPIPHYSL ARRST EPIPHYSIOD/STAPLING TRCHNTR FEMUR,,,21,,RBRVS,9.79 ,6.34 ,6.34 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27187,CPT,PROPH TX N/P/PLTWR W/WO MMA FEM NCK & PROX FEMUR,,,21,,RBRVS,14.23 ,11.49 ,11.49 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27193,CPT,CLTX PEL RING FX DISLC DIAST/SUBLXTJ W/O MANJ,,,21,,RBRVS,6.09 ,6.39 ,6.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27194,CPT,CLTX PEL RING FX DISLC DIAST/SUBLXTJ W/MANJ ANES,,,21,,RBRVS,10.20 ,8.43 ,8.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27200,CPT,CLOSED TREATMENT COCCYGEAL FRACTURE,,,21,,RBRVS,1.92 ,3.12 ,2.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27202,CPT,OPEN TREATMENT COCCYGEAL FRACTURE,,,21,,RBRVS,7.31 ,6.51 ,6.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27215,CPT,OPTX ILIAC TUBRST AVLS/WING FX FIXJ IF PRFRMD,,,21,,RBRVS,10.45 ,6.05 ,6.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27216,CPT,PERQ SKELETAL FIXATION PST PELVIC BONE FX&/DIS,,,21,,RBRVS,15.73 ,8.71 ,8.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27217,CPT,OPTX ANT PELVIC BONE FX&/DISLC INT FIXJ IF PFR,,,21,,RBRVS,14.65 ,8.30 ,8.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27218,CPT,OPTX POST PEL BONE FX&/DISLC INT FIXJ IF PFRMD,,,21,,RBRVS,20.93 ,10.67 ,10.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27220,CPT,CLTX ACETABULUM HIP/SOCKT FX W/O MANJ,,,21,,RBRVS,6.83 ,6.89 ,7.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27222,CPT,CLTX ACETABULM HIP/SOCKT FX MANJ W/WO SKEL TRACJ,,,21,,RBRVS,14.11 ,11.21 ,11.21 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27226,CPT,OPTX PST/ANT ACTBLR WALL FX W/INT FIXJ,,,21,,RBRVS,15.57 ,11.80 ,11.80 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27227,CPT,OPTX ACTBLR FX INVG ANT/PST 1 COLUMN/FX W/INT,,,21,,RBRVS,25.41 ,17.43 ,17.43 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27228,CPT,OPTX ACTBLR FX INVG ANT&POST 2 COLUMNS FX W/INT,,,21,,RBRVS,29.33 ,19.41 ,19.41 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27230,CPT,CLTX FEM FX PROX END NCK W/O MANJ,,,21,,RBRVS,5.81 ,6.56 ,6.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27232,CPT,CLTX FEM FX PROX END NCK W/MANJ W/WO SKEL TRACJ,,,21,,RBRVS,11.72 ,7.76 ,7.76 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27235,CPT,PRQ SKEL FIXJ FEMORAL FX PROX END NECK,,,21,,RBRVS,13.00 ,10.54 ,10.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27236,CPT,OPTX FEM FX PROX END NCK INT FIXJ/PROSTC RPLCMT,,,21,,RBRVS,17.61 ,13.38 ,13.38 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27238,CPT,CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ,,,21,,RBRVS,5.75 ,6.32 ,6.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27240,CPT,CLTX INTR/PERI/SBTRCHNTC FEMORAL FX W/MANJ,,,21,,RBRVS,13.81 ,10.99 ,10.99 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27244,CPT,TX INTER/PR/SUBTRCHNTRIC FEMORAL FX SCREW IMPLT,,,21,,RBRVS,18.18 ,13.69 ,13.69 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27245,CPT,TX INTER/PR/SUBTRCHNTRIC FEM FX IMED IMPLTSCREW,,,21,,RBRVS,18.18 ,13.69 ,13.69 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27246,CPT,CLTX GREATER TROCHANTERIC FX W/O MANJ,,,21,,RBRVS,4.83 ,5.29 ,5.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27248,CPT,OPEN TREATMENT GREATER TROCHANTERIC FRACTURE,,,21,,RBRVS,10.78 ,8.50 ,8.50 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27250,CPT,CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA,,,21,,RBRVS,3.82 ,0.78 ,0.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27252,CPT,CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA,,,21,,RBRVS,11.03 ,8.65 ,8.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27253,CPT,OPTX HIP DISLOCATION TRAUMATIC W/O INTERNAL FIXJ,,,21,,RBRVS,13.58 ,10.79 ,10.79 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27254,CPT,OPTX HIP DISLC TRAUMTC W/ACTBLR WALL&FEM HEAD,,,21,,RBRVS,18.94 ,13.86 ,13.86 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27256,CPT,TX SPONTAN HIP DISLC ABDCT SPLNT/TRCJ W/O ANES,,,21,,RBRVS,4.28 ,1.77 ,3.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27257,CPT,TX SPON HIP DISLC ABDCT SPLNT/TRCJ W/MANJ ANES,,,21,,RBRVS,5.38 ,3.47 ,3.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27258,CPT,OPTX SPON HIP DISLC RPLCMT FEM HEAD ACTBLM,,,21,,RBRVS,16.18 ,12.51 ,12.51 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27259,CPT,OPTX SPON HIP DISLC RPLCMT FEM HEAD ACTBLM SHRT,,,21,,RBRVS,23.26 ,16.80 ,16.80 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27265,CPT,CLTX POST HIP ARTHRP DISLC W/O ANES,,,21,,RBRVS,5.24 ,5.28 ,5.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27266,CPT,CLTX POST HIP ARTHRP DISLC REQ ANES,,,21,,RBRVS,7.78 ,7.35 ,7.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27267,CPT,CLOSED TX FEMORAL FRACTURE PROX HEAD W/O MANJ,,,21,,RBRVS,5.50 ,5.84 ,5.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27268,CPT,CLOSED TX FEMORAL FRACTURE PROX HEAD W/MANJ,,,21,,RBRVS,7.12 ,6.89 ,6.89 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27269,CPT,OPEN TX FEMORAL FRACTURE PROXIMAL END HEAD,,,21,,RBRVS,18.89 ,13.22 ,13.22 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27275,CPT,MANIPULATION HIP JOINT GENERAL ANESTHESIA,,,21,,RBRVS,2.32 ,2.49 ,2.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27279,CPT,ARTHRODESIS SACROILIAC JOINT PERCUTANEOUS,,,21,,RBRVS,9.03 ,5.88 ,5.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27280,CPT,ARTHRODESIS SACROILIAC JOINT W/OBTAINING GRAFT,,,21,,RBRVS,14.64 ,12.29 ,12.29 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27282,CPT,ARTHRODESIS SYMPHYSIS PUBIS W/OBTAINING GRAFT,,,21,,RBRVS,11.85 ,7.16 ,7.16 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27284,CPT,ARTHRODESIS HIP JOINT W/OBTAINING GRAFT,,,21,,RBRVS,25.06 ,13.86 ,13.86 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27286,CPT,ARTHRD HIP JT W/OBTG GRF W/SUBTRCHNTRIC OSTEOT,,,21,,RBRVS,25.17 ,17.42 ,17.42 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27290,CPT,INTERPELVIABDOMINAL AMPUTATION,,,21,,RBRVS,24.55 ,17.33 ,17.33 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27295,CPT,DISARTICULATION HIP,,,21,,RBRVS,19.66 ,12.56 ,12.56 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27299,CPT,UNLISTED PROCEDURE PELVIS/HIP JOINT,,,21,,TotalUnits,,,,13.90 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27301,CPT,I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION,,,21,,RBRVS,6.78 ,6.07 ,10.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27303,CPT,INC DEEP W/OPNG BONE CORTEX FEMUR/KNEE,,,21,,RBRVS,8.63 ,7.94 ,7.94 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27305,CPT,FASCIOTOMY ILIOTIBIAL OPEN,,,21,,RBRVS,6.18 ,6.47 ,6.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27306,CPT,TENOTOMY PRQ ADDUCTOR/HAMSTRING 1 TENDON SPX,,,21,,RBRVS,4.74 ,4.88 ,4.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27307,CPT,TENOTOMY PRQ ADDUCTOR/HAMSTRING MULTIPLE TENDON,,,21,,RBRVS,6.06 ,6.47 ,6.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27310,CPT,ARTHRT KNE W/EXPL DRG/RMVL FB,,,21,,RBRVS,10.00 ,9.02 ,9.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27323,CPT,BIOPSY SOFT TISSUE THIGH/KNEE AREA SUPERFICIAL,,,21,,RBRVS,2.33 ,2.36 ,4.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27324,CPT,BIOPSY SOFT TISSUE THIGH/KNEE AREA DEEP,,,21,,RBRVS,5.04 ,5.22 ,5.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27325,CPT,NEURECTOMY HAMSTRING MUSCLE,,,21,,RBRVS,7.20 ,5.74 ,5.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27326,CPT,NEURECTOMY POPLITEAL,,,21,,RBRVS,6.47 ,6.95 ,6.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27327,CPT,EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM,,,21,,RBRVS,3.96 ,4.20 ,8.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27328,CPT,EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM,,,21,,RBRVS,8.85 ,7.10 ,7.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27329,CPT,RAD RESECT TUMOR SOFT TISSUE THIGH/KNEE <5CM,,,21,,RBRVS,15.72 ,10.78 ,10.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27330,CPT,ARTHROTOMY KNEE W/SYNOVIAL BIOPSY ONLY,,,21,,RBRVS,5.11 ,5.75 ,5.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27331,CPT,ARTHRT KNE W/JT EXPL BX/RMVL LOOSE/FB,,,21,,RBRVS,6.02 ,6.43 ,6.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27332,CPT,ARTHRT W/EXC SEMILUNAR CRTLG KNEE MEDIAL/LAT,,,21,,RBRVS,8.46 ,8.27 ,8.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27333,CPT,ARTHRT W/EXC SEMILUNAR CRTLG KNEE MEDIAL&LAT,,,21,,RBRVS,7.55 ,7.72 ,7.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27334,CPT,ARTHROTOMY W/SYNOVECTOMY KNEE ANTERIOR/POSTERIOR,,,21,,RBRVS,9.19 ,8.65 ,8.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27335,CPT,ARTHRT W/SYNVCT KNE ANT&POST W/POP AREA,,,21,,RBRVS,10.55 ,9.33 ,9.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27337,CPT,EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3 CM/>,,,21,,RBRVS,5.91 ,4.78 ,4.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27339,CPT,EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5 CM/>,,,21,,RBRVS,11.13 ,8.18 ,8.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27340,CPT,EXCISION PREPATELLAR BURSA,,,21,,RBRVS,4.32 ,5.45 ,5.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27345,CPT,EXCISION SYNOVIAL CYST POPLITEAL SPACE,,,21,,RBRVS,6.09 ,6.51 ,6.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27347,CPT,EXCISION LESION MENISCUS/CAPSULE KNEE,,,21,,RBRVS,6.73 ,7.11 ,7.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27350,CPT,PATELLECTOMY/HEMIPATELLECTOMY,,,21,,RBRVS,8.66 ,8.34 ,8.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27355,CPT,EXCISION/CURETTAGE CYST/TUMOR FEMUR,,,21,,RBRVS,8.00 ,7.73 ,7.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27356,CPT,EXCISION/CURETTAGE CYST/TUMOR FEMUR W/ALLOGRAFT,,,21,,RBRVS,10.09 ,9.07 ,9.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27357,CPT,EXCISION/CURETTAGE CYST/TUMOR FEMUR W/AUTOGRAFT,,,21,,RBRVS,11.16 ,9.95 ,9.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27358,CPT,EXCISION/CURETTAGE CYST/TUMOR FEMUR INT FIXATION,,,21,,RBRVS,4.73 ,2.39 ,2.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27360,CPT,PRTL EXC BONE FEMUR PROX TIBIA&/FIBULA,,,21,,RBRVS,11.46 ,10.72 ,10.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27364,CPT,RAD RESECTION TUMOR SOFT TIS THIGH/KNEE 5 CM/>,,,21,,RBRVS,24.49 ,15.54 ,15.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27365,CPT,RADICAL RESECTION TUMOR FEMOR OR KNEE,,,21,,RBRVS,32.21 ,21.00 ,21.00 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27370,CPT,INJECTION KNEE ARTHROGRAPHY,,,21,,RBRVS,0.96 ,0.39 ,3.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27372,CPT,REMOVAL FOREIGN BODY DEEP THIGH/KNEE,,,21,,RBRVS,5.21 ,5.38 ,11.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27380,CPT,SUTURE INFRAPATELLAR TENDON PRIMARY,,,21,,RBRVS,7.45 ,8.11 ,8.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27381,CPT,SUTR INFRAPATELLAR TDN 2 RCNSTJ W/FSCAL/TDN GRF,,,21,,RBRVS,10.76 ,10.00 ,10.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27385,CPT,SUTURE QUADRICEPS/HAMSTRING RUPTURE PRIMARY,,,21,,RBRVS,6.93 ,8.20 ,8.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27386,CPT,SUTR QUADRICEPS/HAMSTRING MUSC RPT RCNSTJ,,,21,,RBRVS,11.13 ,10.50 ,10.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27390,CPT,TENOTOMY OPEN HAMSTRING KNEE HIP SINGLE TENDON,,,21,,RBRVS,5.53 ,6.20 ,6.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27391,CPT,TENOTOMY OPN HAMSTRING KNEE HIP MULTIPLE 1 LEG,,,21,,RBRVS,7.49 ,7.54 ,7.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27392,CPT,TENOTOMY OPEN HAMSTRING KNEE HIP MULTIPLE BI,,,21,,RBRVS,9.63 ,8.88 ,8.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27393,CPT,LENGTHENING HAMSTRING TENDON SINGLE,,,21,,RBRVS,6.59 ,6.71 ,6.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27394,CPT,LENGTHENING HAMSTRING TENDON MULTIPLE 1 LEG,,,21,,RBRVS,8.79 ,8.18 ,8.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27395,CPT,LENGTHENING HAMSTRING TENDON MULTIPLE BILATERAL,,,21,,RBRVS,12.24 ,10.52 ,10.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27396,CPT,TRANSPLANT/TRANSFER THIGH XTNSR TO FLXR 1 TENDON,,,21,,RBRVS,8.15 ,7.87 ,7.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27397,CPT,TRANSPLANT/TRANSFER THIGH XTNSR TO FLXR MULT TDN,,,21,,RBRVS,12.66 ,11.11 ,11.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27400,CPT,TRANSFER TENDON/MUSCLE HAMSTRINGS FEMUR,,,21,,RBRVS,9.33 ,8.73 ,8.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27403,CPT,ARTHROTOMY W/MENISCUS REPAIR KNEE,,,21,,RBRVS,8.62 ,8.06 ,8.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27405,CPT,RPR PRIMARY TORN LIGM&/CAPSULE KNEE COLLATERAL,,,21,,RBRVS,9.08 ,8.56 ,8.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27407,CPT,REPAIR PRIMARY TORN LIGM&/CAPSULE KNEE CRUCIAT,,,21,,RBRVS,10.85 ,9.71 ,9.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27409,CPT,RPR 1 TORN LIGM&/CAPSL KNE COLTRL&CRUCIATE,,,21,,RBRVS,13.71 ,11.26 ,11.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27412,CPT,AUTOLOGOUS CHONDROCYTE IMPLANTATION KNEE,,,21,,RBRVS,24.74 ,17.94 ,17.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27415,CPT,OSTEOCHONDRAL ALLOGRAFT KNEE OPEN,,,21,,RBRVS,20.00 ,15.57 ,15.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27416,CPT,OSTEOCHONDRAL AUTOGRAFT KNEE OPEN MOSAICPLASTY,,,21,,RBRVS,14.16 ,11.18 ,11.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27418,CPT,ANTERIOR TIBIAL TUBERCLEPLASTY,,,21,,RBRVS,11.60 ,9.93 ,9.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27420,CPT,RCNSTJ DISLOCATING PATELLA,,,21,,RBRVS,10.26 ,9.00 ,9.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27422,CPT,RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL,,,21,,RBRVS,10.21 ,9.14 ,9.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27424,CPT,RCNSTJ DISLC PATELLA W/PATELLECTOMY,,,21,,RBRVS,10.24 ,9.19 ,9.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27425,CPT,LATERAL RETINACULAR RELEASE OPEN,,,21,,RBRVS,5.39 ,6.36 ,6.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27427,CPT,LIGAMENTOUS RECONSTRUCTION KNEE EXTRA-ARTICULAR,,,21,,RBRVS,9.79 ,8.80 ,8.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27428,CPT,LIGAMENTOUS RECONSTRUCTION KNEE INTRA-ARTICULAR,,,21,,RBRVS,15.58 ,13.31 ,13.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27429,CPT,LIGMOUS RCNSTJ AGMNTJ KNE INTRA-ARTICULAR XTR,,,21,,RBRVS,17.54 ,14.92 ,14.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27430,CPT,QUADRICEPSPLASTY,,,21,,RBRVS,10.16 ,9.10 ,9.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27435,CPT,CAPSULOTOMY POSTERIOR CAPSULAR RELEASE KNEE,,,21,,RBRVS,10.88 ,10.17 ,10.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27437,CPT,ARTHROPLASTY PATELLA W/O PROSTHESIS,,,21,,RBRVS,8.93 ,8.25 ,8.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27438,CPT,ARTHROPLASTY PATELLA W/PROSTHESIS,,,21,,RBRVS,11.89 ,9.97 ,9.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27440,CPT,ARTHROPLASTY KNEE TIBIAL PLATEAU,,,21,,RBRVS,11.09 ,9.59 ,9.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27441,CPT,ARTHRP KNEE TIBIAL PLATEAU DBRDMT&PRTL SYNVCT,,,21,,RBRVS,11.54 ,9.82 ,9.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27442,CPT,ARTHROPLASTY FEM CONDYLES/TIBIAL PLATEAU KNEE,,,21,,RBRVS,12.37 ,10.20 ,10.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27443,CPT,ARTHRP FEM CONDYLES/TIBL PLATU KNE DBRDMT&PRTL,,,21,,RBRVS,11.41 ,9.75 ,9.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27445,CPT,ARTHROPLASTY KNEE HINGE PROSTHESIS,,,21,,RBRVS,18.66 ,13.72 ,13.72 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27446,CPT,ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT,,,21,,RBRVS,17.48 ,12.54 ,12.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27447,CPT,ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS,,,21,,RBRVS,20.72 ,14.35 ,14.35 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27448,CPT,OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/O FIXATION,,,21,,RBRVS,11.60 ,8.54 ,8.54 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27450,CPT,OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/FIXATION,,,21,,RBRVS,14.61 ,11.56 ,11.56 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27454,CPT,OSTEOT MLT W/RELIGNMT IMED ROD FEM SHFT,,,21,,RBRVS,19.17 ,14.41 ,14.41 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27455,CPT,OSTEOT PROX TIBIA FIB EXC/OSTEOT BEFORE EPIPHYSL,,,21,,RBRVS,13.36 ,11.03 ,11.03 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27457,CPT,OSTEOT PROX TIBIA FIB EXC/OSTEOT AFTER EPIPHYSL,,,21,,RBRVS,14.03 ,10.75 ,10.75 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27465,CPT,OSTEOPLASTY FEMUR SHORTENING EXCLUDING 64876,,,21,,RBRVS,18.60 ,13.58 ,13.58 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27466,CPT,OSTEOPLASTY FEMUR LENGTHENING,,,21,,RBRVS,17.28 ,13.32 ,13.32 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27468,CPT,OSTPL FEMUR CMBN LNGTH&SHRT W/FEMORAL SGM TRNSFR,,,21,,RBRVS,19.97 ,14.69 ,14.69 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27470,CPT,RPR NON/MAL FEMUR DSTL H/N W/O GRF,,,21,,RBRVS,17.14 ,13.33 ,13.33 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27472,CPT,RPR NON/MAL FEMUR DSTL H/N W/ILIAC/AUTOG BONE,,,21,,RBRVS,18.72 ,14.01 ,14.01 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27475,CPT,ARREST EPIPHYSEAL DISTAL FEMUR,,,21,,RBRVS,8.93 ,8.27 ,8.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27477,CPT,ARREST EPIPHYSEAL TIBIA & FIBULA PROXIMAL,,,21,,RBRVS,10.14 ,8.88 ,8.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27479,CPT,ARRST EPIPHYSL CMBN DSTL FEMUR PROX TIBFIB,,,21,,RBRVS,13.16 ,10.65 ,10.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27485,CPT,ARRST HEMIEPIPHYSL DSTL FEMUR/PROX TIBIA/FIBULA,,,21,,RBRVS,9.13 ,8.28 ,8.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27486,CPT,REVJ TOTAL KNEE ARTHRP W/WO ALGRFT 1 COMPONENT,,,21,,RBRVS,21.12 ,15.33 ,15.33 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27487,CPT,REVJ TOT KNEE ARTHRP FEM&ENTIRE TIBIAL COMPONE,,,21,,RBRVS,27.11 ,18.32 ,18.32 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27488,CPT,RMVL PROSTH TOT KNEE PROSTH MMA W/WO INSJ SPACER,,,21,,RBRVS,17.60 ,13.54 ,13.54 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27495,CPT,PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE FEMUR,,,21,,RBRVS,16.54 ,12.64 ,12.64 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27496,CPT,DECOMPRESSION FASCIOTOMY THIGH&/KNEE 1 COMPONENT,,,21,,RBRVS,6.78 ,7.44 ,7.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27497,CPT,DCMPRN FASCT THIGH&/KNEE DBRDMT MUSCLE&/NERVE,,,21,,RBRVS,7.79 ,7.35 ,7.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27498,CPT,DCMPRN FASCIOTOMY THIGH&/KNEE MLT COMPARTMENTS,,,21,,RBRVS,8.66 ,8.39 ,8.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27499,CPT,DCMPRN FASCT THIGH&/KNEE MLT DBRDMT NV MUSC&NRVE,,,21,,RBRVS,9.43 ,8.78 ,8.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27500,CPT,CLOSED TX FEMORAL SHAFT FX W/O MANIPULATION,,,21,,RBRVS,6.30 ,6.26 ,7.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27501,CPT,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANJ,,,21,,RBRVS,6.45 ,6.56 ,6.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27502,CPT,CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL TRACJ,,,21,,RBRVS,11.36 ,8.54 ,8.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27503,CPT,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ,,,21,,RBRVS,11.27 ,9.53 ,9.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27506,CPT,OPTX FEM SHFT FX W/INSJ IMED IMPLT W/WO SCREW,,,21,,RBRVS,19.65 ,15.01 ,15.01 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27507,CPT,OPTX FEM SHFT FX W/PLATE/SCREWS W/WO CERCLAGE,,,21,,RBRVS,14.48 ,10.68 ,10.68 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27508,CPT,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MANJ,,,21,,RBRVS,6.20 ,6.76 ,7.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27509,CPT,PRQ SKELETAL FIXJ FEMORAL FX DISTAL END,,,21,,RBRVS,8.14 ,8.76 ,8.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27510,CPT,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/MANJ,,,21,,RBRVS,9.80 ,7.99 ,7.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27511,CPT,OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/O XTN,,,21,,RBRVS,15.11 ,10.63 ,10.63 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27513,CPT,OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/XTN,,,21,,RBRVS,19.25 ,12.71 ,12.71 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27514,CPT,OPEN TX FEMORAL FRACTURE DISTAL MED/LAT CONDYLE,,,21,,RBRVS,14.60 ,10.38 ,10.38 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27516,CPT,CLTX DISTAL FEMORAL EPIPHYSL SEPARATION W/O MANJ,,,21,,RBRVS,5.59 ,6.94 ,7.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27517,CPT,CLTX DSTL FEM EPIPHYSL SEP W/MANJ W/WO SKIN/SKEL,,,21,,RBRVS,9.12 ,8.73 ,8.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27519,CPT,OPEN TX DISTAL FEMORAL EPIPHYSEAL SEPARATION,,,21,,RBRVS,13.25 ,9.74 ,9.74 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27520,CPT,CLOSED TX PATELLAR FRACTURE W/O MANIPULATION,,,21,,RBRVS,3.04 ,4.81 ,5.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27524,CPT,OPTX PATLLR FX W/INT FIXJ/PATLLC&SOFT TISS RPR,,,21,,RBRVS,10.37 ,9.23 ,9.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27530,CPT,CLTX TIBIAL FX PROXIMAL W/O MANIPULATION,,,21,,RBRVS,2.65 ,4.83 ,5.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27532,CPT,CLTX TIBIAL FX PROXIMAL W/WO MANJ W/SKEL TRACJ,,,21,,RBRVS,7.55 ,7.54 ,8.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27535,CPT,OPEN TX TIBIAL FRACTURE PROXIMAL UNICONDYLAR,,,21,,RBRVS,13.41 ,9.77 ,9.77 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27536,CPT,OPTX TIBIAL FX PROX BICONDYLAR W/WO INT FIXJ,,,21,,RBRVS,17.39 ,13.43 ,13.43 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27538,CPT,CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN,,,21,,RBRVS,5.09 ,6.63 ,7.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27540,CPT,OPEN TX INTERCONDYLAR SPINE/TUBRST FRACTURE KNEE,,,21,,RBRVS,11.30 ,9.82 ,9.82 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27550,CPT,CLOSED TX KNEE DISLOCATION W/O ANESTHESIA,,,21,,RBRVS,5.98 ,6.28 ,7.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27552,CPT,CLOSED TX KNEE DISLOCATION W/ANESTHESIA,,,21,,RBRVS,8.18 ,8.18 ,8.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27556,CPT,OPEN TX KNEE DISLOCATION W/O LIGAMENTOUS REPAIR,,,21,,RBRVS,13.00 ,9.61 ,9.61 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27557,CPT,OPEN TX KNEE DISLOCATION W/LIGAMENTOUS REPAIR,,,21,,RBRVS,15.90 ,11.07 ,11.07 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27558,CPT,OPEN TX KNEE DISLOCATION W/REPAIR/RECONSTRUCTION,,,21,,RBRVS,18.39 ,12.33 ,12.33 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27560,CPT,CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA,,,21,,RBRVS,3.99 ,4.80 ,5.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27562,CPT,CLOSED TX PATELLAR DISLOCATION W/ANESTHESIA,,,21,,RBRVS,5.98 ,6.67 ,6.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27566,CPT,OPTX PATELLAR DISLC W/WO PRTL/TOT PATELLECTOMY,,,21,,RBRVS,12.71 ,10.40 ,10.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27570,CPT,MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA,,,21,,RBRVS,1.79 ,2.19 ,2.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27580,CPT,ARTHRODESIS KNEE ANY TECHNIQUE,,,21,,RBRVS,21.10 ,16.06 ,16.06 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27590,CPT,AMPUTATION THIGH THROUGH FEMUR ANY LEVEL,,,21,,RBRVS,13.47 ,6.87 ,6.87 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27591,CPT,AMP THI THRU FEMUR LVL IMMT FITG TQ W/1ST CST,,,21,,RBRVS,13.94 ,11.04 ,11.04 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27592,CPT,AMPUTATION THIGH THRU FEMUR OPEN CIRCULAR,,,21,,RBRVS,10.98 ,6.46 ,6.46 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27594,CPT,AMP THIGH THRU FEMUR SEC CLOSURE/SCAR REVISION,,,21,,RBRVS,7.29 ,5.73 ,5.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27596,CPT,AMPUTATION THIGH THROUGH FEMUR RE-AMPUTATION,,,21,,RBRVS,11.29 ,7.08 ,7.08 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27598,CPT,DISARTICULATION KNEE,,,21,,RBRVS,11.22 ,7.15 ,7.15 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27599,CPT,UNLISTED PROCEDURE FEMUR/KNEE,,,21,,TotalUnits,,,,35.07 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27600,CPT,DCMPRN FASCT LEG ANT&/LAT COMPARTMENTS ONLY,,,21,,RBRVS,6.03 ,4.66 ,4.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27601,CPT,DCMPRN FASCT LEG POST COMPARTMENT ONLY,,,21,,RBRVS,6.05 ,5.57 ,5.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27602,CPT,DCMPRN FASCT LEG ANT&/LAT&PST CMPRT,,,21,,RBRVS,7.82 ,4.66 ,4.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27603,CPT,INCISION & DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA,,,21,,RBRVS,5.23 ,4.90 ,8.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27604,CPT,INCISION & DRAINAGE LEG/ANKLE INFECTED BURSA,,,21,,RBRVS,4.59 ,4.49 ,8.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27605,CPT,TENOTOMY PRQ ACHILLES TENDON SPX LOCAL ANES,,,21,,RBRVS,2.92 ,2.07 ,6.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27606,CPT,TENOTOMY PRQ ACHILLES TENDON SPX GENERAL ANES,,,21,,RBRVS,4.18 ,3.32 ,3.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27607,CPT,INCISION LEG/ANKLE,,,21,,RBRVS,8.62 ,7.35 ,7.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27610,CPT,ARTHROTOMY ANKLE W/EXPL DRAINAGE/REMOVAL FB,,,21,,RBRVS,9.13 ,7.97 ,7.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27612,CPT,ARTHRT PST CAPSUL RLS ANKLE W/WO ACHLL TDN LNGTH,,,21,,RBRVS,8.15 ,6.89 ,6.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27613,CPT,BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL,,,21,,RBRVS,2.22 ,2.13 ,4.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27614,CPT,BIOPSY SOFT TISSUE LEG/ANKLE AREA DEEP,,,21,,RBRVS,5.80 ,4.82 ,9.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27615,CPT,RAD RESECTION TUMOR SOFT TISSUE LEG/ANKLE <5CM,,,21,,RBRVS,15.72 ,10.52 ,10.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27616,CPT,RAD RESECTION TUMOR SOFT TISSUE LEG/ANKLE 5 CM/>,,,21,,RBRVS,19.63 ,12.86 ,12.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27618,CPT,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM,,,21,,RBRVS,3.96 ,4.08 ,8.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27619,CPT,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASCIAL <5CM,,,21,,RBRVS,6.91 ,5.54 ,5.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27620,CPT,ARTHRT ANKLE W/EXPL W/WO BX W/WO RMVL LOOSE/FB,,,21,,RBRVS,6.15 ,6.01 ,6.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27625,CPT,ARTHROTOMY W/SYNOVECTOMY ANKLE,,,21,,RBRVS,8.49 ,6.97 ,6.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27626,CPT,ARTHROTOMY W/SYNOVECTOMY ANKLE TENOSYNOVECTOMY,,,21,,RBRVS,9.10 ,7.21 ,7.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27630,CPT,EXCISION LESION TENDON SHEATH/CAPSULE LEG&/ANK,,,21,,RBRVS,4.94 ,4.78 ,10.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27632,CPT,EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3 CM/>,,,21,,RBRVS,5.91 ,4.78 ,4.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27634,CPT,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASC 5 CM/>,,,21,,RBRVS,10.13 ,7.58 ,7.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27635,CPT,EXCISION/CURETTAGE BONE CYST/TUMOR TIBIA/FIBULA,,,21,,RBRVS,8.03 ,7.38 ,7.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27637,CPT,EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/AGRAFT,,,21,,RBRVS,10.31 ,9.56 ,9.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27638,CPT,EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/ALGRAFT,,,21,,RBRVS,10.99 ,9.10 ,9.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27640,CPT,PARTIAL EXCISION BONE TIBIA,,,21,,RBRVS,12.24 ,9.57 ,9.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27641,CPT,PARTIAL EXCISION BONE FIBULA,,,21,,RBRVS,9.84 ,7.72 ,7.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27645,CPT,RADICAL RESECTION OF TUMOR TIBIA,,,21,,RBRVS,27.21 ,18.66 ,18.66 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27646,CPT,RADICAL RESECTION TUMOR BONE FIBULA,,,21,,RBRVS,23.21 ,16.65 ,16.65 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27647,CPT,RADICAL RESECTION OF TUMOR TALUS OR CALCANEUS,,,21,,RBRVS,20.26 ,7.76 ,7.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27648,CPT,INJECTION ANKLE ARTHROGRAPHY,,,21,,RBRVS,0.96 ,0.42 ,3.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27650,CPT,REPAIR PRIMARY OPEN/PRQ RUPTURED ACHILLES TENDON,,,21,,RBRVS,9.21 ,8.29 ,8.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27652,CPT,RPR PRIMARY OPEN/PRQ RUPTURED ACHILLES W/GRAFT,,,21,,RBRVS,10.78 ,7.50 ,7.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27654,CPT,REPAIR SECONDARY ACHILLES TENDON W/WO GRAFT,,,21,,RBRVS,10.53 ,8.33 ,8.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27656,CPT,REPAIR FASCIAL DEFECT LEG,,,21,,RBRVS,4.71 ,5.70 ,12.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27658,CPT,REPAIR FLEXOR TENDON LEG PRIMARY W/O GRAFT EACH,,,21,,RBRVS,5.12 ,4.87 ,4.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27659,CPT,RPR FLEXOR TENDON LEG SECONDARY W/O GRAFT EACH,,,21,,RBRVS,7.10 ,5.71 ,5.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27664,CPT,RPR EXTENSOR TENDON LEG PRIMARY W/O GRAFT EACH,,,21,,RBRVS,4.73 ,4.98 ,4.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27665,CPT,RPR EXTENSOR TENDON LEG SECONDRY W/WO GRAFT EACH,,,21,,RBRVS,5.57 ,5.36 ,5.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27675,CPT,RPR DISLOC PERONEAL TENDON W/O FIBULAR OSTEOTOMY,,,21,,RBRVS,7.35 ,5.57 ,5.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27676,CPT,REPAIR DISLOCATING PERONEAL TENDON W/FIB OSTEOT,,,21,,RBRVS,8.73 ,6.98 ,6.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27680,CPT,TENOLYSIS FLXR/XTNSR TENDON LEG&/ANKLE 1 EACH,,,21,,RBRVS,5.88 ,5.52 ,5.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27681,CPT,TNOLS FLXR/XTNSR TDN LEG&/ANKLE MLT TDN,,,21,,RBRVS,7.05 ,7.21 ,7.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27685,CPT,LNGTH/SHRT TENDON LEG/ANKLE 1 TENDON SPX,,,21,,RBRVS,6.69 ,5.74 ,11.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27686,CPT,LNGTH/SHRT TDN LEG/ANKLE MLT TDN SAME INC EA,,,21,,RBRVS,7.75 ,7.05 ,7.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27687,CPT,GASTROCNEMIUS RECESSION,,,21,,RBRVS,6.41 ,5.73 ,5.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27690,CPT,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING SUPFC,,,21,,RBRVS,9.17 ,7.66 ,7.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27691,CPT,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING DP,,,21,,RBRVS,10.49 ,9.32 ,9.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27692,CPT,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING EA TDN,,,21,,RBRVS,1.87 ,0.82 ,0.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27695,CPT,RPR PRIMARY DISRUPTED LIGAMENT ANKLE COLLATERAL,,,21,,RBRVS,6.70 ,6.00 ,6.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27696,CPT,RPR PRIM DISRUPTED LIGM ANKLE BTH COLTRL LIGMS,,,21,,RBRVS,8.58 ,6.16 ,6.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27698,CPT,REPAIR SECONDARY DISRUPTED LIGAMENT ANKLE COLTRL,,,21,,RBRVS,9.61 ,7.31 ,7.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27700,CPT,ARTHROPLASTY ANKLE,,,21,,RBRVS,9.66 ,6.39 ,6.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27702,CPT,ARTHROPLASTY ANKLE W/IMPLANT,,,21,,RBRVS,14.42 ,10.89 ,10.89 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27703,CPT,ARTHROPLASTY ANKLE REVISION TOTAL ANKLE,,,21,,RBRVS,16.94 ,12.08 ,12.08 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27704,CPT,REMOVAL ANKLE IMPLANT,,,21,,RBRVS,7.81 ,7.31 ,7.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27705,CPT,OSTEOTOMY TIBIA,,,21,,RBRVS,10.86 ,8.80 ,8.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27707,CPT,OSTEOTOMY FIBULA,,,21,,RBRVS,4.78 ,5.87 ,5.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27709,CPT,OSTEOTOMY TIBIA & FIBULA,,,21,,RBRVS,17.48 ,12.90 ,12.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27712,CPT,OSTEOT MLT W/RELIGNMT IMED ROD,,,21,,RBRVS,15.87 ,12.74 ,12.74 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27715,CPT,OSTEOPLASTY TIBIA & FIBULA LENGTHENING/SHORTENIN,,,21,,RBRVS,15.50 ,11.57 ,11.57 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27720,CPT,REPAIR NONUNION/MALUNION TIBIA W/O GRAFT,,,21,,RBRVS,12.36 ,10.43 ,10.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27722,CPT,REPAIR NONUNION/MALUNION TIBIA W/SLIDING GRAFT,,,21,,RBRVS,12.45 ,10.64 ,10.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27724,CPT,RPR NON/MAL TIBIA W/ILIAC/OTH AGRFT,,,21,,RBRVS,19.31 ,13.41 ,13.41 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27725,CPT,RPR NON/MAL TIBIA SYNOSTOSIS W/FIBULA ANY METH,,,21,,RBRVS,17.41 ,14.21 ,14.21 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27726,CPT,REPAIR FIBULA NONUNION/MALUNION W/INT FIXATION,,,21,,RBRVS,14.34 ,10.69 ,10.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27727,CPT,REPAIR CONGENITAL PSEUDARTHROSIS TIBIA,,,21,,RBRVS,14.84 ,8.68 ,8.68 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27730,CPT,ARREST EPIPHYSEAL OPEN DISTAL TIBIA,,,21,,RBRVS,7.70 ,7.56 ,7.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27732,CPT,ARREST EPIPHYSEAL OPEN DISTAL FIBULA,,,21,,RBRVS,5.46 ,6.26 ,6.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27734,CPT,ARREST EPIPHYSEAL OPEN DISTAL TIBIA&FIBULA,,,21,,RBRVS,8.83 ,8.22 ,8.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27740,CPT,ARREST EPIPHYSEAL ANY METHOD TIBIA & FIBULA,,,21,,RBRVS,9.61 ,8.80 ,8.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27742,CPT,ARRST EPIPHYSL ANY METH TIBFIB&DSTL FEMUR,,,21,,RBRVS,10.63 ,9.58 ,9.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27745,CPT,PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE TIBIA,,,21,,RBRVS,10.49 ,9.27 ,9.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27750,CPT,CLTX TIBIAL SHAFT FX W/O MANIPULATION,,,21,,RBRVS,3.37 ,5.08 ,5.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27752,CPT,CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ,,,21,,RBRVS,6.27 ,6.69 ,7.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27756,CPT,PRQ SKELETAL FIXATION TIBIAL SHAFT FRACTURE,,,21,,RBRVS,7.45 ,7.67 ,7.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27758,CPT,OPTX TIBIAL SHFT FX W/PLATE/SCREWS W/WO CERCLAGE,,,21,,RBRVS,12.54 ,10.63 ,10.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27759,CPT,TX TIBL SHFT FX IMED IMPLT W/WO SCREWS&/CERCLA,,,21,,RBRVS,14.45 ,11.43 ,11.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27760,CPT,CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION,,,21,,RBRVS,3.21 ,4.92 ,5.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27762,CPT,CLTX MEDIAL MALLS FX W/MANJ W/WO SKN/SKEL TRACJ,,,21,,RBRVS,5.47 ,5.91 ,7.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27766,CPT,OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE,,,21,,RBRVS,7.89 ,8.15 ,8.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27767,CPT,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANJ,,,21,,RBRVS,2.64 ,4.97 ,4.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27768,CPT,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/MANJ,,,21,,RBRVS,5.14 ,6.43 ,6.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27769,CPT,OPEN TREATMENT POSTERIOR MALLEOLUS FRACTURE,,,21,,RBRVS,10.14 ,8.65 ,8.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27780,CPT,CLTX PROX FIBULA/SHFT FX W/O MANJ,,,21,,RBRVS,2.83 ,4.59 ,5.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27781,CPT,CLTX PROX FIBULA/SHFT FX W/MANJ,,,21,,RBRVS,4.59 ,5.77 ,6.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27784,CPT,OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE,,,21,,RBRVS,9.67 ,9.03 ,9.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27786,CPT,CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ,,,21,,RBRVS,3.02 ,4.62 ,5.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27788,CPT,CLTX DSTL FIBULAR FX LAT MALLS W/MANJ,,,21,,RBRVS,4.64 ,5.52 ,6.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27792,CPT,OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS,,,21,,RBRVS,8.75 ,8.36 ,8.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27808,CPT,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANJ,,,21,,RBRVS,3.03 ,5.00 ,5.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27810,CPT,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/MANJ,,,21,,RBRVS,5.32 ,5.86 ,7.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27814,CPT,OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE,,,21,,RBRVS,10.62 ,9.54 ,9.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27816,CPT,CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION,,,21,,RBRVS,3.07 ,4.61 ,5.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27818,CPT,CLTX TRIMALLEOLAR ANKLE FX W/MANIPULATION,,,21,,RBRVS,5.69 ,5.72 ,7.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27822,CPT,OPEN TX TRIMALLEOLAR ANKLE FX W/O FIXJ PST LIP,,,21,,RBRVS,11.21 ,10.80 ,10.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27823,CPT,OPEN TX TRIMALLEOLAR ANKLE FX W/FIXJ PST LIP,,,21,,RBRVS,13.16 ,11.81 ,11.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27824,CPT,CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ,,,21,,RBRVS,3.31 ,4.76 ,5.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27825,CPT,CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ,,,21,,RBRVS,6.69 ,6.22 ,7.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27826,CPT,OPEN TREATMENT FRACTURE DISTAL TIBIA FIBULA,,,21,,RBRVS,11.10 ,10.70 ,10.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27827,CPT,OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY,,,21,,RBRVS,14.79 ,13.44 ,13.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27828,CPT,OPEN TREATMENT FRACTURE DISTAL TIBIA & FIBULA,,,21,,RBRVS,18.43 ,15.27 ,15.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27829,CPT,OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION,,,21,,RBRVS,8.80 ,9.20 ,9.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27830,CPT,CLTX PROX TIBFIB JT DISLC W/O ANES,,,21,,RBRVS,3.96 ,5.39 ,6.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27831,CPT,CLTX PROX TIBFIB JT DISLC REQ ANES,,,21,,RBRVS,4.73 ,5.77 ,5.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27832,CPT,OPEN TX PROX TIBFIB JOINT DISLOCATE EXC PROX FIB,,,21,,RBRVS,10.17 ,9.51 ,9.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27840,CPT,CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA,,,21,,RBRVS,4.77 ,4.97 ,4.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27842,CPT,CLTX ANKLE DISLC REQ ANES W/WO PRQ SKEL FIXJ,,,21,,RBRVS,6.46 ,6.55 ,6.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27846,CPT,OPTX ANKLE DISLOCATION W/O REPAIR/INTERNAL FIXJ,,,21,,RBRVS,10.28 ,8.86 ,8.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27848,CPT,OPTX ANKLE DISLOCATION W/REPAIR/INT/XTRNL FIXJ,,,21,,RBRVS,11.68 ,9.56 ,9.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27860,CPT,MANIPULATION ANKLE UNDER GENERAL ANESTHESIA,,,21,,RBRVS,2.39 ,2.20 ,2.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27870,CPT,ARTHRODESIS ANKLE OPEN,,,21,,RBRVS,15.41 ,11.56 ,11.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27871,CPT,ARTHRODESIS TIBIOFIBULAR JOINT PROXIMAL/DISTAL,,,21,,RBRVS,9.54 ,8.40 ,8.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27880,CPT,AMPUTATION LEG THROUGH TIBIA&FIBULA,,,21,,RBRVS,15.37 ,8.00 ,8.00 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27881,CPT,AMP LEG THRU TIBFIB W/IMMT FITG TQ W/1ST CST,,,21,,RBRVS,13.47 ,8.78 ,8.78 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27882,CPT,AMPUTATION LEG THRU TIBIA&FIBULA OPEN CIRCULAR,,,21,,RBRVS,9.79 ,5.52 ,5.52 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27884,CPT,AMP LEG THRU TIBIA&FIBULA SEC CLOSURE/SCAR REV,,,21,,RBRVS,8.76 ,6.05 ,6.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27886,CPT,AMP LEG THRU TIBIA&FIBULA RE-AMPUTATION,,,21,,RBRVS,10.02 ,6.92 ,6.92 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27888,CPT,AMP ANKLE-MALLI TIBFIB W/PLSTC CLSR&RESCJ NRV,,,21,,RBRVS,10.37 ,7.52 ,7.52 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
27889,CPT,ANKLE DISARTICULATION,,,21,,RBRVS,10.86 ,5.55 ,5.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27892,CPT,DCMPRN FASCT LEG ANT&/LAT W/DBRDMT MUSC&/NERVE,,,21,,RBRVS,7.94 ,6.29 ,6.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27893,CPT,DCMPRN FASCT LEG PST W/DBRDMT MUSC&/NRV,,,21,,RBRVS,7.90 ,8.01 ,8.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27894,CPT,DCMPRN FASCT LEG ANT&/LAT&PST W/DBRDMT MUS,,,21,,RBRVS,12.67 ,9.63 ,9.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
27899,CPT,UNLISTED PROCEDURE LEG/ANKLE,,,21,,TotalUnits,,,,17.11 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28001,CPT,INCISION&DRAINAGE BURSA FOOT,,,21,,RBRVS,2.78 ,1.92 ,5.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28002,CPT,I&D BELOW FASCIA FOOT 1 BURSAL SPACE,,,21,,RBRVS,5.34 ,3.30 ,6.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28003,CPT,I&D BELOW FASCIA FOOT MULTIPLE AREAS,,,21,,RBRVS,9.06 ,6.23 ,10.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28005,CPT,INCISION BONE CORTEX FOOT,,,21,,RBRVS,9.44 ,6.29 ,6.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28008,CPT,FASCIOTOMY FOOT&/TOE,,,21,,RBRVS,4.59 ,3.45 ,7.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28010,CPT,TENOTOMY PERCUTANEOUS TOE SINGLE TENDON,,,21,,RBRVS,2.97 ,2.79 ,3.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28011,CPT,TENOTOMY PERCUTANEOUS TOE MULTIPLE TENDON,,,21,,RBRVS,4.28 ,3.56 ,4.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28020,CPT,ARTHRT W/EXPL DRG/RMVL LOOSE/FB NTRTRSL/TARS JT,,,21,,RBRVS,5.15 ,4.63 ,9.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28022,CPT,ARTHRT W/EXPL DRG/RMVL LOOSE/FB MTTARPHLNGL JT,,,21,,RBRVS,4.81 ,4.04 ,8.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28024,CPT,ARTHRT W/EXPL DRG/RMVL LOOSE/FB IPHAL JT,,,21,,RBRVS,4.52 ,3.82 ,8.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28035,CPT,RELEASE TARSAL TUNNEL,,,21,,RBRVS,5.23 ,4.38 ,9.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28039,CPT,EXCISION TUMOR SOFT TIS FOOT/TOE SUBQ 1.5 CM/>,,,21,,RBRVS,5.42 ,3.99 ,8.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28041,CPT,EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5 CM/>,,,21,,RBRVS,7.13 ,5.22 ,5.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28043,CPT,EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ <1.5CM,,,21,,RBRVS,3.96 ,3.22 ,7.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28045,CPT,EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC <1.5CM,,,21,,RBRVS,5.45 ,4.03 ,8.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28046,CPT,RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE <3CM,,,21,,RBRVS,12.38 ,7.20 ,7.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28047,CPT,RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE 3 CM/>,,,21,,RBRVS,17.45 ,10.62 ,10.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28050,CPT,ARTHRT W/BX INTERTARSAL/TARSOMETATARSAL JOINT,,,21,,RBRVS,4.39 ,4.18 ,9.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28052,CPT,ARTHRTOMY W/BX METATARSOPHALANGEAL JOINT,,,21,,RBRVS,4.06 ,3.64 ,8.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28054,CPT,ARTHRTOMY W/BX INTERPHALANGEAL JOINT,,,21,,RBRVS,3.57 ,2.95 ,7.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28055,CPT,NEURECTOMY INTRINSIC MUSCULATURE OF FOOT,,,21,,RBRVS,6.29 ,4.06 ,4.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28060,CPT,FASCIECTOMY PLANTAR FASCIA PARTIAL SPX,,,21,,RBRVS,5.40 ,4.29 ,9.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28062,CPT,FASCIOTOMY PLANTAR FASCIA RADICAL SPX,,,21,,RBRVS,6.69 ,4.38 ,9.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28070,CPT,SYNVCT INTERTARSAL/TARSOMETATARSAL JT EA SPX,,,21,,RBRVS,5.24 ,4.31 ,9.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28072,CPT,SYNOVECTOMY METATARSOPHALANGEAL JOINT EACH,,,21,,RBRVS,4.72 ,4.36 ,9.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28080,CPT,EXCISION INTERDIGITAL MORTON NEUROMA SINGLE EACH,,,21,,RBRVS,4.86 ,5.24 ,9.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28086,CPT,SYNOVECTOMY TENDON SHEATH FOOT FLEXOR,,,21,,RBRVS,4.92 ,4.81 ,10.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28088,CPT,SYNOVECTOMY TENDON SHEATH FOOT EXTENSOR,,,21,,RBRVS,3.98 ,3.62 ,8.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28090,CPT,EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT FOOT,,,21,,RBRVS,4.55 ,3.85 ,8.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28092,CPT,EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT TOE EA,,,21,,RBRVS,3.78 ,3.57 ,8.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28100,CPT,EXCISION/CURETTAGE CYST/TUMOR TALUS/CALCANEUS,,,21,,RBRVS,5.83 ,5.33 ,11.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28102,CPT,EXC/CURTG CST/B9 TUM TALUS/CLCNS W/ILIAC/AGRFT,,,21,,RBRVS,7.92 ,7.90 ,7.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28103,CPT,EXC/CURETTAGE CYST/TUMOR TALUS/CALCANEUS ALGRFT,,,21,,RBRVS,6.67 ,4.09 ,4.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28104,CPT,EXC/CURTG BONE CYST/B9 TUMORTARSAL/METATARSAL,,,21,,RBRVS,5.26 ,4.37 ,9.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28106,CPT,EXC/CURTG CST/B9 TUM TARSAL/METAR W/ILIAC/AGRFT,,,21,,RBRVS,7.35 ,4.44 ,4.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28107,CPT,EXC/CURTG CST/B9 TUM TARSAL/METAR W/ALGRFT,,,21,,RBRVS,5.73 ,3.87 ,8.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28108,CPT,EXC/CURTG CST/B9 TUM PHALANGES FOOT,,,21,,RBRVS,4.30 ,3.63 ,8.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28110,CPT,OSTECTOMY PRTL 5TH METAR HEAD SPX,,,21,,RBRVS,4.22 ,3.68 ,8.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28111,CPT,OSTECTOMY COMPLETE 1ST METATARSAL HEAD,,,21,,RBRVS,5.15 ,3.68 ,8.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28112,CPT,OSTECTOMY COMPLETE OTHER METATARSAL HEAD 2/3/4,,,21,,RBRVS,4.63 ,3.90 ,9.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28113,CPT,OSTECTOMY COMPLETE 5TH METATARSAL HEAD,,,21,,RBRVS,6.11 ,5.58 ,10.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28114,CPT,OSTC COMPL ALL METAR HEADS W/PRTL PROX PHALANGC,,,21,,RBRVS,12.00 ,10.61 ,17.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28116,CPT,OSTECTOMY TARSAL COALITION,,,21,,RBRVS,9.14 ,6.31 ,11.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28118,CPT,OSTECTOMY CALCANEUS,,,21,,RBRVS,6.13 ,4.99 ,10.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28119,CPT,OSTECTOMY CALCANEUS SPUR W/WO PLNTAR FASCIAL RLS,,,21,,RBRVS,5.56 ,4.28 ,9.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28120,CPT,PARTIAL EXCISION BONE TALUS/CALCANEUS,,,21,,RBRVS,7.31 ,6.05 ,11.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28122,CPT,PRTL EXC B1 TARSAL/METAR B1 XCP TALUS/CALCANEUS,,,21,,RBRVS,6.76 ,5.20 ,9.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28124,CPT,PARTICAL EXCISION BONE PHALANX TOE,,,21,,RBRVS,5.00 ,4.07 ,8.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28126,CPT,RESECTION PARTIAL/COMPLETE PHALANGEAL BASE EACH,,,21,,RBRVS,3.64 ,3.17 ,7.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28130,CPT,TALECTOMY ASTRAGALECTOMY,,,21,,RBRVS,9.50 ,7.36 ,7.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28140,CPT,METATARSECTOMY,,,21,,RBRVS,7.14 ,4.61 ,9.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28150,CPT,PHALANGECTOMY TOE EACH TOE,,,21,,RBRVS,4.23 ,3.44 ,7.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28153,CPT,RESECTION CONDYLE DISTAL END PHALANX EACH TOE,,,21,,RBRVS,3.80 ,3.45 ,7.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28160,CPT,HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT EXC TOE,,,21,,RBRVS,3.88 ,3.53 ,7.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28171,CPT,RAD RESCJ TUMOR TARSAL EXCEPT TALUS/CALCANEUS,,,21,,RBRVS,16.41 ,6.82 ,6.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28173,CPT,RADICAL RESECTION TUMOR METATARSAL,,,21,,RBRVS,14.16 ,6.49 ,6.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28175,CPT,RADICAL RESECTION TUMOR PHALANX OR TOE,,,21,,RBRVS,8.29 ,5.19 ,5.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28190,CPT,REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS,,,21,,RBRVS,2.01 ,1.66 ,5.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28192,CPT,REMOVAL FOREIGN BODY FOOT DEEP,,,21,,RBRVS,4.78 ,3.77 ,8.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28193,CPT,REMOVAL FOREIGN BODY FOOT COMPLICATED,,,21,,RBRVS,5.90 ,4.21 ,8.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28200,CPT,RPR TDN FLXR FOOT 1/2 W/O FREE GRAFG EACH TENDON,,,21,,RBRVS,4.74 ,3.98 ,8.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28202,CPT,RPR TENDON FLXR FOOT SEC W/FREE GRAFT EA TENDON,,,21,,RBRVS,7.07 ,4.50 ,9.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28208,CPT,REPAIR TENDON EXTENSOR FOOT 1/2 EACH TENDON,,,21,,RBRVS,4.51 ,3.98 ,8.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28210,CPT,RPR TENDON XTNSR FOOT SEC W/FREE GRAFT EA TENDON,,,21,,RBRVS,6.52 ,4.85 ,9.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28220,CPT,TENOLYSIS FLEXOR FOOT SINGLE TENDON,,,21,,RBRVS,4.67 ,3.61 ,7.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28222,CPT,TENOLYSIS FLEXOR FOOT MULTIPLE TENDONS,,,21,,RBRVS,5.76 ,3.76 ,8.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28225,CPT,TENOLYSIS EXTENSOR FOOT SINGLE TENDON,,,21,,RBRVS,3.78 ,3.29 ,7.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28226,CPT,TENOLYSIS EXTENSOR FOOT MULTIPLE TENDON,,,21,,RBRVS,4.67 ,3.40 ,7.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28230,CPT,TX OPN TENDON FLEXOR FOOT SINGLE/MULT TENDON SPX,,,21,,RBRVS,4.36 ,3.43 ,7.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28232,CPT,TX OPEN TENDON FLEXOR TOE 1 TENDON SPX,,,21,,RBRVS,3.51 ,3.17 ,7.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28234,CPT,TENOTOMY OPEN EXTENSOR FOOT/TOE EACH TENDON,,,21,,RBRVS,3.54 ,3.72 ,7.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28238,CPT,RCNSTJ PST TIBL TDN W/EXC ACCESSORY TARSL NAVCLR,,,21,,RBRVS,7.96 ,5.32 ,10.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28240,CPT,TENOTOMY LENGTHENING/RLS ABDUCTOR HALLUCIS MUSC,,,21,,RBRVS,4.48 ,3.45 ,7.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28250,CPT,DIVISION PLANTAR FASCIA & MUSCLE SPX,,,21,,RBRVS,6.06 ,4.82 ,9.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28260,CPT,CAPSULOTOMY MIDFOOT MEDIAL RELEASE ONLY SPX,,,21,,RBRVS,8.19 ,5.58 ,10.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28261,CPT,CAPSULOTOMY MIDFOOT W/TENDON LENGTHENING,,,21,,RBRVS,13.11 ,8.10 ,14.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28262,CPT,CAPSUL MIDFOOT W/PST TALOTIBL CAPSUL&TDN LNGTH,,,21,,RBRVS,17.21 ,13.40 ,21.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28264,CPT,CAPSULOTOMY MIDTARSAL,,,21,,RBRVS,10.65 ,7.13 ,12.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28270,CPT,CAPSUL MTTARPHLNGL JT W/WO TENORRHAPHY EA JT SPX,,,21,,RBRVS,4.93 ,4.18 ,8.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28272,CPT,CAPSULOTOMY IPHAL JOINT EACH JOINT SPX,,,21,,RBRVS,3.92 ,3.11 ,7.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28280,CPT,SYNDACTYLIZATION TOES,,,21,,RBRVS,5.33 ,4.12 ,8.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28285,CPT,CORRECTION HAMMERTOE,,,21,,RBRVS,5.62 ,4.69 ,9.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28286,CPT,CORRECTION COCK-UP 5TH TOE W/PLASTIC CLOSURE,,,21,,RBRVS,4.70 ,3.51 ,7.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28288,CPT,OSTC PRTL EXOSTC/CONDYLC METAR HEAD,,,21,,RBRVS,6.02 ,5.67 ,10.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28289,CPT,HALLUX RIGIDUS CORRECT W/CHEILECTOMY 1ST MP JT,,,21,,RBRVS,8.31 ,6.48 ,11.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28290,CPT,CORRJ HALLUX VALGUS W/WO SESMDC SMPL EXOSTECTOMY,,,21,,RBRVS,5.83 ,4.89 ,10.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28292,CPT,KELLER/MCBRIDE/MAYO PROCEDURE,,,21,,RBRVS,9.05 ,7.43 ,12.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28293,CPT,CORRJ HALLUX VALGUS W/WO SESMDC RESCJ JT W/IMPLT,,,21,,RBRVS,11.48 ,8.00 ,17.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28294,CPT,CORRJ HALLUX VALGUS W/WO SESMDC W/TDN TRNSPLS,,,21,,RBRVS,8.75 ,6.13 ,12.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28296,CPT,CORRJ HALLUX VALGUS W/WO SESMDC W/METAR OSTEOT,,,21,,RBRVS,8.35 ,5.89 ,11.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28297,CPT,CORRJ HALLUX VALGUS W/WO SESMDC LAPIDUS-TYP PX,,,21,,RBRVS,9.43 ,6.22 ,12.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28298,CPT,CORRJ HALLUX VALGUS W/WO SESMDC PHALANX OSTEOT,,,21,,RBRVS,8.13 ,5.54 ,11.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28299,CPT,CORRJ HALLUX VALGUS W/WO SESMDC 2 OSTEOT,,,21,,RBRVS,11.57 ,6.81 ,13.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28300,CPT,OSTEOTOMY CALCANEUS W/WO INTERNAL FIXATION,,,21,,RBRVS,9.73 ,7.56 ,7.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28302,CPT,OSTEOTOMY TALUS,,,21,,RBRVS,9.74 ,8.86 ,8.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28304,CPT,OSTEOTOMY TARSAL BONES OTH/THN CALCANEUS/TALUS,,,21,,RBRVS,9.41 ,6.83 ,13.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28305,CPT,OSTEOT TARSAL OTH/THN CALCANEUS/TALUS W/AGRFT,,,21,,RBRVS,10.77 ,7.22 ,7.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28306,CPT,OSTEOT W/WO LNGTH SHRT/CORRJ 1ST METAR,,,21,,RBRVS,6.00 ,4.85 ,10.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28307,CPT,OSTEOT W/WO LNGTH SHRT/CORRJ METAR XCP 1ST TOE,,,21,,RBRVS,6.50 ,5.74 ,12.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28308,CPT,OSTEOT W/WO LNGTH SHRT/CORRJ METAR XCP 1ST EA,,,21,,RBRVS,5.48 ,4.75 ,10.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28309,CPT,OSTEOT W/WO LNGTH SHRT/ANGULAR CORRJ METAR MLT,,,21,,RBRVS,14.16 ,9.92 ,9.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28310,CPT,OSTEOT SHRT CORRJ PROX PHALANX 1ST TOE,,,21,,RBRVS,5.57 ,4.18 ,9.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28312,CPT,OSTEOT SHRT CORRJ OTH PHALANGES ANY TOE,,,21,,RBRVS,4.69 ,4.10 ,9.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28313,CPT,RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY,,,21,,RBRVS,5.15 ,4.51 ,9.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28315,CPT,SESAMOIDECTOMY FIRST TOE SPX,,,21,,RBRVS,5.00 ,3.89 ,8.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28320,CPT,REPAIR NONUNION/MALUNION TARSAL BONES,,,21,,RBRVS,9.37 ,6.83 ,6.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28322,CPT,RPR NON/MALUNION METARSAL W/WO BONE GRAFT,,,21,,RBRVS,8.53 ,6.85 ,13.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28340,CPT,RCNSTJ TOE MACRODACTYLY SOFT TISSUE RESECTION,,,21,,RBRVS,7.15 ,4.21 ,9.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28341,CPT,RCNSTJ TOE MACRODACTYLY REQUIRING BONE RESECTION,,,21,,RBRVS,8.72 ,4.80 ,10.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28344,CPT,RECONSTRUCTION TOE POLYDACTYLY,,,21,,RBRVS,4.40 ,5.06 ,10.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28345,CPT,RCNSTJ TOE SYNDACTYLY W/WO SKIN GRAFT EACH WEB,,,21,,RBRVS,6.09 ,3.95 ,8.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28360,CPT,RECONSTRUCTION CLEFT FOOT,,,21,,RBRVS,14.92 ,7.55 ,7.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28400,CPT,CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION,,,21,,RBRVS,2.31 ,3.84 ,4.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28405,CPT,CLOSED TX CALCANEAL FRACTURE W/MANIPULATION,,,21,,RBRVS,4.74 ,4.89 ,5.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28406,CPT,PRQ SKELETAL FIXJ CALCANEAL FRACTURE W/MANJ,,,21,,RBRVS,6.56 ,7.40 ,7.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28415,CPT,OPEN TREATMENT CALCANEAL FRACTURE,,,21,,RBRVS,16.19 ,12.92 ,12.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28420,CPT,OPEN TREATMENT CALCANEAL FRACTURE W BONE GRAFT,,,21,,RBRVS,17.52 ,15.06 ,15.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28430,CPT,CLOSED TX TALUS FRACTURE W/O MANIPULATION,,,21,,RBRVS,2.22 ,3.46 ,4.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28435,CPT,CLOSED TX TALUS FRACTURE W/MANIPULATION,,,21,,RBRVS,3.54 ,4.04 ,5.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28436,CPT,PRQ SKELETAL FIXATION TALUS FRACTURE W/MANJ,,,21,,RBRVS,4.90 ,7.00 ,7.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28445,CPT,OPEN TREATMENT TALUS FRACTURE,,,21,,RBRVS,15.76 ,12.21 ,12.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28446,CPT,OPEN OSTEOCHONDRAL AUTOGRAFT TALUS,,,21,,RBRVS,17.71 ,13.98 ,13.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28450,CPT,TX TARSAL BONE FX XCP TALUS&CALCN W/O MANJ,,,21,,RBRVS,2.03 ,3.19 ,3.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28455,CPT,TX TARSAL BONE FX XCP TALUS&CALCN W/MANJ,,,21,,RBRVS,3.24 ,3.81 ,4.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28456,CPT,PRQ SKEL FIXJ TARSL FX XCP TALUS&CALCNS W/MANJ,,,21,,RBRVS,2.86 ,5.71 ,5.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28465,CPT,OPEN TX TARSAL FRACTURE XCP TALUS & CALCANEUS EA,,,21,,RBRVS,8.80 ,7.66 ,7.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28470,CPT,CLOSED TX METATARSAL FRACTURE W/O MANIPULATION,,,21,,RBRVS,2.03 ,3.53 ,3.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28475,CPT,CLTX METAR FX W/MANJ,,,21,,RBRVS,3.01 ,3.15 ,3.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28476,CPT,PRQ SKEL FIXJ METAR FX W/MANJ,,,21,,RBRVS,3.60 ,5.88 ,5.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28485,CPT,OPEN TREATMENT METATARSAL FRACTURE EACH,,,21,,RBRVS,7.44 ,6.76 ,6.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28490,CPT,CLTX FX GRT TOE PHLX/PHLG W/O MANJ,,,21,,RBRVS,1.17 ,2.28 ,2.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28495,CPT,CLTX FX GRT TOE PHLX/PHLG W/MANJ,,,21,,RBRVS,1.68 ,2.48 ,3.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28496,CPT,PRQ SKEL FIXJ FX GRT TOE PHLX/PHLG W/MANJ,,,21,,RBRVS,2.48 ,3.85 ,9.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28505,CPT,OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES,,,21,,RBRVS,7.44 ,6.14 ,11.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28510,CPT,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ,,,21,,RBRVS,1.17 ,2.16 ,2.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28515,CPT,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ,,,21,,RBRVS,1.56 ,2.39 ,2.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28525,CPT,OPEN TX FRACTURE PHALANX/PHALANGES NOT GREAT TOE,,,21,,RBRVS,5.62 ,5.06 ,9.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28530,CPT,CLOSED TREATMENT SESAMOID FRACTURE,,,21,,RBRVS,1.11 ,1.72 ,2.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28531,CPT,OPEN TX SESAMOID FRACTURE W/WO INTERNAL FIXATION,,,21,,RBRVS,2.57 ,2.49 ,7.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28540,CPT,CLTX TARSAL DISLC OTH/THN TALOTARSAL W/O ANES,,,21,,RBRVS,2.19 ,2.64 ,3.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28545,CPT,CLTX TARSAL DISLC OTH/THN TALOTARSAL W/ANES,,,21,,RBRVS,2.60 ,4.38 ,5.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28546,CPT,PRQ SKEL FIXJ TARSL DISLC XCP TALOTARSAL W/MANJ,,,21,,RBRVS,3.40 ,5.65 ,12.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28555,CPT,OPEN TREATMENT TARSAL BONE DISLOCATION,,,21,,RBRVS,9.65 ,8.09 ,14.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28570,CPT,CLOSED TX TALOTARSAL JOINT DISLC W/O ANES,,,21,,RBRVS,1.76 ,2.12 ,2.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28575,CPT,CLOSED TX TALOTARSAL JOINT DISLOCATION W/ANES,,,21,,RBRVS,3.49 ,5.20 ,6.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28576,CPT,PRQ SKEL FIXJ TALOTARSAL JT DISLC W/MANJ,,,21,,RBRVS,4.60 ,5.83 ,5.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28585,CPT,OPEN TREATMENT TALOTARSAL JOINT DISLOCATION,,,21,,RBRVS,11.13 ,7.03 ,12.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28600,CPT,CLOSED TX TARSOMETATARSAL DISLOCATION W/O ANES,,,21,,RBRVS,2.02 ,3.07 ,3.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28605,CPT,CLOSED TX TARSOMETATARSAL DISLOCATION W/ANES,,,21,,RBRVS,2.89 ,4.96 ,5.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28606,CPT,PRQ SKEL FIXJ TARS JT DISLC W/MANJ,,,21,,RBRVS,5.09 ,5.39 ,5.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28615,CPT,OPEN TREATMENT TARSOMETATARSAL JOINT DISLOCATION,,,21,,RBRVS,10.70 ,10.22 ,10.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28630,CPT,CLTX METATARSOPHLNGL JT DISLC W/O ANES,,,21,,RBRVS,1.75 ,1.17 ,2.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28635,CPT,CLTX METATARSOPHLNGL JT DISLC REQ ANES,,,21,,RBRVS,1.96 ,1.57 ,2.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28636,CPT,PRQ SKEL FIXJ METATARSOPHLNGL JT DISLC W/MANJ,,,21,,RBRVS,2.77 ,3.12 ,6.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28645,CPT,OPEN TX METATARSOPHALANGEAL JOINT DISLOCATION,,,21,,RBRVS,7.44 ,5.66 ,10.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28660,CPT,CLTX INTERPHALANGEAL JOINT DISLOCATION W/O ANES,,,21,,RBRVS,1.28 ,1.10 ,1.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28665,CPT,CLTX INTERPHALANGEAL JOINT DISLOCATION REQ ANES,,,21,,RBRVS,1.97 ,1.60 ,2.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28666,CPT,PRQ SKEL FIXJ INTERPHALANGEAL JOINT DISLC W/MANJ,,,21,,RBRVS,2.66 ,2.32 ,2.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28675,CPT,OPEN TREATMENT INTERPHALANGEAL JOINT DISLOCATION,,,21,,RBRVS,5.62 ,5.59 ,10.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28705,CPT,ARTHRODESIS PANTALAR,,,21,,RBRVS,20.33 ,12.74 ,12.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28715,CPT,ARTHRODESIS TRIPLE,,,21,,RBRVS,13.42 ,11.33 ,11.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28725,CPT,ARTHRODESIS SUBTALAR,,,21,,RBRVS,11.22 ,9.36 ,9.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28730,CPT,ARTHRD MIDTARSL/TARSOMETATARSAL MULT/TRANSVRS,,,21,,RBRVS,10.70 ,8.74 ,8.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28735,CPT,ARTHRD MIDTARSL/TARS MLT/TRANSVRS W/OSTEOT,,,21,,RBRVS,12.23 ,8.59 ,8.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28737,CPT,ARTHRD W/TDN LNGTH&ADVMNT TARSL NVCLR-CUNEIFOR,,,21,,RBRVS,11.03 ,7.56 ,7.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28740,CPT,ARTHRODESIS MIDTARSOMETATARSAL SINGLE JOINT,,,21,,RBRVS,9.29 ,7.39 ,13.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28750,CPT,ARTHRODESIS GREAT TOE METATARSOPHALANGEAL JOINT,,,21,,RBRVS,8.57 ,7.30 ,13.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28755,CPT,ARTHRODESIS GREAT TOE INTERPHALANGEAL JOINT,,,21,,RBRVS,4.88 ,4.08 ,9.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28760,CPT,ARTHRD W/XTNSR HALLUCIS LONGUS TR 1ST METAR NCK,,,21,,RBRVS,9.14 ,6.51 ,12.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28800,CPT,AMPUTATION FOOT MIDTARSAL,,,21,,RBRVS,8.79 ,5.76 ,5.76 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
28805,CPT,AMPUTATION FOOT TRANSMETARSAL,,,21,,RBRVS,12.71 ,6.60 ,6.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28810,CPT,AMPUTATION METATARSAL W/TOE SINGLE,,,21,,RBRVS,6.64 ,4.72 ,4.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28820,CPT,AMPUTATION TOE METATARSOPHALANGEAL JOINT,,,21,,RBRVS,5.82 ,4.82 ,9.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28825,CPT,AMPUTATION TOE INTERPHALANGEAL JOINT,,,21,,RBRVS,5.37 ,4.63 ,9.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28890,CPT,ESWT HI NRG PHYS/QHP W/US GDN INVG PLNTAR FASCIA,,,21,,RBRVS,3.45 ,2.72 ,5.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
28899,CPT,UNLISTED PROCEDURE FOOT/TOES,,,21,,TotalUnits,,,,10.83 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29000,CPT,APPLICATION HALO TYPE BODY CAST,,,21,,RBRVS,2.25 ,2.19 ,5.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29010,CPT,APPLICATION RISSER JACKET LOCALIZER BODY ONLY,,,21,,RBRVS,2.06 ,1.51 ,3.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29015,CPT,APPLICATION RISSER JACKET LOCALIZER BODY W/HEAD,,,21,,RBRVS,2.41 ,2.16 ,5.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29035,CPT,APPLICATION BODY CAST SHOULDER HIPS,,,21,,RBRVS,1.77 ,1.70 ,4.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29040,CPT,APPLICATION BODY CAST SHOULDER HIPS HEAD MINERVA,,,21,,RBRVS,2.22 ,1.68 ,3.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29044,CPT,APPLICATION BODY CAST SHOULDER HIPS W/ONE THIGH,,,21,,RBRVS,2.12 ,2.32 ,5.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29046,CPT,APPLICATION BODY CAST SHOULDER HIPS BOTH THIGHS,,,21,,RBRVS,2.41 ,1.82 ,4.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29049,CPT,APPLICATION CAST FIGURE-OF-8,,,21,,RBRVS,0.89 ,0.57 ,1.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29055,CPT,APPLICATION CAST SHOULDER SPICA,,,21,,RBRVS,1.78 ,1.86 ,4.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29058,CPT,APPLICATION CAST PLASTER VELPEAU,,,21,,RBRVS,1.31 ,1.16 ,1.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29065,CPT,APPLICATION CAST SHOULDER HAND LONG ARM,,,21,,RBRVS,0.87 ,0.94 ,1.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29075,CPT,APPLICATION CAST ELBOW FINGER SHORT ARM,,,21,,RBRVS,0.77 ,0.89 ,1.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29085,CPT,APPLICATION CAST HAND & LOWER FOREARM GAUNTLET,,,21,,RBRVS,0.87 ,0.93 ,1.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29086,CPT,APPLICATION CAST FINGER,,,21,,RBRVS,0.62 ,0.76 ,1.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29105,CPT,APPLICATION LONG ARM SPLINT SHOULDER HAND,,,21,,RBRVS,0.87 ,0.71 ,1.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29125,CPT,APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC,,,21,,RBRVS,0.50 ,0.56 ,1.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29126,CPT,APPLICATION SHORT ARM SPLINT DYNAMIC,,,21,,RBRVS,0.68 ,0.63 ,1.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29130,CPT,APPLICATION FINGER SPLINT STATIC,,,21,,RBRVS,0.50 ,0.25 ,0.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29131,CPT,APPLICATION FINGER SPLINT DYNAMIC,,,21,,RBRVS,0.55 ,0.33 ,0.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29200,CPT,STRAPPING THORAX,,,21,,RBRVS,0.39 ,0.11 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29240,CPT,STRAPPING SHOULDER,,,21,,RBRVS,0.39 ,0.12 ,0.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29260,CPT,STRAPPING ELBOW/WRIST,,,21,,RBRVS,0.39 ,0.13 ,0.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29280,CPT,STRAPPING HAND/FINGER,,,21,,RBRVS,0.39 ,0.14 ,0.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29305,CPT,APPLICATION HIP SPICA CAST 1 LEG,,,21,,RBRVS,2.03 ,2.16 ,4.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29325,CPT,APPL HIP SPICA CAST ONE&ONE-HALF SPICA/BOTH LEGS,,,21,,RBRVS,2.32 ,2.37 ,5.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29345,CPT,APPLICATION LONG LEG CAST THIGH-TOE,,,21,,RBRVS,1.40 ,1.25 ,2.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29355,CPT,APPLICATION LONG LEG CAST WALKER/AMBULATORY TYPE,,,21,,RBRVS,1.53 ,1.26 ,2.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29358,CPT,APPLICATION LONG LEG CAST BRACE,,,21,,RBRVS,1.43 ,1.28 ,2.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29365,CPT,APPLICATION CYLINDER CAST THIGH ANKLE,,,21,,RBRVS,1.18 ,1.12 ,2.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29405,CPT,APPLICATION SHORT LEG CAST BELOW KNEE-TOE,,,21,,RBRVS,0.80 ,0.81 ,1.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29425,CPT,APPLICATION SHORT LEG CAST WALKING/AMBULATORY,,,21,,RBRVS,0.80 ,0.73 ,1.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29435,CPT,APPLICATION PATELLAR TENDON BEARING CAST,,,21,,RBRVS,1.18 ,1.02 ,2.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29440,CPT,ADDING WALKER PREVIOUSLY APPLIED CAST,,,21,,RBRVS,0.57 ,0.22 ,0.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29445,CPT,APPLICATION RIGID TOTAL CONTACT LEG CAST,,,21,,RBRVS,1.78 ,1.02 ,1.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29450,CPT,APPL CLUBFOOT CAST MOLDING/MANJ LONG/SHORT LEG,,,21,,RBRVS,2.08 ,0.97 ,1.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29505,CPT,APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES,,,21,,RBRVS,0.69 ,0.64 ,1.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29515,CPT,APPLICATION SHORT LEG SPLINT CALF FOOT,,,21,,RBRVS,0.73 ,0.60 ,1.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29520,CPT,STRAPPING HIP,,,21,,RBRVS,0.39 ,0.12 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29530,CPT,STRAPPING KNEE,,,21,,RBRVS,0.39 ,0.11 ,0.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29540,CPT,STRAPPING ANKLE &/FOOT,,,21,,RBRVS,0.39 ,0.10 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29550,CPT,STRAPPING TOES,,,21,,RBRVS,0.25 ,0.06 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29580,CPT,STRAPPING UNNA BOOT,,,21,,RBRVS,0.55 ,0.40 ,0.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29581,CPT,APPL MLTLAYR COMPRES LEG BELOW KNEE W/ANKLE FOOT,,,21,,RBRVS,0.25 ,0.10 ,1.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29582,CPT,APPL MLTLAYR COMPRES THGH LEG ANKLE FT WHEN DONE,,,21,,RBRVS,0.35 ,0.09 ,1.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29583,CPT,APPL MLTLAYR COMPRES SYSTEM UPPER & LOWER ARM,,,21,,RBRVS,0.25 ,0.06 ,0.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29584,CPT,APPL MLTLAYR COMPRES SYS UPARM LWARM HAND&FING,,,21,,RBRVS,0.35 ,0.09 ,1.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29700,CPT,REMOVAL/BIVALVING GAUNTLET BOOT/BODY CAST,,,21,,RBRVS,0.57 ,0.30 ,1.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29705,CPT,REMOVAL/BIVALVING FULL ARM/FULL LEG CAST,,,21,,RBRVS,0.76 ,0.47 ,1.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29710,CPT,RMVL/BIVALV SHO/HIP SPICA MINERVA/RISSER JACKET,,,21,,RBRVS,1.34 ,0.81 ,1.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29720,CPT,REPAIR SPICA BODY CAST/JACKET,,,21,,RBRVS,0.68 ,0.46 ,1.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29730,CPT,WINDOWING CAST,,,21,,RBRVS,0.75 ,0.42 ,0.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29740,CPT,WEDGING CAST EXCEPT CLUBFOOT CASTS,,,21,,RBRVS,1.12 ,0.68 ,1.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29750,CPT,WEDGING CLUBFOOT CAST,,,21,,RBRVS,1.26 ,0.63 ,1.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29799,CPT,UNLISTED PROCEDURE CASTING/STRAPPING,,,21,,TotalUnits,,,,1.39 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29800,CPT,ARTHRS TEMPOROMANDIBULR JT DX W/WO SYNVAL BX SPX,,,21,,RBRVS,6.84 ,6.93 ,6.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29804,CPT,ARTHROSCOPY TEMPOROMANDIBULAR JOINT SURGICAL,,,21,,RBRVS,8.87 ,8.13 ,8.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29805,CPT,ARTHROSCOPY SHOULDER DX W/WO SYNOVIAL BIOPSY SPX,,,21,,RBRVS,6.03 ,6.32 ,6.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29806,CPT,ARTHROSCOPY SHOULDER SURGICAL CAPSULORRHAPHY,,,21,,RBRVS,15.14 ,12.36 ,12.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29807,CPT,ARTHROSCOPY SHOULDER SURGICAL REPAIR SLAP LESION,,,21,,RBRVS,14.67 ,12.19 ,12.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29819,CPT,ARTHROSCOPY SHOULDER SURGICAL REMOVAL LOOSE/FB,,,21,,RBRVS,7.79 ,7.51 ,7.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29820,CPT,ARTHROSCOPY SHOULDER SURG SYNOVECTOMY PARTIAL,,,21,,RBRVS,7.21 ,6.90 ,6.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29821,CPT,ARTHROSCOPY SHOULDER SURG SYNOVECTOMY COMPLETE,,,21,,RBRVS,7.89 ,7.56 ,7.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29822,CPT,ARTHROSCOPY SHOULDER SURG DEBRIDEMENT LIMITED,,,21,,RBRVS,7.60 ,7.42 ,7.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29823,CPT,ARTHROSCOPY SHOULDER SURG DEBRIDEMENT EXTENSIVE,,,21,,RBRVS,8.36 ,8.03 ,8.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29824,CPT,ARTHROSCOPY SHOULDER DISTAL CLAVICULECTOMY,,,21,,RBRVS,8.98 ,8.71 ,8.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29825,CPT,ARTHROSCOPY SHOULDER AHESIOLYSIS W/WO MANIPJ,,,21,,RBRVS,7.79 ,7.52 ,7.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29826,CPT,ARTHROSCOPY SHOULDER W/CORACOACRM LIGMNT RELEASE,,,21,,RBRVS,3.00 ,1.51 ,1.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29827,CPT,ARTHROSCOPY SHOULDER ROTATOR CUFF REPAIR,,,21,,RBRVS,15.59 ,12.24 ,12.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29828,CPT,ARTHROSCOPY SHOULDER BICEPS TENODESIS,,,21,,RBRVS,13.16 ,10.80 ,10.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29830,CPT,ARTHROSCOPY ELBOW DIAG W/WO SYNOVIAL BIOPSY SPX,,,21,,RBRVS,5.88 ,6.05 ,6.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29834,CPT,ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB,,,21,,RBRVS,6.42 ,6.45 ,6.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29835,CPT,ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY PARTIAL,,,21,,RBRVS,6.62 ,6.50 ,6.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29836,CPT,ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY COMPLETE,,,21,,RBRVS,7.72 ,7.30 ,7.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29837,CPT,ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT LIMITED,,,21,,RBRVS,7.01 ,6.85 ,6.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29838,CPT,ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT EXTENSIVE,,,21,,RBRVS,7.88 ,7.55 ,7.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29840,CPT,ARTHROSCOPY WRIST DIAG W/WO SYNOVIAL BIOPSY SPX,,,21,,RBRVS,5.68 ,6.16 ,6.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29843,CPT,ARTHROSCOPY WRIST INFECTION LAVAGE&DRAINAGE,,,21,,RBRVS,6.15 ,6.51 ,6.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29844,CPT,ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY PARTIAL,,,21,,RBRVS,6.51 ,6.60 ,6.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29845,CPT,ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY COMPLETE,,,21,,RBRVS,7.69 ,7.53 ,7.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29846,CPT,ARTHRS WRST EXC&/RPR TRIANG FIBROCART&/JOINT,,,21,,RBRVS,6.89 ,6.82 ,6.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29847,CPT,ARTHROSCOPY WRIST SURG INT FIXJ FX/INSTABILITY,,,21,,RBRVS,7.22 ,6.94 ,6.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29848,CPT,NDSC WRST SURG W/RLS TRANSVRS CARPL LIGM,,,21,,RBRVS,6.39 ,7.05 ,7.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29850,CPT,ARTHROSCOPY AID TX SPINE&/FX KNEE W/O FIXJ,,,21,,RBRVS,8.27 ,8.01 ,8.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29851,CPT,ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ,,,21,,RBRVS,13.26 ,10.90 ,10.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29855,CPT,ARTHRS AID TIBIAL FRACTURE PROXIMAL UNICONDYLAR,,,21,,RBRVS,10.76 ,9.71 ,9.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29856,CPT,ARTHRS AID TIBIAL FX PROX UNICONDYLAR BICONDYLAR,,,21,,RBRVS,14.28 ,11.53 ,11.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29860,CPT,ARTHROSCOPY HIP DIAGNOSTIC W/WO SYNOVIAL BYP SPX,,,21,,RBRVS,9.00 ,8.38 ,8.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29861,CPT,ARTHROSCOPY HIP SURGICAL W/REMOVAL LOOSE/FB,,,21,,RBRVS,10.10 ,8.78 ,8.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29862,CPT,ARTHRS HIP DEBRIDEMENT/SHAVING ARTICULAR CRTLG,,,21,,RBRVS,11.17 ,10.17 ,10.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29863,CPT,ARTHROSCOPY HIP SURGICAL W/SYNOVECTOMY,,,21,,RBRVS,11.17 ,10.11 ,10.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29866,CPT,ARTHROSCOPY KNEE OSTEOCHONDRAL AGRFT MOSAICPLAST,,,21,,RBRVS,14.67 ,12.58 ,12.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29867,CPT,ARTHROSCOPY KNEE OSTEOCHONDRAL ALLOGRAFT,,,21,,RBRVS,18.39 ,14.76 ,14.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29868,CPT,ARTHROSCOPY KNEE MENISCAL TRNSPLJ MED/LAT,,,21,,RBRVS,25.10 ,18.12 ,18.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29870,CPT,ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX,,,21,,RBRVS,5.19 ,5.62 ,10.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29871,CPT,ARTHROSCOPY KNEE INFECTION LAVAGE & DRAINAGE,,,21,,RBRVS,6.69 ,6.75 ,6.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29873,CPT,ARTHROSCOPY KNEE LATERAL RELEASE,,,21,,RBRVS,6.24 ,7.57 ,7.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29874,CPT,ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY,,,21,,RBRVS,7.19 ,6.86 ,6.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29875,CPT,ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX,,,21,,RBRVS,6.45 ,6.52 ,6.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29876,CPT,ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS,,,21,,RBRVS,8.87 ,8.27 ,8.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29877,CPT,ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG,,,21,,RBRVS,8.30 ,7.97 ,7.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29879,CPT,ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX,,,21,,RBRVS,8.99 ,8.33 ,8.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29880,CPT,ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING,,,21,,RBRVS,7.39 ,7.35 ,7.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29881,CPT,ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG,,,21,,RBRVS,7.03 ,7.18 ,7.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29882,CPT,ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL,,,21,,RBRVS,9.60 ,8.62 ,8.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29883,CPT,ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL,,,21,,RBRVS,11.77 ,10.16 ,10.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29884,CPT,ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX,,,21,,RBRVS,8.28 ,7.94 ,7.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29885,CPT,ARTHRS KNEE DRILL OSTEOCHONDRITIS DISSECANS GRFG,,,21,,RBRVS,10.21 ,9.39 ,9.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29886,CPT,ARTHRS KNEE DRILLING OSTEOCHOND DISSECANS LESION,,,21,,RBRVS,8.49 ,8.12 ,8.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29887,CPT,ARTHRS KNEE DRLG OSTEOCHOND DISSECANS INT FIXJ,,,21,,RBRVS,10.16 ,9.35 ,9.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29888,CPT,ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ,,,21,,RBRVS,14.30 ,11.28 ,11.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29889,CPT,ARTHRS AIDED PST CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ,,,21,,RBRVS,17.41 ,14.32 ,14.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29891,CPT,ARTHRS ANKLE EXC OSTCHNDRL DFCT W/DRLG DFCT,,,21,,RBRVS,9.67 ,8.32 ,8.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29892,CPT,ARTHRS AID RPR LES/TALAR DOME FX/TIBL PLAFOND FX,,,21,,RBRVS,10.27 ,6.97 ,6.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29893,CPT,ENDOSCOPIC PLANTAR FASCIOTOMY,,,21,,RBRVS,6.32 ,5.50 ,10.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29894,CPT,ARTHROSCOPY ANKLE W/REMOVAL LOOSE/FOREIGN BODY,,,21,,RBRVS,7.35 ,5.94 ,5.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29895,CPT,ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL,,,21,,RBRVS,7.13 ,5.73 ,5.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29897,CPT,ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT LIMITED,,,21,,RBRVS,7.32 ,6.09 ,6.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29898,CPT,ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE,,,21,,RBRVS,8.49 ,6.55 ,6.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29899,CPT,ARTHROSCOPY ANKLE SURGICAL W/ANKLE ARTHRODESIS,,,21,,RBRVS,15.41 ,11.83 ,11.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29900,CPT,ARTHROSCOPY METACARPOPHALANGEAL SYNOVIAL BIOPSY,,,21,,RBRVS,5.88 ,5.73 ,5.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29901,CPT,ARTHRS METACARPOPHALANGEAL JOINT DEBRIDEMENT,,,21,,RBRVS,6.59 ,7.47 ,7.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29902,CPT,ARTHRS MTCARPHLNGL JT W/RDCTJ UR COLTRL LIGM,,,21,,RBRVS,7.16 ,5.80 ,5.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29904,CPT,ARTHRS SUBTALAR JOINT REMOVE LOOSE/FOREIGN BODY,,,21,,RBRVS,8.65 ,7.97 ,7.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29905,CPT,ARTHROSCOPY SUBTALAR JOINT WITH SYNOVECTOMY,,,21,,RBRVS,9.18 ,8.84 ,8.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29906,CPT,ARTHROSCOPY SUBTALAR JOINT WITH DEBRIDEMENT,,,21,,RBRVS,9.65 ,8.73 ,8.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29907,CPT,ARTHROSCOPY SUBTALAR JOINT SUBTALAR ARTHRODESIS,,,21,,RBRVS,12.18 ,10.59 ,10.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29914,CPT,ARTHROSCOPY HIP W/FEMOROPLASTY,,,21,,RBRVS,14.67 ,11.46 ,11.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29915,CPT,ARTHROSCOPY HIP W/ACETABULOPLASTY,,,21,,RBRVS,15.00 ,11.64 ,11.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29916,CPT,ARTHROSCOPY HIP W/LABRAL REPAIR,,,21,,RBRVS,15.00 ,11.72 ,11.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
29999,CPT,UNLISTED PROCEDURE ARTHROSCOPY,,,21,,TotalUnits,,,,15.02 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30000,CPT,DRAINAGE ABSCESS/HEMATOMA NASAL INT APPROACH,,,21,,RBRVS,1.48 ,1.69 ,4.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30020,CPT,DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM,,,21,,RBRVS,1.48 ,1.72 ,4.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30100,CPT,BIOPSY INTRANASAL,,,21,,RBRVS,0.94 ,0.91 ,2.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30110,CPT,EXCISION NASAL POLYP SIMPLE,,,21,,RBRVS,1.68 ,1.81 ,4.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30115,CPT,EXCISION NASAL POLYP EXTENSIVE,,,21,,RBRVS,4.44 ,7.23 ,7.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30117,CPT,EXCISION/DESTRUCTION INTRANASAL LESION INT APPR,,,21,,RBRVS,3.26 ,5.98 ,21.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30118,CPT,EXCISION/DESTRUCTION INTRANASAL LESION XTRNL,,,21,,RBRVS,9.92 ,10.49 ,10.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30120,CPT,EXCISION/SURGICAL PLANING SKIN NOSE RHINOPHYMA,,,21,,RBRVS,5.39 ,6.26 ,8.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30124,CPT,EXCISION DERMOID CYST NOSE SIMPLE SUBCUTANEOUS,,,21,,RBRVS,3.20 ,4.46 ,4.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30125,CPT,EXC DERMOID CYST NOSE COMPLEX UNDER BONE/CRTLG,,,21,,RBRVS,7.30 ,8.97 ,8.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30130,CPT,EXCISION INFERIOR TURBINATE PARTIAL/COMPLETE,,,21,,RBRVS,3.47 ,6.90 ,6.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30140,CPT,SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL,,,21,,RBRVS,3.57 ,8.47 ,8.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30150,CPT,RHINECTOMY PARTIAL,,,21,,RBRVS,9.55 ,10.91 ,10.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30160,CPT,RHINECTOMY TOTAL,,,21,,RBRVS,9.99 ,10.60 ,10.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30200,CPT,INJECTION TURBINATE THERAPEUTIC,,,21,,RBRVS,0.78 ,0.82 ,2.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30210,CPT,DISPLACEMENT THERAPY PROETZ TYPE,,,21,,RBRVS,1.13 ,1.55 ,2.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30220,CPT,INSERTION NASAL SEPTAL PROSTHESIS BUTTON,,,21,,RBRVS,1.59 ,1.76 ,6.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30300,CPT,REMOVAL FOREIGN BODY INTRANASAL OFFICE PROCEDURE,,,21,,RBRVS,1.09 ,2.38 ,5.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30310,CPT,REMOVAL FOREIGN BODY INTRANASAL GENERAL ANES,,,21,,RBRVS,2.01 ,3.54 ,3.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30320,CPT,RMVL FOREIGN BODY INTRANASAL LATERAL RHINOTOMY,,,21,,RBRVS,4.64 ,7.57 ,7.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30400,CPT,RHINP PRIM LAT&ALAR CRTLGS&/ELVTN NASAL TI,,,21,,RBRVS,10.86 ,16.22 ,16.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30410,CPT,RHINP PRIM COMPLETE XTRNL PARTS,,,21,,RBRVS,14.00 ,17.62 ,17.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30420,CPT,RHINOPLASTY PRIMARY W/MAJOR SEPTAL REPAIR,,,21,,RBRVS,16.90 ,19.74 ,19.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30430,CPT,RHINOPLASTY SECONDARY MINOR REVISION,,,21,,RBRVS,8.24 ,15.07 ,15.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30435,CPT,RHINOPLASTY SECONDARY INTERMEDIATE REVISION,,,21,,RBRVS,12.73 ,20.70 ,20.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30450,CPT,RHINOPLASTY SECONDARY MAJOR REVISION,,,21,,RBRVS,19.66 ,20.13 ,20.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30460,CPT,RHINP DFRM W/COLUM LNGTH TIP ONLY,,,21,,RBRVS,10.32 ,11.17 ,11.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30462,CPT,RHINP DFRM COLUM LNGTH TIP SEPTUM OSTEOT,,,21,,RBRVS,20.28 ,16.71 ,16.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30465,CPT,REPAIR NASAL VESTIBULAR STENOSIS,,,21,,RBRVS,12.36 ,13.77 ,13.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30520,CPT,SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF,,,21,,RBRVS,7.01 ,9.74 ,9.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30540,CPT,REPAIR CHOANAL ATRESIA INTRANASAL,,,21,,RBRVS,7.92 ,10.53 ,10.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30545,CPT,REPAIR CHOANAL ATRESIA TRANSPALATINE,,,21,,RBRVS,11.62 ,11.95 ,11.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30560,CPT,LYSIS INTRANASAL SYNECHIA,,,21,,RBRVS,1.31 ,2.43 ,6.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30580,CPT,REPAIR FISTULA OROMAXILLARY,,,21,,RBRVS,6.88 ,6.67 ,10.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30600,CPT,REPAIR FISTULA ORONASAL,,,21,,RBRVS,6.16 ,5.18 ,9.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30620,CPT,SEPTAL/OTHER INTRANASAL DERMATOPLASTY,,,21,,RBRVS,6.16 ,10.75 ,10.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30630,CPT,REPAIR NASAL SEPTAL PERFORATIONS,,,21,,RBRVS,7.29 ,9.48 ,9.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30801,CPT,ABLTJ SOFT TIS INFERIOR TURBINATES UNI/BI SUPFC,,,21,,RBRVS,1.14 ,2.61 ,5.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30802,CPT,ABLTJ SOF TISS INF TURBS UNI/BI SUPFC INTRAMURAL,,,21,,RBRVS,2.08 ,3.06 ,5.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30901,CPT,CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE,,,21,,RBRVS,1.10 ,0.37 ,1.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30903,CPT,CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX,,,21,,RBRVS,1.54 ,0.51 ,4.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30905,CPT,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST,,,21,,RBRVS,1.97 ,0.61 ,5.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30906,CPT,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY SUBSQ,,,21,,RBRVS,2.45 ,0.97 ,5.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30915,CPT,LIGATION ARTERIES ETHMOIDAL,,,21,,RBRVS,7.44 ,7.90 ,7.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30920,CPT,LIGATION ARTERIES INT MAXILLARY TRANSANTRAL,,,21,,RBRVS,11.14 ,11.05 ,11.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30930,CPT,FRACTURE NASAL INFERIOR TURBINATE THERAPEUTIC,,,21,,RBRVS,1.31 ,2.03 ,2.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
30999,CPT,UNLISTED PROCEDURE NOSE,,,21,,TotalUnits,,,,12.04 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31000,CPT,LAVAGE CANNULATION MAXILLARY SINUS,,,21,,RBRVS,1.20 ,1.67 ,3.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31002,CPT,LAVAGE CANNULATION SPHENOID SINUS,,,21,,RBRVS,1.96 ,3.29 ,3.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31020,CPT,SINUSOTOMY MAXILLARY ANTROTOMY INTRANASAL,,,21,,RBRVS,3.07 ,6.77 ,10.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31030,CPT,SINUSOTOMY MAXILLARY RAD W/O RMVL ANTROCH POLYPS,,,21,,RBRVS,6.01 ,8.21 ,12.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31032,CPT,SINUSOT MAX ANTRT RAD W/RMVL ANTROCH POLYPS,,,21,,RBRVS,6.69 ,8.71 ,8.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31040,CPT,PTERYGOMAXILLARY FOSSA SURGERY ANY APPROACH,,,21,,RBRVS,9.77 ,10.74 ,10.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31050,CPT,SINUSOTOMY SPHENOID W/WO BIOPSY,,,21,,RBRVS,5.37 ,7.66 ,7.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31051,CPT,SINUSOT SPHENOID W/MUCOSAL STRIPPING/RMVL POLYP,,,21,,RBRVS,7.25 ,10.08 ,10.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31070,CPT,SINUSOTOMY FRONTAL EXTERNAL SIMPLE,,,21,,RBRVS,4.40 ,7.47 ,7.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31075,CPT,SINUSOTOMY FRONTAL TRANSORBITAL UNILATERAL,,,21,,RBRVS,9.51 ,11.37 ,11.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31080,CPT,SINUSOTOMY FRNT OBLITERATIVE W/O FLAP BROW INC,,,21,,RBRVS,12.74 ,14.77 ,14.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31081,CPT,SINUSOT FRNT OBLIT W/O OSTPL FLAP CORONAL INC,,,21,,RBRVS,14.19 ,23.36 ,23.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31084,CPT,SINUSOT FRNT OBLIT W/OSTPL FLAP BROW INC,,,21,,RBRVS,14.95 ,15.73 ,15.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31085,CPT,SINUSOT FRNT OBLIT W/OSTPL FLAP CORONAL INC,,,21,,RBRVS,15.64 ,24.04 ,24.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31086,CPT,SINUSOT FRNT NONOBLIT W/OSTPL FLAP BROW INC,,,21,,RBRVS,14.36 ,15.49 ,15.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31087,CPT,SINUSOT FRNT NONOBLIT W/OSTPL FLAP CORONAL INC,,,21,,RBRVS,14.57 ,14.15 ,14.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31090,CPT,SINUSOT UNI 3/> PARANSL SINUSES,,,21,,RBRVS,11.17 ,16.37 ,16.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31200,CPT,ETHMOIDECTOMY INTRANASAL ANTERIOR,,,21,,RBRVS,5.14 ,10.59 ,10.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31201,CPT,ETHMOIDECTOMY INTRANASAL TOTAL,,,21,,RBRVS,8.60 ,11.26 ,11.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31205,CPT,ETHMOIDECTOMY EXTRANASAL TOTAL,,,21,,RBRVS,10.58 ,13.94 ,13.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31225,CPT,MAXILLECTOMY W/O ORBITAL EXENTERATION,,,21,,RBRVS,26.70 ,22.97 ,22.97 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
31230,CPT,MAXILLECTOMY W/ORBITAL EXENTERATION,,,21,,RBRVS,30.82 ,24.03 ,24.03 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
31231,CPT,NASAL ENDOSCOPY DIAGNOSTIC UNI/BI SPX,,,21,,RBRVS,1.10 ,0.62 ,4.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31233,CPT,NASAL/SINUS ENDOSCOPY DX MAXILLARY SINUSOSCOPY,,,21,,RBRVS,2.18 ,1.44 ,4.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31235,CPT,NASAL/SINUS ENDOSCOPY DX SPHENOID SINUSOSCOPY,,,21,,RBRVS,2.64 ,1.65 ,5.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31237,CPT,NASAL/SINUS NDSC SURG W/BX POLYPECT/DBRDMT SPX,,,21,,RBRVS,2.60 ,1.67 ,4.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31238,CPT,NASAL/SINUS NDSC SURG W/CONTROL NASAL HEMRRG,,,21,,RBRVS,2.74 ,1.73 ,4.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31239,CPT,NASAL/SINUS NDSC SURG W/DACRYOCSTORHINOSTOMY,,,21,,RBRVS,9.04 ,7.54 ,7.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31240,CPT,NASAL/SINUS NDSC SURG W/CONCHA BULLOSA RESECTION,,,21,,RBRVS,2.61 ,1.64 ,1.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31254,CPT,NASAL/SINUS ENDOSCOPY W/ETHMOIDECTOMY PARTIAL,,,21,,RBRVS,4.64 ,2.55 ,2.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31255,CPT,NASAL/SINUS ENDOSCOPY W/ETHMOIDECTOMY TOTAL,,,21,,RBRVS,6.95 ,3.55 ,3.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31256,CPT,NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY,,,21,,RBRVS,3.29 ,1.94 ,1.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31267,CPT,NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS,,,21,,RBRVS,5.45 ,2.91 ,2.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31276,CPT,NASAL/SINUS NDSC W/FRONTAL SINUS EXPLORATION,,,21,,RBRVS,8.84 ,4.39 ,4.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31287,CPT,NASAL/SINUS ENDOSCOPY W/SPHENOIDOTOMY,,,21,,RBRVS,3.91 ,2.22 ,2.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31288,CPT,NSL/SINUS NDSC SPHENDT RMVL TISS SPHENOID SINUS,,,21,,RBRVS,4.57 ,2.51 ,2.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31290,CPT,NASAL/SINUS NDSC RPR CEREBRSP FLUID LEAK ETHMOID,,,21,,RBRVS,18.61 ,11.71 ,11.71 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
31291,CPT,NASAL/SINUS NDSC RPR CEREBSP FLUID LEAK SPHENOID,,,21,,RBRVS,19.56 ,12.40 ,12.40 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
31292,CPT,NSL/SINUS NDSC SURG W/MEDIAL/INF ORB WALL DCMPRN,,,21,,RBRVS,15.90 ,10.47 ,10.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31293,CPT,NASAL/SINUS NDSC MEDIAL ORB&NF ORB WALL DCMPR,,,21,,RBRVS,17.47 ,11.09 ,11.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31294,CPT,NASAL/SINUS NDSC SURG W/OPTIC NERVE DCMPRN,,,21,,RBRVS,20.31 ,12.35 ,12.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31295,CPT,NASAL/SINUS NDSC SURG W/DILAT MAXILLARY SINUS,,,21,,RBRVS,2.70 ,1.72 ,55.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31296,CPT,NASAL/SINUS NDSC SURG W/DILATION FRONTAL SINUS,,,21,,RBRVS,3.29 ,1.98 ,55.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31297,CPT,NASAL/SINUS NDSC SURG W/DILATION SPHENOID SINUS,,,21,,RBRVS,2.64 ,1.69 ,55.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31299,CPT,UNLISTED PROCEDURE ACCESSORY SINUSES,,,21,,TotalUnits,,,,5.64 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31300,CPT,LARYNGOTOMY W/RMVL TUMOR/LARYNGOCELE CORDECTOMY,,,21,,RBRVS,15.91 ,17.82 ,17.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31320,CPT,LARYNGOTOMY THYROTOMY LARYNGOFISSURE DX,,,21,,RBRVS,5.73 ,12.16 ,12.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31360,CPT,LARYNGECTOMY TOTAL W/O RADICAL NECK DISSECTION,,,21,,RBRVS,29.91 ,25.27 ,25.27 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
31365,CPT,LARYNGECTOMY TOTAL W/RADICAL NECK DISSECTION,,,21,,RBRVS,38.81 ,29.22 ,29.22 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
31367,CPT,LARYNGECTOMY STOT SUPRAGLOTTIC W/O RAD NECK DSJ,,,21,,RBRVS,30.57 ,28.12 ,28.12 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
31368,CPT,LARYNGECTOMY STOT SUPRAGLOTTIC W/RAD NCK DSJ,,,21,,RBRVS,34.19 ,30.80 ,30.80 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
31370,CPT,PARTIAL LARYNGECTOMY HEMILARYGECTOMY HORIZONTAL,,,21,,RBRVS,27.57 ,27.71 ,27.71 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
31375,CPT,PARTIAL LARYNGECTOMY HEMILARYNG LATEROVERTICAL,,,21,,RBRVS,26.07 ,26.42 ,26.42 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
31380,CPT,PARTIAL LARYNGECTOMY HEMILARYNG ANTEROVERTICAL,,,21,,RBRVS,25.57 ,26.19 ,26.19 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
31382,CPT,PARTIAL LARYNG HEMILARYNG ANTERO-LATERO-VERTICAL,,,21,,RBRVS,28.57 ,28.13 ,28.13 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
31390,CPT,PHARYNGOLARYNGECTOMY W/RAD NECK DSJ W/O RCNSTJ,,,21,,RBRVS,42.51 ,33.02 ,33.02 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
31395,CPT,PHARYNGOLARYNGECTOMY W/RAD NECK DSJ W/RCNSTJ,,,21,,RBRVS,43.80 ,35.83 ,35.83 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
31400,CPT,ARYTENOIDECTOMY/ARYTENOIDOPEXY XTRNL APPROACH,,,21,,RBRVS,11.60 ,15.27 ,15.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31420,CPT,EPIGLOTTIDECTOMY,,,21,,RBRVS,11.43 ,10.78 ,10.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31500,CPT,INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE,,,21,,RBRVS,2.33 ,0.55 ,0.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31502,CPT,TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT,,,21,,RBRVS,0.65 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31505,CPT,LARYNGOSCOPY INDIRECT DIAGNOSTIC SPX,,,21,,RBRVS,0.61 ,0.72 ,1.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31510,CPT,LARYNGOSCOPY INDIRECT W/BIOPSY,,,21,,RBRVS,1.92 ,1.33 ,3.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31511,CPT,LARYNGOSCOPY INDIRECT W/REMOVAL FOREIGN BODY,,,21,,RBRVS,2.16 ,1.25 ,3.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31512,CPT,LARYNGOSCOPY INDIRECT W/REMOVAL LESION,,,21,,RBRVS,2.07 ,1.39 ,3.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31513,CPT,LARYNGOSCOPY INDIRECT W/VOCAL CORD INJECTION,,,21,,RBRVS,2.10 ,1.41 ,1.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31515,CPT,LARYNGOSCOPY W/WO TRACHEOSCOPY ASPIRATION,,,21,,RBRVS,1.80 ,1.15 ,3.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31520,CPT,LARYNGOSCOPY W/WO TRACHEOSCOPY DX NEWBORN,,,21,,RBRVS,2.56 ,1.61 ,1.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31525,CPT,LARYNGOSCOPY W/WO TRACHEOSCOPY DX EXCEPT NEWBORN,,,21,,RBRVS,2.63 ,1.62 ,4.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31526,CPT,LARYNGOSCOPY W/WO TRACHEOSCOPY W/MICRO/TELESCOPE,,,21,,RBRVS,2.57 ,1.61 ,1.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31527,CPT,LARYNGOSCOPY W/WO TRACHEOSCOPY INSERT OBTURATOR,,,21,,RBRVS,3.27 ,1.93 ,1.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31528,CPT,LARYNGOSCOPY W/WO TRACHEOSCOPY W/DILATION IN,,,21,,RBRVS,2.37 ,1.47 ,1.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31529,CPT,LARYNGOSCOPY W/WO TRACHEOSCOPY DILATION SUBSQ,,,21,,RBRVS,2.68 ,1.62 ,1.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31530,CPT,LARYNGOSCOPY W/FOREIGN BODY REMOVAL,,,21,,RBRVS,3.38 ,1.84 ,1.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31531,CPT,LARYNGOSCOPY FOREIGN BODY RMVL MICRO/TELESCOPE,,,21,,RBRVS,3.58 ,2.07 ,2.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31535,CPT,LARYNGOSCOPY DIRECT OPERATIVE W/BIOPSY,,,21,,RBRVS,3.16 ,1.88 ,1.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31536,CPT,LARYNGOSCOPY W/BIOPSY MICROSCOPE/TELESCOPE,,,21,,RBRVS,3.55 ,2.05 ,2.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31540,CPT,LARYNGOSCOPY EXC TUM&/STRIPPING CORDS/EPIGLOTT,,,21,,RBRVS,4.12 ,2.29 ,2.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31541,CPT,LARGSC EXC TUM&/STRPG CORDS/EPIGL MCRSCP/TLSCP,,,21,,RBRVS,4.52 ,2.49 ,2.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31545,CPT,LARGSC MICRO/TELESCOPE RMVL LES VOCAL CORD FLAP,,,21,,RBRVS,6.30 ,3.29 ,3.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31546,CPT,LARGSC MICRO/TELESCOPE RMVL LES VOCAL CORD GRAFT,,,21,,RBRVS,9.73 ,4.82 ,4.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31560,CPT,LARYNGOSCOPY DIRECT OPERATIVE W/ARYTENOIDECTOMY,,,21,,RBRVS,5.45 ,2.86 ,2.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31561,CPT,LARGSC ARYTENOIDECTOMY MICROSCOPE/TELESCOPE,,,21,,RBRVS,5.99 ,3.09 ,3.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31570,CPT,LARYNGOSCOPE INJECTION VOCAL CORD THERAPEUTIC,,,21,,RBRVS,3.86 ,2.20 ,5.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31571,CPT,LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE,,,21,,RBRVS,4.26 ,2.37 ,2.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31575,CPT,LARYNGOSCOPY FLEXIBLE FIBEROPTIC DIAGNOSTIC,,,21,,RBRVS,1.10 ,0.95 ,2.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31576,CPT,LARYNGOSCOPY FLEXIBLE FIBEROPTIC W/BIOPSY,,,21,,RBRVS,1.97 ,1.33 ,4.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31577,CPT,LARYNGOSCOPY FLX FIBEROPTIC RMVL FOREIGN BODY,,,21,,RBRVS,2.47 ,1.52 ,4.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31578,CPT,LARYNGOSCOPY FLEXIBLE FIBEROPTIC REMOVAL LESION,,,21,,RBRVS,2.84 ,1.72 ,4.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31579,CPT,LARYNGOSCOPY FLX/RGD FIBOPT W/STROBOSCOPY,,,21,,RBRVS,2.26 ,1.49 ,3.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31580,CPT,LARYNGOPLASTY LARYN WEB 2 STG W/KEEL INSJ&RMVL,,,21,,RBRVS,14.66 ,18.16 ,18.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31582,CPT,LARYNGP LARYN STENOSIS GRF/CORE MOLD W/TRACHT,,,21,,RBRVS,23.22 ,27.68 ,27.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31584,CPT,LARYNGOPLASTY W/OPEN REDUCTION FRACTURE,,,21,,RBRVS,20.47 ,19.81 ,19.81 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
31587,CPT,LARYNGOPLASTY CRICOID SPLIT,,,21,,RBRVS,15.27 ,11.21 ,11.21 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
31588,CPT,LARYNGOPLASTY NOT OTHERWISE SPECIFIED,,,21,,RBRVS,14.99 ,15.48 ,15.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31590,CPT,LARYNGEAL REINNERVATION NEUROMUSCULAR PEDICLE,,,21,,RBRVS,7.85 ,16.45 ,16.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31595,CPT,SECTION RECURRENT LARYNGEAL NERVE THER UNI SPX,,,21,,RBRVS,8.84 ,11.74 ,11.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31599,CPT,UNLISTED PROCEDURE LARYNX,,,21,,TotalUnits,,,,3.01 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31600,CPT,TRACHEOSTOMY PLANNED SEPARATE PROCEDURE,,,21,,RBRVS,7.17 ,2.97 ,2.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31601,CPT,TRACHEOSTOMY PLANNED UNDER 2 YEARS SPX,,,21,,RBRVS,4.44 ,2.41 ,2.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31603,CPT,TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL,,,21,,RBRVS,4.14 ,1.60 ,1.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31605,CPT,TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE,,,21,,RBRVS,3.57 ,1.11 ,1.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31610,CPT,TRACHEOSTOMY FENESTRATION W/SKIN FLAPS,,,21,,RBRVS,9.38 ,9.66 ,9.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31611,CPT,CONSTJ TRACHEOESOPHGL FSTL&INSJ SP PROSTH,,,21,,RBRVS,6.00 ,8.59 ,8.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31612,CPT,TRACHEAL PNXR PRQ W/TRANSTRACHEAL ASPIR&/NJX,,,21,,RBRVS,0.91 ,0.33 ,1.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31613,CPT,TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION,,,21,,RBRVS,4.71 ,7.51 ,7.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31614,CPT,TRACHEOSTOMA REVJ CPLX W/FLAP ROTATION,,,21,,RBRVS,8.63 ,11.74 ,11.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31615,CPT,TRACHEOBRNCHSC THRU EST TRACHS INC,,,21,,RBRVS,2.09 ,1.33 ,2.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31622,CPT,BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,,,21,,RBRVS,2.78 ,1.11 ,5.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31623,CPT,BRNCHSC BRUSHING/PROTECTED BRUSHINGS,,,21,,RBRVS,2.88 ,1.09 ,6.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31624,CPT,BRNCHSC W/BRNCL ALVEOLAR LAVAGE,,,21,,RBRVS,2.88 ,1.13 ,5.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31625,CPT,BRONCHOSCOPY BRONCHIAL/ENDOBRNCL BX 1+ SITES,,,21,,RBRVS,3.36 ,1.25 ,5.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31626,CPT,BRONCHOSCOPY W/PLMT FIDUCIAL MARKERS SINGLE/MULT,,,21,,RBRVS,4.16 ,1.47 ,21.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31627,CPT,BRONCHOSCOPY W/CPTR-ASST IMAGE-GUIDED NAVIGATION,,,21,,RBRVS,2.00 ,0.60 ,37.92 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
31628,CPT,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE,,,21,,RBRVS,3.80 ,1.37 ,6.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31629,CPT,BRONCHOSCOPY NEEDLE BX TRACHEA MAIN STEM&/BRON,,,21,,RBRVS,4.09 ,1.46 ,12.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31630,CPT,BRNCHSC W/TRACHEAL/BRONCHIAL DILAT/CLSD RDCTJ FX,,,21,,RBRVS,3.81 ,1.51 ,1.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31631,CPT,BRONCHOSCOPY W/PLACEMENT TRACHEAL STENT,,,21,,RBRVS,4.36 ,1.68 ,1.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31632,CPT,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX EACH LOBE,,,21,,RBRVS,1.03 ,0.31 ,0.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31633,CPT,BRONCHOSCOPY W/TRANSBRONCL NDL ASPIR BX EA LOBE,,,21,,RBRVS,1.32 ,0.40 ,1.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31634,CPT,BRONCHOSCOPY BALLOON OCCLUSION,,,21,,RBRVS,4.00 ,1.50 ,49.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31635,CPT,BRONCHOSCOPY W/REMOVAL FOREIGN BODY,,,21,,RBRVS,3.67 ,1.38 ,5.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31636,CPT,BRNCHSC W/PLACEMENT BRNCL STENT 1ST BRONCHUS,,,21,,RBRVS,4.30 ,1.57 ,1.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31637,CPT,BRONCHOSCOPY EACH MAJOR BRONCHUS STENTED,,,21,,RBRVS,1.58 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31638,CPT,BRNCHSC REVJ TRACHEAL/BRNCL STENT INS PREV SESS,,,21,,RBRVS,4.88 ,1.80 ,1.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31640,CPT,BRONCHOSCOPY W/EXCISION TUMOR,,,21,,RBRVS,4.93 ,1.81 ,1.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31641,CPT,BRNCHSC W/DSTRJ TUM RELIEF STENOSIS OTH/THN EXC,,,21,,RBRVS,5.02 ,1.86 ,1.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31643,CPT,BRNCHSC W/PLMT CATH INTRCV RADIOELMNT APPL,,,21,,RBRVS,3.49 ,1.29 ,1.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31645,CPT,BRNCHSC W/THER ASPIR TRACHEOBRNCL TREE 1ST,,,21,,RBRVS,3.16 ,1.21 ,5.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31646,CPT,BRNCHSC W/THER ASPIR TRACHEOBRNCL TREE SBSQ,,,21,,RBRVS,2.72 ,1.06 ,5.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31647,CPT,BRNCHSC OCCLUSION&INSERT BRONCH VALVE INIT LOBE,,,21,,RBRVS,4.40 ,1.54 ,1.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31648,CPT,BRNCHSC REMOVAL BRONCHIAL VALVE INITIAL,,,21,,RBRVS,4.20 ,1.34 ,1.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31649,CPT,BRNCHSC REMOVAL BRONCHIAL VALVE EA ADDL,,,21,,RBRVS,1.44 ,0.41 ,0.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31651,CPT,BRNCHSC OCCLUSION&INSERT BRONCH VALVE ADDL LOBE,,,21,,RBRVS,1.58 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31652,CPT,BRNCHSC EBUS GUIDED SAMPL 1/2 NODE STATION/STRUX,,,21,,RBRVS,4.71 ,1.61 ,20.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31653,CPT,BRNCHSC EBUS GUIDED SAMPL 3/> NODE STATION/STRUX,,,21,,RBRVS,5.21 ,1.76 ,21.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31654,CPT,BRNSCHSC TNDSC EBUS DX/TX INTERVENTION PERPH LES,,,21,,RBRVS,1.40 ,0.42 ,1.56 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
31660,CPT,BRONCHOSCOPIC THERMOPLASTY ONE LOBE,,,21,,RBRVS,4.25 ,1.44 ,1.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31661,CPT,BRONCHOSCOPIC THERMOPLASTY 2/> LOBES,,,21,,RBRVS,4.50 ,1.45 ,1.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31717,CPT,CATHETERIZATION W/BRONCHIAL BRUSH BIOPSY,,,21,,RBRVS,2.12 ,0.84 ,5.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31720,CPT,CATHETER ASPIRATION NASOTRACHEAL SPX,,,21,,RBRVS,1.06 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31725,CPT,CATH ASPIR TRACHEOBRNCL FIBERSCOPE BEDSIDE SPX,,,21,,RBRVS,1.96 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
31730,CPT,TTRACH INTRO NDL WIRE DIL/STENT/TUBE O2 THER,,,21,,RBRVS,2.85 ,0.94 ,31.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31750,CPT,TRACHEOPLASTY CERVICAL,,,21,,RBRVS,15.39 ,21.47 ,21.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31755,CPT,TRACHEOPLASTY TRACHEOPHARYNGEAL FSTLJ EA STG,,,21,,RBRVS,17.54 ,29.18 ,29.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31760,CPT,TRACHEOPLASTY INTRATHORACIC,,,21,,RBRVS,23.48 ,10.91 ,10.91 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
31766,CPT,CARINAL RECONSTRUCTION,,,21,,RBRVS,31.67 ,15.06 ,15.06 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
31770,CPT,BRONCHOPLASTY GRAFT REPAIR,,,21,,RBRVS,23.54 ,9.71 ,9.71 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
31775,CPT,BRONCHOPLASTY EXCISION STENOSIS & ANASTOMOSIS,,,21,,RBRVS,24.59 ,9.13 ,9.13 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
31780,CPT,EXCISION TRACHEAL STENOSIS&ANASTOMOSIS CERVICA,,,21,,RBRVS,19.84 ,10.73 ,10.73 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
31781,CPT,EXC TRACHEAL STENOSIS&ANAST CERVICOTHORACIC,,,21,,RBRVS,24.85 ,9.63 ,9.63 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
31785,CPT,EXCISION TRACHEAL TUMOR/CARCINOMA CERVICAL,,,21,,RBRVS,18.35 ,9.91 ,9.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31786,CPT,EXCISION TRACHEAL TUMOR/CARCINOMA THORACIC,,,21,,RBRVS,25.42 ,14.35 ,14.35 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
31800,CPT,SUTURE TRACHEAL WOUND/INJURY CERVICAL,,,21,,RBRVS,8.18 ,11.03 ,11.03 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
31805,CPT,SUTURE TRACHEAL WOUND/INJURY INTRATHORACIC,,,21,,RBRVS,13.42 ,7.13 ,7.13 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
31820,CPT,SURG CLSR TRACHEOSTOMY/FISTULA W/O PLASTIC RPR,,,21,,RBRVS,4.64 ,4.04 ,7.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31825,CPT,SURG CLSR TRACHEOSTOMY/FISTULA W/PLASTIC RPR,,,21,,RBRVS,7.07 ,5.67 ,9.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31830,CPT,REVISION TRACHEOSTOMY SCAR,,,21,,RBRVS,4.62 ,4.42 ,7.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
31899,CPT,UNLISTED PROCEDURE TRACHEA BRONCHI,,,21,,TotalUnits,,,,4.03 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
32035,CPT,THORACOSTOMY W/RIB RESECTION EMPYEMA,,,21,,RBRVS,11.29 ,7.04 ,7.04 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32036,CPT,THORACOSTOMY OPEN FLAP DRAINAGE EMPYEMA,,,21,,RBRVS,12.30 ,7.44 ,7.44 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32096,CPT,THORACTOMY W/DX BX LUNG INFILTRATE UNILATERAL,,,21,,RBRVS,13.75 ,6.47 ,6.47 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32097,CPT,THORACTOMY W/DX BX LUNG NODULE/MASS UNILATERAL,,,21,,RBRVS,13.75 ,6.48 ,6.48 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32098,CPT,THORACOTOMY W/BIOPSY OF PLEURA,,,21,,RBRVS,12.91 ,6.30 ,6.30 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32100,CPT,THORACOTOMY WITH EXPLORATION,,,21,,RBRVS,13.75 ,6.58 ,6.58 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32110,CPT,THORCOM CTRL TRAUMTC HEMRRG&/RPR LNG TEAR,,,21,,RBRVS,25.28 ,11.41 ,11.41 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32120,CPT,THORACOTOMY POSTOPERATIVE COMPLICATIONS,,,21,,RBRVS,14.39 ,7.57 ,7.57 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32124,CPT,THORACOTOMY OPN INTRAPLEURAL PNEUMONOLYSIS,,,21,,RBRVS,15.45 ,7.90 ,7.90 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32140,CPT,THORCOM W/REMOVAL OF CYST,,,21,,RBRVS,16.66 ,8.32 ,8.32 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32141,CPT,THORACOTOMY W/RESECTION BULLAE,,,21,,RBRVS,27.18 ,10.90 ,10.90 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32150,CPT,THORCOM W/RMVL INTRAPLEURAL FB/FIBRIN DEP,,,21,,RBRVS,16.82 ,8.50 ,8.50 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32151,CPT,THORCOM W/RMVL IPUL FB,,,21,,RBRVS,16.94 ,8.40 ,8.40 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32160,CPT,THORACOTOMY W/CARDIAC MASSAGE,,,21,,RBRVS,13.10 ,6.83 ,6.83 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32200,CPT,PNEUMONOSTOMY W/OPEN DRAINAGE ABSCESS/CYST,,,21,,RBRVS,18.68 ,10.12 ,10.12 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32215,CPT,PLEURAL SCARIFICATION REPEAT PNEUMOTHORAX,,,21,,RBRVS,13.05 ,7.08 ,7.08 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32220,CPT,DECORTICATION PULMONARY TOTAL SEPARATE PROCEDURE,,,21,,RBRVS,26.65 ,13.21 ,13.21 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32225,CPT,DECORTICATION PULMONARY PARTIAL SEPARATE PROC,,,21,,RBRVS,16.75 ,8.26 ,8.26 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32310,CPT,PLEURECTOMY PARIETAL SEPARATE PROCEDURE,,,21,,RBRVS,15.28 ,7.64 ,7.64 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32320,CPT,DECORTICATION & PARIETAL PLEURECTOMY,,,21,,RBRVS,27.25 ,12.90 ,12.90 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32400,CPT,BIOPSY PLEURA PERCUTANEOUS NEEDLE,,,21,,RBRVS,1.76 ,0.60 ,2.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
32405,CPT,BIOPSY LUNG/MEDIASTINUM PERCUTANEOUS NEEDLE,,,21,,RBRVS,1.93 ,0.90 ,10.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
32440,CPT,REMOVAL OF LUNG PNEUMONECTOMY,,,21,,RBRVS,27.28 ,11.87 ,11.87 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32442,CPT,REMOVAL LUNG PNEUMONECTOMY RESXN SGMNT TRACHEA,,,21,,RBRVS,56.47 ,19.63 ,19.63 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32445,CPT,REMOVAL LUNG PNEUMONECTOMY EXTRAPLEURAL,,,21,,RBRVS,63.84 ,24.20 ,24.20 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32480,CPT,RMVL LUNG OTHER THAN PNEUMONECTOMY 1 LOBE LOBECT,,,21,,RBRVS,25.82 ,11.17 ,11.17 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32482,CPT,RMVL LUNG OTHER THAN PNEUMONECT 2 LOBES BILOBEC,,,21,,RBRVS,27.44 ,12.26 ,12.26 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32484,CPT,RMVL LUNG OTHER THAN PNEUMONECT 1 SEGMENTECTOMY,,,21,,RBRVS,25.38 ,10.49 ,10.49 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32486,CPT,RMVL LUNG XCP TOT PNEUMONECTOMY SLEEVE LOBECTOMY,,,21,,RBRVS,42.88 ,15.58 ,15.58 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32488,CPT,RMVL LUNG OTHER/THAN PNUMEC COMPLETION PNUMEC,,,21,,RBRVS,42.99 ,17.01 ,17.01 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32491,CPT,RMVL LUNG OTH/THN PNUMEC RESXN-PLCTJ EMPHY LUNG,,,21,,RBRVS,25.24 ,11.70 ,11.70 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32501,CPT,RESCJ&BRONCHOPLASTY PFRMD TM LOBEC/SGMECTOMY,,,21,,RBRVS,4.68 ,1.37 ,1.37 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32503,CPT,RESCJ APICAL LUNG TUMOR W/O CHEST WALL RCNSTJ,,,21,,RBRVS,31.74 ,13.34 ,13.34 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32504,CPT,RESCJ APICAL LUNG TUMOR W/CHEST WALL RCNSTJ,,,21,,RBRVS,36.54 ,15.14 ,15.14 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32505,CPT,THORACOTOMY W/THERAPEUTIC WEDGE RESEXN INITIAL,,,21,,RBRVS,15.75 ,7.69 ,7.69 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32506,CPT,THORACOTOMY W/THERAP WEDGE RESEXN ADDL IPSILATRL,,,21,,RBRVS,3.00 ,0.88 ,0.88 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32507,CPT,THORACOTOMY W/DX WEDGE RESEXN & ANTOM LUNG RESE,,,21,,RBRVS,3.00 ,0.88 ,0.88 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32540,CPT,EXTRAPLEURAL ENUCLEATION EMPYEMA EMPYEMECTOMY,,,21,,RBRVS,30.35 ,12.96 ,12.96 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32550,CPT,INSERTION INDWELLING TUNNELED PLEURAL CATHETER,,,21,,RBRVS,4.17 ,1.64 ,17.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
32551,CPT,TUBE THORACOSTOMY INCLUDES WATER SEAL,,,21,,RBRVS,3.29 ,1.09 ,1.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
32552,CPT,RMVL NDWELLG TUNNELED PLEURAL CATHETER W/CUFF,,,21,,RBRVS,2.53 ,1.70 ,2.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
32553,CPT,PLMT NTRSTL DEV RADJ THX GID PRQ INTRATHRC 1/MLT,,,21,,RBRVS,3.80 ,1.47 ,12.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
32554,CPT,THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING,,,21,,RBRVS,1.82 ,0.57 ,3.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
32555,CPT,THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING,,,21,,RBRVS,2.27 ,0.79 ,5.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
32556,CPT,PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING,,,21,,RBRVS,2.50 ,0.79 ,12.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
32557,CPT,PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING,,,21,,RBRVS,3.12 ,1.05 ,11.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
32560,CPT,INSTLJ VIA CHEST TUBE/CATH AGENT FOR PLEURODESIS,,,21,,RBRVS,1.54 ,0.47 ,5.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
32561,CPT,INSTLJ VIA CH TUBE/CATH AGENT FBRNLYSIS 1ST DAY,,,21,,RBRVS,1.39 ,0.43 ,1.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
32562,CPT,INSTLJ CH TUBE/CATH AGENT FBRNLYSIS SBSQ DAY,,,21,,RBRVS,1.24 ,0.38 ,0.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
32601,CPT,THORSC DX LUNGS/PERICAR/MED/PLEURAL SPACE W/O BX,,,21,,RBRVS,5.50 ,2.25 ,2.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
32604,CPT,THORACOSCOPY DX PERICARDIAL SAC W/BIOPSY SPX,,,21,,RBRVS,8.77 ,3.21 ,3.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
32606,CPT,THORACOSCOPY DX MEDIASTINAL SPACE W/BIOPSY SPX,,,21,,RBRVS,8.39 ,3.15 ,3.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
32607,CPT,THORACOSCOPY W/DX BX OF LUNG INFILTRATE UNILATRL,,,21,,RBRVS,5.50 ,2.25 ,2.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
32608,CPT,THORACOSCOPY W/DX BX OF LUNG NODULES UNILATRL,,,21,,RBRVS,6.84 ,2.62 ,2.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
32609,CPT,THORACOSCOPY WITH BIOPSYIES OF PLEURA,,,21,,RBRVS,4.58 ,1.96 ,1.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
32650,CPT,THORACOSCOPY W/PLEURODESIS,,,21,,RBRVS,10.83 ,6.02 ,6.02 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32651,CPT,THORACOSCOPY W/PARTIAL PULMONARY DECORTICATION,,,21,,RBRVS,18.78 ,8.73 ,8.73 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32652,CPT,THRSC TOT PULM DCRTCTJ INTRAPLEURAL PNEUMONOLSS,,,21,,RBRVS,29.13 ,12.38 ,12.38 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32653,CPT,THORACOSCOPY RMVL INTRAPLEURAL FB/FIBRIN DEPOSIT,,,21,,RBRVS,18.17 ,8.43 ,8.43 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32654,CPT,THORACOSCOPY CONTROL TRAUMATIC HEMORRHAGE,,,21,,RBRVS,20.52 ,8.77 ,8.77 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32655,CPT,THORACOSCOPY W/RESECTION BULLAE W/WO PLEURAL PX,,,21,,RBRVS,16.17 ,7.86 ,7.86 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32656,CPT,THORACOSCOPY W/PARIETAL PLEURECTOMY,,,21,,RBRVS,13.26 ,6.96 ,6.96 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32658,CPT,THORACOSCOPY W/RMVL CLOT/FB FROM PERICARDIAL SAC,,,21,,RBRVS,11.71 ,6.31 ,6.31 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32659,CPT,THRSC CRTJ PRCRD WINDOW/PRTL RESCJ PRCRD SAC,,,21,,RBRVS,11.94 ,6.57 ,6.57 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32661,CPT,THORACOSCOPY W/EXC PERICARDIAL CYST TUMOR/MASS,,,21,,RBRVS,13.33 ,6.78 ,6.78 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32662,CPT,THORACOSCOPY W/EXC MEDIASTINAL CYST TUMOR/MASS,,,21,,RBRVS,14.99 ,7.49 ,7.49 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32663,CPT,THORACOSCOPY W/LOBECTOMY SINGLE LOBE,,,21,,RBRVS,24.64 ,10.39 ,10.39 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32664,CPT,THORACOSCOPY W/THORACIC SYMPATHECTOMY,,,21,,RBRVS,14.28 ,7.05 ,7.05 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32665,CPT,THORACOSCOPY W/ESOPHAGOMYOTOMY HELLER TYPE,,,21,,RBRVS,21.53 ,9.35 ,9.35 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32666,CPT,THORACOSCOPY W/THERA WEDGE RESEXN INITIAL UNILAT,,,21,,RBRVS,14.50 ,7.44 ,7.44 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32667,CPT,THORACOSCOPY W/THERA WEDGE RESEXN ADDL IPSILATRL,,,21,,RBRVS,3.00 ,0.89 ,0.89 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32668,CPT,THORACOSCOPY W/DX WEDGE RESEXN ANATO LUNG RESEXN,,,21,,RBRVS,3.00 ,0.88 ,0.88 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32669,CPT,THORACOSCOPY W/SEGMENTECTOMY,,,21,,RBRVS,23.53 ,10.10 ,10.10 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32670,CPT,THORACOSCOPY W/BILOBECTOMY,,,21,,RBRVS,28.52 ,11.58 ,11.58 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32671,CPT,THORACOSCOPY W/PNEUMONECTOMY,,,21,,RBRVS,31.92 ,12.43 ,12.43 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32672,CPT,THORACOSCOPY W/RESEXN-PLICAJ EMPHYSEMA LUNG UNIL,,,21,,RBRVS,27.00 ,11.03 ,11.03 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32673,CPT,THORACOSCOPY RESEXN THYMUS UNI/BILATERAL,,,21,,RBRVS,21.13 ,9.43 ,9.43 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32674,CPT,THORCOSCPY W/MEDIASTINL & REGIONL LYMPHDENECTOMY,,,21,,RBRVS,4.12 ,1.22 ,1.22 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32701,CPT,THORAX STEREOTACTIC RADIATION TARGET W/TX COURSE,,PC,21,,RBRVS,4.18 ,1.21 ,1.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
32800,CPT,REPAIR LUNG HERNIA THROUGH CHEST WALL,,,21,,RBRVS,15.71 ,8.27 ,8.27 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32810,CPT,CLSR CH WALL FLWG OPN FLAP DRG EMPYEMA,,,21,,RBRVS,14.95 ,7.78 ,7.78 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32815,CPT,OPEN CLOSURE MAJOR BRONCHIAL FISTULA,,,21,,RBRVS,50.03 ,19.94 ,19.94 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32820,CPT,MAJOR RECONSTRUCTION CHEST WALL POSTTRAUMATIC,,,21,,RBRVS,22.51 ,12.86 ,12.86 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32851,CPT,LUNG TRANSPLANT 1 W/O CARDIOPULMONARY BYPASS,,,21,,RBRVS,59.64 ,22.22 ,22.22 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32852,CPT,LUNG TRANSPLANT 1 W/CARDIOPULMONARY BYPASS,,,21,,RBRVS,65.50 ,23.89 ,23.89 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32853,CPT,LUNG TRANSPLANT 2 W/O CARDIOPULMONARY BYPASS,,,21,,RBRVS,84.48 ,29.52 ,29.52 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32854,CPT,LUNG TRANSPLANT 2 W/CARDIOPULMONARY BYPASS,,,21,,RBRVS,90.00 ,31.13 ,31.13 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32855,CPT,BKBENCH PREPJ CADAVER DONOR LUNG ALLOGRAFT UNI,,,21,,TotalUnits,,,,11.48 ,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32900,CPT,RESECTION RIBS EXTRAPLEURAL ALL STAGES,,,21,,RBRVS,23.81 ,11.97 ,11.97 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32905,CPT,THORACOPLASTY SCHEDE TYPE/EXTRAPLEURAL,,,21,,RBRVS,23.29 ,10.18 ,10.18 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32906,CPT,THORACOP SCHEDE TYP/XTRPLEURAL CLSR BRNCPLR FSTL,,,21,,RBRVS,29.30 ,11.92 ,11.92 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32940,CPT,PNEUMONOLYSIS XTRPRIOSTEAL W/FILLING/PACKING PX,,,21,,RBRVS,21.34 ,9.62 ,9.62 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32960,CPT,PNEUMOTHORAX THER INTRAPLEURAL INJECTION AIR,,,21,,RBRVS,1.84 ,0.66 ,1.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
32997,CPT,TOTAL LUNG LAVAGE UNILATERAL,,,21,,RBRVS,7.31 ,2.01 ,2.01 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
32998,CPT,ABLATION PULMONARY TUMOR PERQ RADIOFREQUENCY UNI,,,21,,RBRVS,5.68 ,2.04 ,77.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
32999,CPT,UNLISTED PROCEDURE LUNGS & PLEURA,,,21,,TotalUnits,,,,3.34 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33010,CPT,PERICARDIOCENTESIS INITIAL,,,21,,RBRVS,2.24 ,0.77 ,0.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33011,CPT,PERICARDIOCENTESIS SUBSEQUENT,,,21,,RBRVS,2.24 ,0.76 ,0.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33015,CPT,TUBE PERICARDIOSTOMY,,,21,,RBRVS,8.52 ,4.50 ,4.50 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33020,CPT,PERICARDIOTOMY REMOVAL CLOT/FOREIGN BODY PRIMARY,,,21,,RBRVS,14.95 ,7.21 ,7.21 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33025,CPT,CRTJ PERICARDIAL WINDOW/PRTL RESECJ W/DRG/BX,,,21,,RBRVS,13.70 ,6.35 ,6.35 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33030,CPT,PRICARDIECTOMY STOT/COMPL W/O CARDPULM BYPASS,,,21,,RBRVS,36.00 ,13.97 ,13.97 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33031,CPT,PRICARDIECTOMY STOT/COMPL W/CARDPULM BYPASS,,,21,,RBRVS,45.00 ,16.50 ,16.50 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33050,CPT,RESECTION PERICARDIAL CYST/TUMOR,,,21,,RBRVS,16.97 ,8.23 ,8.23 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33120,CPT,EXC INTRACARDIAC TUMOR RESCJ CARDIOPULMONARY BYP,,,21,,RBRVS,38.45 ,13.87 ,13.87 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33130,CPT,RESECTION EXTERNAL CARDIAC TUMOR,,,21,,RBRVS,24.17 ,10.44 ,10.44 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33140,CPT,TRANSMYOCARDIAL LASER REVASCULAR THORACOTOMY SPX,,,21,,RBRVS,28.34 ,11.03 ,11.03 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33141,CPT,TRANSMYOCRD LASER REVSC PFRMD TM OTH OPN CAR PX,,,21,,RBRVS,2.54 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33202,CPT,INSERTION EPICARDIAL ELECTRODE OPEN,,,21,,RBRVS,13.20 ,6.22 ,6.22 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33203,CPT,INSERTION EPICARDIAL ELECTRODE ENDOSCOPIC,,,21,,RBRVS,13.97 ,6.15 ,6.15 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33206,CPT,INS NEW/RPLCMT PRM PACEMAKR W/TRANS ELTRD ATRIAL,,,21,,RBRVS,7.39 ,4.31 ,4.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33207,CPT,INS NEW/RPLC PRM PACEMAKER W/TRANSV ELTRD VENTR,,,21,,RBRVS,8.05 ,4.35 ,4.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33208,CPT,INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT,,,21,,RBRVS,8.77 ,4.64 ,4.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33210,CPT,INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH,,,21,,RBRVS,3.30 ,1.17 ,1.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33211,CPT,INSJ/RPLCMT TEMP TRANSVNS 2CHMBR PACG ELTRDS SPX,,,21,,RBRVS,3.39 ,1.16 ,1.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33212,CPT,INS PM PLS GEN W/EXIST SINGLE LEAD,,,21,,RBRVS,5.26 ,3.18 ,3.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33213,CPT,INS PACEMAKER PULSE GEN ONLY W/EXIST DUAL LEADS,,,21,,RBRVS,5.53 ,3.27 ,3.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33214,CPT,UPG PACEMAKER SYS CONVERT 1CHMBR SYS 2CHMBR SYS,,,21,,RBRVS,7.84 ,4.53 ,4.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33215,CPT,RPSG PREV IMPLTED PM/DFB R ATR/R VENTR ELECTRODE,,,21,,RBRVS,4.92 ,2.92 ,2.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33216,CPT,INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB,,,21,,RBRVS,5.87 ,3.86 ,3.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33217,CPT,INSJ 2 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB,,,21,,RBRVS,5.84 ,3.68 ,3.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33218,CPT,RPR 1 TRANSVNS ELTRD PRM PM/PACING IMPLNTBL DFB,,,21,,RBRVS,6.07 ,4.14 ,4.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33220,CPT,RPR 2 TRANSVNS ELECTRODES PRM PM/IMPLANTABLE DFB,,,21,,RBRVS,6.15 ,4.03 ,4.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33221,CPT,INS PACEMAKER PULSE GEN ONLY W/EXIST MULT LEADS,,,21,,RBRVS,5.80 ,3.65 ,3.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33222,CPT,RELOCATION OF SKIN POCKET FOR PACEMAKER,,,21,,RBRVS,5.10 ,3.81 ,3.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33223,CPT,RELOCATE SKIN POCKET IMPLANTABLE DEFIBRILLATOR,,,21,,RBRVS,6.55 ,4.10 ,4.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33224,CPT,INSJ ELTRD CAR VEN SYS ATTCH PREV PM/DFB PLS GEN,,,21,,RBRVS,9.04 ,3.81 ,3.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33225,CPT,INSJ ELTRD CAR VEN SYS TM INSJ DFB/PM PLS GEN,,,21,,RBRVS,8.33 ,3.32 ,3.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33226,CPT,RPSG PREV IMPLTED CAR VEN SYS L VENTR ELTRD,,,21,,RBRVS,8.68 ,3.68 ,3.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33227,CPT,REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD,,,21,,RBRVS,5.50 ,3.38 ,3.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33228,CPT,REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS,,,21,,RBRVS,5.77 ,3.48 ,3.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33229,CPT,REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD,,,21,,RBRVS,6.04 ,3.68 ,3.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33230,CPT,INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST DUAL LEADS,,,21,,RBRVS,6.32 ,3.64 ,3.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33231,CPT,INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST MULTILEADS,,,21,,RBRVS,6.59 ,3.92 ,3.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33233,CPT,REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY,,,21,,RBRVS,3.39 ,2.85 ,2.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33234,CPT,RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR,,,21,,RBRVS,7.91 ,4.66 ,4.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33235,CPT,RMVL TRANSVNS PM ELTRD DUAL LEAD SYS,,,21,,RBRVS,10.15 ,6.23 ,6.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33236,CPT,RMVL PRM EPICAR PM&ELTRDS THORCOM 1 LEAD SYS,,,21,,RBRVS,12.73 ,6.99 ,6.99 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33237,CPT,RMVL PRM EPICAR PM&ELTRDS THORCOM DUAL LEAD SY,,,21,,RBRVS,13.84 ,7.30 ,7.30 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33238,CPT,RMVL PRM TRANSVENOUS ELECTRODE THORACOTOMY,,,21,,RBRVS,15.40 ,8.36 ,8.36 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33240,CPT,INSJ IMPLNTBL DEFIB PULSE GEN W/1 EXISTING LD,,,21,,RBRVS,6.05 ,3.51 ,3.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33241,CPT,REMOVAL IMPLANTABLE DEFIB PULSE GENERATOR ONLY,,,21,,RBRVS,3.29 ,2.56 ,2.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33243,CPT,RMVL 1/DUAL CHAMBER DEFIB ELECTRODE BY THORACOM,,,21,,RBRVS,23.57 ,10.75 ,10.75 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33244,CPT,RMVL1/DUAL CHMBR IMPLTBL DFB ELTRD TRANSVNS XTRJ,,,21,,RBRVS,13.99 ,7.98 ,7.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33249,CPT,INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR,,,21,,RBRVS,15.17 ,8.20 ,8.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33250,CPT,ABLATION ARRHYTHMOGENIC FOCI/PATHWAY W/O BYPASS,,,21,,RBRVS,25.90 ,10.93 ,10.93 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33251,CPT,ABLATION ARRHYTHMOGENIC FOCI/PATHWAY W/BYPASS,,,21,,RBRVS,28.92 ,11.42 ,11.42 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33254,CPT,ABLATION & RECONSTRUCTION ATRIA LIMITED,,,21,,RBRVS,23.71 ,10.26 ,10.26 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33255,CPT,ABLATION & RCNSTJ ATRIA EXTNSV W/O BYPASS,,,21,,RBRVS,29.04 ,11.75 ,11.75 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33256,CPT,ABLATION & RCNSTJ ATRIA EXTNSV W/BYPASS,,,21,,RBRVS,34.90 ,13.55 ,13.55 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33257,CPT,ATRIA ABLATE & RCNSTJ W/OTHER PROCEDURE LIMITE,,,21,,RBRVS,9.63 ,5.10 ,5.10 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33258,CPT,ATRIA ABLTJ & RCNSTJ W/OTHER PX EXTENSIV W/O BYP,,,21,,RBRVS,11.00 ,5.51 ,5.51 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33259,CPT,ATRIA ABLTJ & RCNSTJ W/OTHER PX EXTEN W/BYPASS,,,21,,RBRVS,14.14 ,7.18 ,7.18 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33261,CPT,OPRATIVE ABLTJ VENTR ARRHYTHMOGENIC FOC W/BYPASS,,,21,,RBRVS,28.92 ,11.42 ,11.42 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33262,CPT,RMVL IMPLTBL DFB PLSE GEN W/REPL PLSE GEN 1 LEAD,,,21,,RBRVS,6.06 ,3.68 ,3.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33263,CPT,RMVL IMPLTBL DFB PLSE GEN W/RPLCMT PLSE GEN 2 LD,,,21,,RBRVS,6.33 ,3.79 ,3.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33264,CPT,RMVL IMPLTBL DFB PLS GEN W/RPLCMT PLS GEN MLT LD,,,21,,RBRVS,6.60 ,3.94 ,3.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33265,CPT,NDSC ABLATION & RCNSTJ ATRIA LIMITED W/O BYPAS,,,21,,RBRVS,23.71 ,10.43 ,10.43 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33266,CPT,NDSC ABLATION & RCNSTJ ATRIA EXTEN W/O BYPASS,,,21,,RBRVS,33.04 ,13.10 ,13.10 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33270,CPT,INS/RPLCMNT PERM SUBQ IMPLTBL DFB W/SUBQ ELTRD,,,21,,RBRVS,9.10 ,5.88 ,5.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33271,CPT,INSJ OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE,,,21,,RBRVS,7.50 ,5.14 ,5.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33272,CPT,RMVL OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE,,,21,,RBRVS,5.42 ,3.89 ,3.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33273,CPT,REPOS PREVIOUSLY IMPLANTED SUBQ IMPLANTABLE DFB,,,21,,RBRVS,6.50 ,3.63 ,3.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33282,CPT,IMPLANTATION PT-ACTIVATED CARDIAC EVENT RECORDER,,,21,,RBRVS,3.50 ,2.60 ,2.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33284,CPT,RMVL IMPLANTABLE PT-ACTIVATED CAR EVENT RECORDER,,,21,,RBRVS,3.00 ,2.43 ,2.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33300,CPT,REPAIR CARDIAC WOUND W/O BYPASS,,,21,,RBRVS,44.97 ,16.01 ,16.01 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33305,CPT,REPAIR CARDIAC WOUND W/CARDIOPULMONARY BYPASS,,,21,,RBRVS,76.93 ,25.03 ,25.03 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33310,CPT,CARDIOT EXPL W/RMVL FB ATR/VENTR THRMB W/O BYP,,,21,,RBRVS,20.34 ,9.68 ,9.68 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33315,CPT,CARDIOT EXPL RMVL FB ATR/VENTR THRMB CARD BYP,,,21,,RBRVS,35.00 ,12.76 ,12.76 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33320,CPT,SUTR RPR AORTA/GRT VSL W/O SHUNT/CARD BYP,,,21,,RBRVS,18.54 ,8.02 ,8.02 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33321,CPT,SUTR RPR AORTA/GREAT VESSEL W/SHUNT BYPASS,,,21,,RBRVS,20.81 ,9.32 ,9.32 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33322,CPT,SUTURE REPAIR AORTA/GREAT VESSEL W/BYPASS,,,21,,RBRVS,24.42 ,10.30 ,10.30 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33330,CPT,INSJ GRAFT AORTA/GREAT VESSEL W/O SHUNT/BYPASS,,,21,,RBRVS,25.29 ,10.42 ,10.42 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33335,CPT,INSJ GRAFT AORTA/GREAT VESSEL W/BYPASS,,,21,,RBRVS,33.91 ,13.04 ,13.04 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33361,CPT,REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH,,,21,,RBRVS,25.13 ,8.66 ,8.66 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33362,CPT,REPLACE AORTIC VALVE OPENFEMORAL ARTERY APPROACH,,,21,,RBRVS,27.52 ,9.28 ,9.28 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33363,CPT,REPLACE AORTIC VALVE OPEN AXILLRY ARTRY APPROACH,,,21,,RBRVS,28.50 ,10.26 ,10.26 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33364,CPT,REPLACE AORTIC VALVE OPEN ILIAC ARTERY APPROACH,,,21,,RBRVS,30.00 ,10.00 ,10.00 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33365,CPT,REPLACE AORTIC VALVE OPEN TRANSAORTIC APPROACH,,,21,,RBRVS,33.12 ,11.14 ,11.14 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33366,CPT,TRANSCATHETER TRANSAPICAL REPLACEMT AORTIC VALVE,,,21,,RBRVS,35.88 ,11.87 ,11.87 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33367,CPT,REPLACE AORTIC VALVE W/BYP PRQ ART/VENOUS APPRCH,,,21,,RBRVS,11.88 ,3.50 ,3.50 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33368,CPT,REPLACE AORTIC VALVE W/BYP OPEN ART/VENOUS APRCH,,,21,,RBRVS,14.39 ,4.00 ,4.00 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33369,CPT,REPLACE AORTA VALVE W/BYP CNTRL ART/VENOUS APRCH,,,21,,RBRVS,19.00 ,5.29 ,5.29 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33400,CPT,VALVULOPLASTY AORTIC VALVE OPEN W/BYPASS,,,21,,RBRVS,41.50 ,15.39 ,15.39 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33401,CPT,VALVULOPLASTY AORTIC VALVE OPEN W/INFLOW OCCLUS,,,21,,RBRVS,24.63 ,11.55 ,11.55 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33403,CPT,VLVP AORTIC VALVE W/TRANSVENTR DILAT W/CARD BYP,,,21,,RBRVS,25.61 ,11.46 ,11.46 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33404,CPT,CONSTRUCTION APICAL-AORTIC CONDUIT,,,21,,RBRVS,31.37 ,12.85 ,12.85 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33405,CPT,RPLCMT PROST AORTIC VALVE XCP HOMOGRF/STENT,,,21,,RBRVS,41.32 ,15.35 ,15.35 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33406,CPT,RPLCMT AORTIC VALVE ALLOGRAFT VALVE FREEHAND,,,21,,RBRVS,52.68 ,18.94 ,18.94 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33410,CPT,RPLCMT AORTIC VALVE W/STENTLESS TISSUE VALVE,,,21,,RBRVS,46.41 ,17.04 ,17.04 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33411,CPT,RPLCMT AORTIC VALVE ANNULUS ENLGMENT NONC SINUS,,,21,,RBRVS,62.07 ,21.52 ,21.52 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33412,CPT,REPLACEMENT AORTIC VALVE KONNO PROCEDURE,,,21,,RBRVS,59.00 ,19.53 ,19.53 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33413,CPT,REPLACEMENT AORTIC&PULMON VALVES ROSS PROCEDUR,,,21,,RBRVS,59.87 ,21.29 ,21.29 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33414,CPT,RPR VENTR O/F TRC OBSTRCJ PATCH ENLGMENT O/F TRC,,,21,,RBRVS,39.37 ,13.79 ,13.79 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33415,CPT,RESECTION/INCISION SUBVALVULAR TISSUE,,,21,,RBRVS,37.27 ,13.65 ,13.65 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33416,CPT,VENTRICULOMYOTOMY-MYECTOMY,,,21,,RBRVS,36.56 ,14.22 ,14.22 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33417,CPT,AORTOPLASTY SUPRAVALVULAR STENOSIS,,,21,,RBRVS,29.33 ,12.14 ,12.14 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33418,CPT,TCAT MITRAL VALVE REPAIR INITIAL PROSTHESIS,,,21,,RBRVS,32.25 ,14.68 ,14.68 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33419,CPT,TCAT MITRAL VALVE REPAIR ADDL PROSTHESIS,,,21,,RBRVS,7.93 ,3.03 ,3.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33420,CPT,VALVOTOMY MITRAL VALVE CLOSED HEART,,,21,,RBRVS,25.79 ,12.66 ,12.66 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33422,CPT,VALVOTOMY MITRAL VALVE OPEN HEART W/BYPASS,,,21,,RBRVS,29.73 ,11.97 ,11.97 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33425,CPT,VALVULOPLASTY MITRAL VALVE W/CARDIAC BYPASS,,,21,,RBRVS,49.96 ,18.12 ,18.12 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33426,CPT,VLVP MITRAL VALVE W/CARD BYP W/PROSTC RING,,,21,,RBRVS,43.28 ,16.18 ,16.18 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33427,CPT,VLVP MITRAL VALVE W/BYPASS RAD RCNSTJ W/WO RING,,,21,,RBRVS,44.83 ,16.17 ,16.17 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33430,CPT,REPLACEMENT MITRAL VALVE W/CARDIOPULMONARY BYP,,,21,,RBRVS,50.93 ,18.94 ,18.94 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33460,CPT,VALVECTOMY TRICUSPID VALVE W/CARDIOPULMONARY BYP,,,21,,RBRVS,44.70 ,15.76 ,15.76 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33463,CPT,VALVULOPLASTY TRICUSPID VALVE W/O RING INSERTION,,,21,,RBRVS,57.08 ,20.04 ,20.04 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33464,CPT,VALVULOPLASTY TRICUSPID VALVE W/RING INSERTION,,,21,,RBRVS,44.62 ,16.41 ,16.41 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33465,CPT,REPLACEMENT TRICUSPID VALVE W/CARD BYPASS,,,21,,RBRVS,50.72 ,18.04 ,18.04 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33468,CPT,TRICUSPID VALVE RPSG&PLCTJ EBSTEIN ANOMALY,,,21,,RBRVS,45.13 ,15.44 ,15.44 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33470,CPT,VALVOTOMY PULMONARY VALVE CLSD HEART TRANSVENTR,,,21,,RBRVS,21.54 ,9.27 ,9.27 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33471,CPT,VALVOTOMY PULM VALVE CLSD HEART VIA PULM ARTERY,,,21,,RBRVS,22.96 ,11.86 ,11.86 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33474,CPT,VALVOTOMY PULMONARY VALVE OPEN HEART W/BYPASS,,,21,,RBRVS,39.40 ,14.53 ,14.53 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33475,CPT,REPLACEMENT PULMONARY VALVE,,,21,,RBRVS,42.40 ,15.84 ,15.84 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33476,CPT,R VENTRIC RESCJ INFUND STEN W/WO COMMISSUROTOMY,,,21,,RBRVS,26.57 ,11.65 ,11.65 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33477,CPT,TCAT PULMONARY VALVE IMPLANTATION PRQ APPROACH,,,21,,RBRVS,25.00 ,8.77 ,8.77 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33478,CPT,OUTFLOW TRACT AGMNTJ W/WO COMMISSUR/INFUND RESCJ,,,21,,RBRVS,27.54 ,11.56 ,11.56 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33496,CPT,RPR NON-STRUCT PROSTC VALVE DYSFUNCTION W/BYPASS,,,21,,RBRVS,29.84 ,11.86 ,11.86 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33500,CPT,RPR CORONARY AV/ARTERIOCAR CHMBR FSTL W/BYPASS,,,21,,RBRVS,27.94 ,11.14 ,11.14 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33501,CPT,RPR CORONARY AV/ARTERIOCAR CHMBR FSTL W/O BYPASS,,,21,,RBRVS,19.51 ,8.53 ,8.53 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33502,CPT,RPR ANOM CORONARY ART PULM ART ORIGIN LIGATION,,,21,,RBRVS,21.85 ,10.05 ,10.05 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33503,CPT,RPR ANOM CORONARY ARTERY PULM ART ORIGIN GRAFT,,,21,,RBRVS,22.51 ,10.62 ,10.62 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33504,CPT,RPR ANOM CORONARY ART PULM ART ORIGIN GRF W/BYP,,,21,,RBRVS,25.46 ,11.03 ,11.03 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33505,CPT,RPR ANOM CORON ART W/CONSTJ INTRAPULM ART TUNNEL,,,21,,RBRVS,38.40 ,12.48 ,12.48 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33506,CPT,RPR ANOM CORONARY ART FROM PULM ART TO AORTA,,,21,,RBRVS,37.85 ,16.09 ,16.09 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33507,CPT,RPR ANOM AORTIC ORIGIN CORONARY ART UNROOF/TLCJ,,,21,,RBRVS,31.40 ,11.24 ,11.24 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33508,CPT,NDSC SURG W/VIDEO-ASSISTED HARVEST VEIN CABG,,,21,,RBRVS,0.31 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
33510,CPT,CORONARY ARTERY BYPASS 1 CORONARY VENOUS GRAFT,,,21,,RBRVS,34.98 ,13.33 ,13.33 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33511,CPT,CORONARY ARTERY BYPASS 2 CORONARY VENOUS GRAFTS,,,21,,RBRVS,38.45 ,14.64 ,14.64 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33512,CPT,CORONARY ARTERY BYPASS 3 CORONARY VENOUS GRAFTS,,,21,,RBRVS,43.98 ,16.30 ,16.30 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33513,CPT,CORONARY ARTERY BYPASS 4 CORONARY VENOUS GRAFTS,,,21,,RBRVS,45.37 ,16.59 ,16.59 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33514,CPT,CORONARY ARTERY BYPASS 5 CORONARY VENOUS GRAFTS,,,21,,RBRVS,48.08 ,17.29 ,17.29 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33516,CPT,CORONARY ARTERY BYPASS 6/+ CORONARY VENOUS GRAFT,,,21,,RBRVS,49.76 ,18.37 ,18.37 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33517,CPT,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 1 VEIN,,,21,,RBRVS,3.61 ,1.04 ,1.04 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33518,CPT,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 2 VEIN,,,21,,RBRVS,7.93 ,2.28 ,2.28 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33519,CPT,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 3 VEIN,,,21,,RBRVS,10.49 ,3.01 ,3.01 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33521,CPT,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 4 VEIN,,,21,,RBRVS,12.59 ,3.58 ,3.58 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33522,CPT,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 5 VEIN,,,21,,RBRVS,14.14 ,4.03 ,4.03 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33523,CPT,CORONARY ARTERY BYP W/VEIN &ARTERY GRAFT 6 VEIN,,,21,,RBRVS,16.08 ,4.52 ,4.52 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33530,CPT,ROPRTJ CAB/VALVE PX > 1 MO AFTER ORIGINAL OPERJ,,,21,,RBRVS,10.13 ,2.91 ,2.91 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33533,CPT,CABG W/ARTERIAL GRAFT SINGLE ARTERIAL GRAFT,,,21,,RBRVS,33.75 ,12.99 ,12.99 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33534,CPT,CABG W/ARTERIAL GRAFT TWO ARTERIAL GRAFTS,,,21,,RBRVS,39.88 ,15.07 ,15.07 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33535,CPT,CABG W/ARTERIAL GRAFT THREE ARTERIAL GRAFTS,,,21,,RBRVS,44.75 ,16.56 ,16.56 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33536,CPT,CABG W/ARTERIAL GRAFT FOUR/>ARTERIAL GRAFTS,,,21,,RBRVS,48.43 ,17.64 ,17.64 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33542,CPT,MYOCARDIAL RESECTION,,,21,,RBRVS,48.21 ,17.18 ,17.18 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33545,CPT,RPR POSTINFRCJ VENTRICULAR SEPTAL DEFECT,,,21,,RBRVS,57.06 ,19.53 ,19.53 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33548,CPT,SURG VENTRICULAR RSTRJ PX W/PROSTC PATCH PFRMD,,,21,,RBRVS,54.14 ,19.93 ,19.93 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33572,CPT,CORONARY ENDARTERCOMY OPEN ANY METHOD,,,21,,RBRVS,4.44 ,1.28 ,1.28 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33600,CPT,CLOSURE ATRIOVENTRICULAR VALVE SUTURE/PATCH,,,21,,RBRVS,30.31 ,12.80 ,12.80 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33602,CPT,CLOSURE SEMILUNAR VALVE AORTIC/PULM SUTURE/PATCH,,,21,,RBRVS,29.34 ,12.52 ,12.52 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33606,CPT,ANAST PULMONARY ART AORTA DAMUS-KAYE-STANSEL PX,,,21,,RBRVS,31.53 ,15.34 ,15.34 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33608,CPT,RPR CAR ANOMAL XCP PULM ATRESIA VENTR SEPTL DFCT,,,21,,RBRVS,31.88 ,12.83 ,12.83 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33610,CPT,RPR CAR ANOMAL SURG ENLGMENT VENTR SEPTL DFCT,,,21,,RBRVS,31.40 ,13.12 ,13.12 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33611,CPT,RPR 2 OUTLET R VNTRC W/INTRAVENTR TUNNEL RPR,,,21,,RBRVS,35.57 ,15.99 ,15.99 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33612,CPT,RPR 2 OUTLET R VNTRC RPR R VENTR O/F TRC OBSTRCJ,,,21,,RBRVS,36.57 ,13.01 ,13.01 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33615,CPT,RPR CAR ANOMAL CLSR SEPTL DFCT SMPL FONTAN PX,,,21,,RBRVS,35.89 ,14.07 ,14.07 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33617,CPT,RPR COMPLEX CARDIAC ANOMALY MODIFIED FONTAN PX,,,21,,RBRVS,39.09 ,14.50 ,14.50 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33619,CPT,RPR 1 VNTRC W/O/F OBSTRCJ&AORTIC ARCH HYPOPLAS,,,21,,RBRVS,48.76 ,23.14 ,23.14 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33620,CPT,APPLICATION RIGHT & LEFT PULMONARY ARTERY BAND,,,21,,RBRVS,30.00 ,6.87 ,6.87 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33621,CPT,TRANSTHORACIC CATHETER INSERTION FOR STENT PLMT,,,21,,RBRVS,16.18 ,7.19 ,7.19 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33622,CPT,RECONSTRUCTION COMPLEX CARDIAC ANOMALY,,,21,,RBRVS,64.00 ,19.69 ,19.69 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33641,CPT,RPR ATRIAL SEPTAL DFCT SECUNDUM W/BYP W/WO PATCH,,,21,,RBRVS,29.58 ,11.24 ,11.24 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33645,CPT,DIR/PTCH CLS SINUS VENOSUS W/WO ANOM PUL VEN DRG,,,21,,RBRVS,31.30 ,11.57 ,11.57 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33647,CPT,RPR ATRIAL & VENTRIC SEPTAL DFCT DIR/PATCH CLS,,,21,,RBRVS,33.00 ,12.01 ,12.01 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33660,CPT,RPR INCPLT/PRTL AV CANAL W/WO AV VALVE RPR,,,21,,RBRVS,31.83 ,12.09 ,12.09 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33665,CPT,RPR INTRM/TRANSJ AV CANAL W/WO AV VALVE RPR,,,21,,RBRVS,34.85 ,12.53 ,12.53 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33670,CPT,RPR COMPL AV CANAL W/WO PROSTC VALVE,,,21,,RBRVS,36.63 ,12.51 ,12.51 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33675,CPT,CLOSURE MULTIPLE VENTRICULAR SEPTAL DEFECTS,,,21,,RBRVS,35.95 ,13.32 ,13.32 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33676,CPT,CLOSURE MULTIPLE VSD W/RESECTION,,,21,,RBRVS,36.95 ,16.55 ,16.55 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33677,CPT,CLOSURE MULTIPLE VSD W/REMOVAL ARTERY BAND,,,21,,RBRVS,38.45 ,17.12 ,17.12 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33681,CPT,CLSR 1 VENTRICULAR SEPTAL DEFECT W/WO PATCH,,,21,,RBRVS,32.34 ,13.56 ,13.56 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33684,CPT,CLSR V-SEPTL DFCT W/PULM VLVT/INFUND RESCJ,,,21,,RBRVS,34.37 ,12.83 ,12.83 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33688,CPT,CLSR V-SEPTAL DFCT W/RMVL P-ART BAND W/WO GUSSET,,,21,,RBRVS,34.75 ,11.80 ,11.80 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33690,CPT,BANDING PULMONARY ARTERY,,,21,,RBRVS,20.36 ,9.92 ,9.92 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33692,CPT,COMPL RPR TETRALOGY FALLOT W/O PULM ATRESIA,,,21,,RBRVS,36.15 ,15.61 ,15.61 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33694,CPT,COMPL RPR T-FALLOT W/O PULM ATRESIA TANULR PATCH,,,21,,RBRVS,35.57 ,12.73 ,12.73 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33697,CPT,COMPL RPR T-FALLOT W/PULM ATRESIA,,,21,,RBRVS,37.57 ,14.66 ,14.66 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33702,CPT,RPR SINUS VALSALVA FISTULA,,,21,,RBRVS,27.24 ,11.18 ,11.18 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33710,CPT,RPR SINUS VALSALVA FISTULA W/RPR V-SEPTAL DEFECT,,,21,,RBRVS,37.50 ,14.64 ,14.64 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33720,CPT,RPR SINUS VALSALVA ANEURYSM,,,21,,RBRVS,27.26 ,11.56 ,11.56 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33722,CPT,CLOSURE AORTICO-LEFT VENTRICULAR TUNNEL,,,21,,RBRVS,29.21 ,11.47 ,11.47 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33724,CPT,REPAIR ISOLATED PARTIAL PULM VENOUS RETURN,,,21,,RBRVS,27.63 ,10.55 ,10.55 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33726,CPT,REPAIR PULMONARY VENOUS STENOSIS,,,21,,RBRVS,37.12 ,13.66 ,13.66 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33730,CPT,COMPLETE RPR ANOMALOUS PULMONARY VENOUS RETURN,,,21,,RBRVS,36.14 ,14.01 ,14.01 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33732,CPT,RPR COR TRIATM/SUPVALVR RING RESCJ L ATRIAL MEMB,,,21,,RBRVS,28.96 ,12.41 ,12.41 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33735,CPT,ATRIAL SEPTECTOMY/SEPTOSTOMY CLOSED HEART,,,21,,RBRVS,22.20 ,10.45 ,10.45 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33736,CPT,ATRIAL SEPTECTOMY/SEPTOSTOMY OPEN HEART W/BYPASS,,,21,,RBRVS,24.32 ,10.71 ,10.71 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33737,CPT,ATRIAL SEPTECT/SEPTOST OPN HRT W/INFL OCCLUSION,,,21,,RBRVS,22.47 ,11.67 ,11.67 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33750,CPT,SHUNT SUBCLAVIAN PULMONARY ARTERY,,,21,,RBRVS,22.22 ,11.20 ,11.20 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33755,CPT,SHUNT ASCENDING AORTA PULMONARY ARTERY,,,21,,RBRVS,22.60 ,12.03 ,12.03 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33762,CPT,SHUNT DESCENDING AORTA PULMONARY ARTERY,,,21,,RBRVS,22.60 ,11.16 ,11.16 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33764,CPT,SHUNT CENTRAL W/PROSTHETIC GRAFT,,,21,,RBRVS,22.60 ,12.03 ,12.03 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33766,CPT,SHUNT SUPERIOR VENA CAVA PULMONARY ART 1 LUNG,,,21,,RBRVS,23.57 ,11.69 ,11.69 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33767,CPT,SHUNT SUPERIOR VENA CAVA PULM ARTERY BOTH LUNGS,,,21,,RBRVS,25.30 ,10.00 ,10.00 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33768,CPT,ANASTOMOSIS CAVOPULMARY 2ND SUPRIOR VENA CAVA,,,21,,RBRVS,8.00 ,3.06 ,3.06 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33770,CPT,RPR TRPOS GREAT VSLS W/O ENLGMNT V-SEPTL DFCT,,,21,,RBRVS,39.07 ,16.92 ,16.92 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33771,CPT,RPR TRPOS GREAT VSLS W/ENLGMNT V-SEPTL DFCT,,,21,,RBRVS,40.63 ,17.03 ,17.03 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33774,CPT,RPR TRPOS GREAT VSLS ATRIAL BAFFLE PX W/BYPASS,,,21,,RBRVS,31.73 ,13.42 ,13.42 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33775,CPT,RPR TRPOS GREAT VSLS ATR BAFFLE W/RMVL PULM BAND,,,21,,RBRVS,32.99 ,15.88 ,15.88 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33776,CPT,RPR TRPOS GRT VSL ATR BAFFLE W/CLSR V-SEPTL DFCT,,,21,,RBRVS,34.75 ,16.90 ,16.90 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33777,CPT,RPR TRPOS GRT VSL ATR BAFFLE W/BYP SBPULM OBSTRC,,,21,,RBRVS,34.17 ,15.75 ,15.75 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33778,CPT,RPR TRPOS GRT VESSEL AORTIC PULMONARY ART RCNSTJ,,,21,,RBRVS,42.75 ,19.30 ,19.30 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33779,CPT,RPR TGV AORTIC PULM ART RCNSTJ W/RMVL PULM BAND,,,21,,RBRVS,43.23 ,18.31 ,18.31 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33780,CPT,RPR TGV AORTIC P-ART RCNSTJ W/CLSR V-SEPTL DFCT,,,21,,RBRVS,43.90 ,18.76 ,18.76 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33781,CPT,RPR TGV AORTIC P-ART RCNSTJ RPR SBPULMC OBSTRCJ,,,21,,RBRVS,43.21 ,18.00 ,18.00 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33782,CPT,A-ROOT TLCJ VSD PULM STNS RPR W/O C OST RIMPLTJ,,,21,,RBRVS,60.08 ,20.30 ,20.30 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33783,CPT,A-ROOT TLCJ VSD PULM STNS RPR W/RIMPLTJ C OSTIA,,,21,,RBRVS,65.08 ,27.27 ,27.27 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33786,CPT,TOTAL REPAIR TRUNCUS ARTERIOSUS,,,21,,RBRVS,41.87 ,18.29 ,18.29 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33788,CPT,REIMPLANTATION ANOMALOUS PULMONARY ARTERY,,,21,,RBRVS,27.42 ,10.95 ,10.95 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33800,CPT,AORTIC SUSPENSION TRACHEAL DECOMPRESSION SPX,,,21,,RBRVS,17.28 ,8.93 ,8.93 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33802,CPT,DIVISION ABERRANT VESSEL VASCULAR RING,,,21,,RBRVS,18.37 ,10.56 ,10.56 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33803,CPT,DIVISION ABERRANT VESSEL W/REANASTOMOSIS,,,21,,RBRVS,20.31 ,10.00 ,10.00 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33813,CPT,OBLTRJ AORTOPULMONARY SEPTAL DEFECT W/O BYPASS,,,21,,RBRVS,21.36 ,11.25 ,11.25 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33814,CPT,OBLTRJ AORTOPULMONARY SEPTAL DEFECT W/BYPASS,,,21,,RBRVS,26.57 ,11.71 ,11.71 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33820,CPT,REPAIR PATENT DUCTUS ARTERIOSUS LIGATION,,,21,,RBRVS,16.69 ,7.48 ,7.48 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33822,CPT,RPR PATENT DUXUS ARTERIOSUS DIV UNDER 18 YR,,,21,,RBRVS,17.71 ,9.21 ,9.21 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33824,CPT,RPR PATENT DUXUS ARTERIOSUS DIV 18 YR & OLDER,,,21,,RBRVS,20.23 ,9.21 ,9.21 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33840,CPT,EXC COARCJ AORTA W/WO PDA W/DIRECT ANASTOMOSIS,,,21,,RBRVS,21.34 ,11.24 ,11.24 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33845,CPT,EXCISION COARCTATION AORTA W/WO PDA W/GRAFT,,,21,,RBRVS,22.93 ,10.33 ,10.33 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33851,CPT,EXC COARCJ AORTA W/L SUBCLAV ART/PROSTC GUSSET,,,21,,RBRVS,21.98 ,11.49 ,11.49 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33852,CPT,RPR HYPOPLSTC A-ARCH W/AGRFT/PROSTC W/O BYPASS,,,21,,RBRVS,24.41 ,10.40 ,10.40 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33853,CPT,RPR HYPOPLSTC A-ARCH W/AGRFT/PROSTC W/BYPASS,,,21,,RBRVS,32.51 ,13.00 ,13.00 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33860,CPT,ASCENDING AORTA GRF W/CARD BYP & VALVE SSP,,,21,,RBRVS,59.46 ,20.52 ,20.52 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33863,CPT,AS-AORT GRF W/CARD BYP & AORTIC ROOT RPLCMT,,,21,,RBRVS,58.79 ,19.58 ,19.58 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33864,CPT,ASCENDING AORTA GRF VALVE SPARE ROOT REMODEL,,,21,,RBRVS,60.08 ,20.16 ,20.16 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33870,CPT,TRANSVERSE ARCH GRAFT W/CARDIOPULMONARY BYPASS,,,21,,RBRVS,46.06 ,16.74 ,16.74 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33875,CPT,DESCENDING THORACIC AORTA GRAFT W/WO BYPASS,,,21,,RBRVS,50.72 ,17.53 ,17.53 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33877,CPT,RPR THORACOABDOMINAL AORTIC ANEURYS W/WO BYPASS,,,21,,RBRVS,69.03 ,21.17 ,21.17 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33880,CPT,EVASC RPR DTA COVERAGE ART ORIGIN 1ST ENDOPROSTH,,,21,,RBRVS,34.58 ,10.57 ,10.57 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33881,CPT,EVASC RPR DTA EXP COVERAGE W/O ART ORIGIN,,,21,,RBRVS,29.58 ,9.22 ,9.22 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33883,CPT,PLMT PROX XTN PROSTH EVASC RPR DTA 1ST XTN,,,21,,RBRVS,21.09 ,7.17 ,7.17 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33884,CPT,PLMT PROX XTN PROSTH EVASC RPR DTA EA PROX XTN,,,21,,RBRVS,8.20 ,2.05 ,2.05 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33886,CPT,PLMT DSTL XTN PROSTH DLYD AFTER EVASC RPR DTA,,,21,,RBRVS,18.09 ,6.21 ,6.21 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33889,CPT,OPN SUBCLA CRTD ART TRPOS NCK INC ULAT,,,21,,RBRVS,15.92 ,3.66 ,3.66 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33891,CPT,BYP GRF W/DESCENDING THORACIC AORTA RPR NECK INC,,,21,,RBRVS,20.00 ,3.91 ,3.91 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33910,CPT,PULMONARY ARTERY EMBOLECTOMY W/CARD BYPASS,,,21,,RBRVS,48.21 ,17.54 ,17.54 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33915,CPT,PULMONARY ARTERY EMBOLECTOMY W/O CARD BYPASS,,,21,,RBRVS,24.95 ,6.51 ,6.51 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33916,CPT,PULMONARY ENDARTERCOMY W/WO EMBOLECTOMY W/BYPASS,,,21,,RBRVS,78.00 ,26.23 ,26.23 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33917,CPT,RPR PULMONARY ART STENOSIS RCNSTJ W/PATCH/GRAFT,,,21,,RBRVS,25.30 ,11.34 ,11.34 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33920,CPT,RPR PULMONARY ATRESIA W/CONSTJ/RPLCMT CONDUIT,,,21,,RBRVS,32.74 ,12.49 ,12.49 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33922,CPT,TRANSECTION PULMONARY ARTERY W/CARD BYPASS,,,21,,RBRVS,24.22 ,10.34 ,10.34 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33924,CPT,LIG&TKDN SYSIC-TO-PULM ART SHUNT W/CGEN HEART,,,21,,RBRVS,5.49 ,1.54 ,1.54 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33925,CPT,RPR P-ART ARBORIZJ ANOMAL UNIFCLIZJ W/O BYPASS,,,21,,RBRVS,31.30 ,11.60 ,11.60 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33926,CPT,RPR P-ART ARBORIZJ ANOMAL UNIFCLIZJ W/BYPASS,,,21,,RBRVS,44.73 ,18.70 ,18.70 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33935,CPT,HEART-LUNG TRNSPL W/RECIPIENT CARDIECTOMY-PNUMEC,,,21,,RBRVS,91.78 ,31.19 ,31.19 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33940,CPT,DONOR CARDIECTOMY,,,21,,TotalUnits,,,,39.56 ,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33944,CPT,BKBENCH PREPJ CADAVER DONOR HEART ALLOGRAFT,,,21,,TotalUnits,,,,27.63 ,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33945,CPT,HEART TRANSPLANT W/WO RECIPIENT CARDIECTOMY,,,21,,RBRVS,89.50 ,31.28 ,31.28 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33946,CPT,ECMO/ECLS INITIATION VENO-VENOUS,,,21,,RBRVS,6.00 ,1.86 ,1.86 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33947,CPT,ECMO/ECLS INITIATION VENO-ARTERIAL,,,21,,RBRVS,6.63 ,2.05 ,2.05 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33948,CPT,ECMO/ECLS DAILY MANAGEMENT EACH DAY VENO-VENOUS,,,21,,RBRVS,4.73 ,1.53 ,1.53 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33949,CPT,ECMO/ECLS DAILY MANAGEMENT EA DAY VENO-ARTERIAL,,,21,,RBRVS,4.60 ,1.49 ,1.49 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33951,CPT,ECMO/ECLS INSJ OF PRPH CANNULA BIRTH-5 YRS PERQ,,,21,,RBRVS,8.15 ,2.79 ,2.79 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33952,CPT,ECMO/ECLS INSJ OF PRPH CANNULA 6 YRS&OLDER PERQ,,,21,,RBRVS,8.15 ,2.50 ,2.50 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33953,CPT,ECMO/ECLS INSJ OF PRPH CANNULA BIRTH-5 YRS OPEN,,,21,,RBRVS,9.11 ,3.11 ,3.11 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33954,CPT,ECMO/ECLS INSJ OF PRPH CANNULA 6 YRS&OLDER OPEN,,,21,,RBRVS,9.11 ,2.78 ,2.78 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33955,CPT,ECMO/ECLS INSJ OF CENTRAL CANNULA BIRTH-5 YRS,,,21,,RBRVS,16.00 ,6.18 ,6.18 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33956,CPT,ECMO/ECLS INSJ OF CENTRAL CANNULA 6 YRS & OLDER,,,21,,RBRVS,16.00 ,4.78 ,4.78 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33957,CPT,ECMO/ECLS REPOS PERIPH CANNULA PERQ BIRTH-5 YRS,,,21,,RBRVS,3.51 ,1.43 ,1.43 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33958,CPT,ECMO/ECLS REPOS PERPH CANNULA PRQ 6 YRS & OLDER,,,21,,RBRVS,3.51 ,1.24 ,1.24 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33959,CPT,ECMO/ECLS REPOS PERPH CANNULA OPEN BIRTH-5 YRS,,,21,,RBRVS,4.47 ,1.80 ,1.80 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33962,CPT,ECMO/ECLS REPOS PERPH CANNULA OPEN 6 YRS & OLDER,,,21,,RBRVS,4.47 ,1.35 ,1.35 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33963,CPT,ECMO/ECLS REPOS CENTRAL PERPH CANNULA BIRTH-5YRS,,,21,,RBRVS,9.00 ,3.51 ,3.51 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33964,CPT,ECMO/ECLS ECLS REPOS CENTRAL CNULA 6YRS & OLDER,,,21,,RBRVS,9.50 ,3.22 ,3.22 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33965,CPT,ECMO/ECLS RMVL OF PERPH CANNULA PERQ BIRTH-5 YRS,,,21,,RBRVS,3.51 ,1.43 ,1.43 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33966,CPT,ECMO/ECLS RMVL OF PRPH CANNULA PRQ 6 YRS & OLDER,,,21,,RBRVS,4.50 ,1.36 ,1.36 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33967,CPT,INSERTION INTRA-AORTIC BALLOON ASSIST DEV PERQ,,,21,,RBRVS,4.84 ,1.62 ,1.62 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33968,CPT,REMOVAL INTRA-AORTIC BALLOON ASSIST DEVICE PRQ,,,21,,RBRVS,0.64 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33969,CPT,ECMO/ECLS RMVL OF PERPH CANNULA OPEN BIRTH-5 YRS,,,21,,RBRVS,5.22 ,2.09 ,2.09 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33970,CPT,INSJ INTRA-AORT BALO ASSIST DEV VIA FEM ART OPEN,,,21,,RBRVS,6.74 ,2.08 ,2.08 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33971,CPT,RMVL I-AORT BALO ASST DEV W/RPR FEM ART W/WO GRF,,,21,,RBRVS,11.99 ,5.94 ,5.94 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33973,CPT,INSJ I-AORT BALO ASSIST DEV VIA ASCENDING AORTA,,,21,,RBRVS,9.75 ,3.12 ,3.12 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33974,CPT,RMVL ASCENDING-AORTA BALO DEV W/RPR ASCEND-AORTA,,,21,,RBRVS,15.03 ,7.40 ,7.40 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33975,CPT,INSJ VENTRIC ASSIST DEV XTRCORP SINGLE VENTRICLE,,,21,,RBRVS,25.00 ,7.50 ,7.50 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33976,CPT,INSJ VENTRIC ASSIST DEV XTRCORP BIVENTRICULAR,,,21,,RBRVS,30.75 ,8.58 ,8.58 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33977,CPT,REMOVAL VENTR ASSIST DEVICE XTRCORP 1 VENTRICLE,,,21,,RBRVS,20.86 ,7.33 ,7.33 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33978,CPT,REMOVAL VENTR ASSIST DEVICE XTRCORP BIVENTR,,,21,,RBRVS,25.00 ,8.19 ,8.19 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33979,CPT,INSJ VENTR ASSIST DEV IMPLTABLE ICORP 1 VNTRC,,,21,,RBRVS,37.50 ,10.84 ,10.84 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33980,CPT,RMVL VENTR ASSIST DEV IMPLTABLE ICORP 1 VNTRC,,,21,,RBRVS,33.50 ,10.79 ,10.79 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33981,CPT,RPLCMT XTRCORP VAD 1/BIVENTR PUMP 1/EA PUMP,,,21,,RBRVS,16.11 ,4.48 ,4.48 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33982,CPT,PLCMT VAD PMP IMPLTBL ICORP 1 VENTR W/O BYPASS,,,21,,RBRVS,37.86 ,10.55 ,10.55 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33983,CPT,RPLCMT VAD PMP IMPLTBL ICORP 1 VNTR W/BYPASS,,,21,,RBRVS,44.54 ,12.81 ,12.81 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33984,CPT,ECMO/ECLS RMVL PRPH CANNULA OPEN 6 YRS & OLDER,,,21,,RBRVS,5.46 ,1.63 ,1.63 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33985,CPT,ECMO/ECLS REMOVAL OF CENTRAL CANNULA BIRTH-5 YRS,,,21,,RBRVS,9.89 ,3.84 ,3.84 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33986,CPT,ECMO/ECLS RMVL OF CENTRAL CANNULA 6 YRS & OLDER,,,21,,RBRVS,10.00 ,2.90 ,2.90 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33987,CPT,ARTERY EXPOS/GRAFT ARTERY PERFUSION ECMO/ECLS,,,21,,RBRVS,4.04 ,1.13 ,1.13 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33988,CPT,INSERT LEFT HEART VENT BY THORACIC INC ECMO/ECLS,,,21,,RBRVS,15.00 ,4.27 ,4.27 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33989,CPT,RMVL LEFT HEART VENT BY THORACIC INCIS ECMO/ECLS,,,21,,RBRVS,9.50 ,2.76 ,2.76 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33990,CPT,INSJ PERQ VAD W/IMAGING ARTERY ACCESS ONLY,,,21,,RBRVS,8.15 ,2.78 ,2.78 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33991,CPT,INSJ PERQ VAD TRNSPTAL W/IMAGE ART&VENOUS ACCESS,,,21,,RBRVS,11.88 ,3.86 ,3.86 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33992,CPT,REMOVAL PERCUTANEOUS VAD DIFFERENT SESSION,,,21,,RBRVS,4.00 ,1.30 ,1.30 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33993,CPT,REPOSITION VAD W/IMAGING DIFFERENT SESSION,,,21,,RBRVS,3.51 ,1.19 ,1.19 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
33999,CPT,UNLISTED CARDIAC SURGERY,,,21,,TotalUnits,,,,13.41 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
34001,CPT,EMBLC/THRMBC CATH CRTD SUBCLA/INNOMINATE ART,,,21,,RBRVS,17.88 ,7.03 ,7.03 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34051,CPT,EMBLC/THRMBC INNOMINATE SUBCLAVIAN ARTERY,,,21,,RBRVS,16.99 ,5.36 ,5.36 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34101,CPT,EMBLC/THRMBC AX BRACH INNOMINATE SUBCLA ART,,,21,,RBRVS,10.93 ,4.31 ,4.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
34111,CPT,EMBLC/THRMBC W/WO CATH RADIAL/ULNAR ART ARM INC,,,21,,RBRVS,10.93 ,4.22 ,4.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
34151,CPT,EMBLC/THRMBC RNL CELIAC MESENTRY AORTO-ILIAC ART,,,21,,RBRVS,26.52 ,8.79 ,8.79 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34201,CPT,EMBLC/THRMBC FEMORAL POPLITEAL AORTO-ILIAC ART,,,21,,RBRVS,19.48 ,6.49 ,6.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
34203,CPT,EMBLC/THRMBC POPLITEAL-TIBIO-PRONEAL ART LEG INC,,,21,,RBRVS,17.86 ,6.17 ,6.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
34401,CPT,THRMBC DIR/W/CATH VENA CAVA ILIAC VEIN ABDL INC,,,21,,RBRVS,26.52 ,10.18 ,10.18 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34421,CPT,THRMBC DIR/W/CATH V/C ILIAC FEMPOP VEIN LEG INC,,,21,,RBRVS,13.37 ,5.04 ,5.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
34451,CPT,THRMBC DIR/W/CATH V/C ILIAC FEMPOP VEIN ABDL&LEG,,,21,,RBRVS,28.52 ,13.18 ,13.18 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34471,CPT,THRMBC DIR/W/CATH SUBCLAVIAN VEIN NECK INC,,,21,,RBRVS,21.11 ,5.88 ,5.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
34490,CPT,THRMBC DIR/W/CATH AXILL&SUBCLAVIAN VEIN ARM IN,,,21,,RBRVS,10.91 ,4.57 ,4.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
34501,CPT,VALVULOPLASTY FEMORAL VEIN,,,21,,RBRVS,16.85 ,5.63 ,5.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
34502,CPT,RECONSTRUCTION VENA CAVA ANY METHOD,,,21,,RBRVS,28.07 ,10.75 ,10.75 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34510,CPT,VENOUS VALVE TRANSPOSITION ANY VEIN DONOR,,,21,,RBRVS,19.91 ,10.14 ,10.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
34520,CPT,CROSS-OVER VEIN GRAFT VENOUS SYSTEM,,,21,,RBRVS,19.18 ,5.60 ,5.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
34530,CPT,SAPHENOPOPLITEAL VEIN ANASTOMOSIS,,,21,,RBRVS,17.93 ,10.10 ,10.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
34800,CPT,EVASC RPR AAA W/AORTO-AORTIC TUBE PROSTH,,,21,,RBRVS,21.54 ,6.93 ,6.93 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34802,CPT,EVASC RPR AAA W/MDLR BFRC PROSTH 1 LIMB,,,21,,RBRVS,23.79 ,7.73 ,7.73 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34803,CPT,EVASC RPR AAA W/MDLR BFRC PROSTH 2 LIMBS,,,21,,RBRVS,24.82 ,7.65 ,7.65 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34804,CPT,EVASC RPR AAA W/UNIBDY BFRC PROSTH,,,21,,RBRVS,23.79 ,7.64 ,7.64 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34805,CPT,EVASC RPR AAA AORTO-UNIILIAC/AORTO-UNIFEM PROSTH,,,21,,RBRVS,22.67 ,7.40 ,7.40 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34806,CPT,TCAT PLACEMENT PHYSIOLOGIC SENSOR ANEURYSMAL SAC,,,21,,RBRVS,2.06 ,0.41 ,0.41 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34808,CPT,EVASC PLACEMENT ILIAC ARTERY OCCLUSION DEVICE,,,21,,RBRVS,4.12 ,1.03 ,1.03 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34812,CPT,OPN FEM ART EXPOS DLVR EVASC PROSTH UNI,,,21,,RBRVS,6.74 ,1.66 ,1.66 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34813,CPT,PLMT FEM-FEM PROSTC GRF EVASC AORTIC ARYSM RPR,,,21,,RBRVS,4.79 ,1.10 ,1.10 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34820,CPT,ILIAC ART EXPOS PROSTH/ILIAC OCCLS EVASC UNI,,,21,,RBRVS,9.74 ,2.48 ,2.48 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34825,CPT,PLMT XTN PROSTH EVASC RPR ARYSM/DSJ 1ST VSL,,,21,,RBRVS,12.80 ,4.90 ,4.90 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34826,CPT,PLMT XTN PROSTH EVASC RPR ARYSM/DSJ EA VSL,,,21,,RBRVS,4.12 ,1.02 ,1.02 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34830,CPT,OPN RPR ARYSM RPR ARTL TRAUMA TUBE PROSTH,,,21,,RBRVS,35.23 ,8.75 ,8.75 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34831,CPT,OPN RPR ARYSM RPR ARTL TRMA AORTOBIILIAC PROSTH,,,21,,RBRVS,37.98 ,9.29 ,9.29 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34832,CPT,OPN RPR ARYSM RPR ARTL TRMA AORTO-BIFEM PROSTH,,,21,,RBRVS,37.98 ,9.29 ,9.29 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34833,CPT,ILIAC ART EXPOS W/CRTJ CONDUIT UNI,,,21,,RBRVS,11.98 ,3.27 ,3.27 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34834,CPT,BRACH ART EXPOS DPLMNT AORTIC/ILIAC PROSTH UNI,,,21,,RBRVS,5.34 ,1.49 ,1.49 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34841,CPT,ENDOVASC VISCER AORTA REPAIR FENEST 1 ENDOGRAFT,,,21,,TotalUnits,,,,15.50 ,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34842,CPT,ENDOVASC VISCER AORTA REPAIR FENEST 2 ENDOGRAFT,,,21,,TotalUnits,,,,31.00 ,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34843,CPT,ENDOVASC VISCER AORTA REPAIR FENEST 3 ENDOGRAFT,,,21,,TotalUnits,,,,46.50 ,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34844,CPT,ENDOVASC VISCER AORTA REPR FENEST 4+ ENDOGRAFT,,,21,,TotalUnits,,,,62.00 ,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34845,CPT,VISCER AND INFRARENAL ABDOM AORTA 1 PROSTHESIS,,,21,,TotalUnits,,,,21.51 ,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34846,CPT,VISCER AND INFRARENAL ABDOM AORTA 2 PROSTHESIS,,,21,,TotalUnits,,,,43.03 ,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34847,CPT,VISCER AND INFRARENAL ABDOM AORTA 3 PROSTHESIS,,,21,,TotalUnits,,,,64.54 ,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34848,CPT,VISCER AND INFRARENAL ABDOM AORTA 4+ PROSTHESIS,,,21,,TotalUnits,,,,86.05 ,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
34900,CPT,EVASC RPR ILIAC ART ILIO-ILIAC PROSTHESIS,,,21,,RBRVS,16.85 ,5.79 ,5.79 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35001,CPT,DIR RPR ANEURYSM CAROTID-SUBCLAVIAN ARTERY,,,21,,RBRVS,20.81 ,7.69 ,7.69 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35002,CPT,DIR RPR RUPTD ANEURYSM CAROTID-SUBCLAVIAN ARTERY,,,21,,RBRVS,22.23 ,6.18 ,6.18 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35005,CPT,DIR RPR ANEURYSM VERTEBRAL ARTERY,,,21,,RBRVS,19.29 ,10.03 ,10.03 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35011,CPT,DIR RPR ANEURYSM AXIL-BRACHIAL ARM INCISION,,,21,,RBRVS,18.58 ,6.67 ,6.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35013,CPT,DIR RPR RUPTD ANEURYSM AXIL-BRACHIAL ARM INCIS,,,21,,RBRVS,23.23 ,8.14 ,8.14 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35021,CPT,DIR RPR ANEURYSM INNOMINATE/SUBCLAVIAN ARTERY,,,21,,RBRVS,22.17 ,9.65 ,9.65 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35022,CPT,DIR RPR RUPTD ANEURYSM INNOMINATE/SUBCLAVIAN,,,21,,RBRVS,25.70 ,10.66 ,10.66 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35045,CPT,DIR RPR RUPTD ANEURYSM RADIAL/ULNAR ARTERY,,,21,,RBRVS,18.01 ,7.23 ,7.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35081,CPT,DIR RPR ANEURYSM ABDOMINAL AORTA,,,21,,RBRVS,33.53 ,10.39 ,10.39 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35082,CPT,DIR RPR RUPTD ANEURYSM ABDOMINAL AORTA,,,21,,RBRVS,42.09 ,13.04 ,13.04 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35091,CPT,DIR RPR ANEURYSM ABDOM AORTA W/VISCERAL VESSELS,,,21,,RBRVS,35.35 ,9.48 ,9.48 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35092,CPT,DIR RPR RUPTD ANEURSM ABDOM AORTA W/VISCERA VSLS,,,21,,RBRVS,50.97 ,14.42 ,14.42 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35102,CPT,DIR RPR ANEURYSM ABDOM AORTA W/ILIAC VESSELS,,,21,,RBRVS,36.53 ,10.94 ,10.94 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35103,CPT,DIR RPR RUPTD ANEURYSM ABDOM AORTA W/ILIAC VSLS,,,21,,RBRVS,43.62 ,12.94 ,12.94 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35111,CPT,DIR RPR ANEURYSM SPLENIC ARTERY,,,21,,RBRVS,26.28 ,6.90 ,6.90 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35112,CPT,DIR RPR RUPTD ANEURYSM SPLENIC ARTERY,,,21,,RBRVS,32.57 ,14.79 ,14.79 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35121,CPT,DIR RPR ANEURYSM HEPATIC/CELIAC/RENAL/MESENTERIC,,,21,,RBRVS,31.52 ,9.70 ,9.70 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35122,CPT,DIR RPR RUPTD ANEURSM HEPATIC/CELIAC/RENAL/MESEN,,,21,,RBRVS,37.89 ,16.67 ,16.67 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35131,CPT,DIR RPR ANEURYSM & GRAFT ILIAC ARTERY,,,21,,RBRVS,26.40 ,8.58 ,8.58 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35132,CPT,DIR RPR RUPTD ANEURYSM & GRAFT ILIAC ARTERY,,,21,,RBRVS,32.57 ,8.22 ,8.22 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35141,CPT,DIR RPR ANEURYSM & GRAFT COMMON FEMORAL ARTERY,,,21,,RBRVS,20.91 ,7.05 ,7.05 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35142,CPT,DIR RPR RUPTD ANEURYSM & GRF COMMON FEMORAL ART,,,21,,RBRVS,25.16 ,8.05 ,8.05 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35151,CPT,DIR RPR ANEURYSM & GRAFT POPLITEAL ARTERY,,,21,,RBRVS,23.72 ,7.58 ,7.58 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35152,CPT,DIR RPR RUPTD ANEURYSM & GRF POPLITEAL ARTERY,,,21,,RBRVS,27.66 ,7.25 ,7.25 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35180,CPT,REPAIR CONGENITAL AV FISTULA HEAD & NECK,,,21,,RBRVS,15.10 ,9.12 ,9.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35182,CPT,RPR CONGENITAL AV FISTULA THORAX & ABDOMEN,,,21,,RBRVS,31.71 ,8.67 ,8.67 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35184,CPT,RPR CONGENITAL AV FISTULA EXTREMITIES,,,21,,RBRVS,18.82 ,9.51 ,9.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35188,CPT,RPR/TRAUMATIC AV FISTULA HEAD & NECK,,,21,,RBRVS,18.00 ,8.96 ,8.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35189,CPT,RPR/TRAUMATIC AV FISTULA THORAX & ABDOMEN,,,21,,RBRVS,29.98 ,7.71 ,7.71 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35190,CPT,RPR/TRAUMATIC AV FISTULA EXTREMITIES,,,21,,RBRVS,13.42 ,5.85 ,5.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35201,CPT,REPAIR BLOOD VESSEL DIRECT NECK,,,21,,RBRVS,16.93 ,7.42 ,7.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35206,CPT,REPAIR BLOOD VESSEL DIRECT UPPER EXTREMITY,,,21,,RBRVS,13.84 ,5.83 ,5.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35207,CPT,REPAIR BLOOD VESSEL DIRECT HAND FINGER,,,21,,RBRVS,10.94 ,8.86 ,8.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35211,CPT,RPR BLOOD VESSEL DIRECT INTRATHORACIC W/BYPASS,,,21,,RBRVS,24.58 ,10.10 ,10.10 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35216,CPT,RPR BLOOD VESSEL DIRECT INTRATHORACIC W/O BYPASS,,,21,,RBRVS,36.61 ,14.79 ,14.79 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35221,CPT,RPR BLOOD VESSEL DIRECT INTRA-ABDOMINAL,,,21,,RBRVS,26.62 ,9.88 ,9.88 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35226,CPT,RPR BLOOD VESSEL DIRECT LOWER EXTREMITY,,,21,,RBRVS,15.30 ,5.70 ,5.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35231,CPT,REPAIR BLOOD VESSEL W/VEIN GRAFT NECK,,,21,,RBRVS,21.16 ,10.77 ,10.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35236,CPT,REPAIR BLOOD VESSEL W/VEIN GRAFT UPPER EXTREMITY,,,21,,RBRVS,18.02 ,6.83 ,6.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35241,CPT,RPR BLOOD VESSEL VEIN GRAFT INTRATHORACIC W/BYP,,,21,,RBRVS,25.58 ,10.47 ,10.47 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35246,CPT,RPR BLOOD VESSEL VEIN GRF INTRATHORACIC W/O BYP,,,21,,RBRVS,28.23 ,11.25 ,11.25 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35251,CPT,REPAIR BLOOD VESSEL VEIN GRAFT INTRA-ABDOMINAL,,,21,,RBRVS,31.91 ,10.94 ,10.94 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35256,CPT,REPAIR BLOOD VESSEL VEIN GRAFT LOWER EXTREMITY,,,21,,RBRVS,19.06 ,6.58 ,6.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35261,CPT,REPAIR BLOOD VESSEL W/GRAFT OTHER/THAN VEIN NECK,,,21,,RBRVS,18.96 ,8.16 ,8.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35266,CPT,RPR BLOOD VSL GRF OTH/THN VEIN UPPER EXTREMITY,,,21,,RBRVS,15.83 ,6.03 ,6.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35271,CPT,RPR BLOOD VSL GRF OTH/THN VEIN INTRATHRC W/BYP,,,21,,RBRVS,24.58 ,10.03 ,10.03 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35276,CPT,RPR BLOOD VSL GRF OTH/THN VEIN INTRATHRC W/O BYP,,,21,,RBRVS,25.83 ,10.98 ,10.98 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35281,CPT,RPR BLVSL W/GRFT OTHER/THAN VEIN INTRA-ABDOMINAL,,,21,,RBRVS,30.06 ,10.72 ,10.72 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35286,CPT,RPR BLVSL W/GRF OTHER/THAN VEIN LOWER EXTREMITY,,,21,,RBRVS,17.19 ,6.40 ,6.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35301,CPT,TEAEC W/PATCH GRF CAROTID VERTB SUBCLAV NECK INC,,,21,,RBRVS,21.16 ,7.37 ,7.37 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35302,CPT,TEAEC W/GRAFT SUPERFICIAL FEMORAL ARTERY,,,21,,RBRVS,21.35 ,7.06 ,7.06 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35303,CPT,TEAEC W/GRAFT POPLITEAL ARTERY,,,21,,RBRVS,23.60 ,7.69 ,7.69 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35304,CPT,TEAEC W/GRAFT TIBIOPERONEAL TRUNK ARTERY,,,21,,RBRVS,24.60 ,7.74 ,7.74 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35305,CPT,TEAEC W/GRAFT TIBIAL/PERONEAL ART 1ST VESSEL,,,21,,RBRVS,23.60 ,7.14 ,7.14 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35306,CPT,TEAEC W/GRAFT EA ADDL TIBIAL/PERONEAL ART,,,21,,RBRVS,9.25 ,1.82 ,1.82 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35311,CPT,TEAEC W/WO PATCH GRF SUBCLAV INNOM THORACIC INC,,,21,,RBRVS,28.60 ,10.60 ,10.60 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35321,CPT,TEAEC W/WO PATCH GRF AXILLARY-BRACHIAL,,,21,,RBRVS,16.59 ,5.82 ,5.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35331,CPT,TEAEC W/WO PATCH GRAFT ABDOMINAL AORTA,,,21,,RBRVS,27.72 ,8.95 ,8.95 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35341,CPT,TEAEC W/WO PATCH GRAFT MESENTERIC CELIAC/RENAL,,,21,,RBRVS,26.21 ,7.93 ,7.93 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35351,CPT,TEAEC W/WO PATCH GRAFT ILIAC,,,21,,RBRVS,24.61 ,7.59 ,7.59 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35355,CPT,TEAEC W/WO PATCH GRAFT ILIOFEMORAL,,,21,,RBRVS,19.86 ,6.18 ,6.18 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35361,CPT,TEAEC W/WO PATCH GRAFT COMBINED AORTOILIAC,,,21,,RBRVS,30.24 ,7.77 ,7.77 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35363,CPT,TEAEC W/WO PATCH GRAFT COMBINED AORTOILIOFEMORAL,,,21,,RBRVS,32.35 ,11.88 ,11.88 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35371,CPT,TEAEC W/WO PATCH GRAFT COMMON FEMORAL,,,21,,RBRVS,15.31 ,5.40 ,5.40 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35372,CPT,TEAEC W/WO PATCH GRAFT DEEP PROFUNDA FEMORAL,,,21,,RBRVS,18.58 ,6.16 ,6.16 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35390,CPT,ROPRTJ CRTD TEAEC > 1 MO AFTER ORIGINAL OPRATIO,,,21,,RBRVS,3.19 ,0.80 ,0.80 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35400,CPT,ANGIOSCOPY NON-CORONARY VESSEL/GRAFTS THER IVNTJ,,,21,,RBRVS,3.00 ,0.71 ,0.71 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35450,CPT,TRLUML BALOON ANGIOPL OPN RENAL/OTH VISCERAL ART,,,21,,RBRVS,10.05 ,2.50 ,2.50 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35452,CPT,TRLUML BALLOON ANGIOPLASTY OPEN AORTIC,,,21,,RBRVS,6.90 ,1.58 ,1.58 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35458,CPT,TRLUML BALO ANGIOP OPN BRCH/CPHLC TRNK/BRNCH EA,,,21,,RBRVS,9.48 ,2.78 ,2.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35460,CPT,TRLUML BALLOON ANGIOPLASTY OPEN VENOUS,,,21,,RBRVS,6.03 ,1.84 ,1.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35471,CPT,TRLUML BALLOON ANGIOP PRQ RENAL/VISCERAL ART,,,21,,RBRVS,10.05 ,3.22 ,60.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35472,CPT,TRLUML BALLOON ANGIOPLASTY PERCUTANEOUS AORTIC,,,21,,RBRVS,6.90 ,2.09 ,44.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35475,CPT,TRLUML BALO ANGIOP PRQ BRCH/CPHLC TRNK/BRNCH EA,,,21,,RBRVS,6.60 ,2.20 ,36.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35476,CPT,TRLUML BALLOON ANGIOPLASTY PERCUTANEOUS VENOUS,,,21,,RBRVS,5.10 ,2.04 ,34.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35500,CPT,HARVEST UXTR VEIN 1 SGM LOWER EXTREMITY/CABG PX,,,21,,RBRVS,6.44 ,1.52 ,1.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35501,CPT,BYPASS W/VEIN COMMON-IPSILATERAL CAROTID,,,21,,RBRVS,29.09 ,8.69 ,8.69 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35506,CPT,BYPASS W/VEIN CAROTID-SUBCLV/SUBCLAVIAN CAROTID,,,21,,RBRVS,25.33 ,6.51 ,6.51 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35508,CPT,BYPASS W/VEIN CAROTID-VERTEBRAL,,,21,,RBRVS,26.09 ,7.17 ,7.17 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35509,CPT,BYPASS W/VEIN CAROTID-CONTRALATERAL CAROTID,,,21,,RBRVS,28.09 ,7.25 ,7.25 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35510,CPT,BYPASS W/VEIN CAROTID-BRACHIAL,,,21,,RBRVS,24.39 ,6.36 ,6.36 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35511,CPT,BYPASS W/VEIN SUBCLAVIAN-SUBCLAVIAN,,,21,,RBRVS,22.20 ,5.81 ,5.81 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35512,CPT,BYPASS W/VEIN SUBCLAVIAN-BRACHIAL,,,21,,RBRVS,23.89 ,11.25 ,11.25 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35515,CPT,BYPASS W/VEIN SUBCLAVIAN-VERTEBRAL,,,21,,RBRVS,26.09 ,12.87 ,12.87 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35516,CPT,BYPASS W/VEIN SUBCLAVIAN-AXILLARY,,,21,,RBRVS,24.21 ,6.29 ,6.29 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35518,CPT,BYPASS W/VEIN AXILLARY-AXILLARY,,,21,,RBRVS,22.65 ,5.90 ,5.90 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35521,CPT,BYPASS W/VEIN AXILLARY-FEMORAL,,,21,,RBRVS,24.13 ,6.56 ,6.56 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35522,CPT,BYPASS W/VEIN AXILLARY-BRACHIAL,,,21,,RBRVS,23.15 ,7.37 ,7.37 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35523,CPT,BYPASS W/VEIN BRACHIAL-ULNAR/-RADIAL,,,21,,RBRVS,24.13 ,8.59 ,8.59 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35525,CPT,BYPASS W/VEIN BRACHIAL-BRACHIAL,,,21,,RBRVS,21.69 ,7.35 ,7.35 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35526,CPT,BYPASS W/VEIN AORTOSUBCLAV/CAROTID/INNOMINATE,,,21,,RBRVS,31.55 ,12.09 ,12.09 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35531,CPT,BYPASS W/VEIN AORTOCELIAC/AORTOMESENTERIC,,,21,,RBRVS,39.11 ,11.55 ,11.55 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35533,CPT,BYPASS W/VEIN AXILLARY-FEMORAL-FEMORAL,,,21,,RBRVS,29.92 ,7.70 ,7.70 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35535,CPT,BYPASS W/VEIN HEPATORENAL,,,21,,RBRVS,38.13 ,9.35 ,9.35 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35536,CPT,BYPASS W/VEIN SPLENORENAL,,,21,,RBRVS,33.73 ,8.45 ,8.45 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35537,CPT,BYPASS W/VEIN AORTOILIAC,,,21,,RBRVS,41.88 ,18.21 ,18.21 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35538,CPT,BYPASS W/VEIN AORTOBI-ILIAC,,,21,,RBRVS,47.03 ,11.14 ,11.14 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35539,CPT,BYPASS W/VEIN AORTOFEMORAL,,,21,,RBRVS,44.11 ,10.55 ,10.55 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35540,CPT,BYPASS W/VEIN AORTOBIFEMORAL,,,21,,RBRVS,49.33 ,15.20 ,15.20 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35556,CPT,BYPASS W/VEIN FEMORAL-POPLITEAL,,,21,,RBRVS,26.75 ,8.58 ,8.58 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35558,CPT,BYPASS W/VEIN FEMORAL-FEMORAL,,,21,,RBRVS,23.13 ,8.00 ,8.00 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35560,CPT,BYPASS W/VEIN AORTORENAL,,,21,,RBRVS,34.03 ,8.51 ,8.51 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35563,CPT,BYPASS W/VEIN ILIOILIAC,,,21,,RBRVS,26.12 ,12.48 ,12.48 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35565,CPT,BYPASS W/VEIN ILIOFEMORAL,,,21,,RBRVS,25.13 ,8.42 ,8.42 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35566,CPT,BYP FEM-ANT TIBL PST TIBL PRONEAL ART/OTH DSTL,,,21,,RBRVS,32.35 ,9.70 ,9.70 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35570,CPT,BYP TIBL-TIBL/PRONEAL-TIBL/TIBL/PRONEAL TRK-TIBL,,,21,,RBRVS,29.15 ,8.97 ,8.97 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35571,CPT,BYP W/VEIN POP-TIBL-PRONEAL ART/OTH DSTL VSL,,,21,,RBRVS,25.52 ,7.97 ,7.97 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35572,CPT,HARVEST FEMPOP VEIN 1 SGM VASC RCNSTJ PX,,,21,,RBRVS,6.81 ,1.82 ,1.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35583,CPT,IN-SITU VEIN BYPASS FEMORAL-POPLITEAL,,,21,,RBRVS,27.75 ,8.89 ,8.89 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35585,CPT,IN-SITU FEM-ANT TIBL PST TIBL/PRONEAL ART,,,21,,RBRVS,32.35 ,9.96 ,9.96 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35587,CPT,IN-SITU VEIN BYP POP-TIBL PRONEAL,,,21,,RBRVS,26.21 ,8.39 ,8.39 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35600,CPT,HARVEST UPPER EXTREMITY ARTERY 1 SEGMENT CABG,,,21,,RBRVS,4.94 ,1.43 ,1.43 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35601,CPT,BYP OTH/THN VEIN COMMON-IPSILATERAL CAROTID,,,21,,RBRVS,27.09 ,8.21 ,8.21 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35606,CPT,BYP OTH/THN VEIN CAROTID-SUBCLAVIAN,,,21,,RBRVS,22.46 ,7.22 ,7.22 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35612,CPT,BYP OTH/THN VEIN SUBCLAVIAN-SUBCLAVIAN,,,21,,RBRVS,20.35 ,5.81 ,5.81 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35616,CPT,BYP OTH/THN VEIN SUBCLAVIAN-AXILLARY,,,21,,RBRVS,21.82 ,5.73 ,5.73 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35621,CPT,BYP OTH/THN VEIN AXILLARY-FEMORAL,,,21,,RBRVS,21.03 ,6.72 ,6.72 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35623,CPT,BYP OTH/THN VEIN AXILLARY-POPLITEAL/-TIBIAL,,,21,,RBRVS,25.92 ,6.92 ,6.92 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35626,CPT,BYPASS NOT VEIN AORTOSUBCLA/CAROTID/INNOMINATE,,,21,,RBRVS,29.14 ,10.52 ,10.52 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35631,CPT,BYP OTH/THN VEIN AORTOCELIAC AORTOMSN AORTORNL,,,21,,RBRVS,36.03 ,10.48 ,10.48 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35632,CPT,BYPASS GRAFT W/OTHER THAN VEIN ILIO-CELIAC,,,21,,RBRVS,36.13 ,8.97 ,8.97 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35633,CPT,BYPASS GRAFT W/OTHER THAN VEIN ILIO-MESENTERIC,,,21,,RBRVS,39.11 ,11.38 ,11.38 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35634,CPT,BYPASS GRAFT W/OTHER THAN VEIN ILIORENAL,,,21,,RBRVS,35.33 ,10.64 ,10.64 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35636,CPT,BYP OTH/THN VEIN SPLENORENAL,,,21,,RBRVS,31.75 ,8.06 ,8.06 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35637,CPT,BYP OTH/THN VEIN AORTOILIAC,,,21,,RBRVS,33.05 ,10.75 ,10.75 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35638,CPT,BYP OTH/THN VEIN AORTOBI-ILIAC,,,21,,RBRVS,33.60 ,10.86 ,10.86 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35642,CPT,BYP OTH/THN VEIN CAROTID-VERTEBRAL,,,21,,RBRVS,18.94 ,10.44 ,10.44 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35645,CPT,BYP OTH/THN VEIN SUBCLAVIAN-VERTEBRAL,,,21,,RBRVS,18.43 ,5.26 ,5.26 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35646,CPT,BYP OTH/THN VEIN AORTOBIFEMORAL,,,21,,RBRVS,32.98 ,10.29 ,10.29 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35647,CPT,BYP OTH/THN VEIN AORTOFEMORAL,,,21,,RBRVS,29.73 ,9.39 ,9.39 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35650,CPT,BYP OTH/THN VEIN AXILLARY-AXILLARY,,,21,,RBRVS,20.16 ,7.36 ,7.36 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35654,CPT,BYP OTH/THN VEIN AXILLARY-FEMORAL-FEMORAL,,,21,,RBRVS,26.28 ,8.30 ,8.30 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35656,CPT,BYP OTH/THN VEIN FEMORAL-POPLITEAL,,,21,,RBRVS,20.47 ,6.94 ,6.94 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35661,CPT,BYP OTH/THN VEIN FEMORAL-FEMORAL,,,21,,RBRVS,20.35 ,7.12 ,7.12 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35663,CPT,BYP OTH/THN VEIN ILIOILIAC,,,21,,RBRVS,23.93 ,7.86 ,7.86 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35665,CPT,BYP OTH/THN VEIN ILIOFEMORAL,,,21,,RBRVS,22.35 ,7.27 ,7.27 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35666,CPT,BYP OTH/THN VEIN FEM-ANT TIBL PST TIBL/PRONEAL,,,21,,RBRVS,23.66 ,8.34 ,8.34 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35671,CPT,BYP OTH/THN VEIN POPLITEAL-TIBIAL/-PERONEAL ART,,,21,,RBRVS,20.77 ,7.60 ,7.60 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35681,CPT,BYPASS COMPOSITE GRAFT PROSTHETIC & VEIN,,,21,,RBRVS,1.60 ,0.41 ,0.41 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35682,CPT,BYP AUTOG COMPOSIT 2 SEG VEINS FROM 2 LOCATIONS,,,21,,RBRVS,7.19 ,1.64 ,1.64 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35683,CPT,BYP AUTOG COMPOSIT 3/> SEG FROM 2/> LOCATION,,,21,,RBRVS,8.49 ,1.67 ,1.67 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35685,CPT,PLMT VEIN PATCH/CUFF DSTL ANAST BYP CONDUIT,,,21,,RBRVS,4.04 ,0.91 ,0.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35686,CPT,CRTJ DSTL ARVEN FSTL LXTR BYP SURG NON-HEMO,,,21,,RBRVS,3.34 ,0.66 ,0.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35691,CPT,TRPOS&/RIMPLTJ VERTEBRAL CAROTID ART,,,21,,RBRVS,18.41 ,5.26 ,5.26 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35693,CPT,TRPOS&/RIMPLTJ VERTEBRAL SUBCLAVIAN ART,,,21,,RBRVS,15.73 ,5.28 ,5.28 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35694,CPT,TRPOS&/RIMPLTJ SUBCLAVIAN CAROTID ART,,,21,,RBRVS,19.28 ,5.43 ,5.43 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35695,CPT,TRPOS&/RIMPLTJ CAROTID SUBCLAVIAN ART,,,21,,RBRVS,20.06 ,5.59 ,5.59 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35697,CPT,RIMPLTJ VISC ART INFRARNL AORTIC PROSTH EA ART,,,21,,RBRVS,3.00 ,0.68 ,0.68 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35700,CPT,ROPRTJ > 1 MO AFTER ORIGINAL OPRATION,,,21,,RBRVS,3.08 ,0.73 ,0.73 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35701,CPT,EXPL N/FLWD SURG RPR W/WO LYSIS CAROTID ARTERY,,,21,,RBRVS,9.19 ,5.56 ,5.56 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35721,CPT,EXPL N/FLWD SURG RPR W/WO LYSIS FEMORAL ARTERY,,,21,,RBRVS,7.72 ,3.96 ,3.96 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35741,CPT,EXPL N/FLWD SURG RPR W/WO LYSIS POPLITEAL ARTERY,,,21,,RBRVS,8.69 ,4.42 ,4.42 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35761,CPT,EXPL N/FLWD SURG RPR W/WO LYSIS OTHER ARTERY,,,21,,RBRVS,5.93 ,4.26 ,4.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35800,CPT,EXPL PO HEMRRG THROMBOSIS/INFCTJ NCK,,,21,,RBRVS,12.00 ,6.41 ,6.41 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35820,CPT,EXPL PO HEMRRG THROMBOSIS/INFCTJ CH,,,21,,RBRVS,36.89 ,13.32 ,13.32 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35840,CPT,EXPL PO HEMRRG THROMBOSIS/INFCTJ ABD,,,21,,RBRVS,20.75 ,9.12 ,9.12 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35860,CPT,EXPL PO HEMRRG THROMBOSIS/INFCTJ XTR,,,21,,RBRVS,15.25 ,5.96 ,5.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35870,CPT,RPR GRF-ENTERIC FSTL,,,21,,RBRVS,24.50 ,6.63 ,6.63 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35875,CPT,THRMBC ARTL/VEN GRF OTH/THN HEMO GRF/FSTL,,,21,,RBRVS,10.72 ,4.34 ,4.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35876,CPT,THRMBC ARTL/VEN GRF XCP HEMO GRF/FSTL W/REVJ GRF,,,21,,RBRVS,17.82 ,6.04 ,6.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35879,CPT,REVJ LXTR ARTL BYP OPN VEIN PATCH ANGIOP,,,21,,RBRVS,17.41 ,5.87 ,5.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35881,CPT,REVJ LXTR ARTL BYP OPN W/SGMTL VEIN INTERPOS,,,21,,RBRVS,19.35 ,6.37 ,6.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35883,CPT,REVISION FEMORAL ANAST OPEN NONAUTOG GRAFT,,,21,,RBRVS,23.15 ,7.32 ,7.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35884,CPT,REVISION FEMORAL ANAST OPEN W/AUTOG GRAFT,,,21,,RBRVS,24.65 ,6.35 ,6.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35901,CPT,EXCISION INFECTED NECK GRAFT,,,21,,RBRVS,8.38 ,4.20 ,4.20 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35903,CPT,EXCISION INFECTED GRAFT EXTREMITY,,,21,,RBRVS,9.53 ,4.93 ,4.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
35905,CPT,EXCISION INFECTED GRAFT THORAX,,,21,,RBRVS,33.52 ,10.64 ,10.64 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
35907,CPT,EXCISION INFECTED GRAFT ABDOMEN,,,21,,RBRVS,37.27 ,10.61 ,10.61 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
36000,CPT,INTRODUCTION NEEDLE/INTRACATHETER VEIN,,,21,,RBRVS,0.18 ,0.07 ,0.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36002,CPT,INJECTION PX PRQ TX EXTREMITY PSEUDOANEURYSM,,,21,,RBRVS,1.96 ,0.86 ,2.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36005,CPT,NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH,,,21,,RBRVS,0.95 ,0.31 ,8.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36010,CPT,INTRO CATHETER SUPERIOR/INFERIOR VENA CAVA,,,21,,RBRVS,2.43 ,0.74 ,11.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36011,CPT,SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH,,,21,,RBRVS,3.14 ,0.97 ,20.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36012,CPT,SLCTV CATH PLMT VEN SYS 2ND ORDER/> SLCTV BRANC,,,21,,RBRVS,3.51 ,1.07 ,20.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36013,CPT,INTRO CATHETER RIGHT HEART/MAIN PULMONARY ARTERY,,,21,,RBRVS,2.52 ,0.80 ,19.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36014,CPT,SLCTV CATHETER PLMT LEFT/RIGHT PULMONARY ARTERY,,,21,,RBRVS,3.02 ,0.99 ,19.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36015,CPT,SLCTV CATH PLMT SEGMENTAL/SUBSEGMENTAL PULM ART,,,21,,RBRVS,3.51 ,1.07 ,20.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36100,CPT,INTRO NEEDLE/INTRACATH CAROTID/VERTEBRAL ARTERY,,,21,,RBRVS,3.02 ,0.82 ,10.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36120,CPT,INTRO NEEDLE/INTRACATH RETROGRADE BRACHIAL ART,,,21,,RBRVS,2.01 ,0.55 ,9.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36140,CPT,INTRO NEEDLE/INTRACATH EXTREMITY ARTERY,,,21,,RBRVS,2.01 ,0.59 ,10.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36147,CPT,INTRO NDL/CATH AV SHUNT IST ACCESS W/ RAD EVAL,,,21,,RBRVS,3.72 ,1.18 ,19.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36148,CPT,INTRO NDL/CATH AV SHUNT ADDL ACCESS THER IVNTJ,,,21,,RBRVS,1.00 ,0.30 ,6.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36160,CPT,INTRO NEEDLE/INTRACATH AORTIC TRANSLUMBAR,,,21,,RBRVS,2.52 ,0.79 ,11.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36200,CPT,INTRODUCTION CATHETER AORTA,,,21,,RBRVS,3.02 ,0.82 ,14.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36215,CPT,SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH,,,21,,RBRVS,4.67 ,1.48 ,26.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36216,CPT,SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH,,,21,,RBRVS,5.27 ,1.69 ,27.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36217,CPT,SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH,,,21,,RBRVS,6.29 ,1.95 ,46.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36218,CPT,SLCTV CATHJ EA 2ND+ ORD THRC/BRCH/CPHLC BRNCH,,,21,,RBRVS,1.01 ,0.33 ,4.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36221,CPT,NONSLCTV CATH THOR AORTA ANGIO INTR/XTRCRANL ART,,,21,,RBRVS,4.17 ,1.26 ,26.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36222,CPT,SLCTV CATH CAROTID/INNOM ART ANGIO XTRCRANL ART,,,21,,RBRVS,5.53 ,1.87 ,29.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36223,CPT,SLCTV CATH CAROTID/INNOM ART ANGIO INTRCRANL ART,,,21,,RBRVS,6.00 ,2.13 ,35.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36224,CPT,SLCTV CATH INTRNL CAROTID ART ANGIO INTRCRNL ART,,,21,,RBRVS,6.50 ,2.58 ,45.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36225,CPT,SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY,,,21,,RBRVS,6.00 ,2.05 ,34.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36226,CPT,SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY,,,21,,RBRVS,6.50 ,2.55 ,44.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36227,CPT,SLCTV CATH XTRNL CAROTID ANGIO XTRNL CAROTD CIRC,,,21,,RBRVS,2.09 ,0.79 ,4.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36228,CPT,SLCTV CATH INTRCRNL BRNCH ANGIO INTRL CAROT/VERT,,,21,,RBRVS,4.25 ,1.61 ,30.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36245,CPT,SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH,,,21,,RBRVS,4.90 ,1.62 ,33.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36246,CPT,SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH,,,21,,RBRVS,5.27 ,1.57 ,19.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36247,CPT,SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH,,,21,,RBRVS,6.29 ,1.89 ,37.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36248,CPT,SLCTV CATHJ EA 2ND+ ORD ABDL PEL/LXTR ART BRNCH,,,21,,RBRVS,1.01 ,0.31 ,3.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36251,CPT,SLCTV CATH 1STORD W/WO ART PUNCT/FLUORO/S&I UN,,,21,,RBRVS,5.35 ,1.80 ,34.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36252,CPT,SLCTV CATH 1STORD W/WO ART PUNCT/FLUOR/S&I BIL,,,21,,RBRVS,6.99 ,2.42 ,35.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36253,CPT,SUPSLCTV CATH 2ND+ORD RENAL&ACCESSORY ARTERY/S&I,,,21,,RBRVS,7.55 ,2.49 ,55.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36254,CPT,SUPSLCTV CATH 2ND+ORD RENAL&ACCESSORY ARTERY/S&I,,,21,,RBRVS,8.15 ,2.78 ,52.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36260,CPT,INSJ IMPLANTABLE INTRA-ARTERIAL INFUSION PUM,,,21,,RBRVS,9.91 ,6.43 ,6.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36261,CPT,REVJ IMPLANTED INTRA-ARTERIAL INFUSION PUMP,,,21,,RBRVS,5.63 ,3.52 ,3.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36262,CPT,REMOVAL IMPLANTED INTRA-ARTERIAL INFUSION PUMP,,,21,,RBRVS,4.11 ,3.75 ,3.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36299,CPT,UNLISTED PROCEDURE VASCULAR INJECTION,,,21,,TotalUnits,,,,0.68 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36400,CPT,VNPNXR <3 YEARS PHY/QHP SKILL FEMRAL/JUGLAR VEIN,,,21,,RBRVS,0.38 ,0.15 ,0.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
36405,CPT,VNPNXR <3 YEARS PHYS/QHP SKILL SCALP VEIN,,,21,,RBRVS,0.31 ,0.13 ,0.42 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
36406,CPT,VNPNXR <3 YEARS PHYS/QHP SKILL OTHER VEIN,,,21,,RBRVS,0.18 ,0.08 ,0.37 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
36410,CPT,VNPNXR 3 YEARS/> PHYS/QHP SKILL,,,21,,RBRVS,0.18 ,0.07 ,0.28 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
36415,CPT,COLLECTION VENOUS BLOOD VENIPUNCTURE,,,17,,TotalUnits,,,,0.08 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
36416,CPT,COLLECTION CAPILLARY BLOOD SPECIMEN,,,17,,TotalUnits,,,,0.11 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
36420,CPT,VENIPUNCTURE CUTDOWN UNDER AGE 1 YR,,,21,,RBRVS,1.01 ,0.39 ,0.39 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
36425,CPT,VENIPUNCTURE CUTDOWN AGE 1 YR/>,,,21,,RBRVS,0.76 ,0.29 ,0.29 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
36430,CPT,TRANSFUSION BLOOD/BLOOD COMPONENTS,,,21,,RBRVS,,0.96 ,0.96 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
36440,CPT,PUSH TRANSFUSION BLOOD 2 YR/UNDER,,,21,,RBRVS,1.03 ,0.35 ,0.35 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
36450,CPT,EXCHNG TRANSFUSION BLOOD NEWBORN,,,21,,RBRVS,2.23 ,0.88 ,0.88 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
36455,CPT,EXCHNG TRANSFUSION BLOOD OTHER/THAN NEW BORN,,,21,,RBRVS,2.43 ,0.71 ,0.71 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
36460,CPT,TRANSFUSION INTRAUTERINE FETAL,,,21,,RBRVS,6.58 ,2.59 ,2.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
36468,CPT,1/MLT NJXS SCLRSG SLNS SPIDER VEINS LIMB/TRUNK,,,21,,TotalUnits,,,,2.24 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36470,CPT,NJX SCLEROSING SOLUTION SINGLE VEIN,,,21,,RBRVS,1.10 ,1.12 ,2.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36471,CPT,NJX SCLEROSING SOLUTION MULTIPLE VEINS SAME LEG,,,21,,RBRVS,1.65 ,0.96 ,3.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36475,CPT,ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN,,,21,,RBRVS,5.30 ,1.81 ,37.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36476,CPT,ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 2ND+ VEINS,,,21,,RBRVS,2.65 ,0.76 ,5.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36478,CPT,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN,,,21,,RBRVS,5.30 ,1.81 ,27.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36479,CPT,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND+ VEINS,,,21,,RBRVS,2.65 ,0.82 ,5.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36481,CPT,PRQ PORTAL VEIN CATHETERIZATION ANY METHOD,,,21,,RBRVS,6.98 ,2.55 ,50.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36500,CPT,VEN CATHJ SLCTV ORGAN BLD SAMPLING,,,21,,RBRVS,3.51 ,1.18 ,1.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36510,CPT,CATHJ UMBILICAL VEIN DX/THER NB,,,21,,RBRVS,1.09 ,0.43 ,1.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36511,CPT,THERAPEUTIC APHERESIS WHITE BLOOD CELLS,,,21,,RBRVS,1.74 ,0.74 ,0.74 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
36512,CPT,THERAPEUTIC APHERESIS RED BLOOD CELLS,,,21,,RBRVS,1.74 ,0.84 ,0.84 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
36513,CPT,THERAPEUTIC APHERESIS PLATELETS,,,21,,RBRVS,1.74 ,0.78 ,0.78 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
36514,CPT,THERAPEUTIC APHERESIS PLASMA PHERESIS,,,21,,RBRVS,1.74 ,0.75 ,13.24 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
36515,CPT,THER APHERESIS W/XTRCORP IMMUNODSPTJ& PLSM RENFJ,,,21,,RBRVS,1.74 ,0.69 ,56.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
36516,CPT,THER APHRS XTRCORP SLCTV ADSRPJ/FILTRJ & REINFSJ,,,21,,RBRVS,1.22 ,0.49 ,57.27 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
36522,CPT,PHOTOPHERESIS EXTRACORPOREAL,,,21,,RBRVS,1.67 ,1.12 ,37.66 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
36555,CPT,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE < 5 Y,,,21,,RBRVS,2.68 ,0.48 ,4.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36556,CPT,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>,,,21,,RBRVS,2.50 ,0.70 ,3.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36557,CPT,INSERT TUNNELED CVC W/O SUBQ PORT/PMP AGE <5 YR,,,21,,RBRVS,5.14 ,3.20 ,22.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36558,CPT,INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>,,,21,,RBRVS,4.84 ,2.54 ,16.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36560,CPT,INSJ TUNNELED CTR VAD W/SUBQ PORT UNDER 5 YR,,,21,,RBRVS,6.29 ,3.35 ,23.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36561,CPT,INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>,,,21,,RBRVS,6.04 ,3.17 ,26.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36563,CPT,INSJ TUNNELED CTR VAD W/SUBQ PUMP,,,21,,RBRVS,6.24 ,3.42 ,30.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36565,CPT,INSJ TUN VAD REQ 2 CATH 2 SITS W/O SUBQ PORT/PMP,,,21,,RBRVS,6.04 ,2.76 ,20.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36566,CPT,INSJ TUN VAD REQ 2 CATH 2 SITS W/SUBQ PORT,,,21,,RBRVS,6.54 ,3.38 ,149.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36568,CPT,INSJ PRPH CVC W/O SUBQ PORT/PMP UNDER 5 YR,,,21,,RBRVS,1.92 ,0.76 ,6.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36569,CPT,INSJ PRPH CVC W/O SUBQ PORT/PMP AGE 5 YR/>,,,21,,RBRVS,1.82 ,0.67 ,5.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36570,CPT,INSJ PRPH CTR VAD W/SUBQ PORT UNDER 5 YR,,,21,,RBRVS,5.36 ,3.12 ,28.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36571,CPT,INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>,,,21,,RBRVS,5.34 ,3.02 ,30.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36575,CPT,RPR TUN/NON-TUN CTR VAD CATH W/O SUBQ PORT/PMP,,,21,,RBRVS,0.67 ,0.26 ,3.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36576,CPT,RPR CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ SIT,,,21,,RBRVS,3.24 ,1.89 ,7.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36578,CPT,RPLCMT CATH CTR VAD SUBQ PORT/PMP,,,21,,RBRVS,3.54 ,2.23 ,10.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36580,CPT,RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP,,,21,,RBRVS,1.31 ,0.48 ,4.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36581,CPT,RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP,,,21,,RBRVS,3.48 ,1.78 ,17.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36582,CPT,RPLCMT COMPL TUN CTR VAD W/SUBQ PORT,,,21,,RBRVS,5.24 ,2.73 ,25.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36583,CPT,RPLCMT COMPL TUN CTR VAD W/SUBQ PMP,,,21,,RBRVS,5.29 ,3.26 ,32.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36584,CPT,RPLCMT COMPL PRPH CVC W/O SUBQ PORT/PMP,,,21,,RBRVS,1.20 ,0.62 ,4.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36585,CPT,RPLCMT COMPL PRPH CTR VAD W/SUBQ PORT,,,21,,RBRVS,4.84 ,2.65 ,27.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36589,CPT,RMVL TUN CVC W/O SUBQ PORT/PMP,,,21,,RBRVS,2.28 ,1.39 ,2.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36590,CPT,RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ,,,21,,RBRVS,3.35 ,1.98 ,4.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36591,CPT,COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE,,TC,21,,RBRVS,,0.65 ,0.65 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
36592,CPT,COLLECT BLOOD FROM CATHETER VENOUS NOS,,TC,21,,RBRVS,,0.73 ,0.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
36593,CPT,DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH,,TC,21,,RBRVS,,0.86 ,0.86 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
36595,CPT,MCHNL RMVL PRICATH OBSTR CV DEV VIA VEN ACCESS,,,21,,RBRVS,3.59 ,1.35 ,12.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36596,CPT,MCHNL RMVL INTRAL OBSTR CV DEV THRU DEV LUMEN,,,21,,RBRVS,0.75 ,0.45 ,2.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36597,CPT,RPSG PREVIOUSLY PLACED CVC UNDER FLUOR GDNCE,,,21,,RBRVS,1.21 ,0.45 ,2.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36598,CPT,CNTRST NJX RAD EVAL CTR VAD FLUOR IMG&REPRT,,,21,,RBRVS,0.74 ,0.26 ,2.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36600,CPT,ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX,,,21,,RBRVS,0.32 ,0.10 ,0.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36620,CPT,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ,,,21,,RBRVS,1.15 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36625,CPT,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX CUTDOWN,,,21,,RBRVS,2.11 ,0.55 ,0.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36640,CPT,ARTL CATHJ PROLNG NFS THER CHEMOTX CUTDOWN,,,21,,RBRVS,2.10 ,1.19 ,1.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36660,CPT,CATHETERIZATION UMBILICAL NEWBORN ART DX/THERAPY,,,21,,RBRVS,1.40 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
36680,CPT,PLACEMENT NEEDLE INTRAOSSEOUS INFUSION,,,21,,RBRVS,1.20 ,0.31 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36800,CPT,INSJ CANNULA HEMO OTH PURPOSE SPX VEIN VEIN,,,21,,RBRVS,2.43 ,0.79 ,0.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36810,CPT,INSJ CANNULA HEMO OTH PURPOSE SPX ARVEN XTRNL,,,21,,RBRVS,3.96 ,1.59 ,1.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36815,CPT,INSJ CANNULA HEMO OTH SPX ARVEN XTRNL REVJ/CLSR,,,21,,RBRVS,2.62 ,0.80 ,0.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36818,CPT,ARVEN ANAST OPN UPR ARM CEPHALIC VEIN TRPOS,,,21,,RBRVS,12.39 ,5.17 ,5.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36819,CPT,ARVEN ANAST OPN UPR ARM BASILIC VEIN TRPOS,,,21,,RBRVS,13.29 ,5.28 ,5.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36820,CPT,ARVEN ANAST OPN F/ARM VEIN TRPOS,,,21,,RBRVS,13.07 ,5.39 ,5.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36821,CPT,ARTERIOVENOUS ANASTOMOSIS OPEN DIRECT,,,21,,RBRVS,11.90 ,4.95 ,4.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36823,CPT,INSJ CNULA ISLTD XC-CIRCJ REG CHEMOTX XTR RMVL,,,21,,RBRVS,22.98 ,11.85 ,11.85 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
36825,CPT,CRTJ ARVEN FSTL XCP DIR ARVEN ANAST AUTOG GRF,,,21,,RBRVS,14.17 ,6.17 ,6.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36830,CPT,CRTJ ARVEN FSTL XCP DIR ARVEN ANAST NONAUTOG GRF,,,21,,RBRVS,12.03 ,4.90 ,4.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36831,CPT,THRMBC OPN ARVEN FSTL W/O REVJ DIAL GRF,,,21,,RBRVS,11.00 ,4.68 ,4.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36832,CPT,REVJ OPN ARVEN FSTL W/O THRMBC DIAL GRF,,,21,,RBRVS,13.50 ,5.72 ,5.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36833,CPT,REVJ OPN ARVEN FSTL W/THRMBC DIAL GRF,,,21,,RBRVS,14.50 ,6.06 ,6.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36835,CPT,INSERTION THOMAS SHUNT SEPARATE PROCEDURE,,,21,,RBRVS,7.51 ,5.36 ,5.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36838,CPT,DSTL REVSC&INTERVAL LIG UXTR HEMO ACCESS,,,21,,RBRVS,21.69 ,7.11 ,7.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36860,CPT,XTRNL CANNULA DECLTNG SPX W/O BALO CATH,,,21,,RBRVS,2.01 ,1.02 ,3.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36861,CPT,XTRNL CANNULA DECLTNG SPX W/BALO CATH,,,21,,RBRVS,2.52 ,0.77 ,0.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
36870,CPT,THRMBC PRQ ARVEN FSTL AUTOG/NONAUTOG GRF,,,21,,RBRVS,5.20 ,2.85 ,46.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37140,CPT,VENOUS ANASTOMOSIS OPEN PORTOCAVAL,,,21,,RBRVS,40.00 ,17.61 ,17.61 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
37145,CPT,VENOUS ANASTOMOSIS OPEN RENOPORTAL,,,21,,RBRVS,37.00 ,16.44 ,16.44 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
37160,CPT,VENOUS ANASTOMOSIS OPEN CAVAL-MESENTERIC,,,21,,RBRVS,38.00 ,16.89 ,16.89 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
37180,CPT,VENOUS ANASTOMOSIS OPEN SPLENORENAL PROXIMAL,,,21,,RBRVS,36.50 ,16.32 ,16.32 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
37181,CPT,VENOUS ANASTOMOSIS OPEN SPLENORENAL DISTAL,,,21,,RBRVS,40.00 ,17.61 ,17.61 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
37182,CPT,INSJ TRANSVNS INTRAHEPATC PORTOSYSIC SHUNT,,,21,,RBRVS,16.97 ,5.78 ,5.78 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
37183,CPT,REVJ TRANSVNS INTRAHEPATIC PORTOSYSTEMIC SHUNT,,,21,,RBRVS,7.99 ,2.75 ,159.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37184,CPT,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA 1ST,,,21,,RBRVS,8.66 ,3.03 ,54.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37185,CPT,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA SBSQ,,,21,,RBRVS,3.28 ,0.93 ,16.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37186,CPT,SEC PRQ TRLUML THRMBC N-CORONARY N-INTRACRANIAL,,,21,,RBRVS,4.92 ,1.38 ,33.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37187,CPT,PRQ TRANSLUMINAL MECHANICAL THROMBECTOMY VEIN,,,21,,RBRVS,8.03 ,2.56 ,49.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37188,CPT,PRQ TRLUML MCHNL THRMBC VEIN REPEAT TX,,,21,,RBRVS,5.71 ,1.99 ,43.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37191,CPT,INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I,,,21,,RBRVS,4.71 ,1.57 ,69.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37192,CPT,REPSNG INTRVAS VC FILTR W/WO ACS VSL SELXN RS&,,,21,,RBRVS,7.35 ,2.87 ,39.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37193,CPT,RTRVL INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I,,,21,,RBRVS,7.35 ,2.29 ,37.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37195,CPT,THROMBOLYSIS CEREBRAL IV INFUSION,,,21,,TotalUnits,,,,7.04 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37197,CPT,PRQ TRANSCATHETER RTRVL INTRVAS FB WITH IMAGING,,,21,,RBRVS,6.29 ,1.97 ,36.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37200,CPT,TRANSCATHETER BIOPSY,,,21,,RBRVS,4.55 ,1.45 ,1.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37211,CPT,THROMBOLYSIS ARTERIAL INFUSION ICRA RS&I INIT TX,,,21,,RBRVS,8.00 ,2.29 ,2.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37212,CPT,THROMBOLYSIS VENOUS INFUSION W/IMAGING INIT TX,,,21,,RBRVS,7.06 ,2.01 ,2.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37213,CPT,THROMBOLYSIS ART/VENOUS INFSN W/IMAGE SUBSQ TX,,,21,,RBRVS,5.00 ,1.51 ,1.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37214,CPT,CESSATION THROMBOLYTIC THER W/CATHETER REMOVAL,,,21,,RBRVS,2.74 ,0.82 ,0.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37215,CPT,TCAT IV STENT CRV CRTD ART EMBOLIC PROTECJ,,,21,,RBRVS,19.68 ,7.65 ,7.65 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
37216,CPT,TCAT IV STENT CRV CRTD ART W/O EMBOLIC PROTECJ,,,21,,TotalUnits,,,,30.15 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37217,CPT,TCATH STENT PLACEMT RETROGRAD CAROTID/INNOMINATE,,,21,,RBRVS,20.38 ,7.67 ,7.67 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
37218,CPT,TCATH STENT PLACEMT ANTEGRADE CAROTID/INNOMINATE,,,21,,RBRVS,15.00 ,5.94 ,5.94 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
37220,CPT,REVASCULARIZATION ILIAC ARTERY ANGIOP 1ST VSL,,,21,,RBRVS,8.15 ,2.33 ,80.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37221,CPT,REVSC OPN/PRQ ILIAC ART W/STNT PLMT & ANGIOPLSTY,,,21,,RBRVS,10.00 ,2.90 ,120.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37222,CPT,REVASCULARIZATION ILIAC ART ANGIOP EA IPSI VSL,,,21,,RBRVS,3.73 ,0.97 ,20.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37223,CPT,REVSC OPN/PRQ ILIAC ART W/STNT & ANGIOP IPSILATL,,,21,,RBRVS,4.25 ,1.16 ,68.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37224,CPT,REVSC OPN/PRG FEM/POP W/ANGIOPLASTY UNI,,,21,,RBRVS,9.00 ,2.61 ,98.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37225,CPT,REVSC OPN/PRQ FEM/POP W/ATHRC/ANGIOP SM VSL,,,21,,RBRVS,12.00 ,3.58 ,299.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37226,CPT,REVSC OPN/PRQ FEM/POP W/STNT/ANGIOP SM VSL,,,21,,RBRVS,10.49 ,3.07 ,245.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37227,CPT,REVSC OPN/PRQ FEM/POP W/STNT/ATHRC/ANGIOP SM VSL,,,21,,RBRVS,14.50 ,4.23 ,406.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37228,CPT,REVSC OPN/PRQ TIB/PERO W/ANGIOPLASTY UNI,,,21,,RBRVS,11.00 ,3.11 ,141.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37229,CPT,REVSC OPN/PRQ TIB/PERO W/ATHRC/ANGIOP SM VSL,,,21,,RBRVS,14.05 ,4.15 ,292.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37230,CPT,REVSC OPN/PRQ TIB/PERO W/STNT/ANGIOP SM VSL,,,21,,RBRVS,13.80 ,4.15 ,219.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37231,CPT,REVSC OPN/PRQ TIB/PERO W/STNT/ATHR/ANGIOP SM VSL,,,21,,RBRVS,15.00 ,4.51 ,362.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37232,CPT,REVSC OPN/PRQ TIB/PERO W/ANGIOPLASTY UNI EA VSL,,,21,,RBRVS,4.00 ,1.12 ,29.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37233,CPT,REVSC OPN/PRQ TIB/PERO W/ATHRC/ANGIOP UNI EA VSL,,,21,,RBRVS,6.50 ,1.82 ,34.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37234,CPT,REVSC OPN/PRQ TIB/PERO W/STNT/ANGIOP UNI EA VSL,,,21,,RBRVS,5.50 ,1.67 ,103.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37235,CPT,REVSC OPN/PRQ TIB/PERO W/STNT/ATHR/ANGIOP EA VSL,,,21,,RBRVS,7.80 ,2.11 ,109.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37236,CPT,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL,,,21,,RBRVS,9.00 ,2.71 ,107.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37237,CPT,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT EA ADDL,,,21,,RBRVS,4.25 ,1.17 ,65.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37238,CPT,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT SAME 1ST,,,21,,RBRVS,6.29 ,1.92 ,109.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37239,CPT,OPEN/PERQ PLACEMENT INTRAVASC STENT SAME EA ADDL,,,21,,RBRVS,2.97 ,0.82 ,54.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37241,CPT,VASCULAR EMBOLIZATION OR OCCLUSION VENOUS RS&I,,,21,,RBRVS,9.00 ,2.83 ,120.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37242,CPT,VASCULAR EMBOLIZATION OR OCCLUSION ARTERIAL RS&I,,,21,,RBRVS,10.05 ,3.13 ,208.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37243,CPT,VASCULAR EMBOLIZE/OCCLUDE ORGAN TUMOR INFARCT,,,21,,RBRVS,11.99 ,3.72 ,264.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37244,CPT,VASCULAR EMBOLIZATION OR OCCLUSION HEMORRHAGE,,,21,,RBRVS,14.00 ,4.33 ,178.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37252,CPT,INTRAVASCULAR US NONCORONARY RS&I INTIAL VESSEL,,,21,,RBRVS,1.80 ,0.50 ,37.50 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
37253,CPT,INTRAVASCULAR US NONCORONARY RS&I ADDL VESSEL,,,21,,RBRVS,1.44 ,0.39 ,4.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
37500,CPT,VASC ENDOSCOPY SURG W/LIG PERFORATOR VEINS SPX,,,21,,RBRVS,11.67 ,4.44 ,4.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37501,CPT,UNLISTED VASCULAR ENDOSCOPY PROCEDURE,,,21,,TotalUnits,,,,16.11 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37565,CPT,LIGATION INTERNAL JUGULAR VEIN,,,21,,RBRVS,12.05 ,7.55 ,7.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37600,CPT,LIGATION EXTERNAL CAROTID ARTERY,,,21,,RBRVS,12.42 ,5.81 ,5.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37605,CPT,LIGATION INTERNAL/COMMON CAROTID ARTERY,,,21,,RBRVS,14.28 ,5.60 ,5.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37606,CPT,LIG INT/COMMON CAROTID ART W/GRADUAL OCCLUSION,,,21,,RBRVS,8.81 ,3.32 ,3.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37607,CPT,LIG/BANDING ANGIOACCESS ARTERIOVENOUS FISTULA,,,21,,RBRVS,6.25 ,3.37 ,3.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37609,CPT,LIGATION/BIOPSY TEMPORAL ARTERY,,,21,,RBRVS,3.05 ,2.35 ,5.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37615,CPT,LIGATION MAJOR ARTERY NECK,,,21,,RBRVS,7.80 ,5.77 ,5.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37616,CPT,LIGATION MAJOR ARTERY CHEST,,,21,,RBRVS,18.97 ,8.80 ,8.80 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
37617,CPT,LIGATION MAJOR ARTERY ABDOMEN,,,21,,RBRVS,23.79 ,10.13 ,10.13 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
37618,CPT,LIGATION MAJOR ARTERY EXTREMITY,,,21,,RBRVS,6.03 ,3.79 ,3.79 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
37619,CPT,INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I,,,21,,RBRVS,30.00 ,10.96 ,10.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37650,CPT,REPSNG INTRVAS VC FILTR W/WO ACS VSL SELXN RS&,,,21,,RBRVS,8.49 ,3.12 ,3.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37660,CPT,RTRVL INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I,,,21,,RBRVS,22.28 ,10.47 ,10.47 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
37700,CPT,LIG&DIV LONG SAPH VEIN SAPHFEM JUNCT/INTERRUPJ,,,21,,RBRVS,3.82 ,2.63 ,2.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37718,CPT,LIGJ DIVJ & STRIPPING SHORT SAPHENOUS VEIN,,,21,,RBRVS,7.13 ,4.05 ,4.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37722,CPT,LIGJ DIVJ&STRIP LONG SAPH SAPHFEM JUNCT KNE/BELW,,,21,,RBRVS,8.16 ,3.96 ,3.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37735,CPT,LIGJ & DIVJ RADICAL STRIP LONG/SHORT SAPHENOUS,,,21,,RBRVS,10.90 ,3.73 ,3.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37760,CPT,LIG PRFRATR VEIN SUBFSCAL RAD INCL SKN GRF 1 LEG,,,21,,RBRVS,10.78 ,4.76 ,4.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37761,CPT,LIG PRFRATR VEIN SUBFSCAL OPEN INCL US GID 1 LEG,,,21,,RBRVS,9.13 ,5.12 ,5.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37765,CPT,STAB PHLEBT VARICOSE VEINS 1 XTR 10-20 STAB INCS,,,21,,RBRVS,7.71 ,3.86 ,9.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37766,CPT,STAB PHLEBT VARICOSE VEINS 1 XTR > 20 INCS,,,21,,RBRVS,9.66 ,4.44 ,10.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37780,CPT,LIGJ & DIV SHORT SAPH VEIN SAPHENOPOP JUNCT SPX,,,21,,RBRVS,3.93 ,2.71 ,2.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37785,CPT,LIGJ DIVJ &/EXCJ VARICOSE VEIN CLUSTER 1 LEG,,,21,,RBRVS,3.93 ,2.92 ,5.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37788,CPT,PENILE REVASCULARIZATION ARTERY W/WO VEIN GRAFT,,,21,,RBRVS,23.33 ,10.34 ,10.34 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
37790,CPT,PENILE VENOUS OCCLUSIVE PROCEDURE,,,21,,RBRVS,8.43 ,4.60 ,4.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
37799,CPT,UNLISTED PROCEDURE VASCULAR SURGERY,,,21,,TotalUnits,,,,0.08 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38100,CPT,SPLENECTOMY TOTAL SEPARATE PROCEDURE,,,21,,RBRVS,19.55 ,9.32 ,9.32 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
38101,CPT,SPLENECTOMY TOTAL EN BLOC W/OTHER PROCEDURE,,,21,,RBRVS,19.55 ,9.50 ,9.50 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
38102,CPT,SPLENC TOT EN BLOC EXTNSV DS CONJUNCT W/OTH PX,,,21,,RBRVS,4.79 ,1.74 ,1.74 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
38115,CPT,RPR RPTD SPLEEN SPLENORRHAPHY W/WO PRTL SPLENECT,,,21,,RBRVS,21.88 ,10.16 ,10.16 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
38120,CPT,LAPAROSCOPIC SURGICAL SPLENECTOMY,,,21,,RBRVS,17.07 ,9.40 ,9.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38129,CPT,UNLISTED LAPAROSCOPY PROCEDURE SPLEEN,,,21,,TotalUnits,,,,26.47 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38200,CPT,INJECTION PROCEDURE SPLENOPORTOGRAPY,,,21,,RBRVS,2.64 ,0.99 ,0.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38204,CPT,MGMT RCP HEMATOP PROGENITOR CELL DONOR &ACQUISJ,,,21,,RBRVS,2.00 ,0.77 ,0.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38205,CPT,BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ ALGNC,,,21,,RBRVS,1.50 ,0.76 ,0.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38206,CPT,BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ AUTOL,,,21,,RBRVS,1.50 ,0.78 ,0.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38207,CPT,TRNSPL PREPJ HEMATOP PROGEN CELLS CRYOPRSRV STOR,,,21,,RBRVS,0.89 ,0.34 ,0.34 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
38208,CPT,TRNSPL PREP HEMATOP PROGEN THAW PREV HRV PER DNR,,,21,,RBRVS,0.56 ,0.21 ,0.21 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
38209,CPT,TRNSP PREP HMATOP PROG THAW PREV HRV WSH PER DNR,,,21,,RBRVS,0.24 ,0.09 ,0.09 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
38210,CPT,TRNSPL PREPJ HEMATOP PROGEN DEPLJ IN HRV T-CELL,,,21,,RBRVS,1.57 ,0.60 ,0.60 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
38211,CPT,TRNSPL PREPJ HEMATOP PROGEN TUM CELL DEPLJ,,,21,,RBRVS,1.42 ,0.54 ,0.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
38212,CPT,TRNSPL PREPJ HEMATOP PROGEN RED BLD CELL RMVL,,,21,,RBRVS,0.94 ,0.36 ,0.36 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
38213,CPT,TRNSPL PREPJ HEMATOP PROGEN PLTLT DEPLJ,,,21,,RBRVS,0.24 ,0.09 ,0.09 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
38214,CPT,TRNSPL PREPJ HEMATOP PROGEN PLSM VOL DEPLJ,,,21,,RBRVS,0.81 ,0.31 ,0.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
38215,CPT,TRNSPL PREPJ HEMATOP PROGEN CONCENTRATION PLSM,,,21,,RBRVS,0.94 ,0.36 ,0.36 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
38220,CPT,MARROW ASPIRATION ONLY,,,21,,RBRVS,1.08 ,0.55 ,3.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38221,CPT,BONE MARROW BIOPSY NEEDLE/TROCAR,,,21,,RBRVS,1.37 ,0.69 ,3.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38230,CPT,BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC,,,21,,RBRVS,3.50 ,1.76 ,1.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38232,CPT,BONE MARROW HARVEST TRANSPLANTATION AUTOLOGOUS,,,21,,RBRVS,3.50 ,1.66 ,1.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38240,CPT,TRNSPLJ ALLOGENEIC HEMATOPOIETIC CELLS PER DONOR,,,21,,RBRVS,4.00 ,2.16 ,2.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38241,CPT,TRNSPLJ AUTOLOGOUS HEMATOPOIETIC CELLS PER DONOR,,,21,,RBRVS,3.00 ,1.64 ,1.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38242,CPT,ALLOGENEIC LYMPHOCYTE INFUSIONS,,,21,,RBRVS,2.11 ,1.16 ,1.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38243,CPT,TRNSPLJ HEMATOPOIETIC CELL BOOST,,,21,,RBRVS,2.13 ,1.15 ,1.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38300,CPT,DRG LYMPH NODE ABSC/LYMPHADENITIS SMPL,,,21,,RBRVS,2.36 ,2.48 ,5.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38305,CPT,DRG LYMPH NODE ABSC/LYMPHADENITIS EXTNSV,,,21,,RBRVS,6.68 ,5.06 ,5.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38308,CPT,LYMPHANGIOTOMY/OTH OPRATIONS LYMPHATIC CHANNELS,,,21,,RBRVS,6.81 ,4.46 ,4.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38380,CPT,SUTR&/LIG THORACIC DUCT CERVICAL APPROACH,,,21,,RBRVS,8.46 ,6.43 ,6.43 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
38381,CPT,SUTR&/LIG THORACIC DUCT THORACIC APPROACH,,,21,,RBRVS,13.38 ,6.80 ,6.80 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
38382,CPT,SUTR&/LIG THORACIC DUCT ABDOMINAL APPROACH,,,21,,RBRVS,10.65 ,6.44 ,6.44 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
38500,CPT,BX/EXC LYMPH NODE OPEN SUPERFICIAL,,,21,,RBRVS,3.79 ,2.69 ,4.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38505,CPT,BX/EXC LYMPH NODE NEEDLE SUPERFICIAL,,,21,,RBRVS,1.14 ,0.81 ,2.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38510,CPT,BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE,,,21,,RBRVS,6.74 ,4.08 ,6.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38520,CPT,BX/EXC LYMPH NODE OPN DP CRV NODE W/EXC FAT PAD,,,21,,RBRVS,7.03 ,4.88 ,4.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38525,CPT,BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE,,,21,,RBRVS,6.43 ,4.63 ,4.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38530,CPT,BX/EXC LYMPH NODE OPEN INT MAMMARY NODE,,,21,,RBRVS,8.34 ,5.61 ,5.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38542,CPT,DISSECTION DEEP JUGULAR NODE,,,21,,RBRVS,7.95 ,5.59 ,5.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38550,CPT,EXC CSTIC HYGROMA AX/CRV W/O DP NEUROVASC DSJ,,,21,,RBRVS,7.11 ,5.84 ,5.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38555,CPT,EXC CSTIC HYGROMA AX/CRV W/DP NEUROVASC DSJ,,,21,,RBRVS,15.59 ,9.74 ,9.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38562,CPT,LMTD LMPHADEC STAGING SPX PEL&PARA-AORTIC,,,21,,RBRVS,11.06 ,7.07 ,7.07 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
38564,CPT,LMTD LMPHADEC STAGING SPX RPR AORTIC&/SPLENIC,,,21,,RBRVS,11.38 ,6.45 ,6.45 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
38570,CPT,LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT,,,21,,RBRVS,9.34 ,4.58 ,4.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38571,CPT,LAPS SURG BILATERAL TOTAL PELVIC LMPHADECTOMY,,,21,,RBRVS,14.76 ,6.32 ,6.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38572,CPT,LAPS BI TOT PEL LMPHADEC & PRI-AORTIC LYMPH BX 1,,,21,,RBRVS,16.94 ,8.15 ,8.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38589,CPT,UNLISTED LAPAROSCOPY PX LYMPHATIC SYSTEM,,,21,,TotalUnits,,,,21.08 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38700,CPT,SUPRAHYOID LYMPHADENECTOMY,,,21,,RBRVS,12.81 ,8.48 ,8.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38720,CPT,CERVICAL LYMPHADENECTOMY,,,21,,RBRVS,21.95 ,13.19 ,13.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38724,CPT,CERVICAL LYMPHADEC MODIFIED RADICAL NECK DSJ,,,21,,RBRVS,23.95 ,14.34 ,14.34 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
38740,CPT,AXILLARY LYMPHADENECTOMY SUPERFICIAL,,,21,,RBRVS,10.70 ,6.82 ,6.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38745,CPT,AXILLARY LYMPHADENECTOMY COMPLETE,,,21,,RBRVS,13.87 ,8.17 ,8.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38746,CPT,THORCOM THRC W/MEDSTNL & REGIONAL LMPHADEC,,,21,,RBRVS,4.12 ,1.21 ,1.21 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
38747,CPT,ABDL LMPHADEC REG CELIAC GSTR PORTAL PRIPNCRTC,,,21,,RBRVS,4.88 ,1.75 ,1.75 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
38760,CPT,INGUINOFEM LMPHADEC SUPFC W/CLOQUETS NODE SPX,,,21,,RBRVS,13.62 ,7.71 ,7.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38765,CPT,INGUINOFEM LMPHADEC SUPFC W/PEL LMPHADEC,,,21,,RBRVS,21.91 ,10.84 ,10.84 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
38770,CPT,PEL LMPHADEC W/XTRNL ILIAC HYPOGSTR&OBTURATOR,,,21,,RBRVS,14.06 ,7.08 ,7.08 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
38780,CPT,RPR TABDL LMPHADEC EXTNSV W/PEL AORTIC&RNL,,,21,,RBRVS,17.70 ,9.11 ,9.11 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
38790,CPT,INJECTION PROCEDURE LYMPHANGIOGRAPHY,,,21,,RBRVS,1.29 ,0.90 ,0.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38792,CPT,INJ RADIOACTIVE TRACER FOR ID OF SENTINEL NODE,,,21,,RBRVS,0.52 ,0.56 ,0.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38794,CPT,CANNULATION THORACIC DUCT,,,21,,RBRVS,4.62 ,3.62 ,3.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
38900,CPT,INTRAOP SENTINEL LYMPH NODE ID W/DYE INJECTION,,,21,,RBRVS,2.50 ,0.91 ,0.91 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
38999,CPT,UNLISTED PROCEDURE HEMIC OR LYMPHATIC SYSTEM,,,21,,TotalUnits,,,,3.12 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
39000,CPT,MEDIAST W/EXPL DRG RMVL FB/BX CRV APPR,,,21,,RBRVS,7.57 ,5.16 ,5.16 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
39010,CPT,MEDIAST W/EXPL DRG RMVL FB/BX TTHRC APPR,,,21,,RBRVS,13.19 ,6.68 ,6.68 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
39200,CPT,RESECTION OF MEDIASTINAL CYST,,,21,,RBRVS,15.09 ,6.87 ,6.87 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
39220,CPT,RESECTION MEDIASTINAL TUMOR,,,21,,RBRVS,19.55 ,9.18 ,9.18 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
39401,CPT,MEDIASTINOSCOPY INCLUDES MEDIASTINAL MASS BIOPSY,,,21,,RBRVS,5.44 ,2.35 ,2.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
39402,CPT,MEDIASTINOSCOPY WITH LYMPH NODE BIOPSY/IES,,,21,,RBRVS,7.25 ,2.88 ,2.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
39499,CPT,UNLISTED PROCEDURE MEDIASTINUM,,,21,,TotalUnits,,,,19.87 ,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
39501,CPT,REPAIR LACERATION DIAPHRAGM ANY APPROACH,,,21,,RBRVS,13.98 ,7.46 ,7.46 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
39503,CPT,RPR NEONATAL DIPHRG HERNIA W/WO CHEST TUBE INSJ,,,21,,RBRVS,108.91 ,43.40 ,43.40 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
39540,CPT,RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC AQT,,,21,,RBRVS,14.57 ,7.19 ,7.19 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
39541,CPT,RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC CHRNC,,,21,,RBRVS,15.75 ,7.98 ,7.98 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
39545,CPT,IMBRICATION DIAPHRAGM EVENTRATION,,,21,,RBRVS,14.67 ,7.84 ,7.84 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
39560,CPT,RESCJ DIAPHRAGM W/SIMPLE REPAIR,,,21,,RBRVS,13.06 ,7.05 ,7.05 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
39561,CPT,RESCJ DIAPHRAGM W/COMPLEX REPAIR,,,21,,RBRVS,19.99 ,11.23 ,11.23 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
39599,CPT,UNLISTED PROCEDURE DIAPHRAGM,,,21,,TotalUnits,,,,21.44 ,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
40490,CPT,BIOPSY OF LIP,,,21,,RBRVS,1.22 ,0.73 ,2.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40500,CPT,VERMILIONECTOMY LIP SHV W/MUCOSAL ADVMNT,,,21,,RBRVS,4.47 ,5.37 ,9.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40510,CPT,EXC LIP TRANSVRS WEDGE EXC W/PRIM CLSR,,,21,,RBRVS,4.82 ,4.74 ,8.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40520,CPT,EXC LIP V-EXC W/PRIM DIR LINR CLSR,,,21,,RBRVS,4.79 ,4.84 ,8.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40525,CPT,EXC LIP FULL THKNS RCNSTJ W/LOCAL FLAP,,,21,,RBRVS,7.72 ,6.98 ,6.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40527,CPT,EXC LIP FULL THKNS RCNSTJ W/CROSS LIP FLAP,,,21,,RBRVS,9.32 ,7.19 ,7.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40530,CPT,RESCJ LIP > ONE-FOURTH W/O RCNSTJ,,,21,,RBRVS,5.54 ,5.25 ,9.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40650,CPT,RPR LIP FULL THICKNESS VERMILION ONLY,,,21,,RBRVS,3.78 ,4.26 ,8.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40652,CPT,RPR LIP FULL THICKNESS HALF/< VERTICAL HEIGHT,,,21,,RBRVS,4.43 ,5.15 ,9.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40654,CPT,RPR LIP FULL THKNS >ONE-HALF VERT HEIGHT/COMPLE,,,21,,RBRVS,5.48 ,5.93 ,10.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40700,CPT,PLSTC RPR CL LIP/NSL DFRM PRIM PRTL/COMPL UNI,,,21,,RBRVS,14.17 ,12.52 ,12.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40701,CPT,PLSTC RPR CL LIP/NSL DFRM PRIM BI 1 STG PX,,,21,,RBRVS,17.23 ,9.80 ,9.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40702,CPT,PLSTC RPR CL LIP/NSL DFRM PRIM BI 1 2 STGS,,,21,,RBRVS,14.27 ,9.90 ,9.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40720,CPT,PLSTC RPR CL LIP/NSL DFRM SEC RECRTJ DFCT & RECL,,,21,,RBRVS,14.72 ,12.51 ,12.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40761,CPT,PLSTC RPR CL LIP/NSL DFRM W/CROSS LIP PEDCL FLAP,,,21,,RBRVS,15.84 ,10.05 ,10.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40799,CPT,UNLISTED PROCEDURE LIPS,,,21,,TotalUnits,,,,3.47 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40800,CPT,DRG ABSC CST HMTMA VESTIBULE MOUTH SMPL,,,21,,RBRVS,1.23 ,2.45 ,4.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40801,CPT,DRG ABSC CST HMTMA VESTIBULE MOUTH COMP,,,21,,RBRVS,2.63 ,3.47 ,6.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40804,CPT,RMVL EMBEDDED FB VESTIBULE MOUTH SMPL,,,21,,RBRVS,1.30 ,2.35 ,4.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40805,CPT,RMVL EMBEDDED FB VESTIBULE MOUTH COMP,,,21,,RBRVS,2.79 ,3.60 ,6.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40806,CPT,INCISION LABIAL FRENUM FRENOTOMY,,,21,,RBRVS,0.31 ,0.61 ,2.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40808,CPT,BIOPSY VESTIBULE MOUTH,,,21,,RBRVS,1.01 ,2.02 ,4.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40810,CPT,EXC LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR,,,21,,RBRVS,1.36 ,2.18 ,4.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40812,CPT,EXC LESION MUCOSA & SBMCSL VESTIBULE SMPL RPR,,,21,,RBRVS,2.37 ,3.06 ,5.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40814,CPT,EXC LESION MUCOSA & SBMCSL VESTIBULE CPLX RPR,,,21,,RBRVS,3.52 ,4.88 ,7.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40816,CPT,EXC LESION MUCOSA&SBMCSL VESTIBULE CPLX EXC MUSC,,,21,,RBRVS,3.77 ,4.91 ,7.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40818,CPT,EXC MUCOSA VESTIBULE MOUTH AS DON GRF,,,21,,RBRVS,2.83 ,4.80 ,7.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40819,CPT,EXC FRENUM LABIAL/BUCCAL,,,21,,RBRVS,2.51 ,4.08 ,6.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40820,CPT,DSTRJ LES/SCAR VESTIBULE MOUTH PHYSICAL METHS,,,21,,RBRVS,1.34 ,3.51 ,6.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40830,CPT,CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<,,,21,,RBRVS,1.82 ,2.78 ,5.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40831,CPT,CLOSURE LACERATION VESTIBULE MOUTH > 2.5 CM/CPL,,,21,,RBRVS,2.57 ,3.59 ,6.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40840,CPT,VESTIBULOPLASTY ANTERIOR,,,21,,RBRVS,9.15 ,7.82 ,13.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40842,CPT,VESTIBULOPLASTY POSTERIOR UNILATERAL,,,21,,RBRVS,9.15 ,8.36 ,13.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40843,CPT,VESTIBULOPLASTY POSTERIOR BILATERAL,,,21,,RBRVS,12.79 ,10.19 ,16.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40844,CPT,VESTIBULOPLASTY ENTIRE ARCH,,,21,,RBRVS,16.80 ,11.30 ,18.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40845,CPT,VESTIBULOPLASTY CPLX W/RIDGE XTN MUSC RPSG,,,21,,RBRVS,19.36 ,13.46 ,20.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
40899,CPT,UNLISTED PROCEDURE VESTIBULE MOUTH,,,21,,TotalUnits,,,,5.47 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41000,CPT,INTRAORAL I&D TONGUE/FLOOR LINGUAL,,,21,,RBRVS,1.35 ,1.74 ,3.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41005,CPT,INTRAORAL I&D TONGUE/FLOOR SUBLNGL SUPFC,,,21,,RBRVS,1.31 ,2.16 ,5.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41006,CPT,INTRAORAL I&D TONGUE/FLOOR SUBLNGL DP SPRMLHYD,,,21,,RBRVS,3.34 ,3.95 ,7.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41007,CPT,INTRAORAL I&D TONGUE/FLOOR SUBMENTAL SPACE,,,21,,RBRVS,3.20 ,3.88 ,7.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41008,CPT,INTRAORAL I&D TONGUE/FLOOR SUBMNDBLR SPACE,,,21,,RBRVS,3.46 ,3.90 ,7.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41009,CPT,INTRAORAL I&D TONGUE/FLOOR MASTICATOR SPACE,,,21,,RBRVS,3.71 ,4.27 ,7.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41010,CPT,INCISION LINGUAL FRENUM FRENOTOMY,,,21,,RBRVS,1.11 ,1.89 ,4.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41015,CPT,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBLNGL,,,21,,RBRVS,4.08 ,5.52 ,8.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41016,CPT,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMENT,,,21,,RBRVS,4.19 ,5.45 ,7.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41017,CPT,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMNDB,,,21,,RBRVS,4.19 ,5.51 ,8.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41018,CPT,XTRORAL I&D FLOOR MASTICATOR SPACE,,,21,,RBRVS,5.22 ,6.02 ,8.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41019,CPT,PLACEMENT NEEDLE HEAD/NECK RADIOELEMENT APPLICAT,,,21,,RBRVS,8.84 ,3.84 ,3.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41100,CPT,BIOPSY TONGUE ANTERIOR TWO-THIRDS,,,21,,RBRVS,1.42 ,1.52 ,3.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41105,CPT,BIOPSY TONGUE POSTERIOR ONE-THIRD,,,21,,RBRVS,1.47 ,1.57 ,3.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41108,CPT,BIOPSY FLOOR MOUTH,,,21,,RBRVS,1.10 ,1.38 ,3.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41110,CPT,EXCISION LESION TONGUE W/O CLOSURE,,,21,,RBRVS,1.56 ,2.06 ,4.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41112,CPT,EXC LESION TONGUE W/CLSR ANTERIOR TWO-THIRDS,,,21,,RBRVS,2.83 ,4.14 ,6.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41113,CPT,EXC LESION TONGUE W/CLSR POSTERIOR ONE-THIRD,,,21,,RBRVS,3.29 ,4.41 ,6.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41114,CPT,EXC LESION TONGUE W/CLSR W/LOCAL TONGUE FLAP,,,21,,RBRVS,8.82 ,8.38 ,8.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41115,CPT,EXCISION LINGUAL FRENUM FRENECTOMY,,,21,,RBRVS,1.79 ,2.20 ,5.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41116,CPT,EXCISION LESION FLOOR MOUTH,,,21,,RBRVS,2.52 ,3.53 ,6.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41120,CPT,GLOSSECTOMY <ONE-HALF TONGUE,,,21,,RBRVS,11.14 ,17.63 ,17.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41130,CPT,GLOSSECTOMY HEMIGLOSSECTOMY,,,21,,RBRVS,15.74 ,19.61 ,19.61 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
41135,CPT,GLOSSECTOMY PRTL W/UNI RADICAL NECK DSJ,,,21,,RBRVS,30.14 ,27.90 ,27.90 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
41140,CPT,GLSSC COMPL/TOT W/WOTRACHS W/O RAD NECK DSJ,,,21,,RBRVS,29.15 ,29.44 ,29.44 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
41145,CPT,GLSSC COMPL/TOT W/WO TRACHS W/UNI RAD NECK DSJ,,,21,,RBRVS,37.93 ,36.06 ,36.06 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
41150,CPT,GLSSC COMPOSIT W/RESCJ FLOOR & MANDIBULAR RESCJ,,,21,,RBRVS,29.86 ,28.89 ,28.89 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
41153,CPT,GLSSC COMPOSIT RESCJ FLOOR SUPRAHYOID NCK DSJ,,,21,,RBRVS,33.59 ,30.40 ,30.40 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
41155,CPT,GLSSC COMPOSIT RESCJ FLR MNDBLR RESCJ & RAD NECK,,,21,,RBRVS,44.30 ,35.83 ,35.83 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
41250,CPT,RPR LAC 2.5 CM/< MOUTH&/ANT TWO-THIRDS TONG,,,21,,RBRVS,1.96 ,2.26 ,5.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41251,CPT,RPR LAC 2.5 CM/< PST ONE-THIRD TONGUE,,,21,,RBRVS,2.32 ,2.65 ,5.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41252,CPT,RPR LAC TONGUE FLOOR MOUTH > 2.6 CM/CPLX,,,21,,RBRVS,3.02 ,2.63 ,5.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41500,CPT,FIXJ TONGUE MECHANICAL OTHER/THAN SUTURE,,,21,,RBRVS,3.80 ,8.92 ,8.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41510,CPT,SUTURE TONGUE LIP MICROGNATHIA,,,21,,RBRVS,3.51 ,7.84 ,7.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41512,CPT,TONGUE BASE SUSPENSION PERMANENT SUTURE TQ,,,21,,RBRVS,6.86 ,10.61 ,10.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41520,CPT,FRENOPLASTY SURG REVJ FRENUM EG W/Z-PLASTY,,,21,,RBRVS,2.83 ,4.28 ,7.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41530,CPT,SUBMUCOSAL ABLTJ TONGUE RF 1/> SITES PR SESSION,,,21,,RBRVS,4.51 ,6.88 ,87.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41599,CPT,UNLISTED PROCEDURE TONGUE FLOOR MOUTH,,,21,,TotalUnits,,,,4.53 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41800,CPT,DRG ABSC CST HMTMA FROM DENTOALVEOLAR STRUXS,,,21,,RBRVS,1.27 ,2.83 ,6.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41805,CPT,RMVL EMBEDDED FB FROM DENTALVLR STRUXS SOFT TISS,,,21,,RBRVS,1.34 ,3.46 ,5.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41806,CPT,RMVL EMBEDDED FB FROM DENTOALVEOLAR STRUXS BONE,,,21,,RBRVS,2.79 ,4.40 ,7.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41820,CPT,GINGIVECTOMY EXC GINGIVA EACH QUADRANT,,,21,,TotalUnits,,,,5.61 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41821,CPT,OPRCULECTOMY EXC PRICORONAL TISSUE,,,21,,TotalUnits,,,,1.26 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41822,CPT,EXC FIBROUS TUBEROSITIES DENTOALVEOLAR STRUXS,,,21,,RBRVS,2.41 ,2.59 ,6.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41823,CPT,EXC OSS TUBEROSITIES DENTOALVEOLAR STRUXS,,,21,,RBRVS,3.77 ,5.31 ,8.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41825,CPT,EXC LESION/TUMOR DENTOALVEOLAR STRUX W/O RPR,,,21,,RBRVS,1.41 ,1.96 ,4.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41826,CPT,EXC LESION/TUMOR DENTOALVEOLAR STRUX W/SMPL RPR,,,21,,RBRVS,2.41 ,3.45 ,6.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41827,CPT,EXC LESION/TUMOR DENTALVEOLAR STRUX W/CMPLX RPR,,,21,,RBRVS,3.83 ,4.62 ,8.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41828,CPT,EXC HYPRPLSTC ALVEOLAR MUCOSA EA QUADRANT SPEC,,,21,,RBRVS,3.14 ,2.67 ,5.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41830,CPT,ALVEOLECTOMY W/CURTG OSTEITIS/SEQUESTRECTOMY,,,21,,RBRVS,3.45 ,4.36 ,7.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41850,CPT,DESTRUCTION LESION DENTOALVEOLAR STRUCTURES,,,21,,TotalUnits,,,,2.80 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41870,CPT,PERIODONTAL MUCOSAL GRAFTING,,,21,,TotalUnits,,,,7.01 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41872,CPT,GINGIVOPLASTY EACH QUADRANT SPECIFY,,,21,,RBRVS,3.01 ,4.17 ,7.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41874,CPT,ALVEOLOPLASTY EACH QUADRANT SPECIFY,,,21,,RBRVS,3.19 ,3.81 ,7.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
41899,CPT,UNLISTED PROCEDURE DENTOALVEOLAR STRUCTURES,,,21,,TotalUnits,,,,10.06 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42000,CPT,DRAINAGE ABSCESS PALATE UVULA,,,21,,RBRVS,1.28 ,1.56 ,3.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42100,CPT,BIOPSY PALATE UVULA,,,21,,RBRVS,1.36 ,1.64 ,2.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42104,CPT,EXC LESION PALATE UVULA W/O CLOSURE,,,21,,RBRVS,1.69 ,2.12 ,4.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42106,CPT,EXC LESION PALATE UVULA W/SMPL PRIM CLOSURE,,,21,,RBRVS,2.15 ,2.76 ,5.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42107,CPT,EXC LESION PALATE UVULA W/LOCAL FLAP CLOSURE,,,21,,RBRVS,4.56 ,4.83 ,8.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42120,CPT,RESCJ PALATE/EXTENSIVE RESCJ LESION,,,21,,RBRVS,11.86 ,15.27 ,15.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42140,CPT,UVULECTOMY EXCISION UVULA,,,21,,RBRVS,1.70 ,2.57 ,5.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42145,CPT,PALATOPHARYNGOPLASTY,,,21,,RBRVS,9.78 ,9.24 ,9.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42160,CPT,DSTRJ LESION PALATE/UVULA THERMAL CRYO/CHEM,,,21,,RBRVS,1.85 ,2.18 ,4.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42180,CPT,REPAIR LACERATION PALATE </2 CM,,,21,,RBRVS,2.55 ,2.43 ,4.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42182,CPT,REPAIR LACERATION PALATE >2 CM/COMPLEX,,,21,,RBRVS,3.87 ,3.01 ,4.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42200,CPT,PALATOP CL PALATE SOFT&/HARD PALATE ONLY,,,21,,RBRVS,12.53 ,10.27 ,10.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42205,CPT,PALATOPLASTY W/CLSR ALVEOLAR RIDGE SOFT TISSUE,,,21,,RBRVS,13.66 ,10.06 ,10.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42210,CPT,PALATOP CLSR ALVEOLAR RIDGE GRF ALVEOLAR RIDGE,,,21,,RBRVS,15.03 ,13.73 ,13.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42215,CPT,PALATOPLASTY CLEFT PALATE MAJOR REVJ,,,21,,RBRVS,8.99 ,10.36 ,10.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42220,CPT,PALATOPLASTY CLEFT PALATE SEC LNGTH PX,,,21,,RBRVS,7.16 ,7.18 ,7.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42225,CPT,PALATOP CL PALATE ATTACHMENT PHARYNGEAL FLAP,,,21,,RBRVS,9.77 ,14.28 ,14.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42226,CPT,LENGTHENING PALATE & PHARYNGEAL FLAP,,,21,,RBRVS,10.35 ,14.07 ,14.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42227,CPT,LENGTHENING PALATE W/ISLAND FLAP,,,21,,RBRVS,9.90 ,12.96 ,12.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42235,CPT,REPAIR ANTERIOR PALATE W/VOMER FLAP,,,21,,RBRVS,8.01 ,12.12 ,12.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42260,CPT,REPAIR NASOLABIAL FISTULA,,,21,,RBRVS,10.22 ,9.03 ,13.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42280,CPT,MAXILLARY IMPRESJ PALATAL PROSTHESIS,,,21,,RBRVS,1.59 ,1.40 ,2.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42281,CPT,INSJ PIN-RETAINED PALATAL PROSTHESIS,,,21,,RBRVS,1.98 ,2.13 ,3.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42299,CPT,UNLISTED PROCEDURE PALATE UVULA,,,21,,TotalUnits,,,,6.82 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42300,CPT,DRAINAGE ABSCESS PAROTID SIMPLE,,,21,,RBRVS,1.98 ,2.17 ,3.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42305,CPT,DRAINAGE ABSCESS PAROTID COMPLICATED,,,21,,RBRVS,6.31 ,5.24 ,5.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42310,CPT,DRG ABSC SUBMAXILLARY/SUBLINGUAL INTRAORAL,,,21,,RBRVS,1.61 ,1.77 ,2.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42320,CPT,DRAINAGE ABSCESS SUBMAXILLARY INTRAORAL,,,21,,RBRVS,2.40 ,2.36 ,4.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42330,CPT,SIALOT SUBMNDBLR SUBLNGL/PRTD UNCOMP INTRAORAL,,,21,,RBRVS,2.26 ,2.22 ,4.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42335,CPT,SIALOLITHOTOMY SUBMNDBLR SUBMAX COMP INTRAORAL,,,21,,RBRVS,3.41 ,3.56 ,6.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42340,CPT,SIALOLITHOTOMY PRTD XTRORAL/COMP INTRAORAL,,,21,,RBRVS,4.72 ,4.39 ,8.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42400,CPT,BIOPSY SALIVARY GLAND NEEDLE,,,21,,RBRVS,0.78 ,0.73 ,2.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42405,CPT,BIOPSY SALIVARY GLAND INCISIONAL,,,21,,RBRVS,3.34 ,2.75 ,4.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42408,CPT,EXC SUBLINGUAL SALIVARY CYST RANULA,,,21,,RBRVS,4.66 ,4.11 ,7.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42409,CPT,MARSUPIALIZATION SUBLNGL SALIVARY CST RANULA,,,21,,RBRVS,2.91 ,3.12 ,6.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42410,CPT,EXC PRTD TUM/PRTD GLND LAT LOBE W/O NRV DSJ,,,21,,RBRVS,9.57 ,6.90 ,6.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42415,CPT,EXC PRTD TUM/PRTD GLND LAT DSJ&PRSRV FACIAL NR,,,21,,RBRVS,17.16 ,10.86 ,10.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42420,CPT,EXC PRTD TUM/PRTD GLND TOT DSJ&PRSRV FACIAL NR,,,21,,RBRVS,19.53 ,11.93 ,11.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42425,CPT,EXCISION PAROTID TUMOR/GLAND TOTAL EN BLOC RMVL,,,21,,RBRVS,13.42 ,8.80 ,8.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42426,CPT,EXC PRTD TUM/PRTD GLND TOT W/UNI RAD NCK DSJ,,,21,,RBRVS,22.66 ,13.04 ,13.04 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
42440,CPT,EXCISION SUBMANDIBULAR SUBMAXILLARY GLAND,,,21,,RBRVS,6.14 ,4.88 ,4.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42450,CPT,EXISION OF SUBLINGUAL GLAND,,,21,,RBRVS,4.74 ,4.99 ,7.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42500,CPT,PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY PRIM,,,21,,RBRVS,4.42 ,4.86 ,7.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42505,CPT,PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY SEC/COMP,,,21,,RBRVS,6.32 ,5.91 ,8.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42507,CPT,PAROTID DUCT DIVERSION BILATERAL WILKE PX,,,21,,RBRVS,6.25 ,7.70 ,7.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42509,CPT,PAROTID DUCT DVRJ BI W/EXC BOTH SUBMNDBLR GLANDS,,,21,,RBRVS,11.76 ,11.01 ,11.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42510,CPT,PAROTID DUCT DVRJ BILATERAL WITH LIG BOTH DUCTS,,,21,,RBRVS,8.35 ,8.64 ,8.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42550,CPT,INJECTION PROCEDURE SIALOGRAPHY,,,21,,RBRVS,1.25 ,0.47 ,2.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42600,CPT,CLOSURE SALIVARY FISTULA,,,21,,RBRVS,4.94 ,4.42 ,8.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42650,CPT,DILATION SALIVARY DUCT,,,21,,RBRVS,0.77 ,0.83 ,1.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42660,CPT,DILAT&CATHJ SALIVARY DUCT W/WO INJECTION,,,21,,RBRVS,1.13 ,1.13 ,2.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42665,CPT,LIGATION SALIVARY DUCT INTRAORAL,,,21,,RBRVS,2.63 ,2.97 ,6.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42699,CPT,UNLISTED PX SALIVARY GLANDS/DUCTS,,,21,,TotalUnits,,,,16.47 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42700,CPT,I&D ABSCESS PERITONSILLAR,,,21,,RBRVS,1.67 ,2.03 ,3.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42720,CPT,I&D ABSC RTRPHRNGL/PARAPHARYNGEAL INTRAORAL,,,21,,RBRVS,6.31 ,4.13 ,5.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42725,CPT,I&D ABSC RTRPHRNGL/PARAPHARYNGEAL XTRNL APPR,,,21,,RBRVS,12.41 ,9.46 ,9.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42800,CPT,BIOPSY OROPHARYNX,,,21,,RBRVS,1.44 ,1.60 ,2.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42804,CPT,BIOPSY NASOPHARYNX VISIBLE LESION SIMPLE,,,21,,RBRVS,1.29 ,1.81 ,4.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42806,CPT,BX NASOPHARYNX SURVEY UNKNOWN PRIMARY LESION,,,21,,RBRVS,1.63 ,1.96 ,4.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42808,CPT,EXCISION/DESTRUCTION LESION PHARYNX ANY METHOD,,,21,,RBRVS,2.35 ,2.02 ,3.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42809,CPT,REMOVAL FOREIGN BODY PHARYNX,,,21,,RBRVS,1.86 ,1.72 ,2.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42810,CPT,EXC BRANCHIAL CLEFT CYST CONFINED SKN&SUBQ TIS,,,21,,RBRVS,3.38 ,4.51 ,7.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42815,CPT,EXC BRANCHIAL CLEFT CYST BELOW SUBQ TISS&/PHRYNX,,,21,,RBRVS,7.31 ,7.82 ,7.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42820,CPT,TONSILLECTOMY & ADENOIDECTOMY <AGE 12,,,21,,RBRVS,4.22 ,3.56 ,3.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42821,CPT,TONSILLECTOMY & ADENOIDECTOMY AGE 12/>,,,21,,RBRVS,4.36 ,3.72 ,3.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42825,CPT,TONSILLECTOMY ONE-HALF <AGE 12,,,21,,RBRVS,3.51 ,3.56 ,3.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42826,CPT,TONSILLECTOMY ONE-HALF AGE 12/>,,,21,,RBRVS,3.45 ,3.32 ,3.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42830,CPT,ADENOIDECTOMY PRIMARY <AGE 12,,,21,,RBRVS,2.65 ,2.99 ,2.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42831,CPT,ADENOIDECTOMY PRIMARY AGE 12/>,,,21,,RBRVS,2.81 ,3.25 ,3.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42835,CPT,ADENOIDECTOMY SECONDARY<AGE 12,,,21,,RBRVS,2.38 ,2.87 ,2.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42836,CPT,ADENOIDECTOMY SECONDARY AGE 12/>,,,21,,RBRVS,3.26 ,3.24 ,3.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42842,CPT,RADICAL RESECTION TONSIL W/O CLOSURE,,,21,,RBRVS,12.23 ,14.81 ,14.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42844,CPT,RADICAL RESCJ TONSIL CLOSURE W/LOCAL FLAP,,,21,,RBRVS,17.78 ,19.30 ,19.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42845,CPT,RADICAL RESCJ TONSIL CLOSURE W/OTHER FLAP,,,21,,RBRVS,32.56 ,26.85 ,26.85 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
42860,CPT,EXCISION TONSIL TAGS,,,21,,RBRVS,2.30 ,2.83 ,2.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42870,CPT,EXC/DSTRJ LINGUAL TONSIL ANY METHOD SPX,,,21,,RBRVS,5.52 ,10.45 ,10.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42890,CPT,LIMITED PHARYNGECTOMY,,,21,,RBRVS,19.13 ,18.92 ,18.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42892,CPT,RESCJ LAT PHRNGL WALL/PYRIFORM SINUS DIR CLSR,,,21,,RBRVS,26.03 ,24.48 ,24.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42894,CPT,RESCJ PHRNGL WALL CLSR W/FLP OR FLP W/MVASC ANAS,,,21,,RBRVS,33.92 ,29.40 ,29.40 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
42900,CPT,SUTURE PHARYNX WOUND/INJURY,,,21,,RBRVS,5.29 ,3.75 ,3.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42950,CPT,PHARYNGOPLASTY PLSTC/RCNSTV OPRATION PHARYNX,,,21,,RBRVS,8.27 ,13.48 ,13.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42953,CPT,PHARYNGOESOPHAGEAL REPAIR,,,21,,RBRVS,9.45 ,16.75 ,16.75 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
42955,CPT,PHARYNGOSTOMY FSTLJ PHARYNX XTRNL FEEDING,,,21,,RBRVS,8.01 ,12.59 ,12.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42960,CPT,CONTROL OROPHARYNGEAL HEMORRHAGE SIMPLE,,,21,,RBRVS,2.38 ,2.22 ,2.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42961,CPT,CTRL OROPHARYNGEAL HEMORRHAGE COMP REQ HOSPITJ,,,21,,RBRVS,5.77 ,5.66 ,5.66 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
42962,CPT,CTRL OROPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ,,,21,,RBRVS,7.40 ,6.54 ,6.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42970,CPT,CTRL NASOPHARYNGEAL HEMRRG SMPL W/PST NSL PACKS,,,21,,RBRVS,5.82 ,5.34 ,5.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42971,CPT,CTRL NASOPHARYNGEAL HEMRRG COMP REQ HOSPIZATION,,,21,,RBRVS,6.60 ,5.69 ,5.69 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
42972,CPT,CTRL NASOPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ,,,21,,RBRVS,7.59 ,6.13 ,6.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
42999,CPT,UNLISTED PROCEDURE PHARYNX ADENOIDS/TONSILS,,,21,,TotalUnits,,,,6.77 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43020,CPT,ESOPHAGOTOMY CERVICAL APPR W/RMVL FB,,,21,,RBRVS,8.23 ,6.19 ,6.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43030,CPT,CRICOPHARYNGEAL MYOTOMY,,,21,,RBRVS,7.99 ,5.78 ,5.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43045,CPT,ESOPHAGOTOMY THORACIC APPR W/RMVL FB,,,21,,RBRVS,21.88 ,10.88 ,10.88 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43100,CPT,EXC LESION ESOPHOGUS W/PRIM RPR CERVICAL APPR,,,21,,RBRVS,9.66 ,7.09 ,7.09 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43101,CPT,EXC LESION ESOPHAGUS W/PRIM RPR THRC/ABDL APPR,,,21,,RBRVS,17.07 ,9.68 ,9.68 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43107,CPT,TOT ESOPHAGECTOMY W/O THORCOM W/WO PYLOROPLASTY,,,21,,RBRVS,44.18 ,19.83 ,19.83 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43108,CPT,TOT ESOPHG W/O THORCOM COLON NTRPSTJ/INT RCNSTJ,,,21,,RBRVS,82.87 ,33.68 ,33.68 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43112,CPT,TOTAL ESOPHAGECTOMY W/THORCOM W/WO PYLORPLASTY,,,21,,RBRVS,47.48 ,19.76 ,19.76 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43113,CPT,TOT ESOPHG W/THORCOM W/COLON NTRPSTJ/INT RCNSTJ,,,21,,RBRVS,80.06 ,28.26 ,28.26 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43116,CPT,PRTL ESOPHAGECTOMY CERVICAL W/FREE INTSTINAL GRF,,,21,,RBRVS,92.99 ,44.92 ,44.92 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43117,CPT,PRTL ESOPHECT DSTL W/WO PROX GASTRECT/PYLORPLSTY,,,21,,RBRVS,43.65 ,17.88 ,17.88 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43118,CPT,PRTL ESOPH DSTL W/WO PROX GASTRC W/COLON NTRPSTJ,,,21,,RBRVS,67.07 ,28.05 ,28.05 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43121,CPT,PRTL ESOPHAGEC W/WO PROX GASTREC/PYLOROPLASTY,,,21,,RBRVS,51.43 ,19.94 ,19.94 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43122,CPT,PRTL ESOPHG THORACOABD W/WO PROXGASTREC/PYLOROPL,,,21,,RBRVS,44.18 ,19.87 ,19.87 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43123,CPT,PRTL ESPHG THORACOABDL/ABDL APPR NTRPSTJ/RCNSTJ,,,21,,RBRVS,83.12 ,35.14 ,35.14 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43124,CPT,TOT/PRTL ESPHG W/O RCNSTJ W/CRV ESOPHAGOSTOMY,,,21,,RBRVS,69.09 ,25.89 ,25.89 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43130,CPT,DIVERTICULECTOMY HYPOPHARYNX/ESOPH CRV APPR,,,21,,RBRVS,12.53 ,8.12 ,8.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43135,CPT,DIVERTICULECTOMY HYPOPHARYNX/ESOPH THRC APPR,,,21,,RBRVS,26.17 ,10.99 ,10.99 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43180,CPT,ESOPHAGOSCP RIG TRANSORAL HYPOPHARYNX CRV ESOPH,,,21,,RBRVS,9.03 ,5.59 ,5.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43191,CPT,ESOPHAGOSCOPY RIGID TRANSORAL DIAGNOSTIC BRUSH,,,21,,RBRVS,2.49 ,1.61 ,1.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43192,CPT,ESOPHAGOSCOPY RIGID TRANSORAL INJ SUBMUCOSAL,,,21,,RBRVS,2.79 ,1.75 ,1.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43193,CPT,ESOPHAGOSCOPY RIGID TRANSORAL WITH BIOPSY,,,21,,RBRVS,2.79 ,1.74 ,1.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43194,CPT,ESOPHAGOSCOPY RIG TRANSORAL REMOVAL FOREIGN BODY,,,21,,RBRVS,3.51 ,1.55 ,1.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43195,CPT,ESOPHAGOSCOPY RIGID TRANSORAL BALLOON DILATION,,,21,,RBRVS,3.07 ,1.88 ,1.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43196,CPT,ESOPHAGOSCOPY RIG TRANSORAL GUIDE WIRE DILATION,,,21,,RBRVS,3.31 ,1.95 ,1.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43197,CPT,ESOPHAGOSCOPY FLEXIBLE TRANSNASAL DIAGNOSTIC,,,21,,RBRVS,1.52 ,0.66 ,3.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43198,CPT,ESOPHAGOSCOPY FLEXIBLE TRANSNASAL WITH BIOPSY,,,21,,RBRVS,1.82 ,0.79 ,3.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43200,CPT,ESOPHAGOSCOPY FLEXIBLE TRANSORAL DIAGNOSTIC,,,21,,RBRVS,1.52 ,0.98 ,5.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43201,CPT,ESOPHAGOSCOPY FLEXIBLE TRANSORAL W SUBMUCOUS INJ,,,21,,RBRVS,1.82 ,1.12 ,5.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43202,CPT,ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY,,,21,,RBRVS,1.82 ,1.12 ,8.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43204,CPT,ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES,,,21,,RBRVS,2.43 ,1.44 ,1.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43205,CPT,ESPHGOSCOPY FLEX W/BAND LIGATION ESOPHGL VARICES,,,21,,RBRVS,2.54 ,1.46 ,1.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43206,CPT,ESOPHAGOSCOPY TRANSORAL W/OPTICAL ENDOMICROSCOPY,,,21,,RBRVS,2.39 ,1.35 ,6.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43210,CPT,EGD PARTIAL/COMPL ESOPHAGOGASTRIC FUNDOPLASTY,,,21,,RBRVS,7.75 ,3.67 ,3.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43211,CPT,ESOPHAGOSCOPY FLEXIBLE TRANSORAL MUCOSAL RESEXN,,,21,,RBRVS,4.30 ,2.30 ,2.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43212,CPT,ESOPHAGOSCOPY TRANSORAL STENT PLACEMENT,,,21,,RBRVS,3.50 ,1.66 ,1.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43213,CPT,ESOPHAGOSCOPY RETROGRADE DILATE BALLOON/OTHER,,,21,,RBRVS,4.73 ,2.42 ,29.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43214,CPT,ESOPHAGOSCOPY DILATE ESOPHAGUS BALLOON 30 MM,,,21,,RBRVS,3.50 ,1.86 ,1.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43215,CPT,ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY,,,21,,RBRVS,2.54 ,1.39 ,8.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43216,CPT,ESPHAGOSCOPY FLEX LESION REMOVAL HOT BX FORCEPS,,,21,,RBRVS,2.40 ,1.43 ,9.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43217,CPT,ESOPHAGOSCOPY FLEXIB LESION REMOVAL TUMOR SNARE,,,21,,RBRVS,2.90 ,1.56 ,9.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43220,CPT,ESOPHAGOSCOPY FLEX BALLOON DILAT <30 MM DIAM,,,21,,RBRVS,2.10 ,1.25 ,30.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43226,CPT,ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION,,,21,,RBRVS,2.34 ,1.33 ,8.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43227,CPT,ESOPHAGOSCOPY FLEXIBLE W/BLEEDING CONTROL,,,21,,RBRVS,2.99 ,1.61 ,16.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43229,CPT,ESOPHAGOSCOPY FLEX TRANSORAL LESION ABLATION,,,21,,RBRVS,3.59 ,1.93 ,16.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43231,CPT,ESOPHAGOSCOPY FLEXIBLE TRANSORAL ULTRASOUND EXAM,,,21,,RBRVS,2.90 ,1.63 ,8.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43232,CPT,ESOPHAGOSCOPY INTRA/TRANSMURAL NEEDLE ASPIRAT/BX,,,21,,RBRVS,3.69 ,1.88 ,9.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43233,CPT,EGD ESOPHAGUS BALLOON DILATION 30 MM OR LARGER,,,21,,RBRVS,4.17 ,2.15 ,2.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43235,CPT,ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC,,,21,,RBRVS,2.19 ,1.30 ,6.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43236,CPT,ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION,,,21,,RBRVS,2.49 ,1.45 ,8.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43237,CPT,ESOPHAGOGASTRODUODENOSCOPY US SCOPE W/ADJ STRXRS,,,21,,RBRVS,3.57 ,1.92 ,1.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43238,CPT,EGD INTRMURAL US NEEDLE ASPIRATE/BIOPSY ESOPHAGS,,,21,,RBRVS,4.26 ,2.24 ,2.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43239,CPT,EGD TRANSORAL BIOPSY SINGLE/MULTIPLE,,,21,,RBRVS,2.49 ,1.44 ,8.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43240,CPT,EGD TRANSORAL TRANSMURAL DRAINAGE PSEUDOCYST,,,21,,RBRVS,7.25 ,3.58 ,3.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43241,CPT,EGD INTRALUMINAL TUBE/CATHETER INSERTION,,,21,,RBRVS,2.59 ,1.43 ,1.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43242,CPT,EGD INTRMURAL NEEDLE ASPIR/BIOP ALTERED ANATOMY,,,21,,RBRVS,4.83 ,2.53 ,2.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43243,CPT,EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES,,,21,,RBRVS,4.37 ,2.24 ,2.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43244,CPT,EGD BAND LIGATION ESOPHGEAL/GASTRIC VARICES,,,21,,RBRVS,4.50 ,2.38 ,2.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43245,CPT,EGD DILATION GASTRIC/DUODENAL STRICTURE,,,21,,RBRVS,3.18 ,1.70 ,14.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43246,CPT,EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE,,,21,,RBRVS,3.66 ,1.86 ,1.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43247,CPT,EGD FLEXIBLE FOREIGN BODY REMOVAL,,,21,,RBRVS,3.21 ,1.75 ,8.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43248,CPT,EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS,,,21,,RBRVS,3.01 ,1.69 ,8.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43249,CPT,EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM,,,21,,RBRVS,2.77 ,1.57 ,27.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43250,CPT,EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS,,,21,,RBRVS,3.07 ,1.65 ,9.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43251,CPT,EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH,,,21,,RBRVS,3.57 ,1.93 ,10.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43252,CPT,EGD FLEX TRANSORAL W/OPTICAL ENDOMICROSCOPY,,,21,,RBRVS,3.06 ,1.67 ,7.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43253,CPT,EGD US GUIDED TRANSMURAL INJXN/FIDUCIAL MARKER,,,21,,RBRVS,4.83 ,2.53 ,2.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43254,CPT,EGD TRANSORAL ENDOSCOPIC MUCOSAL RESECTION,,,21,,RBRVS,4.97 ,2.55 ,2.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43255,CPT,EGD TRANSORAL CONTROL BLEEDING ANY METHOD,,,21,,RBRVS,3.66 ,1.99 ,8.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43257,CPT,EGD DELIVER THERMAL ENERGY SPHNCTR/CARDIA GERD,,,21,,RBRVS,4.25 ,2.20 ,2.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43259,CPT,EDG US EXAM SURGICAL ALTER STOM DUODENUM/JEJUNUM,,,21,,RBRVS,4.14 ,2.21 ,2.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43260,CPT,ERCP DX COLLECTION SPECIMEN BRUSHING/WASHING,,,21,,RBRVS,5.95 ,3.03 ,3.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43261,CPT,ERCP W/BIOPSY SINGLE/MULTIPLE,,,21,,RBRVS,6.25 ,3.15 ,3.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43262,CPT,ERCP W/SPHINCTEROTOMY/PAPILLOTOMY,,,21,,RBRVS,6.60 ,3.31 ,3.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43263,CPT,ERCP W/PRESSURE MEASUREMENT SPHINCTER OF ODDI,,,21,,RBRVS,6.60 ,3.32 ,3.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43264,CPT,ERCP REMOVE CALCULI/DEBRIS BILIARY/PANCREAS DUCT,,,21,,RBRVS,6.73 ,3.37 ,3.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43265,CPT,ERCP DESTRUCTION/LITHOTRIPSY CALCULI ANY METHOD,,,21,,RBRVS,8.03 ,3.95 ,3.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43266,CPT,EGD ENDOSCOPIC STENT PLACEMENT W/WIRE& DILATION,,,21,,RBRVS,4.17 ,2.11 ,2.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43270,CPT,EGD ABLATE TUMOR POLYP/LESION W/DILATION& WIRE,,,21,,RBRVS,4.26 ,2.25 ,16.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43273,CPT,ENDOSCOPIC PAPILLA CANNULATION BILE/PANCREATIC,,,21,,RBRVS,2.24 ,1.02 ,1.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43274,CPT,ERCP STENT PLACEMENT BILIARY/PANCREATIC DUCT,,,21,,RBRVS,8.58 ,4.20 ,4.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43275,CPT,ERCP REMOVE FOREIGN BODY/STENT BILIARY/PANC DUCT,,,21,,RBRVS,6.96 ,3.47 ,3.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43276,CPT,ERCP BILIARY/PANC DUCT STENT EXCHANGE W/DIL&WIRE,,,21,,RBRVS,8.94 ,4.36 ,4.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43277,CPT,ERCP BALLOON DILATE BILIARY/PANC DUCT/AMPULLA EA,,,21,,RBRVS,7.00 ,3.49 ,3.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43278,CPT,ERCP TUMOR/POLYP/LESION ABLATION W/DILATION&WIRE,,,21,,RBRVS,8.02 ,3.95 ,3.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43279,CPT,LAPS ESOPHAGOMYOTOMY W/FUNDOPLASTY IF PERFORMED,,,21,,RBRVS,22.10 ,10.20 ,10.20 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43280,CPT,LAPS SURG ESOPG/GSTR FUNDOPLASTY,,,21,,RBRVS,18.10 ,9.01 ,9.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43281,CPT,LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/O MESH,,,21,,RBRVS,26.60 ,11.96 ,11.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43282,CPT,LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/MESH,,,21,,RBRVS,30.10 ,13.22 ,13.22 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43283,CPT,LAPS ESOPHAGEAL LENGTHENING ADDL,,,21,,RBRVS,2.95 ,0.97 ,0.97 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43289,CPT,UNLISTED LAPAROSCOPIC PROCEDURE ESOPHAGUS,,,21,,TotalUnits,,,,32.30 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43300,CPT,ESPHGP CRV APPR W/O RPR TRACHEOESOPHGL FSTL,,,21,,RBRVS,9.33 ,7.13 ,7.13 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43305,CPT,ESPHGP CRV APPR W/RPR TRACHEOESOPHGL FSTL,,,21,,RBRVS,18.10 ,10.87 ,10.87 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43310,CPT,ESPHGP THRC APPR W/O RPR TRACHEOESOPHGL FSTL,,,21,,RBRVS,26.26 ,10.49 ,10.49 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43312,CPT,ESPHGP THRC APPR W/RPR TRACHEOESOPHGL FSTL,,,21,,RBRVS,29.25 ,10.49 ,10.49 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43313,CPT,ESPHGP CGEN DFCT THRC APPR W/O RPR FSTL,,,21,,RBRVS,48.45 ,23.46 ,23.46 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43314,CPT,ESPHGP CGEN DFCT THRC APPR W/RPR FSTL,,,21,,RBRVS,53.43 ,24.09 ,24.09 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43320,CPT,EGST W/WO VAGOTOMY&PYLOROPLASTY TABDL/TTHRC AP,,,21,,RBRVS,23.31 ,11.55 ,11.55 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43325,CPT,ESOPG/GSTR FUNDOPLASTY W/FUNDIC PATCH,,,21,,RBRVS,22.60 ,11.07 ,11.07 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43327,CPT,ESOPG/GSTR FUNDOPLASTY W/LAPAROTOMY,,,21,,RBRVS,13.35 ,7.16 ,7.16 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43328,CPT,ESOPG/GSTR FUNDOPLASTY W/THORACOTOMY,,,21,,RBRVS,19.91 ,8.34 ,8.34 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43330,CPT,ESOPHAGOMYOTOMY HELLER TYPE ABDOMINAL APPROACH,,,21,,RBRVS,22.19 ,11.15 ,11.15 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43331,CPT,ESOPHAGOMYOTOMY HELLER TYPE THORACIC APPROACH,,,21,,RBRVS,23.06 ,10.62 ,10.62 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43332,CPT,RPR PARAESOPH HIATAL HERNIA W/LAPT W/O MESH,,,21,,RBRVS,19.62 ,9.45 ,9.45 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43333,CPT,LAPT RPR PARAESOPH HIATAL HERNIA W/MESH,,,21,,RBRVS,21.46 ,10.17 ,10.17 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43334,CPT,RPR PARAESOPH HIATAL HERNIA W/THORCOM W/O MESH,,,21,,RBRVS,22.12 ,9.19 ,9.19 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43335,CPT,RPR PARAESOPH HIATAL HERNIA W/THORCOM W/MESH,,,21,,RBRVS,23.97 ,9.50 ,9.50 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43336,CPT,RPR PARAESOPH HIATAL HERNIA THORCOABDOM W/O MESH,,,21,,RBRVS,25.81 ,12.16 ,12.16 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43337,CPT,RPR PARAESOPH HIATAL HERNIA THORCOABDOM W/MESH,,,21,,RBRVS,27.65 ,13.18 ,13.18 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43338,CPT,ESOPHAGUS LENGTHENING,,,21,,RBRVS,2.21 ,0.66 ,0.66 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43340,CPT,ESOPHAGOJEJUNOSTOMY W/O TOT GSTRCT ABDL APPR,,,21,,RBRVS,22.99 ,11.43 ,11.43 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43341,CPT,ESOPHAGOJEJUNOSTOMY W/O TOT GSTRCT THRC APPR,,,21,,RBRVS,24.23 ,12.94 ,12.94 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43351,CPT,ESOPHAGOSTOMY FSTLJ ESOPH XTRNL THRC APPR,,,21,,RBRVS,22.05 ,13.04 ,13.04 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43352,CPT,ESOPHAGOSTOMY FSTLJ ESOPH XTRNL CRV APPR,,,21,,RBRVS,17.81 ,9.12 ,9.12 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43360,CPT,GI RCNSTJ PREV ESPHG/EXCLUSION W/STOMACH,,,21,,RBRVS,40.11 ,19.37 ,19.37 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43361,CPT,GI RCNSTJ PREV ESPHG/EXCLUSION W/COLON SM INT,,,21,,RBRVS,45.68 ,17.96 ,17.96 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43400,CPT,LIGATION DIRECT ESOPHAGEAL VARICES,,,21,,RBRVS,25.60 ,12.36 ,12.36 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43401,CPT,TRNSXJ ESOPH W/RPR ESOPHAGEAL VARICES,,,21,,RBRVS,26.49 ,12.68 ,12.68 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43405,CPT,LIG/STAPLING G-ESOP JUNCT PRE-ESOPHGL PRF8J,,,21,,RBRVS,24.73 ,14.00 ,14.00 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43410,CPT,SUTR ESOPHGL WND/INJ CRV APPR,,,21,,RBRVS,16.41 ,10.16 ,10.16 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43415,CPT,SUTR ESOPHGL WND/INJ TTHRC/TABDL APPR,,,21,,RBRVS,44.88 ,19.37 ,19.37 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43420,CPT,CLSR ESOPHAGOSTOMY/FSTL CRV APPR,,,21,,RBRVS,16.78 ,10.26 ,10.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43425,CPT,CLSR ESOPHAGOSTOMY/FSTL TTHRC/TABDL APPR,,,21,,RBRVS,25.04 ,11.19 ,11.19 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43450,CPT,DILATION ESOPH UNGUIDED SOUND/BOUGIE 1/MULT PASS,,,21,,RBRVS,1.38 ,0.95 ,4.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43453,CPT,DILATION ESOPHAGUS GUIDE WIRE,,,21,,RBRVS,1.51 ,1.00 ,26.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43460,CPT,ESOPG/GSTR TAMPONADE W/BALO SENGSTAKEN TYPE,,,21,,RBRVS,3.79 ,2.04 ,2.04 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43496,CPT,FREE JEJUNUM TRSF W/MICROVASC ANASTOMOSIS,,,21,,TotalUnits,,,,3.93 ,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43499,CPT,UNLISTED PROCEDURE ESOPHAGUS,,,21,,TotalUnits,,,,4.35 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43500,CPT,GASTROTOMY W/EXPLORATION/FOREIGN BODY REMOVAL,,,21,,RBRVS,12.79 ,7.02 ,7.02 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43501,CPT,GASTROTOMY W/SUTURE REPAIR BLEEDING ULCER,,,21,,RBRVS,22.60 ,11.12 ,11.12 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43502,CPT,GASTROTOMY W/SUTR RPR PRE-ESOPG/GASTRIC LAC,,,21,,RBRVS,25.69 ,12.34 ,12.34 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43510,CPT,GSTRT W/ESOPHGL DILAT&INSJ PRM INTRAL TUBE,,,21,,RBRVS,15.14 ,8.60 ,8.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43520,CPT,PYLOROMYOTOMY CUTTING PYLORIC MUSC,,,21,,RBRVS,11.29 ,5.96 ,5.96 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43605,CPT,BIOPSY STOMACH LAPAROTOMY,,,21,,RBRVS,13.72 ,7.28 ,7.28 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43610,CPT,EXC LOCAL ULCER/BENIGN TUMOR STOMACH,,,21,,RBRVS,16.34 ,8.27 ,8.27 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43611,CPT,EXC LOCAL MALIGNANT TUMOR STOMACH,,,21,,RBRVS,20.38 ,10.24 ,10.24 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43620,CPT,GSTRCT TOT W/ESOPHAGOENTEROSTOMY,,,21,,RBRVS,34.04 ,15.02 ,15.02 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43621,CPT,GSTRCT TOT W/ROUX-EN-Y RCNSTJ,,,21,,RBRVS,39.53 ,16.97 ,16.97 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43622,CPT,GSTRCT TOT W/FRMJ INTSTINAL POUCH ANY TYPE,,,21,,RBRVS,40.03 ,17.45 ,17.45 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43631,CPT,GSTRCT PRTL DSTL W/GASTRODUODENOSTOMY,,,21,,RBRVS,24.51 ,11.74 ,11.74 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43632,CPT,GSTRCT PRTL DSTL W/GASTROJEJUNOSTOMY,,,21,,RBRVS,35.14 ,15.49 ,15.49 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43633,CPT,GSTRCT PRTL DSTL W/ROUX-EN-Y RCNSTJ,,,21,,RBRVS,33.14 ,14.75 ,14.75 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43634,CPT,GSTRCT PRTL DSTL W/FRMJ INTSTINAL POUCH,,,21,,RBRVS,36.64 ,16.23 ,16.23 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43635,CPT,VAGOTOMY PFRMD W/PRTL DSTL GSTRCT,,,21,,RBRVS,2.06 ,0.73 ,0.73 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43640,CPT,VGTMY W/PYLORPLSTY W/WO GASTROST TRUNCAL/SLCTV,,,21,,RBRVS,19.56 ,9.98 ,9.98 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43641,CPT,VGTMY W/PYLOROPLASTY W/WO GASTROST PARIETAL CELL,,,21,,RBRVS,19.81 ,10.25 ,10.25 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43644,CPT,LAPS GSTR RSTCV PX W/BYP ROUX-EN-Y LIMB <150 CM,,,21,,RBRVS,29.40 ,13.93 ,13.93 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43645,CPT,LAPS GSTR RSTCV PX W/BYP&SM INT RCNSTJ,,,21,,RBRVS,31.53 ,14.73 ,14.73 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43651,CPT,LAPS SURG TRNSXJ VAGUS NRV TRUNCAL,,,21,,RBRVS,10.13 ,6.38 ,6.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43652,CPT,LAPS SURG TRNSXJ VAGUS NRV SLCTV/HILY SLCTV,,,21,,RBRVS,12.13 ,7.09 ,7.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43653,CPT,LAPS SURG GASTROSTOMY W/O CONSTJ GSTR TUBE SPX,,,21,,RBRVS,8.48 ,6.06 ,6.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43659,CPT,UNLISTED LAPAROSCOPIC PROCEDURE STOMACH,,,21,,TotalUnits,,,,43.33 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43752,CPT,NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE,,,21,,RBRVS,0.81 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43753,CPT,GASTRIC INTUBATJ & ASPIRAJ W/PHYS SKILL/LAVAGE,,,21,,RBRVS,0.45 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43754,CPT,GASTRIC INTUBAT DX W/ASPIRATION SINGLE SPECIMEN,,,21,,RBRVS,0.45 ,0.53 ,3.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43755,CPT,GASTRIC INTUBATION DX & ASPIRATJ MULTIPLE SPEC,,,21,,RBRVS,0.94 ,0.63 ,2.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43756,CPT,DUODENAL INTUBAT W/IMAG GUIDED SINGLE SPECIMEN,,,21,,RBRVS,0.77 ,0.63 ,5.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43757,CPT,DUODENAL INTUBAT W/IMAG GUIDED MULTIPLE SPECIMEN,,,21,,RBRVS,1.26 ,0.86 ,6.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43760,CPT,CHANGE GASTROSTOMY TUBE PERCUTANEOUS W/O GDNCE,,,21,,RBRVS,0.90 ,0.34 ,12.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43761,CPT,REPOS NASO/ORO GASTRIC FEEDING TUBE THRU DUO,,,21,,RBRVS,2.01 ,0.76 ,1.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43770,CPT,LAPS GASTRIC RESTRICTIVE PROCEDURE PLACE DEVICE,,,21,,RBRVS,18.00 ,10.15 ,10.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43771,CPT,LAPS GASTRIC RESTRICTIVE PX REVISION DEVICE,,,21,,RBRVS,20.79 ,11.13 ,11.13 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43772,CPT,LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE,,,21,,RBRVS,15.70 ,8.19 ,8.19 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43773,CPT,LAPS GASTRIC RESTRICTIVE PX REMOVE&RPLCMT DEVICE,,,21,,RBRVS,20.79 ,11.27 ,11.27 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43774,CPT,LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE & PORT,,,21,,RBRVS,15.76 ,8.34 ,8.34 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43775,CPT,LAPS GSTRC RSTRICTIV PX LONGITUDINAL GASTRECTOMY,,,21,,RBRVS,20.38 ,10.73 ,10.73 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43800,CPT,PYLOROPLASTY,,,21,,RBRVS,15.43 ,7.87 ,7.87 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43810,CPT,GASTRODUODENOSTOMY,,,21,,RBRVS,16.88 ,8.57 ,8.57 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43820,CPT,GASTROJEJUNOSTOMY W/O VAGOTOMY,,,21,,RBRVS,22.53 ,11.01 ,11.01 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43825,CPT,GASTROJEJUNOSTOMY W/VAGOTOMY ANY TYPE,,,21,,RBRVS,21.76 ,10.94 ,10.94 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43830,CPT,GASTROSTOMY OPN W/O CONSTJ GSTR TUBE SPX,,,21,,RBRVS,10.85 ,6.87 ,6.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43831,CPT,GASTROSTOMY OPN NEONATAL FEEDING,,,21,,RBRVS,8.49 ,6.67 ,6.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43832,CPT,GASTROSTOMY OPN W/CONSTJ GSTR TUBE,,,21,,RBRVS,17.34 ,8.82 ,8.82 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43840,CPT,GASTRORRHAPHY SUTR PRF8 DUOL/GSTR ULCER WND/INJ,,,21,,RBRVS,22.83 ,11.18 ,11.18 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43842,CPT,GASTRIC RSTCV W/O BYP VERTICAL-BANDED GASTROPLY,,,21,,RBRVS,21.03 ,10.53 ,10.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43843,CPT,GSTR RSTCV W/O BYP OTH/THN VER-BANDED GSTP,,,21,,RBRVS,21.21 ,10.79 ,10.79 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43845,CPT,GASTRIC RSTCV W/PRTL GASTRECTOMY 50-100 CM,,,21,,RBRVS,33.30 ,15.73 ,15.73 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43846,CPT,GASTRIC RSTCV W/BYP W/SHORT LIMB 150 CM/<,,,21,,RBRVS,27.41 ,12.91 ,12.91 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43847,CPT,GASTRIC RSTCV W/BYP W/SM INT RCNSTJ LIMIT ABSRPJ,,,21,,RBRVS,30.28 ,14.70 ,14.70 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43848,CPT,REVISION OPEN GASTRIC RESTRICTIVE PX NOT DEVICE,,,21,,RBRVS,32.75 ,15.35 ,15.35 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43850,CPT,REVJ GASTRODUOL ANAST W/RCNSTJ W/O VAGOTOMY,,,21,,RBRVS,27.58 ,13.02 ,13.02 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43855,CPT,REVJ GASTRODUOL ANAST W/RCNSTJ W/VGTMY,,,21,,RBRVS,28.69 ,13.41 ,13.41 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43860,CPT,REVJ GSTR/JJ ANAST W/RCNSTJ W/O VGTMY,,,21,,RBRVS,27.89 ,13.07 ,13.07 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43865,CPT,REVJ GSTR/JJ ANAST W/RCNSTJ W/VGTMY,,,21,,RBRVS,29.05 ,13.54 ,13.54 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43870,CPT,CLOSURE GASTROSTOMY SURG,,,21,,RBRVS,11.44 ,6.57 ,6.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43880,CPT,CLOSURE GASTROCOLIC FISTULA,,,21,,RBRVS,27.18 ,12.72 ,12.72 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
43886,CPT,GSTR RSTCV PX OPN REVJ SUBQ PORT COMPONENT ONLY,,,21,,RBRVS,4.64 ,4.70 ,4.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43887,CPT,GSTR RSTCV PX OPN RMVL SUBQ PORT COMPONENT ONLY,,,21,,RBRVS,4.32 ,4.07 ,4.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43888,CPT,GSTR RSTCV OPN RMVL & RPLCMT SUBQ PORT,,,21,,RBRVS,6.44 ,5.32 ,5.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
43999,CPT,UNLISTED PROCEDURE STOMACH,,,21,,TotalUnits,,,,4.16 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44005,CPT,ENTEROLSS FRING INTSTINAL ADHESION SPX,,,21,,RBRVS,18.46 ,8.99 ,8.99 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44010,CPT,DUODENOTOMY EXPLORATION/BX/FOREIGN BODY REMOVAL,,,21,,RBRVS,14.26 ,7.75 ,7.75 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44015,CPT,TUBE/NEEDLE CATH JEJUNOSTOMY ANY METHOD,,,21,,RBRVS,2.62 ,0.90 ,0.90 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44020,CPT,ENTEROTOMY SM INT OTH/THN DUO EXPL BX/FB RMVL,,,21,,RBRVS,16.22 ,8.25 ,8.25 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44021,CPT,ENTEROTOMY SM INT OTH/THN DUO DCMPRN,,,21,,RBRVS,16.31 ,8.25 ,8.25 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44025,CPT,COLOTOMY EXPLORATION/BIOPSY/FOREIGN BODY REMOVAL,,,21,,RBRVS,16.51 ,8.38 ,8.38 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44050,CPT,RDCTJ VOLVULUS INTUSSUSCEPTION INT HRNA LAPT,,,21,,RBRVS,15.52 ,7.96 ,7.96 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44055,CPT,CORRJ MALROTATION BANDS&/RDCTJ VOLVULUS,,,21,,RBRVS,25.63 ,11.71 ,11.71 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44100,CPT,BX INTESTINE CAPSULE TUBE PRORAL 1/> SPECIMENS,,,21,,RBRVS,2.01 ,0.91 ,0.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44110,CPT,EXC 1/> SMALL/LARGE LESIONS INTESTINE ENTEROTOM,,,21,,RBRVS,14.04 ,7.45 ,7.45 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44111,CPT,EXC 1/> SM/LG LESIONS INTESTNE MULT ENTEROTOMIE,,,21,,RBRVS,16.52 ,8.29 ,8.29 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44120,CPT,ENTRC RESCJ SMALL INTESTINE 1 RESCJ & ANAST,,,21,,RBRVS,20.82 ,9.83 ,9.83 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44121,CPT,ENTERECTOMY RESCJ SMALL INTESTINE EA RESCJ & ANA,,,21,,RBRVS,4.44 ,1.59 ,1.59 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44125,CPT,ENTERECTOMY RESCJ SMALL INTESTINE W/ENTEROSTOMY,,,21,,RBRVS,20.03 ,9.73 ,9.73 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44126,CPT,ENTRC RESCJ ATRESIA RESCJ & ANAST W/O TAPRING,,,21,,RBRVS,42.23 ,19.17 ,19.17 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44127,CPT,ENTRC RESCJ ATRESIA RESCJ & ANAST SGM W/TAPRING,,,21,,RBRVS,49.30 ,21.60 ,21.60 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44128,CPT,ENTRC RESCJ ATRESIA EA RESCJ & ANASTOMOSIS,,,21,,RBRVS,4.44 ,1.59 ,1.59 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44130,CPT,ENTEROENTEROST ANAST INT W/WO CUTAN NTRSTM SPX,,,21,,RBRVS,22.11 ,10.93 ,10.93 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44139,CPT,MOBLJ SPLENIC FLXR PFRMD CONJUNCT W/PRTL COLCT,,,21,,RBRVS,2.23 ,0.80 ,0.80 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44140,CPT,COLECTOMY PARTIAL W/ANASTOMOSIS,,,21,,RBRVS,22.59 ,11.15 ,11.15 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44141,CPT,COLECTOMY PRTL W/SKIN LEVEL CECOST/COLOSTOMY,,,21,,RBRVS,29.91 ,16.22 ,16.22 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44143,CPT,COLECTOMY PRTL W/END COLOSTOMY & CLSR DSTL SGMT,,,21,,RBRVS,27.79 ,14.17 ,14.17 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44144,CPT,COLECTOMY PRTL W/COLOST/ILEOST & MUCOFISTULA,,,21,,RBRVS,29.91 ,14.62 ,14.62 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44145,CPT,COLECTOMY PRTL W/COLOPROCTOSTOMY,,,21,,RBRVS,28.58 ,13.40 ,13.40 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44146,CPT,COLECTOMY PRTL W/COLOPROCTOSTOMY & COLOSTOMY,,,21,,RBRVS,35.30 ,18.74 ,18.74 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44147,CPT,COLECTOMY PRTL ABDOMINAL & TRANSANAL APPROACH,,,21,,RBRVS,33.69 ,15.17 ,15.17 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44150,CPT,COLCT TOT ABDL W/O PRCTECT W/ILEOST/ILEOPXTS,,,21,,RBRVS,30.18 ,17.45 ,17.45 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44151,CPT,COLCT TOT ABDL W/O PRCTECT W/CONTINENT ILEOST,,,21,,RBRVS,34.92 ,19.03 ,19.03 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44155,CPT,COLECTOMY TOT ABDL W/PROCTECTOMY W/ILEOSTOMY,,,21,,RBRVS,34.42 ,19.05 ,19.05 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44156,CPT,COLECTOMY TOT ABDL W/PROCTECTOMY W/CONTNT ILEOST,,,21,,RBRVS,37.42 ,20.67 ,20.67 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44157,CPT,COLECTOMY TOT ABD W/PROCTECTOMY ILEOANAL ANAST,,,21,,RBRVS,35.70 ,18.97 ,18.97 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44158,CPT,COLCT TTL ABD W/PRCTECT ILEOANAL ANAST & RSVR,,,21,,RBRVS,36.70 ,19.66 ,19.66 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44160,CPT,COLECTOMY PRTL W/RMVL TERMINAL ILEUM & ILEOCOLOS,,,21,,RBRVS,20.89 ,10.43 ,10.43 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44180,CPT,LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE,,,21,,RBRVS,15.27 ,7.87 ,7.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44186,CPT,LAPAROSCOPY SURGICAL JEJUNOSTOMY,,,21,,RBRVS,10.38 ,6.05 ,6.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44187,CPT,LAPAROSCOPY SURG ILEOSTOMY/JEJUNOSTOMY NON-TUBE,,,21,,RBRVS,17.40 ,11.16 ,11.16 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44188,CPT,LAPAROSCOPY SURG COLOSTOMY/SKN LVL CECOSTOMY,,,21,,RBRVS,19.35 ,12.02 ,12.02 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44202,CPT,LAPS ENTERECT RESCJ 1 SMALL INTEST RESCJ & ANA,,,21,,RBRVS,23.39 ,11.47 ,11.47 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44203,CPT,LAPAROSCOPY SMALL INTESTINE RESCJ & ANASTOMOSIS,,,21,,RBRVS,4.44 ,1.59 ,1.59 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44204,CPT,LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS,,,21,,RBRVS,26.42 ,12.59 ,12.59 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44205,CPT,LAPS COLECTOMY PRTL W/RMVL TERMINAL ILEUM,,,21,,RBRVS,22.95 ,11.04 ,11.04 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44206,CPT,LAPS COLECTOMY PRTL W/END CLST & CLSR DSTL SGM,,,21,,RBRVS,29.79 ,14.64 ,14.64 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44207,CPT,LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST,,,21,,RBRVS,31.92 ,14.51 ,14.51 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44208,CPT,LAPS COLECTMY PRTL W/COLOPXTSTMY LW ANAST W/CLST,,,21,,RBRVS,33.99 ,16.88 ,16.88 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44210,CPT,LAPS COLECTOMY TOT W/O PRCTECT W/ILEOST/ILEOPXTS,,,21,,RBRVS,30.09 ,15.87 ,15.87 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44211,CPT,LAPS COLCT TTL ABD W/PRCTECT ILEOANAL ANASTOMSIS,,,21,,RBRVS,37.08 ,19.59 ,19.59 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44212,CPT,LAPS COLECTOMY ABDL W/PROCTECTOMY W/ILEOSTOMY,,,21,,RBRVS,34.58 ,18.66 ,18.66 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44213,CPT,LAPS MOBLJ SPLENIC FLXR PFRMD W/PRTL COLECTOMY,,,21,,RBRVS,3.50 ,1.27 ,1.27 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44227,CPT,LAPS CLSR NTRSTM LG/SM INT W/RESCJ & ANASTOMOSIS,,,21,,RBRVS,28.62 ,13.47 ,13.47 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44238,CPT,UNLISTED LAPAROSCOPY PX INTESTINE XCP RECTUM,,,21,,TotalUnits,,,,39.01 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44300,CPT,PLACEMENT ENTEROSTOMY/CECOSTOMY TUBE OPEN,,,21,,RBRVS,13.75 ,7.41 ,7.41 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44310,CPT,ILEOSTOMY/JEJUNOSTOMY NON-TUBE,,,21,,RBRVS,17.59 ,8.94 ,8.94 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44312,CPT,REVJ ILEOSTOMY SIMPLE RLS SUPERFICIAL SCAR SPX,,,21,,RBRVS,9.43 ,5.86 ,5.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44314,CPT,REVJ ILEOSTOMY COMPLIC RCNSTJ IN-DEPTH SPX,,,21,,RBRVS,16.74 ,9.06 ,9.06 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44316,CPT,CONTINENT ILEOSTOMY KOCK PROCEDURE SPX,,,21,,RBRVS,23.59 ,11.72 ,11.72 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44320,CPT,COLOSTOMY/SKIN LEVEL CECOSTOMY,,,21,,RBRVS,19.91 ,10.50 ,10.50 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44322,CPT,COLOSTOMY/SKN LVL CECOSTOMY W/MULT BXS SPX,,,21,,RBRVS,13.32 ,12.41 ,12.41 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44340,CPT,REVJ COLOSTOMY SMPL RLS SUPFC SCAR SPX,,,21,,RBRVS,9.28 ,6.75 ,6.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44345,CPT,REVJ COLOSTOMY COMP RCNSTJ IN-DEPTH SPX,,,21,,RBRVS,17.22 ,9.55 ,9.55 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44346,CPT,REVJ COLOSTOMY W/RPR PARACLST HERNIA SPX,,,21,,RBRVS,19.63 ,10.46 ,10.46 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44360,CPT,ENDOSCOPY UPPER SMALL INTESTINE,,,21,,RBRVS,2.59 ,1.50 ,1.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44361,CPT,ENDOSCOPY UPPER SMALL INTESTINE W/BIOPSY,,,21,,RBRVS,2.87 ,1.63 ,1.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44363,CPT,ENTEROSCOPY > 2ND PRTN W/RMVL FOREIGN BODY,,,21,,RBRVS,3.49 ,1.88 ,1.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44364,CPT,ENTEROSCOPY > 2ND PRTN W/RMVL LESION SNARE,,,21,,RBRVS,3.73 ,2.02 ,2.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44365,CPT,ENTEROSCOPY > 2ND PRTN W/RMVL LESION CAUTERY,,,21,,RBRVS,3.31 ,1.79 ,1.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44366,CPT,ENTEROSCOPY > 2ND PRTN W/CONTROL BLEEDING,,,21,,RBRVS,4.40 ,2.33 ,2.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44369,CPT,ENTEROSCOPY > 2ND PRTN ABLTJ LESION,,,21,,RBRVS,4.51 ,2.38 ,2.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44370,CPT,ENTEROSCOPY > 2ND PRTN TNDSC STENT PLMT,,,21,,RBRVS,4.79 ,2.65 ,2.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44372,CPT,ENTEROSCOPY > 2ND PRTN W/PLMT PRQ TUBE,,,21,,RBRVS,4.40 ,2.26 ,2.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44373,CPT,ENTEROSCOPY > 2ND PRTN CONV GSTRST TUBE,,,21,,RBRVS,3.49 ,1.86 ,1.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44376,CPT,ENTEROSC >2ND PRTN W/ILEUM W/WO COLLJ SPEC SPX,,,21,,RBRVS,5.25 ,2.63 ,2.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44377,CPT,ENTEROSC >2ND PRTN W/ILEUM W/BX SINGLE/MULTIPLE,,,21,,RBRVS,5.52 ,2.80 ,2.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44378,CPT,ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING,,,21,,RBRVS,7.12 ,3.54 ,3.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44379,CPT,ENTEROSCOPY > 2ND PRTN W/ILEUM W/STENT PLMT,,,21,,RBRVS,7.46 ,3.88 ,3.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44380,CPT,ILEOSCOPY THRU STOMA DX W/COLLJ SPEC WHEN PRFMD,,,21,,RBRVS,0.97 ,0.71 ,5.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44381,CPT,ILEOSCOPY STOMA W/BALLOON DILATION,,,21,,RBRVS,1.48 ,0.94 ,26.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44382,CPT,ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE,,,21,,RBRVS,1.27 ,0.86 ,7.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44384,CPT,ILEOSCOPY STOMA W/PLMT OF ENDOSCOPIC STENT,,,21,,RBRVS,2.95 ,1.29 ,1.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44385,CPT,NDSC EVAL INTSTINAL POUCH DX W/COLLJ SPEC SPX,,,21,,RBRVS,1.82 ,1.02 ,5.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44386,CPT,NDSC EVAL INTSTINAL POUCH W/BX SINGLE/MULTIPLE,,,21,,RBRVS,2.12 ,1.23 ,7.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44388,CPT,COLONOSCOPY STOMA DX INCLUDING COLLJ SPEC SPX,,,21,,RBRVS,2.82 ,1.51 ,6.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44389,CPT,COLONOSCOPY STOMA W/BIOPSY SINGLE/MULTIPLE,,,21,,RBRVS,3.13 ,1.69 ,7.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44390,CPT,COLONOSCOPY STOMA W/RMVL FOREIGN BODY,,,21,,RBRVS,3.82 ,2.08 ,8.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44391,CPT,COLONOSCOPY STOMA CONTROL BLEEDING,,,21,,RBRVS,4.31 ,2.25 ,9.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44392,CPT,COLONOSCOPY STOMA RMVL LES BY HOT BIOPSY FORCEPS,,,21,,RBRVS,3.81 ,1.91 ,8.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44394,CPT,COLONOSCOPY STOMA W/RMVL TUM POLYP/OTH LES SNARE,,,21,,RBRVS,4.42 ,2.24 ,9.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44401,CPT,COLONOSCOPY STOMA ABLATION LESION,,,21,,RBRVS,4.44 ,2.17 ,87.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44402,CPT,COLONOSCOPY STOMA W/ENDOSCOPIC STENT PLCMT,,,21,,RBRVS,4.80 ,2.36 ,2.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44403,CPT,COLONOSCOPY STOMA W/ENDOSCOPIC MUCOSAL RESCJ,,,21,,RBRVS,5.60 ,2.64 ,2.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44404,CPT,COLONOSCOPY STOMA W/SUBMUCOSAL INJECTION,,,21,,RBRVS,3.12 ,1.62 ,8.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44405,CPT,COLONOSCOPY STOMA W/BALLOON DILATION,,,21,,RBRVS,3.33 ,1.71 ,13.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44406,CPT,COLONOSCOPY STOMA W/ENDOSCOPIC ULTRASOUND EXAM,,,21,,RBRVS,4.20 ,2.07 ,2.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44407,CPT,COLONOSCOPY STOMA W/US GID NDL ASPIR/BX,,,21,,RBRVS,5.06 ,2.42 ,2.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44408,CPT,COLONOSCOPY THROUGH STOMA WITH DECOMPRESSION,,,21,,RBRVS,4.24 ,2.09 ,2.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44500,CPT,INTRODUCTION LONG GI TUBE SEPARATE PROCEDURE,,,21,,RBRVS,0.49 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44602,CPT,ENTERORRHAPHY 1PERFORATION,,,21,,RBRVS,24.72 ,10.51 ,10.51 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44603,CPT,ENTERORRHAPHY MULTIPLE PERFORATIONS,,,21,,RBRVS,28.16 ,12.45 ,12.45 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44604,CPT,SUTR LG INTESTINE 1/MULT PERFORAT W/O COLOSTOMY,,,21,,RBRVS,18.16 ,8.42 ,8.42 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44605,CPT,SUTR LG INTESTINE 1/MULT PERFORAT W/COLOSTOMY,,,21,,RBRVS,22.08 ,10.83 ,10.83 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44615,CPT,INTSTINAL STRICTUROPLASTY W/WO DILAT OBSTRCJ,,,21,,RBRVS,18.16 ,8.90 ,8.90 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44620,CPT,CLOSURE ENTEROSTOMY LG/SMALL INTESTINE,,,21,,RBRVS,14.43 ,7.67 ,7.67 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44625,CPT,CLSR NTRSTM LG/SM RESCJ & ANAST OTH/THN CLRCT,,,21,,RBRVS,17.28 ,8.74 ,8.74 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44626,CPT,CLSR NTRSTM LG/SM RESCJ & COLORECTAL ANASTOMOSIS,,,21,,RBRVS,27.90 ,12.42 ,12.42 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44640,CPT,CLOSURE INTESTINAL CUTANEOUS FISTULA,,,21,,RBRVS,24.20 ,11.13 ,11.13 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44650,CPT,CLSR ENTEROENTERIC/ENTEROCOLIC FSTL,,,21,,RBRVS,25.12 ,11.43 ,11.43 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44660,CPT,CLSR ENTEROVES FSTL W/O INTSTINAL/BLADDER RESCJ,,,21,,RBRVS,23.91 ,10.53 ,10.53 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44661,CPT,CLSR ENTEROVES FSTL W/INTESTINE&/BLADDER RESCJ,,,21,,RBRVS,27.35 ,12.11 ,12.11 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44680,CPT,INTESTINAL PLICATION SEPARATE PROCEDURE,,,21,,RBRVS,17.96 ,8.89 ,8.89 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44700,CPT,EXCLUSION SM INT FROM PELVIS MESH/PROSTH/TISS,,,21,,RBRVS,17.48 ,8.79 ,8.79 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44701,CPT,INTRAOPERATIVE COLONIC LAVAGE,,,21,,RBRVS,3.10 ,1.12 ,1.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44705,CPT,PREPARE FECAL MICROBIOTA FOR INSTILLATION,,,21,,TotalUnits,,,,0.90 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44720,CPT,BKBENCH RCNSTJ INT ALGRFT VEN ANAST EA,,,21,,RBRVS,5.00 ,1.79 ,1.79 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44721,CPT,BKBENCH RCNSTJ INT ALGRFT ARTL ANAST EA,,,21,,RBRVS,7.00 ,2.50 ,2.50 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44799,CPT,UNLISTED PROCEDURE SMALL INTESTINE,,,21,,TotalUnits,,,,29.76 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44800,CPT,EXC MECKEL'S DIVERTICULUM/OMPHALOMESENTERIC DUCT,,,21,,RBRVS,12.05 ,7.39 ,7.39 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44820,CPT,EXCISION LESION MESENTERY SEPARATE PROCEDURE,,,21,,RBRVS,13.73 ,7.53 ,7.53 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44850,CPT,SUTURE MESENTERY SEPARATE PROCEDURE,,,21,,RBRVS,12.11 ,6.86 ,6.86 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44899,CPT,UNLISTED PX MECKEL'S DIVERTICULUM & MESENTERY,,,21,,TotalUnits,,,,19.44 ,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44900,CPT,INCISION AND DRAINAGE APPENDICEAL ABSCESS OPEN,,,21,,RBRVS,12.57 ,6.84 ,6.84 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44950,CPT,APPENDECTOMY,,,21,,RBRVS,10.60 ,5.51 ,5.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44955,CPT,APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX,,,21,,RBRVS,1.53 ,0.57 ,0.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44960,CPT,APPENDEC RPTD APPENDIX ABSC/PRITONITIS,,,21,,RBRVS,14.50 ,7.39 ,7.39 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
44970,CPT,LAPAROSCOPIC APPENDECTOMY,,,21,,RBRVS,9.45 ,5.71 ,5.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
44979,CPT,UNLISTED LAPAROSCOPY PROCEDURE APPENDIX,,,21,,TotalUnits,,,,15.16 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45000,CPT,TRANSRECTAL DRAINAGE OF PELVIC ABSCESS,,,21,,RBRVS,6.30 ,4.72 ,4.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45005,CPT,I&D SUBMUCOSAL ABSCESS RECTUM,,,21,,RBRVS,2.02 ,2.18 ,5.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45020,CPT,I&D DP SUPRALEVATOR PELVIRCT/RETRORCT ABSC,,,21,,RBRVS,8.56 ,6.16 ,6.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45100,CPT,BX ANORECTAL WALL ANAL APPROACH,,,21,,RBRVS,4.04 ,3.85 ,3.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45108,CPT,ANORECTAL MYOMECTOMY,,,21,,RBRVS,5.12 ,4.30 ,4.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45110,CPT,PRCTECT COMPL CMBN ABDOMINOPRNL W/CLST,,,21,,RBRVS,30.76 ,16.80 ,16.80 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
45111,CPT,PRCTECT PRTL RESCJ RECTUM TABDL APPR,,,21,,RBRVS,18.01 ,9.77 ,9.77 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
45112,CPT,PRCTECT CMBN ABDOMINOPRNL PULL-THRU PX,,,21,,RBRVS,33.18 ,15.34 ,15.34 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
45113,CPT,PRCTECT PRTL W/MUCOSEC ILEOANAL ANAST RSVR,,,21,,RBRVS,33.22 ,16.98 ,16.98 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
45114,CPT,PRCTECT PRTL W/ANAST ABDL & TRANSSAC APPROACH,,,21,,RBRVS,30.79 ,14.52 ,14.52 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
45116,CPT,PRCTECT PRTL W/ANAST TRANSSAC APPR ONLY,,,21,,RBRVS,27.72 ,13.41 ,13.41 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
45119,CPT,PRCTECT CMBN PULL-THRU W/RSVR W/NTRSTM,,,21,,RBRVS,33.48 ,17.06 ,17.06 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
45120,CPT,PRCTECT COMPL W/PULL-THRU PX & ANASTOMOSIS,,,21,,RBRVS,26.40 ,13.36 ,13.36 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
45121,CPT,PRCTECT COMPL W/STOT/TOT COLCT W/MLT BXS,,,21,,RBRVS,29.08 ,14.63 ,14.63 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
45123,CPT,PRCTECT PRTL W/O ANAST PRNL APPR,,,21,,RBRVS,18.86 ,10.31 ,10.31 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
45126,CPT,PELVIC EXENTERATION COLORECTAL MALIGNANCY,,,21,,RBRVS,49.10 ,22.88 ,22.88 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
45130,CPT,EXC RCT PROCIDENTIA W/ANAST PERINEAL APPROACH,,,21,,RBRVS,18.50 ,9.90 ,9.90 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
45135,CPT,EXC RCT PROCIDENTIA W/ANAST ABDL & PRNL APPROACH,,,21,,RBRVS,22.36 ,12.16 ,12.16 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
45136,CPT,EXC ILEOANAL RSVR W/ILEOSTOMY,,,21,,RBRVS,30.82 ,17.22 ,17.22 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
45150,CPT,DIVISION STRICTURE RECTUM,,,21,,RBRVS,5.85 ,3.83 ,3.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45160,CPT,EXC RCT TUM PROCTOTOMY TRANSSAC/TRANSCOCCYGEAL,,,21,,RBRVS,16.33 ,9.36 ,9.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45171,CPT,EXC RCT TUM NOT INCL MUSCULARIS PROPRIA,,,21,,RBRVS,8.13 ,7.65 ,7.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45172,CPT,EXC RCT TUM INCL MUSCULARIS PROPRIA,,,21,,RBRVS,12.13 ,9.13 ,9.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45190,CPT,DESTRUCTION RECTAL TUMOR TRANSANAL APPROACH,,,21,,RBRVS,10.42 ,7.83 ,7.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45300,CPT,PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX,,,21,,RBRVS,0.80 ,0.64 ,2.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45303,CPT,PROCTOSGMDSC RIGID W/DILATION,,,21,,RBRVS,1.50 ,0.90 ,25.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45305,CPT,PROCTOSGMDSC RIGID W/BX SINGLE/MULTIPLE,,,21,,RBRVS,1.25 ,0.82 ,4.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45307,CPT,PROCTOSGMDSC RIGID W/RMVL FOREIGN BODY,,,21,,RBRVS,1.70 ,0.98 ,4.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45308,CPT,PROCTOSGMDSC RIGID RMVL 1 LESION CAUTERY,,,21,,RBRVS,1.40 ,0.86 ,4.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45309,CPT,PROCTOSGMDSC RIGID RMVL 1 LESION SNARE TQ,,,21,,RBRVS,1.50 ,0.90 ,4.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45315,CPT,PROCTOSGMDSC RIGID RMVL MULT TUMOR CAUTERY/SNARE,,,21,,RBRVS,1.80 ,1.01 ,4.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45317,CPT,PROCTOSGMDSC RIGID CONTROL BLEEDING,,,21,,RBRVS,2.00 ,1.09 ,4.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45320,CPT,PROCTOSGMDSC RIGID ABLATION LESION,,,21,,RBRVS,1.78 ,1.00 ,4.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45321,CPT,PROCTOSGMDSC RIGID DCMPRN VOLVULUS,,,21,,RBRVS,1.75 ,1.02 ,1.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45327,CPT,PROCTOSGMDSC RIGID TNDSC STENT PLMT,,,21,,RBRVS,2.00 ,1.24 ,1.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45330,CPT,SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD,,,21,,RBRVS,0.96 ,0.72 ,2.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45331,CPT,SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE,,,21,,RBRVS,1.15 ,0.84 ,3.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45332,CPT,SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY,,,21,,RBRVS,1.79 ,1.10 ,6.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45333,CPT,SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS,,,21,,RBRVS,1.79 ,1.09 ,6.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45334,CPT,SIGMOIDOSCOPY FLX CONTROL BLEEDING,,,21,,RBRVS,2.10 ,1.23 ,14.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45335,CPT,SGMDSC FLX DIRED SBMCSL NJX ANY SBST,,,21,,RBRVS,1.46 ,0.96 ,6.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45337,CPT,SGMDSC FLX W/DCMPRN W/PLMT DCMPRN TUBE,,,21,,RBRVS,2.36 ,1.36 ,1.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45338,CPT,SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ,,,21,,RBRVS,2.34 ,1.35 ,6.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45340,CPT,SIGMOIDOSCOPY FLX TNDSC BALO DILAT,,,21,,RBRVS,1.89 ,1.14 ,11.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45341,CPT,SIGMOIDOSCOPY FLX NDSC US XM,,,21,,RBRVS,2.60 ,1.49 ,1.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45342,CPT,SIGMOIDOSCOPY FLX TNDSC US GID NDL ASPIR/BX,,,21,,RBRVS,4.05 ,2.17 ,2.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45346,CPT,SIGMOIDOSCOPY FLX ABLATION TUMOR POLYP/OTH LES,,,21,,RBRVS,2.91 ,1.55 ,85.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45347,CPT,SIGMOIDOSCOPY FLX PLACEMENT OF ENDOSCOPIC STENT,,,21,,RBRVS,2.82 ,1.49 ,1.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45349,CPT,SGMDSC FLX WITH ENDOSCOPIC MUCOSAL RESECTION,,,21,,RBRVS,3.62 ,1.83 ,1.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45350,CPT,SIGMOIDOSCOPY FLX WITH WITH BAND LIGATION(S),,,21,,RBRVS,1.78 ,1.06 ,14.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45378,CPT,COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD,,,21,,RBRVS,3.69 ,1.94 ,6.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45379,CPT,COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S),,,21,,RBRVS,4.68 ,2.38 ,8.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45380,CPT,COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE,,,21,,RBRVS,4.43 ,2.31 ,8.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45381,CPT,COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST,,,21,,RBRVS,4.19 ,2.20 ,8.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45382,CPT,COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD,,,21,,RBRVS,5.68 ,2.89 ,10.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45384,CPT,COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS,,,21,,RBRVS,4.69 ,2.33 ,7.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45385,CPT,COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ,,,21,,RBRVS,5.30 ,2.69 ,8.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45386,CPT,COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT,,,21,,RBRVS,4.57 ,2.33 ,13.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45388,CPT,COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES,,,21,,RBRVS,4.98 ,2.42 ,87.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45389,CPT,COLONOSCOPY FLX WITH ENDOSCOPIC STENT PLACEMENT,,,21,,RBRVS,5.34 ,2.60 ,2.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45390,CPT,COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION,,,21,,RBRVS,6.14 ,2.87 ,2.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45391,CPT,COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX,,,21,,RBRVS,5.09 ,2.62 ,2.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45392,CPT,COLSC FLX W/US GUID NDL ASPIR/BX W/US RCTM ET AL,,,21,,RBRVS,6.54 ,3.25 ,3.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45393,CPT,COLONOSCOPY FLEXIBLE WITH DECOMPRESSION,,,21,,RBRVS,4.78 ,2.12 ,2.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45395,CPT,LAPS PROCTECTOMY ABDOMINOPERINEAL W/COLOSTOMY,,,21,,RBRVS,33.00 ,18.38 ,18.38 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
45397,CPT,LAPS PROCTECTOMY COMBINED PULL-THRU W/RESERVOIR,,,21,,RBRVS,36.50 ,19.68 ,19.68 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
45398,CPT,COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S),,,21,,RBRVS,4.30 ,2.11 ,15.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45399,CPT,UNLISTED PROCEDURE COLON,,,21,,TotalUnits,,,,7.01 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45400,CPT,LAPAROSCOPY PROCTOPEXY PROLAPSE,,,21,,RBRVS,19.44 ,10.25 ,10.25 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
45402,CPT,LAPAROSCOPY PROCTOPEXY PROLAPSE SIGMOID RESCJ,,,21,,RBRVS,26.51 ,12.85 ,12.85 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
45499,CPT,UNLISTED LAPAROSCOPY PROCEDURE RECTUM,,,21,,TotalUnits,,,,51.38 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45500,CPT,PROCTOPLASTY STENOSIS,,,21,,RBRVS,7.73 ,6.37 ,6.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45505,CPT,PROCTOPLASTY PROLAPSE MUCOUS MEMBRANE,,,21,,RBRVS,8.36 ,7.22 ,7.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45520,CPT,PERIRECTAL INJ SCLEROSING SOLUTION PROLAPSE,,,21,,RBRVS,0.55 ,0.55 ,3.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45540,CPT,PROCTOPEXY ABDOMINAL APPROACH,,,21,,RBRVS,18.12 ,9.35 ,9.35 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
45541,CPT,PROCTOPEXY PERINEAL APPROACH,,,21,,RBRVS,14.85 ,9.31 ,9.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45550,CPT,PROCTOPEXY W/SIGMOID RESCJ ABDL APPR,,,21,,RBRVS,24.80 ,13.08 ,13.08 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
45560,CPT,REPAIR RECTOCELE SEPARATE PROCEDURE,,,21,,RBRVS,11.50 ,6.84 ,6.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45562,CPT,EXPL RPR & PRESACRAL DRG RECTAL INJURY,,,21,,RBRVS,17.98 ,10.82 ,10.82 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
45563,CPT,EXPL RPR & PRESACRAL DRG RECTAL INJ W/COLOSTOMY,,,21,,RBRVS,26.38 ,15.04 ,15.04 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
45800,CPT,CLOSURE RECTOVESICAL FISTULA,,,21,,RBRVS,20.31 ,10.65 ,10.65 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
45805,CPT,CLSR RECTOVESICAL FISTULA W/COLOSTOMY,,,21,,RBRVS,23.32 ,13.45 ,13.45 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
45820,CPT,CLOSURE RECTOURETHRAL FISTULA,,,21,,RBRVS,20.37 ,9.76 ,9.76 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
45825,CPT,CLOSURE RECTOURETHRAL FISTULA W/COLOSTOMY,,,21,,RBRVS,24.17 ,14.39 ,14.39 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
45900,CPT,RDCTJ PROCIDENTIA UNDER ANES SEPARATE PROCEDURE,,,21,,RBRVS,2.99 ,2.30 ,2.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45905,CPT,DILAT ANAL SPHNCTR SPX UNDER ANES OTH/THN LOCAL,,,21,,RBRVS,2.35 ,2.10 ,2.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45910,CPT,DILAT RCT STRIX SPX UNDER ANES OTH/THN LOCAL,,,21,,RBRVS,2.85 ,2.29 ,2.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45915,CPT,RMVL FECAL IMPACTION/FB SPX UNDER ANES,,,21,,RBRVS,3.19 ,2.87 ,5.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45990,CPT,ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX,,,21,,RBRVS,1.80 ,0.98 ,0.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
45999,CPT,UNLISTED PROCEDURE RECTUM,,,21,,TotalUnits,,,,7.01 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46020,CPT,PLACEMENT SETON,,,21,,RBRVS,3.00 ,3.20 ,4.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46030,CPT,REMOVAL ANAL SETON OTHER MARKER,,,21,,RBRVS,1.26 ,1.12 ,2.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46040,CPT,I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX,,,21,,RBRVS,5.37 ,5.45 ,8.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46045,CPT,I&D INTRAMURAL IM/ABSC TRANSANAL ANES,,,21,,RBRVS,5.87 ,5.44 ,5.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46050,CPT,I&D PERIANAL ABSCESS SUPERFICIAL,,,21,,RBRVS,1.24 ,1.34 ,4.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46060,CPT,I&D ISCHIORCT/INTRAMURAL ABSC W/WO SETON,,,21,,RBRVS,6.37 ,6.16 ,6.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46070,CPT,INCISION ANAL SEPTUM INFANT,,,21,,RBRVS,2.79 ,3.35 ,3.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46080,CPT,SPHINCTEROTOMY ANAL DIVISION SPHINCTER SPX,,,21,,RBRVS,2.52 ,1.57 ,4.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46083,CPT,INCISION THROMBOSED HEMORRHOID EXTERNAL,,,21,,RBRVS,1.45 ,1.37 ,3.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46200,CPT,FISSURECTOMY INCL SPHINCTEROTOMY WHEN PERFORMED,,,21,,RBRVS,3.59 ,5.12 ,8.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46220,CPT,EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS,,,21,,RBRVS,1.61 ,1.52 ,3.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46221,CPT,HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS,,,21,,RBRVS,2.36 ,2.80 ,5.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46230,CPT,EXCISION MULTIPLE EXTERNAL PAPILLAE/TAGS ANUS,,,21,,RBRVS,2.62 ,1.90 ,4.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46250,CPT,HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP,,,21,,RBRVS,4.25 ,3.96 ,8.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46255,CPT,HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP,,,21,,RBRVS,4.96 ,4.25 ,8.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46257,CPT,HEMORRHOID NTRNL & XTRNL 1 COLUMN W/FISSURECTO,,,21,,RBRVS,5.76 ,5.27 ,5.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46258,CPT,HRHC 1 COL/GRP W/FSTULECTMY INCL FSSRECTOMY,,,21,,RBRVS,6.41 ,5.48 ,5.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46260,CPT,HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO,,,21,,RBRVS,6.73 ,5.65 ,5.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46261,CPT,HRHC NTRNL & XTRNL 2/> COLUMN/GROUP W/FISSU,,,21,,RBRVS,7.76 ,5.90 ,5.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46262,CPT,HRHC 2/> COL/GRP W/FSTULECTMY INCL FSSRECTMY,,,21,,RBRVS,7.91 ,6.61 ,6.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46270,CPT,SURG TX ANAL FISTULA SUBQ,,,21,,RBRVS,4.92 ,5.36 ,8.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46275,CPT,SURG TX ANAL FISTULA INTERSPHINCTERIC,,,21,,RBRVS,5.42 ,5.54 ,9.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46280,CPT,TX ANAL FSTL TRANS/SUPRA/XTRASPHNCTRC INCL SETON,,,21,,RBRVS,6.39 ,6.03 ,6.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46285,CPT,SURG TX ANAL FISTULA 2ND STAGE,,,21,,RBRVS,5.42 ,5.53 ,8.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46288,CPT,CLSR ANAL FSTL W/RCT ADVMNT FLAP,,,21,,RBRVS,7.81 ,6.68 ,6.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46320,CPT,EXC THROMBOSED HEMORRHOID XTRNL,,,21,,RBRVS,1.64 ,1.26 ,3.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46500,CPT,INJECTION SCLEROSING SOLUTION HEMORRHOIDS,,,21,,RBRVS,1.69 ,1.77 ,4.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46505,CPT,CHEMODENERVATION INTERNAL ANAL SPHINCTER,,,21,,RBRVS,3.18 ,3.13 ,4.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46600,CPT,ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD,,,21,,RBRVS,0.55 ,0.55 ,1.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46601,CPT,ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT,,,21,,RBRVS,1.60 ,0.98 ,2.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46604,CPT,ANOSCOPY W/DILATION,,,21,,RBRVS,1.03 ,0.73 ,16.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46606,CPT,ANOSCOPY W/BX SINGLE/MULTIPLE,,,21,,RBRVS,1.20 ,0.81 ,5.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46607,CPT,ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT W/BX,,,21,,RBRVS,2.20 ,1.23 ,3.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46608,CPT,ANOSCOPY W/RMVL FOREIGN BODY,,,21,,RBRVS,1.30 ,0.83 ,5.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46610,CPT,ANOSCOPY W/RMVL LESION CAUTERY,,,21,,RBRVS,1.28 ,0.81 ,4.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46611,CPT,ANOSC RMVL 1 TUM POLYP/OTH LES SNARE TQ,,,21,,RBRVS,1.30 ,0.84 ,3.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46612,CPT,ANOSC RMVL MULT TUMORS CAUTERY/SNARE,,,21,,RBRVS,1.50 ,0.90 ,5.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46614,CPT,ANOSCOPY CONTROL BLEEDING,,,21,,RBRVS,1.00 ,0.72 ,2.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46615,CPT,ANOSCOPY ABLATION LESION,,,21,,RBRVS,1.50 ,0.91 ,2.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46700,CPT,ANOPLASTY PLASTIC OPERATION STRICTURE ADULT,,,21,,RBRVS,9.81 ,7.43 ,7.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46705,CPT,ANOPLASTY PLASTIC OPERATION STRICTURE INFANT,,,21,,RBRVS,7.43 ,5.97 ,5.97 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
46706,CPT,REPAIR ANAL FISTULA W/FIBRIN GLUE,,,21,,RBRVS,2.44 ,2.05 ,2.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46707,CPT,REPAIR ANORECTAL FISTULA PLUG,,,21,,RBRVS,6.39 ,5.98 ,5.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46710,CPT,RPR ILEOANAL POUCH FSTL/POUCH ADVMNT TPRNL APPR,,,21,,RBRVS,17.14 ,10.79 ,10.79 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
46712,CPT,RPR ILEOANAL POUCH FSTL/POUCH ADVMNT CMBN APPR,,,21,,RBRVS,36.45 ,18.85 ,18.85 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
46715,CPT,RPR LW IMPERFORATE ANUS W/ANOPRNL FSTL CUT-BK,,,21,,RBRVS,7.62 ,6.16 ,6.16 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
46716,CPT,RPR LW IMPERFORATE ANUS W/TRPOS FISTULA,,,21,,RBRVS,17.54 ,12.02 ,12.02 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
46730,CPT,RPR HI IMPRF ANUS W/O FSTL PRNL/SACROPRNL APPR,,,21,,RBRVS,30.65 ,18.72 ,18.72 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
46735,CPT,RPR HI IMPRF ANUS W/O FISTULA CMBN APPR,,,21,,RBRVS,36.14 ,19.83 ,19.83 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
46740,CPT,RPR HI IMPRF ANUS W/FSTL PRNL/SACROPRNL APPR,,,21,,RBRVS,33.90 ,19.98 ,19.98 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
46742,CPT,RPR HI IMPRF ANUS W/FSTL TABDL & SACROPRNL,,,21,,RBRVS,40.14 ,21.36 ,21.36 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
46744,CPT,RPR CLOACAL ANOMALY SACROPERINEAL,,,21,,RBRVS,58.94 ,28.88 ,28.88 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
46746,CPT,RPR CLOACAL ANOMALY CMBN ABDL&SACROPRNL,,,21,,RBRVS,65.44 ,27.74 ,27.74 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
46748,CPT,RPR CLOACAL ANOMALY CMBN ABDL & SACROPRNL W/GRF,,,21,,RBRVS,71.42 ,33.41 ,33.41 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
46750,CPT,SPHNCTROP ANAL INCONTINENCE/PROLAPSE ADULT,,,21,,RBRVS,12.15 ,7.82 ,7.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46751,CPT,SPHNCTROP ANAL INCONTINENCE/PROLAPSE CHLD,,,21,,RBRVS,9.30 ,6.61 ,6.61 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
46753,CPT,GRAFT THIERSCH RCT INCONTINENCE &/PROLAPSE,,,21,,RBRVS,8.89 ,6.57 ,6.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46754,CPT,RMVL THIERSCH WIRE/SUTURE ANAL CANAL,,,21,,RBRVS,3.01 ,3.33 ,5.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46760,CPT,SPHINCTEROPLASTY ANAL MUSCLE TRANSPLANT,,,21,,RBRVS,17.45 ,11.77 ,11.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46761,CPT,SPHNCTROP ANAL LEVATOR MUSC IMBRCJ,,,21,,RBRVS,15.29 ,9.20 ,9.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46762,CPT,SPHNCTROP ANAL IMPLTJ ARTIF SPHNCTR,,,21,,RBRVS,14.82 ,9.83 ,9.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46900,CPT,DSTRJ LESION ANUS SIMPLE CHEMICAL,,,21,,RBRVS,1.91 ,1.78 ,4.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46910,CPT,DSTRJ LESION ANUS SMPL ELTRDSICCATION,,,21,,RBRVS,1.91 ,1.62 ,5.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46916,CPT,DSTRJ LESION ANUS SIMPLE CRYOSURGERY,,,21,,RBRVS,1.91 ,1.96 ,4.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46917,CPT,DSTRJ LESION ANUS SIMPLE LASER SURG,,,21,,RBRVS,1.91 ,1.64 ,10.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46922,CPT,DSTRJ LESION ANUS SIMPLE SURG EXCISION,,,21,,RBRVS,1.91 ,1.65 ,5.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46924,CPT,DSTRJ LESION ANUS EXTENSIVE,,,21,,RBRVS,2.81 ,2.06 ,12.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46930,CPT,DESTRUCTION INTERNAL HEMORRHOID THERMAL ENERGY,,,21,,RBRVS,1.61 ,2.43 ,4.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46940,CPT,CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX 1ST,,,21,,RBRVS,2.35 ,1.52 ,3.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46942,CPT,CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX SBSQ,,,21,,RBRVS,2.07 ,1.43 ,3.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46945,CPT,HRHC NTRNL LIG OTH THAN RBBR BAND 1 COL/GRP,,,21,,RBRVS,2.21 ,3.87 ,6.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46946,CPT,HRHC NTRNL LIG OTH THAN RBBR BAND 2/> COL/GRP,,,21,,RBRVS,2.63 ,3.41 ,5.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46947,CPT,HEMORRHOIDOPEXY STAPLING,,,21,,RBRVS,5.57 ,4.26 ,4.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
46999,CPT,UNLISTED PROCEDURE ANUS,,,21,,TotalUnits,,,,6.26 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47000,CPT,BIOPSY LIVER NEEDLE PERCUTANEOUS,,,21,,RBRVS,1.90 ,0.91 ,8.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47001,CPT,BX LVR NDL DONE PURPOSE TM OTH MAJOR PX,,,21,,RBRVS,1.90 ,0.67 ,0.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47010,CPT,HEPATOTOMY OPEN DRAINAGE ABSCESS/CYST 1/2 STAGES,,,21,,RBRVS,19.40 ,10.99 ,10.99 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47015,CPT,LAPT W/ASPIR &/NJX HEPATC PARASITIC CYST/ABSCESS,,,21,,RBRVS,18.50 ,10.70 ,10.70 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47100,CPT,BIOPSY LIVER WEDGE,,,21,,RBRVS,12.91 ,8.53 ,8.53 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47120,CPT,HEPATECTOMY RESCJ PARTIAL LOBECTOMY,,,21,,RBRVS,39.01 ,19.24 ,19.24 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47122,CPT,HEPATECTOMY RESCJ TRISEGMENTECTOMY,,,21,,RBRVS,59.48 ,25.81 ,25.81 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47125,CPT,HEPATECTOMY RESCJ TOTAL LEFT LOBECTOMY,,,21,,RBRVS,53.04 ,23.44 ,23.44 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47130,CPT,HEPATECTOMY RESCJ TOTAL RIGHT LOBECTOMY,,,21,,RBRVS,57.19 ,24.84 ,24.84 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47135,CPT,LVR ALTRNSPLJ ORTHOTOPIC PRTL/WHL DON ANY AGE,,,21,,RBRVS,83.64 ,38.24 ,38.24 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47140,CPT,DONOR HEPATECTOMY LIVING DONOR SEG II & III,,,21,,RBRVS,59.40 ,29.28 ,29.28 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47141,CPT,DONOR HEPATECTOMY LIVING DONOR SEG II III & IV,,,21,,RBRVS,71.50 ,34.89 ,34.89 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47142,CPT,DONOR HEPATECTOMY LIVING DONOR SEG V VI VII &VI,,,21,,RBRVS,79.44 ,37.73 ,37.73 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47143,CPT,BKBENCH PREP CADAVER DONOR,,,21,,TotalUnits,,,,22.65 ,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47146,CPT,BKBENCH RCNSTJ LVR GRF VENOUS ANAST EA,,,21,,RBRVS,6.00 ,2.14 ,2.14 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47147,CPT,BKBENCH RCNSTJ LVR GRF ARTL ANAST EA,,,21,,RBRVS,7.00 ,2.50 ,2.50 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47300,CPT,MARSUPIALIZATION CST/ABSC LVR,,,21,,RBRVS,18.14 ,10.42 ,10.42 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47350,CPT,MGMT LVR HEMRRG SMPL SUTR LVR WND/INJ,,,21,,RBRVS,22.49 ,11.96 ,11.96 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47360,CPT,MGMT LVR HEMRRG CPLX SUTR WND/INJ,,,21,,RBRVS,31.31 ,15.30 ,15.30 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47361,CPT,MGMT LVR HEMRRG EXPL WND DBRDMT COAGJ/SUTR,,,21,,RBRVS,52.60 ,23.15 ,23.15 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47362,CPT,MGMT LVR HEMRRG RE-EXPL WND RMVL PACKING,,,21,,RBRVS,23.54 ,12.80 ,12.80 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47370,CPT,LAPS SURG ABLTJ 1/> LVR TUM RF,,,21,,RBRVS,20.80 ,10.40 ,10.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47371,CPT,LAPS SURG ABLTJ 1 > LVR TUM CRYOSURG,,,21,,RBRVS,20.80 ,10.59 ,10.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47379,CPT,UNLIS LAPAROSCOPIC PROCEDURE LIVER,,,21,,TotalUnits,,,,31.20 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47380,CPT,ABLTJ OPN 1/> LVR TUM RF,,,21,,RBRVS,24.56 ,11.58 ,11.58 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47381,CPT,ABLTJ OPN 1/> LVR TUM CRYOSURG,,,21,,RBRVS,24.88 ,11.60 ,11.60 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47382,CPT,ABLTJ 1/> LVR TUM PRQ RF,,,21,,RBRVS,15.22 ,5.73 ,125.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47383,CPT,ABLATION 1/> LIVER TUMOR PERQ CRYOABLATION,,,21,,RBRVS,9.13 ,3.82 ,205.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47399,CPT,UNLISTED PROCEDURE LIVER,,,21,,TotalUnits,,,,3.22 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47400,CPT,HEPATCOTOMY/HEPATCOSTOMY W/EXPL DRG/RMVL ST1,,,21,,RBRVS,36.36 ,17.36 ,17.36 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47420,CPT,CHOLEDOCHOT/OST W/O SPHNCTROTOMY/SPHNCTROP,,,21,,RBRVS,22.03 ,11.63 ,11.63 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47425,CPT,CHOLEDOCHOT/OST W/SPHNCTROTOMY/SPHNCTROP,,,21,,RBRVS,22.31 ,11.91 ,11.91 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47460,CPT,TRANSDUOL SPHINCTEROT/PLASTY W/WO RMVL CALCULUS,,,21,,RBRVS,20.52 ,11.27 ,11.27 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47480,CPT,CHOLECSTOT/CHOLECSTOST W/EXPL DRG/RMVL ST1 SPX,,,21,,RBRVS,13.25 ,8.98 ,8.98 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47490,CPT,CHOLECYSTOSTOMY PRQ W/IMAGING & CATHETER PLMT,,,21,,RBRVS,4.76 ,4.39 ,4.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47531,CPT,NJX CHOLANGIO PRQ W/IMG GID RS&I EXISTING ACCESS,,,21,,RBRVS,1.80 ,0.81 ,8.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47532,CPT,NJX CHOLANGIO PRQ W/IMG GID RS&I NEW ACCESS,,,21,,RBRVS,4.25 ,1.57 ,18.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47533,CPT,PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I EXTERNL,,,21,,RBRVS,6.00 ,2.16 ,31.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47534,CPT,PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I INT-EXT,,,21,,RBRVS,8.03 ,2.78 ,37.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47535,CPT,CONV EXT BIL DRG CATH TO INT-EXT BIL DRG CATH,,,21,,RBRVS,4.50 ,1.68 ,26.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47536,CPT,EXCHANGE BILIARY DRG CATHETER PRQ W/IMG GID RS&I,,,21,,RBRVS,2.88 ,1.14 ,19.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47537,CPT,REMOVAL BILIARY DRG CATHETER REQ FLUOR GID RS&I,,,21,,RBRVS,1.83 ,0.82 ,9.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47538,CPT,PLMT BILE DUCT STENT PRQ EXISTING ACCESS,,,21,,RBRVS,6.60 ,2.35 ,120.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47539,CPT,PLMT BILE DUCT STENT PRQ NEW ACCESS W/O SEP CATH,,,21,,RBRVS,9.00 ,3.09 ,129.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47540,CPT,PLMT BILE DUCT STENT PRQ NEW ACCESS W/SEP CATH,,,21,,RBRVS,10.75 ,3.69 ,133.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47541,CPT,PLMT ACCESS THRU BILIARY TREE INTO SMALL BWL NEW,,,21,,RBRVS,5.61 ,2.01 ,27.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47542,CPT,BALLOON DILAT BILIARY DUCT/AMPULLA PRQ EACH DUCT,,,21,,RBRVS,2.50 ,0.78 ,11.56 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
47543,CPT,ENDOLUMINAL BX BILIARY TREE PRQ ANY METH SNG/MLT,,,21,,RBRVS,3.07 ,1.08 ,33.88 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
47544,CPT,REMOVAL BILIARY DUCT &/GLBLDR CALCULI PERQ RS&I,,,21,,RBRVS,4.29 ,1.40 ,18.30 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
47550,CPT,BILIARY NDSC INTRAOPERATIVE,,,21,,RBRVS,3.02 ,1.08 ,1.08 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47552,CPT,BILIARY ENDO PRQ T-TUBE DX W/COLLECT SPEC BRUSH,,,21,,RBRVS,6.03 ,2.46 ,2.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47553,CPT,BILIARY NDSC PRQ T-TUBE W/BX SINGLE/MULTIPLE,,,21,,RBRVS,6.34 ,2.08 ,2.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47554,CPT,BILIARY ENDOSCOPY PRQ VIA T-TUBE W/RMVL CALCULUS,,,21,,RBRVS,9.05 ,3.61 ,3.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47555,CPT,BILIARY NDSC PRQ T-TUBE W/DIL DUCT W/O STENT,,,21,,RBRVS,7.55 ,2.45 ,2.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47556,CPT,BILIARY NDSC PRQ T-TUBE DILAT STRIX W/STENT,,,21,,RBRVS,8.55 ,2.83 ,2.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47562,CPT,LAPAROSCOPY SURG CHOLECYSTECTOMY,,,21,,RBRVS,10.47 ,6.09 ,6.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47563,CPT,LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY,,,21,,RBRVS,11.47 ,6.48 ,6.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47564,CPT,LAPS SURG CHOLECSTC W/EXPL COMMON DUCT,,,21,,RBRVS,18.00 ,9.94 ,9.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47570,CPT,LAPAROSCOPY SURG CHOLECYSTOENETEROSTOMY,,,21,,RBRVS,12.56 ,6.87 ,6.87 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47579,CPT,UNLISTED LAPAROSCOPY PROCEDURE BILIARY TRACT,,,21,,TotalUnits,,,,16.56 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
47600,CPT,CHOLECYSTECTOMY,,,21,,RBRVS,17.48 ,9.33 ,9.33 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47605,CPT,CHOLECYSTECTOMY W/CHOLANGIOGRAPHY,,,21,,RBRVS,18.48 ,9.67 ,9.67 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47610,CPT,CHOLECYSTECTOMY W/EXPLORATION COMMON DUCT,,,21,,RBRVS,20.92 ,10.48 ,10.48 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47612,CPT,CHOLECYSTECTOMY EXPL DUCT CHOLEDOCHOENTEROSTOMY,,,21,,RBRVS,21.21 ,10.56 ,10.56 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47620,CPT,CHOLECSTC EXPL DUX SPHNCTROTOMY/SPHNCTROP,,,21,,RBRVS,23.07 ,11.33 ,11.33 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47700,CPT,EXPL CONGENITAL ATRESIA BILE DUCTS,,,21,,RBRVS,16.50 ,9.98 ,9.98 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47701,CPT,PORTOENETEROSTOMY,,,21,,RBRVS,28.73 ,14.63 ,14.63 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47711,CPT,EXC BILE DUX TUM W/WO PRIM RPR XTRHEPATC,,,21,,RBRVS,25.90 ,12.98 ,12.98 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47712,CPT,EXC BILE DUX TUM W/WO PRIM RPR INTRAHEPATC,,,21,,RBRVS,33.72 ,16.12 ,16.12 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47715,CPT,EXCISION CHOLEDOCHAL CYST,,,21,,RBRVS,21.55 ,11.79 ,11.79 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47720,CPT,CHOLECYSTOENTEROSTOMY DIRECT,,,21,,RBRVS,18.34 ,10.66 ,10.66 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47721,CPT,CHOLECYSTOENTEROSTOMY W/GASTROENTEROSTOMY,,,21,,RBRVS,21.99 ,11.95 ,11.95 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47740,CPT,CHOLECYSTOENTEROSTOMY ROUX-EN-Y,,,21,,RBRVS,21.23 ,11.68 ,11.68 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47741,CPT,CHOLECSTONTRSTM ROUX-EN-Y W/GASTRONTRSTM,,,21,,RBRVS,24.21 ,12.74 ,12.74 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47760,CPT,ANAST XTRHEPATC BILIARY DUCTS & GI TRACT,,,21,,RBRVS,38.32 ,17.99 ,17.99 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47765,CPT,ANAST INTRAHEPATC DUCTS & GI TRACT,,,21,,RBRVS,52.19 ,23.42 ,23.42 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47780,CPT,ANAST ROUX-EN-Y XTRHEPATC BILIARY DUCTS & GI,,,21,,RBRVS,42.32 ,19.27 ,19.27 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47785,CPT,ANAST ROUX-EN-Y INTRAHEPATC BILIARY DUCTS & GI,,,21,,RBRVS,56.19 ,24.62 ,24.62 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47800,CPT,RCNSTJ PLSTC BILIARY DUCTS W/END-TO-END ANAST,,,21,,RBRVS,26.17 ,13.39 ,13.39 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47801,CPT,PLACEMENT CHOLEDOCHAL STENT,,,21,,RBRVS,17.60 ,8.93 ,8.93 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47802,CPT,U-TUBE HEPATICOENTEROSTOMY,,,21,,RBRVS,24.93 ,13.29 ,13.29 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47900,CPT,SUTURE EXTRAHEPATIC BILE DUCT PRE-EXIST INJURY,,,21,,RBRVS,22.44 ,12.02 ,12.02 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
47999,CPT,UNLISTED PROCEDURE BILIARY TRACT,,,21,,TotalUnits,,,,16.56 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
48000,CPT,PLACE DRAIN PERIPANCREATIC ACUTE PANCREATITIS,,,21,,RBRVS,31.95 ,14.87 ,14.87 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
48001,CPT,PLACE DRAIN PERIPANCREATIC W/CHOLECYSTOSTOMY,,,21,,RBRVS,39.69 ,17.75 ,17.75 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
48020,CPT,REMOVAL PANCREATIC CALCULUS,,,21,,RBRVS,19.09 ,10.42 ,10.42 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
48100,CPT,BIOPSY PANCREAS OPEN,,,21,,RBRVS,14.46 ,7.79 ,7.79 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
48102,CPT,BIOPSY PANCREA PERCUTANEOUS NEEDLE,,,21,,RBRVS,4.70 ,1.90 ,10.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
48105,CPT,RESECJ/DBRDMT PANCREAS NECROTIZING PANCREATITIS,,,21,,RBRVS,49.26 ,21.81 ,21.81 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
48120,CPT,EXCISION LESION PANCREAS,,,21,,RBRVS,18.41 ,9.35 ,9.35 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
48140,CPT,PNCRTECT DSTL STOT W/O PNCRTCOJEJUNOSTOMY,,,21,,RBRVS,26.32 ,12.74 ,12.74 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
48145,CPT,PNCRTECT DSTL STOT W/PNCRTCOJEJUNOSTOMY,,,21,,RBRVS,27.39 ,13.37 ,13.37 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
48146,CPT,PNCRTECT DSTL NR-TOT W/PRSRV DUO CHLD-TYP PX,,,21,,RBRVS,30.60 ,16.49 ,16.49 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
48148,CPT,EXCISION AMPULLA VATER,,,21,,RBRVS,20.39 ,10.87 ,10.87 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
48150,CPT,PNCRTECT PROX STOT W/PANCREATOJEJUNOSTOMY,,,21,,RBRVS,52.84 ,24.72 ,24.72 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
48152,CPT,PNCRTECT WHIPPLE W/O PANCREATOJEJUNOSTOMY,,,21,,RBRVS,48.65 ,23.34 ,23.34 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
48153,CPT,PNCRTECT W/PANCREATOJEJUNOSTOMY,,,21,,RBRVS,52.79 ,24.39 ,24.39 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
48154,CPT,PNCRTECT PROX STOT W/O PANCREATOJEJUNOSTOMY,,,21,,RBRVS,48.88 ,23.43 ,23.43 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
48155,CPT,PANCREATECTOMY TOTAL,,,21,,RBRVS,29.45 ,16.09 ,16.09 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
48160,CPT,PANCREATECTOMY W/TRNSPLJ PANCREAS/ISLET CELLS,,,21,,RBRVS,44.20 ,37.51 ,37.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
48400,CPT,INJECTION INTRAOPERATIVE PANCREATOGRAPHY,,,21,,RBRVS,1.95 ,0.70 ,0.70 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
48500,CPT,MARSUPIALIZATION PANCREATIC CYST,,,21,,RBRVS,18.16 ,10.79 ,10.79 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
48510,CPT,EXTERNAL DRAINAGE PSEUDOCYST OF PANCREAS OPEN,,,21,,RBRVS,17.19 ,10.45 ,10.45 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
48520,CPT,INT ANAST PANCREATIC CYST GI TRACT DIRECT,,,21,,RBRVS,18.15 ,9.36 ,9.36 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
48540,CPT,INT ANAST PANCREATIC CYST GI TRACT ROUX-EN-Y,,,21,,RBRVS,21.94 ,10.77 ,10.77 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
48545,CPT,PANCREATORRHAPHY INJURY,,,21,,RBRVS,22.23 ,11.40 ,11.40 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
48547,CPT,DUOL EXCLUSION W/GASTROJEJUNOSTOMY PNCRTC INJ,,,21,,RBRVS,30.38 ,14.32 ,14.32 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
48548,CPT,PANCREATICOJEJUNOSTOMY SIDE-TO-SIDE ANAST,,,21,,RBRVS,28.09 ,13.52 ,13.52 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
48552,CPT,BKBENCH RCNSTJ CDVR PNCRS ALGRFT VEN ANAST EA,,,21,,RBRVS,4.30 ,1.54 ,1.54 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
48554,CPT,TRANSPLANTATION PANCREATIC ALLOGRAFT,,,21,,RBRVS,37.80 ,27.32 ,27.32 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
48556,CPT,RMVL TRANSPLANTED PANCREATIC ALLOGRAFT,,,21,,RBRVS,19.47 ,12.72 ,12.72 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
48999,CPT,UNLISTED PROCEDURE PANCREAS,,,21,,TotalUnits,,,,57.44 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49000,CPT,EXPLORATORY LAPAROTOMY CELIOTOMY W/WO BIOPSY SPX,,,21,,RBRVS,12.54 ,6.93 ,6.93 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
49002,CPT,REOPENING RECENT LAPAROTOMY,,,21,,RBRVS,17.63 ,8.68 ,8.68 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
49010,CPT,EXPL RETROPERITONEUM W/WO BX SPX,,,21,,RBRVS,16.06 ,7.44 ,7.44 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
49020,CPT,DRAINAGE PERITON ABSCESS/LOCAL PERITONITIS OPEN,,,21,,RBRVS,26.67 ,13.42 ,13.42 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
49040,CPT,DRAINAGE SUBDIAPHRAGMATIC/SUBPHREN ABSCESS OPEN,,,21,,RBRVS,16.52 ,8.68 ,8.68 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
49060,CPT,DRAINAGE OF RETROPERITONEAL ABSCESS OPEN,,,21,,RBRVS,18.53 ,9.22 ,9.22 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
49062,CPT,DRG XTRAPERITONEAL LYMPHOCELE PERITON CAVITY OPN,,,21,,RBRVS,12.22 ,6.48 ,6.48 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
49082,CPT,ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE,,,21,,RBRVS,1.24 ,0.76 ,4.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49083,CPT,ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE,,,21,,RBRVS,2.00 ,0.97 ,6.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49084,CPT,PERITONEAL LAVAGE W/WO IMAGING GUIDANCE,,,21,,RBRVS,2.00 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49180,CPT,BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE,,,21,,RBRVS,1.73 ,0.60 ,2.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49185,CPT,SCLEROTHERAPY FLUID COLLECTION PRQ W/IMG GID,,,21,,RBRVS,2.35 ,0.98 ,25.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49203,CPT,EXCISION/DESTRUCTION OPEN ABDOMINAL TUMOR 5 CM/<,,,21,,RBRVS,20.13 ,10.20 ,10.20 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
49204,CPT,EXC/DESTRUCTION OPEN ABDMNL TUMORS 5.1-10.0 CM,,,21,,RBRVS,26.13 ,12.56 ,12.56 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
49205,CPT,EXC/DESTRUCTION OPEN ABDOMINAL TUMORS >10.0 CM,,,21,,RBRVS,30.13 ,14.05 ,14.05 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
49215,CPT,EXC PRESAC/SACROCOCCYGEAL TUMOR,,,21,,RBRVS,37.81 ,18.31 ,18.31 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
49220,CPT,STAGING LAPAROTOMY HODGKINS DISEASE/LYMPHOMA,,,21,,RBRVS,15.79 ,8.53 ,8.53 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
49250,CPT,UMBILECTOMY OMPHALECTOMY EXC UMBILICUS SPX,,,21,,RBRVS,9.01 ,5.86 ,5.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49255,CPT,OMNTC EPIPLOECTOMY RESCJ OMENTUM SPX,,,21,,RBRVS,12.56 ,7.56 ,7.56 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
49320,CPT,LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX,,,21,,RBRVS,5.14 ,3.21 ,3.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49321,CPT,LAPAROSCOPY SURG W/BX SINGLE/MULTIPLE,,,21,,RBRVS,5.44 ,3.36 ,3.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49322,CPT,LAPS SURG W/ASPIR CAVITY/CYST SINGLE/MULTIPLE,,,21,,RBRVS,6.01 ,3.46 ,3.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49323,CPT,LAPS SURG W/DRG LYMPHOCELE PRTL CAVITY,,,21,,RBRVS,10.23 ,6.13 ,6.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49324,CPT,LAPS INSERTION TUNNELED INTRAPERITONEAL CATHETER,,,21,,RBRVS,6.32 ,3.54 ,3.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49325,CPT,LAPS W/REVISION INTRAPERITONEAL CATHETER,,,21,,RBRVS,6.82 ,3.67 ,3.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49326,CPT,LAPAROSCOPY W/OMENTOPEXY,,,21,,RBRVS,3.50 ,1.18 ,1.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49327,CPT,LAPS W/INSERTION NTRSTL DEV W/IMG GUID 1/MLT,,,21,,RBRVS,2.38 ,0.85 ,0.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49329,CPT,UNLISTED LAPAROSCOPIC PX ABD PERTONEUM & OMENTUM,,,21,,TotalUnits,,,,8.80 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49400,CPT,INJECTION AIR/CONTRAST PERITONEAL CAVITY SPX,,,21,,RBRVS,1.88 ,0.63 ,1.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49402,CPT,REMOVAL PERITONEAL FOREIGN BODY FROM CAVITY,,,21,,RBRVS,14.09 ,7.45 ,7.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49405,CPT,IMAGE-GUIDE FLUID COLLXN DRAINAGE CATH VISC PERQ,,,21,,RBRVS,4.25 ,1.51 ,20.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49406,CPT,IMG-GUIDE FLUID COLLXN DRAINAG CATH PERITON PERQ,,,21,,RBRVS,4.25 ,1.52 ,20.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49407,CPT,IMAGE FLUID COLLXN DRAINAG CATH TRANSREC/VAGINAL,,,21,,RBRVS,4.50 ,1.63 ,15.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49411,CPT,INTERSTITIAL DEV PLMT RADIATION THERAPY 1/MLT,,,21,,RBRVS,3.82 ,1.55 ,11.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49412,CPT,PLACEMENT INTRSTL DEV OPN W/IMG GUID 1/MLT,,,21,,RBRVS,1.50 ,0.55 ,0.55 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
49418,CPT,INSJ INTRAPERITONEAL CATHETER W/IMG GUID,,,21,,RBRVS,4.21 ,1.68 ,36.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49419,CPT,INSERTION TUNNEL INTRAPERITONEAL CATH SUBQ PORT,,,21,,RBRVS,7.08 ,4.40 ,4.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49421,CPT,INSERTION TUNNEL INTRAPERITONEAL CATH DIAL OPEN,,,21,,RBRVS,4.21 ,1.52 ,1.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49422,CPT,REMOVAL TUNNELED INTRAPERITONEAL CATHETER,,,21,,RBRVS,6.29 ,3.30 ,3.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49423,CPT,EXCHNG ABSC/CST DRG CATH RAD GID SPX,,,21,,RBRVS,1.46 ,0.50 ,14.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49424,CPT,CNTRST NJX ASSMT ABSC/CST VIA DRG CATH/TUBE SPX,,,21,,RBRVS,0.76 ,0.28 ,3.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49425,CPT,INSERTION PERITONEAL-VENOUS SHUNT,,,21,,RBRVS,12.22 ,6.48 ,6.48 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
49426,CPT,REVIS PERITONEAL-VENOUS SHUNT,,,21,,RBRVS,10.41 ,4.91 ,4.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49427,CPT,INJECT EVALUATE PREVIOUS PERITONEAL-VENOUS SHUNT,,,21,,RBRVS,0.89 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49428,CPT,LIGATION PERITONEAL-VENOUS SHUNT,,,21,,RBRVS,6.87 ,5.64 ,5.64 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
49429,CPT,RMVL PERITONEAL-VENOUS SHUNT,,,21,,RBRVS,7.44 ,4.05 ,4.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49435,CPT,INSJ SUBQ EXTENSION INTRAPERITONEAL CATHETER,,,21,,RBRVS,2.25 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49436,CPT,DELAYED CREATION EXIT SITE EMBEDDED CATHETER,,,21,,RBRVS,2.72 ,2.05 ,2.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49440,CPT,INSERT GASTROSTOMY TUBE PERCUTANEOUS,,,21,,RBRVS,4.18 ,1.85 ,24.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49441,CPT,INSERT DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,,,21,,RBRVS,4.77 ,2.08 ,27.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49442,CPT,INSERT CECOSTOMY/OTHER COLONIC TUBE PERCUTANEOUS,,,21,,RBRVS,4.00 ,2.09 ,23.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49446,CPT,CONVERT GASTROSTOMY-GASTRO-JEJUNOSTOMY TUBE PERQ,,,21,,RBRVS,3.31 ,1.11 ,24.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49450,CPT,REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS,,,21,,RBRVS,1.36 ,0.46 ,17.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49451,CPT,REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,,,21,,RBRVS,1.84 ,0.62 ,18.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49452,CPT,REPLACEMENT GASTRO-JEJUNOSTOMY TUBE PERCUTANEOUS,,,21,,RBRVS,2.86 ,0.95 ,22.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49460,CPT,OBSTRUCTIVE MATERIAL REMOVAL FROM GI TUBE,,,21,,RBRVS,0.96 ,0.34 ,19.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49465,CPT,CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE,,,21,,RBRVS,0.62 ,0.23 ,3.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49491,CPT,RPR 1ST INGUN HRNA PRETERM INFT RDC,,,21,,RBRVS,12.53 ,6.05 ,6.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49492,CPT,RPR 1ST INGUN HRNA PRETERM INFT INCARCERATED,,,21,,RBRVS,15.43 ,8.25 ,8.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49495,CPT,RPR 1ST INGUN HRNA FULL TERM INFT <6 MO RDC,,,21,,RBRVS,6.20 ,4.15 ,4.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49496,CPT,RPR 1ST INGUN HRNA FULL TERM INFT <6 MO INCARCER,,,21,,RBRVS,9.42 ,5.68 ,5.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49500,CPT,RPR 1ST INGUN HRNA AGE 6 MO-5 YRS REDUCIBLE,,,21,,RBRVS,5.84 ,4.62 ,4.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49501,CPT,RPR 1ST INGUN HRNA AGE 6 MO-5 YRS INCARCERATED,,,21,,RBRVS,9.36 ,5.88 ,5.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49505,CPT,RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE,,,21,,RBRVS,7.96 ,5.20 ,5.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49507,CPT,RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED,,,21,,RBRVS,9.09 ,5.68 ,5.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49520,CPT,RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE,,,21,,RBRVS,9.99 ,5.92 ,5.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49521,CPT,RPR RECRT INGUN HERNIA ANY AGE INCARCERATED,,,21,,RBRVS,11.48 ,6.51 ,6.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49525,CPT,RPR INGUN HERNIA SLIDING ANY AGE,,,21,,RBRVS,8.93 ,5.53 ,5.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49540,CPT,REPAIR LUMBAR HERNIA,,,21,,RBRVS,10.74 ,6.18 ,6.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49550,CPT,RPR 1ST FEM HRNA ANY AGE REDUCIBLE,,,21,,RBRVS,8.99 ,5.52 ,5.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49553,CPT,RPR 1ST FEM HERNIA ANY AGE INCARCERATED,,,21,,RBRVS,9.92 ,5.98 ,5.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49555,CPT,RPR RECRT FEM HERNIA REDUCIBLE,,,21,,RBRVS,9.39 ,5.65 ,5.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49557,CPT,RPR RECRT FEM HRNA INCARCERATED,,,21,,RBRVS,11.62 ,6.59 ,6.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49560,CPT,REPAIR FIRST ABDOMINAL WALL HERNIA,,,21,,RBRVS,11.92 ,6.64 ,6.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49561,CPT,RPR 1ST INCAL/VNT HERNIA INCARCERATED,,,21,,RBRVS,15.38 ,7.94 ,7.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49565,CPT,RPR RECRT INCAL/VNT HERNIA REDUCIBLE,,,21,,RBRVS,12.37 ,6.98 ,6.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49566,CPT,RPR RECRT INCAL/VNT HERNIA INCARCERATED,,,21,,RBRVS,15.53 ,8.00 ,8.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49568,CPT,IMPLANT MESH OPN HERNIA RPR/DEBRIDEMENT CLOSURE,,,21,,RBRVS,4.88 ,1.75 ,1.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49570,CPT,RPR EPIGASTRIC HERNIA REDUCIBLE SPX,,,21,,RBRVS,6.05 ,4.52 ,4.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49572,CPT,RPR EPIGASTRIC HERNIA INCARCERATED,,,21,,RBRVS,7.87 ,5.17 ,5.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49580,CPT,RPR UMBILICAL HERNIA < 5 YRS REDUCIBLE,,,21,,RBRVS,4.47 ,4.04 ,4.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49582,CPT,RPR UMBILICAL HERNIA < 5 YRS INCARCERATED,,,21,,RBRVS,7.13 ,5.08 ,5.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49585,CPT,RPR UMBILICAL HRNA 5 YRS/> REDUCIBLE,,,21,,RBRVS,6.59 ,4.70 ,4.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49587,CPT,RPR UMBILICAL HERNIA AGE 5 YRS/> INCARCERATED,,,21,,RBRVS,7.08 ,4.98 ,4.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49590,CPT,RPR SPIGELIAN HERNIA,,,21,,RBRVS,8.90 ,5.54 ,5.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49600,CPT,RPR SMALL OMPHALOCELE W/PRIMARY CLOSURE,,,21,,RBRVS,11.55 ,5.80 ,5.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49605,CPT,RPR LG OMPHALOCELE/GASTROSCHISIS W/WO PROSTH,,,21,,RBRVS,87.09 ,35.18 ,35.18 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
49606,CPT,RPR LG OMPHALOCELE/GASTROSCHISIS RMVL PROSTH,,,21,,RBRVS,19.00 ,9.24 ,9.24 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
49610,CPT,RPR OMPHALOCELE GROSS TYP OPRATION 1ST STG,,,21,,RBRVS,10.91 ,6.35 ,6.35 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
49611,CPT,RPR OMPHALOCELE GROSS TYP OPRATION 2ND STG,,,21,,RBRVS,9.34 ,5.56 ,5.56 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
49650,CPT,LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA,,,21,,RBRVS,6.36 ,4.50 ,4.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49651,CPT,LAPS SURG RPR RECURRENT INGUINAL HERNIA,,,21,,RBRVS,8.38 ,5.71 ,5.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49652,CPT,LAPS REPAIR HERNIA EXCEPT INCAL/INGUN REDUCIBLE,,,21,,RBRVS,11.92 ,6.80 ,6.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49653,CPT,LAP RPR HRNA XCPT INCAL/INGUN NCRC8/STRANGULATED,,,21,,RBRVS,14.94 ,8.41 ,8.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49654,CPT,LAPAROSCOPY REPAIR INCISIONAL HERNIA REDUCIBLE,,,21,,RBRVS,13.76 ,7.48 ,7.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49655,CPT,LAPS RPR INCISIONAL HERNIA NCRC8/STRANGULATED,,,21,,RBRVS,16.84 ,9.10 ,9.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49656,CPT,LAPS RPR RECURRENT INCISIONAL HERNIA REDUCIBLE,,,21,,RBRVS,15.08 ,7.95 ,7.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49657,CPT,LAPS RPR RECURRENT INCAL HRNA NCRC8/STRANGULATED,,,21,,RBRVS,22.11 ,10.93 ,10.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49659,CPT,UNLIS LAPS PX HRNAP HERNIORRHAPHY HERNIOTOMY,,,21,,TotalUnits,,,,10.86 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
49900,CPT,SEC ABDOMINAL WALL SUTURE EVISCERATION/DEHSN,,,21,,RBRVS,12.41 ,8.34 ,8.34 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
49904,CPT,OMENTAL FLAP EXTRA-ABDOMINAL,,,21,,RBRVS,22.35 ,14.08 ,14.08 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
49905,CPT,OMENTAL FLAP INTRA-ABDOMINAL,,,21,,RBRVS,6.54 ,2.34 ,2.34 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
49999,CPT,UNLISTED PROCEDURE ABDOMEN PERITONEUM & OMENTUM,,,21,,TotalUnits,,,,7.24 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50010,CPT,RNL EXPL X NECESSITATING OTH SPEC PX,,,21,,RBRVS,12.28 ,7.00 ,7.00 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50020,CPT,DRAINAGE PERIRENAL/RENAL ABSCESS OPEN,,,21,,RBRVS,18.08 ,8.95 ,8.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50040,CPT,NEPHROSTOMY/NEPHROTOMY W/DRAINAGE,,,21,,RBRVS,16.68 ,8.04 ,8.04 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50045,CPT,NEPHROTOMY W/EXPLORATION,,,21,,RBRVS,16.82 ,8.06 ,8.06 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50060,CPT,NEPHROLITHOTOMY REMOVAL STAGE 1,,,21,,RBRVS,20.95 ,9.44 ,9.44 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50065,CPT,NEPHROLITHOTOMY SECONDARY FOR CALCULUS,,,21,,RBRVS,22.32 ,9.90 ,9.90 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50070,CPT,NEPHROLITHOTOMY COMP CGEN KDN ABNORMALITY,,,21,,RBRVS,21.85 ,9.74 ,9.74 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50075,CPT,NEPHROLITHOTOMY RMVL LG STAGHORN STAGE 1,,,21,,RBRVS,27.09 ,11.74 ,11.74 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50080,CPT,PRQ NEPHROSTOLITHOTOMY/PYELOSTOLITHOTOMY </2 CM,,,21,,RBRVS,15.74 ,7.46 ,7.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50081,CPT,PRQ NEPHROSTOLITHOTOMY/PYELOSTOLITHOTOMY > 2 CM,,,21,,RBRVS,23.50 ,10.52 ,10.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50100,CPT,TRNSXJ/REPOSITIONING ABERRANT RENAL VESSEL SPX,,,21,,RBRVS,17.45 ,9.56 ,9.56 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50120,CPT,PYELOTOMY W/EXPLORATION,,,21,,RBRVS,17.21 ,8.12 ,8.12 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50125,CPT,PYELOTOMY W/DRAINAGE PYELOSTOMY,,,21,,RBRVS,17.82 ,8.40 ,8.40 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50130,CPT,PYELOTOMY W/REMOVAL CALCULUS,,,21,,RBRVS,18.82 ,8.74 ,8.74 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50135,CPT,PYELOTOMY COMPLICATED,,,21,,RBRVS,20.59 ,9.34 ,9.34 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50200,CPT,RENAL BIOPSY PRQ TROCAR/NEEDLE,,,21,,RBRVS,2.63 ,1.22 ,14.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50205,CPT,RENAL BIOPSY SURG EXPOSURE KIDNEY,,,21,,RBRVS,12.29 ,6.76 ,6.76 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50220,CPT,NEPHRECTOMY W/PRTL URETERECTOMY W/OPEN RIB RESCJ,,,21,,RBRVS,18.68 ,8.85 ,8.85 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50225,CPT,NEPHRECTOMY W/PRTL URETERECT OPN RIB RESCJ COMPL,,,21,,RBRVS,21.88 ,9.87 ,9.87 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50230,CPT,NEPHRECTOMY W/PRTL URETERECT OPEN RIB RESCJ RAD,,,21,,RBRVS,23.81 ,10.17 ,10.17 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50234,CPT,NEPHRECTOMY W/TOT URETERECT&BLDR CUFF SAME INC,,,21,,RBRVS,24.05 ,10.50 ,10.50 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50236,CPT,NEPHRECTOMY TOT URETEREC&BLDR CUFF SEPAR INCISN,,,21,,RBRVS,26.94 ,12.11 ,12.11 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50240,CPT,NEPHRECTOMY PARTIAL,,,21,,RBRVS,24.21 ,11.02 ,11.02 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50250,CPT,OPEN ABLATION RENAL MASS CRYOSURG ULTRASOUND,,,21,,RBRVS,22.22 ,10.21 ,10.21 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50280,CPT,EXCISION/UNROOFING CYST KIDNEY,,,21,,RBRVS,17.09 ,8.25 ,8.25 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50290,CPT,EXCISION PERINEPHRIC CYST,,,21,,RBRVS,16.15 ,7.83 ,7.83 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50300,CPT,DONOR NEPHRECTOMY CADAVER DONOR UNI/BILATERAL,,,21,,TotalUnits,,,,23.05 ,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50320,CPT,DONOR NEPHRECTOMY OPEN LIVING DONOR,,,21,,RBRVS,22.43 ,15.60 ,15.60 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50323,CPT,BKBENCH PREPJ CADAVER DONOR RENAL ALLOGRAFT,,,21,,TotalUnits,,,,8.69 ,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50325,CPT,BKBENCH PREPJ LIVING RENAL DONOR ALLOGRAFT,,,21,,TotalUnits,,,,9.48 ,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50327,CPT,BKBENCH RCNSTJ RENAL ALGRFT VENOUS ANAST EA,,,21,,RBRVS,4.00 ,1.41 ,1.41 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50328,CPT,BKBENCH RCNSTJ RENAL ALLOGRAFT ARTERIAL ANAST EA,,,21,,RBRVS,3.50 ,1.24 ,1.24 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50329,CPT,BKBENCH RCNSTJ ALGRFT URETERAL ANAST EA,,,21,,RBRVS,3.34 ,1.17 ,1.17 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50340,CPT,RECIPIENT NEPHRECTOMY SEPARATE PROCEDURE,,,21,,RBRVS,14.04 ,9.96 ,9.96 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50360,CPT,RENAL ALTRNSPLJ IMPLTJ GRF W/O RCP NEPHRECTOMY,,,21,,RBRVS,39.88 ,20.99 ,20.99 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50365,CPT,RENAL ALTRNSPLJ IMPLTJ GRF W/RCP NEPHRECTOMY,,,21,,RBRVS,46.13 ,25.83 ,25.83 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50370,CPT,RMVL TRNSPLED RENAL ALLOGRAFT,,,21,,RBRVS,18.88 ,11.59 ,11.59 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50380,CPT,RENAL AUTOTRNSPLJ REIMPLANTATION KIDNEY,,,21,,RBRVS,30.11 ,20.51 ,20.51 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50382,CPT,RMVL & RPLCMT INTLY DWELLING URETERAL STENT PRQ,,,21,,RBRVS,5.50 ,1.85 ,27.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50384,CPT,REMOVAL INDWELLING URETERAL STENT PRQ,,,21,,RBRVS,5.00 ,1.65 ,21.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50385,CPT,REMOVE & REPLACE INDWELL URETERAL STENT TRURTHRL,,,21,,RBRVS,4.44 ,1.83 ,27.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50386,CPT,REMOVE INT DWELL URETERAL STENT TRANSURETHRAL,,,21,,RBRVS,3.30 ,1.43 ,17.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50387,CPT,RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH,,,21,,RBRVS,2.00 ,0.65 ,13.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50389,CPT,RMVL NFROS TUBE REQ FLUORO GUIDANCE,,,21,,RBRVS,1.10 ,0.37 ,7.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50390,CPT,ASPIR &/NJX RENAL CYST/PELVIS NEEDLE PRQ,,,21,,RBRVS,1.96 ,0.66 ,0.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50391,CPT,INSTLJ THER AGENT RENAL PELVIS&/URETER VIA TUB,,,21,,RBRVS,1.96 ,0.68 ,1.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50395,CPT,INTRO GUIDE PELVIS&/URETER W/DILAT NFROS TRACT,,,21,,RBRVS,3.37 ,1.47 ,1.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50396,CPT,MANOMETRIC STDS THRU TUBE/NDWELLG URTRL CATH,,,21,,RBRVS,2.09 ,1.14 ,1.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50400,CPT,PYELOPLASTY SIMPLE,,,21,,RBRVS,21.27 ,9.56 ,9.56 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50405,CPT,PYELOPLASTY COMPLICATED,,,21,,RBRVS,25.86 ,11.38 ,11.38 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50430,CPT,NJX PX ANTEGRDE NFROSGRM &/URTRGRM NEW ACCESS,,,21,,RBRVS,3.15 ,1.40 ,11.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50431,CPT,NJX PX ANTEGRDE NFROSGRM &/URTRGRM EXSTNG ACESS,,,21,,RBRVS,1.10 ,0.72 ,3.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50432,CPT,PLMT NEPHROSTOMY CATH PRQ NEW ACCESS RS&I,,,21,,RBRVS,4.25 ,1.76 ,19.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50433,CPT,PLMT NEPHROURETERAL CATH PRQ NEW ACCESS RS&I,,,21,,RBRVS,5.30 ,2.11 ,26.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50434,CPT,CONVERT NEPHROSTOMY CATH TO NEPHROURTRL CATH PRQ,,,21,,RBRVS,4.00 ,1.68 ,21.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50435,CPT,EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I,,,21,,RBRVS,1.82 ,0.95 ,11.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50500,CPT,NEPHRORRHAPHY SUTURE KIDNEY WOUND/INJURY,,,21,,RBRVS,21.22 ,9.53 ,9.53 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50520,CPT,CLOSURE NEPHROCUTANEOUS/PYELOCUTANEOUS FISTULA,,,21,,RBRVS,18.88 ,8.76 ,8.76 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50525,CPT,CLSR NEPHROVISCERAL FISTULA W/VISC RPR ABDL APPR,,,21,,RBRVS,24.39 ,16.68 ,16.68 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50526,CPT,CLSR NEPHROVISCERAL FISTULA W/VISC RPR THRC APPR,,,21,,RBRVS,26.31 ,12.80 ,12.80 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50540,CPT,SYMPHYSIOTOMY HORSESHOE KDN W/WO PLOP UNI/BI,,,21,,RBRVS,21.10 ,9.49 ,9.49 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50541,CPT,LAPAROSCOPY SURG ABLATION RENAL CYSTS,,,21,,RBRVS,16.86 ,7.62 ,7.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50542,CPT,LAPS ABLTJ RENAL MASS LESION W/INTRAOP US,,,21,,RBRVS,21.36 ,9.72 ,9.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50543,CPT,LAPAROSCOPY SURG PARTIAL NEPHRECTOMY,,,21,,RBRVS,27.41 ,12.23 ,12.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50544,CPT,LAPAROSCOPY SURG PYELOPLASTY,,,21,,RBRVS,23.37 ,9.78 ,9.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50545,CPT,LAPAROSCOPY RADICAL NEPHRECTOMY,,,21,,RBRVS,25.06 ,10.58 ,10.58 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50546,CPT,LAPAROSCOPY NEPHRECTOMY W/PARTIAL URETERECT,,,21,,RBRVS,21.87 ,10.03 ,10.03 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50547,CPT,LAPAROSCOPY DONOR NEPHRECTOMY LIVING DONOR,,,21,,RBRVS,26.34 ,14.60 ,14.60 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50548,CPT,LAPAROSCOPY NEPHRECTOMY W/TOTAL URETERECTOMY,,,21,,RBRVS,25.36 ,10.48 ,10.48 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50549,CPT,UNLISTED LAPAROSCOPY PROCEDURE RENAL,,,21,,TotalUnits,,,,35.64 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50551,CPT,RENAL ENDOSCOPY NEPHROSTOMY W/WO IRRIGATION,,,21,,RBRVS,5.59 ,2.28 ,4.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50553,CPT,RENAL NDSC NEPHROST W/URETERAL CATH W/WO DILA,,,21,,RBRVS,5.98 ,2.39 ,4.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50555,CPT,RENAL NDSC NEPHROS/PYELOSTOMY BIOPSY,,,21,,RBRVS,6.52 ,2.60 ,4.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50557,CPT,RENAL NDSC NEPHROS/PYELOSTOMY FULG&/INC W/WO BI,,,21,,RBRVS,6.61 ,2.63 ,4.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50561,CPT,RENAL NDSC NEPHROS/PYELOSTOMY RMVL FB/CALCULUS,,,21,,RBRVS,7.58 ,2.92 ,5.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50562,CPT,RENAL NDSC NEPHROS/PYELOSTOMY RESCJ TUMOR,,,21,,RBRVS,10.90 ,4.59 ,4.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50570,CPT,RENAL NDSC NEPHROTOMY W/WO IRRIGATION,,,21,,RBRVS,9.53 ,3.55 ,3.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50572,CPT,RNL NDSC NFROT W/URTRL CATHJ W/WO DILAT URETER,,,21,,RBRVS,10.33 ,3.82 ,3.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50574,CPT,RENAL NDSC NEPHROTOMY W/BIOPSY,,,21,,RBRVS,11.00 ,4.04 ,4.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50575,CPT,RNL NDSC NFROT/PLOT W/ENDOPYELOTOMY,,,21,,RBRVS,13.96 ,5.04 ,5.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50576,CPT,RNL NDSC NFROT FULGURATION &/INCISION W/WO BX,,,21,,RBRVS,10.97 ,4.03 ,4.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50580,CPT,RNL NDSC NFROT/PLOT W/RMVL FB/CALCULUS,,,21,,RBRVS,11.84 ,4.33 ,4.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50590,CPT,LITHOTRIPSY XTRCORP SHOCK WAVE,,,21,,RBRVS,9.77 ,5.42 ,9.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50592,CPT,ABLTJ 1/> RENAL TUMOR PRQ UNI RADIOFREQUENCY,,,21,,RBRVS,6.80 ,3.08 ,81.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50593,CPT,ABLATION RENAL TUMOR UNILATERAL PERQ CRYOTHERAPY,,,21,,RBRVS,9.13 ,3.93 ,121.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50600,CPT,URTROTOMY W/EXPL/DRG SEPARATE PROCEDURE,,,21,,RBRVS,17.17 ,7.88 ,7.88 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50605,CPT,URETEROTOMY INSERTION INDWELLING STENT ALL TYPES,,,21,,RBRVS,16.79 ,8.41 ,8.41 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50606,CPT,ENDOLUMINAL BX URTR &/RNL PELVIS NONENDOSCOPIC,,,21,,RBRVS,3.16 ,1.05 ,11.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
50610,CPT,URTROLITHOTOMY UPPER ONE-THIRD URETER,,,21,,RBRVS,17.25 ,7.97 ,7.97 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50620,CPT,URTROLITHOTOMY MIDDLE ONE-THIRD URETER,,,21,,RBRVS,16.43 ,7.70 ,7.70 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50630,CPT,URTROLITHOTOMY LOWER ONE-THIRD URETER,,,21,,RBRVS,16.21 ,7.62 ,7.62 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50650,CPT,URETRECECTOMY W/BLADDER CUFF SEPARATE PROCEDURE,,,21,,RBRVS,18.82 ,8.76 ,8.76 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50660,CPT,URETERECTOMY TOT ECTOPIC URETER CMBN APPR,,,21,,RBRVS,21.02 ,9.46 ,9.46 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50684,CPT,INJ PX URETEROGRAPHY/URETEROPYLOGRAPHY CATH,,,21,,RBRVS,0.76 ,0.61 ,2.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50686,CPT,MANOMETRIC STDS THRU URTROST/NDWELLG URTRL CATH,,,21,,RBRVS,1.51 ,1.03 ,2.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50688,CPT,CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL,,,21,,RBRVS,1.20 ,0.99 ,0.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50690,CPT,NJX VISUALIZATION ILEAL CONDUIT&/URETEROPYELOG,,,21,,RBRVS,1.16 ,0.77 ,1.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50693,CPT,PLMT URTRL STENT PRQ PRE-EXISTING NFROS TRACT,,,21,,RBRVS,4.21 ,1.74 ,25.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50694,CPT,PLMT URTRL STNT PRQ NEW ACESS W/O SEP NFROS CATH,,,21,,RBRVS,5.50 ,2.18 ,27.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50695,CPT,PLMT URTRL STENT PRQ NEW ACCESS W/SEP NFROS CATH,,,21,,RBRVS,7.05 ,2.68 ,32.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50700,CPT,URETEROPLASTY PLASTIC OPERATION URETER,,,21,,RBRVS,16.69 ,8.02 ,8.02 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50705,CPT,URETERAL EMBOLIZATION/OCCLUSION W/IMG GID RS&I,,,21,,RBRVS,4.03 ,1.34 ,43.86 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
50706,CPT,BALLOON DILAT URETERAL STRICTURE W/IMG GID RS&I,,,21,,RBRVS,3.80 ,1.26 ,17.53 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
50715,CPT,URETEROLYSIS W/WORPSG URETER RETROPERIT FIBROSIS,,,21,,RBRVS,20.64 ,10.66 ,10.66 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50722,CPT,URETEROLYSIS FOR OVARIAN VEIN SYNDROME,,,21,,RBRVS,17.95 ,9.42 ,9.42 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50725,CPT,URTROLSS RETROCAVAL URTR W/REANAST,,,21,,RBRVS,20.20 ,9.20 ,9.20 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50727,CPT,REVJ URINARY-CUTANEOUS ANASTAMOSIS,,,21,,RBRVS,8.28 ,5.26 ,5.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50728,CPT,REVJ UR-CUTAN ANAST RPR FSCAL DFCT & HERNIA,,,21,,RBRVS,12.18 ,6.49 ,6.49 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50740,CPT,EXC URACHAL CYST/SINUS W/WO UMBILICAL HERNIA RPR,,,21,,RBRVS,20.07 ,10.50 ,10.50 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50750,CPT,URETEROCALYCOSTOMY ANAST URETER RENAL CALYX,,,21,,RBRVS,21.22 ,9.53 ,9.53 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50760,CPT,URETEROURETEROSTOMY,,,21,,RBRVS,20.07 ,9.43 ,9.43 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50770,CPT,TRANSURETEROURETEROSTOMY ANAST URETER CLAT URTR,,,21,,RBRVS,21.22 ,9.53 ,9.53 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50780,CPT,URETERONEOCYSTOSTOMY ANAST 1 URETER BLADDER,,,21,,RBRVS,19.95 ,9.29 ,9.29 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50782,CPT,URETERONEOCYSTOSTOMY ANAST DUPLICATE URETER BLDR,,,21,,RBRVS,19.66 ,10.35 ,10.35 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50783,CPT,URETERONEOCYSTOSTOMY W/URETERAL TAILORING,,,21,,RBRVS,20.70 ,9.36 ,9.36 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50785,CPT,URTRONEOCSTOST W/VESICO-PSOAS HITCH/BLDR FLAP,,,21,,RBRVS,22.23 ,9.98 ,9.98 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50800,CPT,URETEROENTEROSTOMY ANAST URETER INTESTINE,,,21,,RBRVS,16.41 ,8.21 ,8.21 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50810,CPT,URETEROSIGMOIDOSTOMY W/SIGMOID BLADDER & COLOSTO,,,21,,RBRVS,22.61 ,12.38 ,12.38 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50815,CPT,URETEROCOLON CONDUIT INTESTINE ANASTOMOSIS,,,21,,RBRVS,22.26 ,10.35 ,10.35 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50820,CPT,URETEROILEAL CONDUIT W/INTESTINE ANASTOMOSIS,,,21,,RBRVS,24.07 ,10.85 ,10.85 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50825,CPT,CONTINENT DVRJ W/INT ANAST ANY SGM SM&/LG INTSTN,,,21,,RBRVS,30.68 ,13.43 ,13.43 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50830,CPT,URINARY UNIDIVERSION,,,21,,RBRVS,33.77 ,14.23 ,14.23 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50840,CPT,RPLCMT ALL/PART URETER INTESTINE SGM W/ANAST,,,21,,RBRVS,22.39 ,10.39 ,10.39 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50845,CPT,CUTANANEOUS APPENDICO-VESICOSTOMY,,,21,,RBRVS,22.46 ,10.87 ,10.87 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50860,CPT,URETEROSTOMY TRANSPLANTATION URETER SKIN,,,21,,RBRVS,17.08 ,8.15 ,8.15 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50900,CPT,URETERORRHAPHY SUTURE URETER SEPARATE PROCEDURE,,,21,,RBRVS,15.04 ,7.67 ,7.67 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50920,CPT,CLOSURE URETEROCUTANEOUS FISTULA,,,21,,RBRVS,15.81 ,7.72 ,7.72 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50930,CPT,CLOSURE URETEROCUTANEOUS FISTULA W/VISC RPR,,,21,,RBRVS,20.19 ,9.20 ,9.20 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50940,CPT,DELIGATION URETER,,,21,,RBRVS,15.93 ,7.76 ,7.76 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
50945,CPT,LAPAROSCOPY URTROLITHOTOMY,,,21,,RBRVS,17.97 ,7.98 ,7.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50947,CPT,LAPS URTRONEOCSTOST W/CSTSC&URTRL STENT PLMT,,,21,,RBRVS,25.78 ,11.15 ,11.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50948,CPT,LAPS URTRONEOCSTOST W/O CSTSC&URTRL STENT PLMT,,,21,,RBRVS,23.82 ,10.15 ,10.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50949,CPT,UNLISTED LAPAROSCOPY PROCEDURE URETER,,,21,,TotalUnits,,,,36.93 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50951,CPT,URETERAL ENDOSCOPY VIA URETEROSTOMY,,,21,,RBRVS,5.83 ,2.36 ,4.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50953,CPT,URETERAL ENDOSCOPY VIA URETEROST W/WO DIL URETER,,,21,,RBRVS,6.23 ,2.49 ,4.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50955,CPT,URETERAL ENDOSCOPY VIA URETEROSTOMY W/BIOPSY,,,21,,RBRVS,6.74 ,2.67 ,4.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50957,CPT,URETERAL ENDOSCOPY W/DEST&/INC W/WO BIOPSY,,,21,,RBRVS,6.78 ,2.69 ,4.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50961,CPT,URETERAL ENDOSCOPY VIA URETEROST W/RMVL FB/STONE,,,21,,RBRVS,6.04 ,2.44 ,4.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50970,CPT,URETERAL ENDOSCOPY VIA URETEROTOMY W/O IMAGING,,,21,,RBRVS,7.13 ,2.76 ,2.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50972,CPT,NDSC URETEROTOMY URTRL CATHJ W/WO DILAT URETER,,,21,,RBRVS,6.88 ,2.68 ,2.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50974,CPT,URETERAL ENDOSCOPY VIA URETEROT W/O IMAGING W/BX,,,21,,RBRVS,9.16 ,3.43 ,3.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50976,CPT,URETERAL ENDOSC VIA URETEROT W/DEST&/INC W/WO BX,,,21,,RBRVS,9.03 ,3.39 ,3.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
50980,CPT,NDSC URETEROTOMY RMVL FB/CALCULUS,,,21,,RBRVS,6.84 ,2.67 ,2.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51020,CPT,CYSTOTOMY/CYSTOSTOMY FULG&/INSJ RADACT MATRL,,,21,,RBRVS,7.69 ,4.86 ,4.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51030,CPT,CSTOTOMY/CSTOST CRYOSURG DSTRJ INTRAVESICAL LES,,,21,,RBRVS,7.81 ,4.80 ,4.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51040,CPT,CYSTOSTOMY CYSTOTOMY W/DRAINAGE,,,21,,RBRVS,4.49 ,3.28 ,3.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51045,CPT,CYSTOTOMY W/INSJ URETERAL CATH/STENT SPX,,,21,,RBRVS,7.81 ,5.10 ,5.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51050,CPT,CYSTOLITHOTOMY CYSTOTOMY W/RMVL CALCULUS,,,21,,RBRVS,7.97 ,4.67 ,4.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51060,CPT,TRANSVESICAL URETROLITHOTOMY,,,21,,RBRVS,9.95 ,5.59 ,5.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51065,CPT,CYSTOTOMY W/CALCULUS BASKET XTRJ&/FRAGMENTATIO,,,21,,RBRVS,9.95 ,5.52 ,5.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51080,CPT,DRG PRIVESICAL/PREVESICAL SPACE ABSC,,,21,,RBRVS,6.71 ,4.24 ,4.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51100,CPT,ASPIRATION BLADDER NEEDLE,,,21,,RBRVS,0.78 ,0.26 ,0.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51101,CPT,ASPIRATION BLADDER TROCAR/INTRACATHETER,,,21,,RBRVS,1.02 ,0.36 ,2.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51102,CPT,ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER,,,21,,RBRVS,2.70 ,1.18 ,3.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51500,CPT,EXC URACHAL CYST/SINUS W/WO UMBILICAL HERNIA RPR,,,21,,RBRVS,11.05 ,5.96 ,5.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51520,CPT,CYSTOTOMY SIMPLE EXCISION VESICAL NECK,,,21,,RBRVS,10.21 ,5.68 ,5.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51525,CPT,CYSTOTOMY EXCISE BLADDER DIVERTICULUM 1/MULTIPLE,,,21,,RBRVS,15.42 ,7.48 ,7.48 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
51530,CPT,CYSTOTOMY EXCISION BLADDER TUMOR,,,21,,RBRVS,13.71 ,7.23 ,7.23 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
51535,CPT,CYSTOTOMY EXCISE/INCISE/REPAIR URETEROCELE,,,21,,RBRVS,13.90 ,6.91 ,6.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51550,CPT,CYSTECTOMY PARTIAL SIMPLE,,,21,,RBRVS,17.23 ,8.23 ,8.23 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
51555,CPT,CYSTECTOMY PARTIAL COMPLICATED,,,21,,RBRVS,23.18 ,10.38 ,10.38 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
51565,CPT,CSTC PRTL W/RIMPLTJ URTR IN BLDR URTRONEOCSTOST,,,21,,RBRVS,23.68 ,10.76 ,10.76 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
51570,CPT,CYSTECTOMY COMPLETE SEPARATE PROCEDURE,,,21,,RBRVS,27.46 ,11.84 ,11.84 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
51575,CPT,CYSTECTOMY W/BI PELVIC LYMPHADENECTOMY,,,21,,RBRVS,34.18 ,14.27 ,14.27 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
51580,CPT,CYSTECTOMY W/URETEROSIGMOIDOSTOMY W/NODES,,,21,,RBRVS,35.37 ,15.13 ,15.13 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
51585,CPT,CYSTECTOMY W/URETEROSIGMOID BI PELV LYMPH NODES,,,21,,RBRVS,39.64 ,16.56 ,16.56 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
51590,CPT,CSTC COMPL W/URTROILEAL CONDUIT/BLDR W/INT ANAST,,,21,,RBRVS,36.33 ,15.04 ,15.04 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
51595,CPT,CSTC COMPL W/CONDUIT/SIGMOID BLDR PEL LMPHADEC,,,21,,RBRVS,41.32 ,16.90 ,16.90 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
51596,CPT,CSTC COMPL W/CONTINENT DVRJ OPN NEOBLDR,,,21,,RBRVS,44.26 ,18.30 ,18.30 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
51597,CPT,PELVIC EXENTERATION COMPLETE MALIGNANCY,,,21,,RBRVS,42.86 ,17.99 ,17.99 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
51600,CPT,NJX CSTOGRAPY/VOIDING URETHROCSTOGRAPY,,,21,,RBRVS,0.88 ,0.32 ,4.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51605,CPT,NJX & PLACEMENT CHAIN CONTRAST&/URETHROCSTOGRAPY,,,21,,RBRVS,0.64 ,0.39 ,0.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51610,CPT,NJX RETROGRADE URETHROCSTOGRAPY,,,21,,RBRVS,1.05 ,0.70 ,1.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51700,CPT,BLDR IRRIGATION SMPL LAVAGE &/INSTLJ,,,21,,RBRVS,0.88 ,0.31 ,1.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51701,CPT,INSJ NON-NDWELLG BLADDER CATHETER,,,21,,RBRVS,0.50 ,0.24 ,0.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51702,CPT,INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE,,,21,,RBRVS,0.50 ,0.31 ,1.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51703,CPT,INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED,,,21,,RBRVS,1.47 ,0.71 ,2.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51705,CPT,CHANGE CYSTOSTOMY TUBE SIMPLE,,,21,,RBRVS,0.90 ,0.49 ,1.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51710,CPT,CHANGE CYSTOSTOMY TUBE COMPLICATED,,,21,,RBRVS,1.35 ,0.80 ,2.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51715,CPT,NDSC NJX IMPLT MATRL URT&/BLDR NCK,,,21,,RBRVS,3.73 ,1.60 ,4.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51720,CPT,BLADDER INSTILLATION ANTICARCINOGENIC AGENT,,,21,,RBRVS,1.50 ,0.64 ,1.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51725,CPT,SIMPLE CYSTOMETROGRAM,,,21,,RBRVS,1.51 ,3.65 ,3.65 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
51725,CPT,SIMPLE CYSTOMETROGRAM,26,,21,,RBRVS,1.51 ,0.55 ,0.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51725,CPT,SIMPLE CYSTOMETROGRAM,TC,,21,,RBRVS,,3.10 ,3.10 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
51726,CPT,BLADDER PRESSURE MEASUREMENT DURING FILLING,,,21,,RBRVS,1.71 ,5.56 ,5.56 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
51726,CPT,BLADDER PRESSURE MEASUREMENT DURING FILLING,26,,21,,RBRVS,1.71 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51726,CPT,BLADDER PRESSURE MEASUREMENT DURING FILLING,TC,,21,,RBRVS,,4.96 ,4.96 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
51727,CPT,COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE,,,21,,RBRVS,2.11 ,6.49 ,6.49 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
51727,CPT,COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE,26,,21,,RBRVS,2.11 ,0.78 ,0.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51727,CPT,COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE,TC,,21,,RBRVS,,5.71 ,5.71 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
51728,CPT,COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES,,,21,,RBRVS,2.11 ,6.58 ,6.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
51728,CPT,COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES,26,,21,,RBRVS,2.11 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51728,CPT,COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES,TC,,21,,RBRVS,,5.86 ,5.86 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
51729,CPT,COMPLX CYSTOMETRO W/VOID PRESS & URETHRAL PROFIL,,,21,,RBRVS,2.51 ,6.86 ,6.86 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
51729,CPT,COMPLX CYSTOMETRO W/VOID PRESS & URETHRAL PROFIL,26,,21,,RBRVS,2.51 ,0.91 ,0.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51729,CPT,COMPLX CYSTOMETRO W/VOID PRESS & URETHRAL PROFIL,TC,,21,,RBRVS,,5.95 ,5.95 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
51736,CPT,SIMPLE UROFLOMETRY,,,21,,RBRVS,0.17 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
51736,CPT,SIMPLE UROFLOMETRY,26,,21,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51736,CPT,SIMPLE UROFLOMETRY,TC,,21,,RBRVS,,0.19 ,0.19 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
51741,CPT,COMPLEX UROFLOMETRY,,,21,,RBRVS,0.17 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
51741,CPT,COMPLEX UROFLOMETRY,26,,21,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51741,CPT,COMPLEX UROFLOMETRY,TC,,21,,RBRVS,,0.20 ,0.20 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
51784,CPT,EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL,,,21,,RBRVS,1.53 ,3.76 ,3.76 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
51784,CPT,EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL,26,,21,,RBRVS,1.53 ,0.54 ,0.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51784,CPT,EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL,TC,,21,,RBRVS,,3.22 ,3.22 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
51785,CPT,NDL EMG STDS EMG ANAL/URTL SPHNCTR ANY TQ,,,21,,RBRVS,1.53 ,5.33 ,5.33 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
51785,CPT,NDL EMG STDS EMG ANAL/URTL SPHNCTR ANY TQ,26,,21,,RBRVS,1.53 ,0.62 ,0.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51785,CPT,NDL EMG STDS EMG ANAL/URTL SPHNCTR ANY TQ,TC,,21,,RBRVS,,4.71 ,4.71 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
51792,CPT,STIMULUS EVOKED RESPONSE,,,21,,RBRVS,1.10 ,4.75 ,4.75 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
51792,CPT,STIMULUS EVOKED RESPONSE,26,,21,,RBRVS,1.10 ,0.39 ,0.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51792,CPT,STIMULUS EVOKED RESPONSE,TC,,21,,RBRVS,,4.36 ,4.36 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
51797,CPT,VOID PRESSURE STUDIES INTRAABDOMINAL,,,21,,RBRVS,0.80 ,2.29 ,2.29 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
51797,CPT,VOID PRESSURE STUDIES INTRAABDOMINAL,26,,21,,RBRVS,0.80 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51797,CPT,VOID PRESSURE STUDIES INTRAABDOMINAL,TC,,21,,RBRVS,,2.01 ,2.01 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
51798,CPT,MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP,,TC,21,,RBRVS,,0.52 ,0.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
51800,CPT,CSTOPLASTY/CSTOURTP PLSTC ANY,,,21,,RBRVS,18.89 ,8.91 ,8.91 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
51820,CPT,CSTOURTP W/UNI/BI URTRONEOCSTOST,,,21,,RBRVS,19.59 ,10.77 ,10.77 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
51840,CPT,ANT VESICOURETHROPEXY/URETHROPEXY SMPL,,,21,,RBRVS,11.36 ,6.11 ,6.11 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
51841,CPT,ANT VESICOURETHROPEXY/URETHROPEXY COMP,,,21,,RBRVS,13.68 ,7.01 ,7.01 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
51845,CPT,ABDOMINO-VAG VESICAL NCK SSP W/WO NDSC CTRL,,,21,,RBRVS,10.15 ,5.52 ,5.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51860,CPT,CYSTORRHAPHY SUTR BLDR WND INJ/RPT SIMPLE,,,21,,RBRVS,12.60 ,6.93 ,6.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51865,CPT,CYSTORRHAPHY SUTR BLDR WND INJ/RPT COMPLICATED,,,21,,RBRVS,15.80 ,7.88 ,7.88 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
51880,CPT,CLOSURE CYSTOSTOMY SEPARATE PROCEDURE,,,21,,RBRVS,7.87 ,4.54 ,4.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51900,CPT,CLSR VESICOVAGINAL FISTUL AABDL APPROACH,,,21,,RBRVS,14.63 ,7.64 ,7.64 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
51920,CPT,CLOSURE VESICOUTERINE FISTULA,,,21,,RBRVS,13.41 ,6.98 ,6.98 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
51925,CPT,CLSR VESICOUTERINE FISTULA W/HYSTERECTOMY,,,21,,RBRVS,17.53 ,10.59 ,10.59 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
51940,CPT,CLOSURE EXSTROPHY BLADDER,,,21,,RBRVS,30.66 ,13.06 ,13.06 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
51960,CPT,ENTEROCYSTOPLASTY W/INTESTINAL ANASTOMOSIS,,,21,,RBRVS,25.40 ,11.52 ,11.52 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
51980,CPT,CUTANEOUS VESICOSTOMY,,,21,,RBRVS,12.57 ,6.48 ,6.48 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
51990,CPT,LAPAROSCOPY URETHRAL SUSPENSION STRESS INCONT,,,21,,RBRVS,13.36 ,6.65 ,6.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51992,CPT,LAPAROSCOPY SLING OPERATION STRESS INCONT,,,21,,RBRVS,14.87 ,7.45 ,7.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
51999,CPT,UNLISTED LAPAROSCOPY PROCEDURE BLADDER,,,21,,TotalUnits,,,,22.32 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52000,CPT,CYSTOURETHROSCOPY,,,21,,RBRVS,2.23 ,1.14 ,3.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52001,CPT,CYSTO W/IRRIG & EVAC MULTPLE OBSTRUCTING CLOTS,,,21,,RBRVS,5.44 ,2.23 ,4.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52005,CPT,CYSTO BLADDER W/URETERAL CATHETERIZATION,,,21,,RBRVS,2.37 ,1.19 ,4.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52007,CPT,CYSTO W/URTRL CATHJ BRUSH BX URTR&/RENAL PELVIS,,,21,,RBRVS,3.02 ,1.41 ,9.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52010,CPT,CYSTO W/EJACULATORY DUCT CATHETERIZATION,,,21,,RBRVS,3.02 ,1.41 ,7.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52204,CPT,CYSTOURETHROSCOPY WITH BIOPSY,,,21,,RBRVS,2.59 ,1.20 ,7.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52214,CPT,CYSTO W/DESTRUCTION OF LESIONS,,,21,,RBRVS,3.50 ,1.18 ,14.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52224,CPT,CYSTO W/REMOVAL OF LESIONS SMALL,,,21,,RBRVS,4.05 ,1.37 ,14.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52234,CPT,CYSTO W/REMOVAL OF TUMORS SMALL,,,21,,RBRVS,4.62 ,1.95 ,1.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52235,CPT,CYSTOURETHROSCOPY W/DEST &/RMVL MED BLADDER TUM,,,21,,RBRVS,5.44 ,2.26 ,2.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52240,CPT,CYSTOURETHROSCOPY W/DEST &/RMVL TUMOR LARGE,,,21,,RBRVS,7.50 ,2.96 ,2.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52250,CPT,CYSTOURETHROSCOPY INSJ RADIOACT SBST W/WOBX/FULG,,,21,,RBRVS,4.49 ,1.91 ,1.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52260,CPT,CYSTOURETHROSCOPY W/DIL BLADDER GENERAL ANESTH,,,21,,RBRVS,3.91 ,1.71 ,1.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52265,CPT,CYSTOURETHROSCOPY W/DIL BLADDER LOCAL ANESTHESIA,,,21,,RBRVS,2.94 ,1.40 ,7.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52270,CPT,CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY FEMALE,,,21,,RBRVS,3.36 ,1.50 ,6.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52275,CPT,CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY MALE,,,21,,RBRVS,4.69 ,1.95 ,8.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52276,CPT,CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY MALE,,,21,,RBRVS,4.99 ,2.08 ,2.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52277,CPT,CYSTOURETHROSCOPY W/RESECJ EXTERNAL SPHINCTER,,,21,,RBRVS,6.16 ,2.47 ,2.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52281,CPT,CYSTO CALIBRATION DILAT URTL STRIX/STENOSIS,,,21,,RBRVS,2.75 ,1.32 ,4.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52282,CPT,CYSTOURETHROSCOPY INSERTION PERM URETHRAL STENT,,,21,,RBRVS,6.39 ,2.58 ,2.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52283,CPT,CYSTOURETHROSCOPY W/STEROID INJECTION STRICTURE,,,21,,RBRVS,3.73 ,1.65 ,3.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52285,CPT,CYSTOURETHROSCOPY TX FEMALE URETHRAL SYNDROME,,,21,,RBRVS,3.60 ,1.63 ,3.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52287,CPT,CYSTOURETHROSCOPY INJ CHEMODENERVATION BLADDER,,,21,,RBRVS,3.20 ,1.31 ,5.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52290,CPT,CYSTOURETHROSCOPY W/URETERAL MEATOTOMY UNI/BI,,,21,,RBRVS,4.58 ,1.94 ,1.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52300,CPT,CYSTO W/RESCJ/FULG ORTHOPIC URETEROCELE UNI/BI,,,21,,RBRVS,5.30 ,2.19 ,2.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52301,CPT,CYSTO W/RESECJ ECTOPIC URETEROCELE UNI/BI,,,21,,RBRVS,5.50 ,2.25 ,2.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52305,CPT,CYSTO INC/RESCJ ORIFICE BLDR DIVERTICULUM 1/MLT,,,21,,RBRVS,5.30 ,2.13 ,2.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52310,CPT,CYSTO W/SIMPLE REMOVAL STONE & STENT,,,21,,RBRVS,2.81 ,1.23 ,3.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52315,CPT,CYSTO W/COMPLEX REMOVAL STONE & STENT,,,21,,RBRVS,5.20 ,2.13 ,5.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52317,CPT,LITHOLAPAXY SMPL/SM <2.5 CM,,,21,,RBRVS,6.71 ,2.55 ,15.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52318,CPT,LITHOLAPAXY COMP/LG > 2.5 CM,,,21,,RBRVS,9.18 ,3.43 ,3.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52320,CPT,CYSTOURETHROSCOPY W/RMVL URETERAL CALCULUS,,,21,,RBRVS,4.69 ,1.89 ,1.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52325,CPT,CYSTO FRAGMENTATION URETERAL STONE,,,21,,RBRVS,6.15 ,2.40 ,2.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52327,CPT,CYSTO W/SUBURTRIC NJX IMPLT MATRL,,,21,,RBRVS,5.18 ,1.79 ,1.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52330,CPT,CYSTO MANJ W/O RMVL URETERAL STONE,,,21,,RBRVS,5.03 ,2.01 ,8.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52332,CPT,CYSTO W/INSERT URETERAL STENT,,,21,,RBRVS,2.82 ,1.34 ,10.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52334,CPT,CYSTO INSJ URTRL GD WIRE PRQ NFROS RTRGR,,,21,,RBRVS,4.82 ,2.02 ,2.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52341,CPT,CYSTO W/TX URETERAL STRICTURE,,,21,,RBRVS,5.35 ,2.23 ,2.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52342,CPT,CYSTO W/TX URETEROPELVIC JUNCTION STRICTURE,,,21,,RBRVS,5.85 ,2.40 ,2.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52343,CPT,CYSTO W/TX INTRA-RENAL STRICTURE,,,21,,RBRVS,6.55 ,2.64 ,2.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52344,CPT,CYSTO W/URTROSCOPY W/TX URETERAL STRICTURE,,,21,,RBRVS,7.05 ,2.80 ,2.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52345,CPT,CYSTO W/URTROSCOPY W/TX URTROPEL JUNCT STRIX,,,21,,RBRVS,7.55 ,2.97 ,2.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52346,CPT,CYSTO W/URTROSCOPY W/TX INTRA-RENAL STRICTURE,,,21,,RBRVS,8.58 ,3.32 ,3.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52351,CPT,CYSTO W/URTROSCOPY&/PYELOSCOPY DX,,,21,,RBRVS,5.75 ,2.33 ,2.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52352,CPT,CYSTO W/URETEROSCOPY W/RMVL/MANJ STONES,,,21,,RBRVS,6.75 ,2.71 ,2.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52353,CPT,CYSTO W/URETEROSCOPY W/LITHOTRIPSY,,,21,,RBRVS,7.50 ,2.96 ,2.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52354,CPT,CYSTO/PYELOSCOPY BX&/FULGURATION PELIVC LESION,,,21,,RBRVS,8.00 ,3.12 ,3.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52355,CPT,CYSTO/PYELOSCOPY RESCJ PELVIC TUMOR,,,21,,RBRVS,9.00 ,3.44 ,3.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52356,CPT,CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT,,,21,,RBRVS,8.00 ,3.09 ,3.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52400,CPT,CYSTO INC FULG/RESCJ URTL VALVES/FOLDS,,,21,,RBRVS,8.69 ,4.06 ,4.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52402,CPT,CSTO W/TRURL RESCJ/INC EJACULATORY DUXS,,,21,,RBRVS,5.27 ,1.83 ,1.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52441,CPT,CYSTO INSERTION TRANSPROSTATIC IMPLANT SINGLE,,,21,,RBRVS,4.50 ,1.52 ,29.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52442,CPT,CYSTO INSERTION TRANSPROSTATIC IMPLANT EA ADDL,,,21,,RBRVS,1.20 ,0.41 ,25.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52450,CPT,TRANSURETHRAL INCISION PROSTATE,,,21,,RBRVS,7.78 ,4.81 ,4.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52500,CPT,TRANSURETHRAL RESECTION PROSTATE,,,21,,RBRVS,8.14 ,4.93 ,4.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52601,CPT,TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE,,,21,,RBRVS,15.26 ,7.30 ,7.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52630,CPT,TRURL RESCJ RESIDUAL/REGROWTH OBSTR PRSTATE TISS,,,21,,RBRVS,6.55 ,4.17 ,4.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52640,CPT,TRURL RESCJ POSTOP BLADDER NECK CONTRACTURE,,,21,,RBRVS,4.79 ,3.69 ,3.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52647,CPT,LASER COAGULATION OF PROSTATE FOR URINE FLOW,,,21,,RBRVS,11.30 ,6.00 ,37.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52648,CPT,LASER VAPORIZATION OF PROSTATE FOR URINE FLOW,,,21,,RBRVS,12.15 ,6.29 ,38.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52649,CPT,LASER ENUCLEATION PROSTATE W/MORCELLATION,,,21,,RBRVS,14.56 ,7.43 ,7.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
52700,CPT,TRURL DRAINAGE PROSTATIC ABSCESS,,,21,,RBRVS,7.49 ,4.30 ,4.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53000,CPT,URTT/URTS XTRNL SPX PENDULOUS URETHRA,,,21,,RBRVS,2.33 ,1.66 ,1.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53010,CPT,URETHROTOMY/URETHROSTOMY XT SPX PERINEAL URETHRA,,,21,,RBRVS,4.45 ,3.49 ,3.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53020,CPT,MEATOTOMY CUTTING MEATUS SPX EXCEPT INFANT,,,21,,RBRVS,1.77 ,0.82 ,0.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53025,CPT,MEATOTOMY CUTTING MEATUS SPX INFANT,,,21,,RBRVS,1.13 ,0.71 ,0.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53040,CPT,DRAINAGE DEEP PERIURETHRAL ABSCESS,,,21,,RBRVS,6.55 ,3.96 ,3.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53060,CPT,DRG OF SKENE'S GLAND ABSCESS OR CYST,,,21,,RBRVS,2.68 ,1.73 ,2.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53080,CPT,DRG PERINEAL URINARY XTRVASATION UNCOMP SPX,,,21,,RBRVS,6.92 ,4.83 ,4.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53085,CPT,DRG PERINEAL URINARY XTRVASATION COMPLIC,,,21,,RBRVS,11.18 ,6.18 ,6.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53200,CPT,BIOPSY URETHRA,,,21,,RBRVS,2.59 ,1.19 ,1.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53210,CPT,URETHRECTOMY TOT W/CYSTOST FEMALE,,,21,,RBRVS,13.72 ,6.91 ,6.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53215,CPT,URETHRECTOMY TOT W/CYSTOST MALE,,,21,,RBRVS,16.85 ,7.90 ,7.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53220,CPT,EXC/FULGURATION CARCINOMA URETHRA,,,21,,RBRVS,7.63 ,4.51 ,4.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53230,CPT,EXC URETHRAL DIVERTICULUM SPX FEMALE,,,21,,RBRVS,10.44 ,5.76 ,5.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53235,CPT,EXC URETHRAL DIVERTICULUM SPX MALE,,,21,,RBRVS,10.99 ,5.92 ,5.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53240,CPT,MARSUPIALIZATION URTL DIVERTICULUM MALE/FEMALE,,,21,,RBRVS,7.08 ,4.29 ,4.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53250,CPT,EXCISION OF BULBOURETHRAL GLAND,,,21,,RBRVS,6.52 ,4.08 ,4.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53260,CPT,EXC/FULGURATION URETHRAL POLYP DSTL URETHRA,,,21,,RBRVS,3.03 ,1.78 ,2.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53265,CPT,EXC/FULGURATION URETHRAL CARUNCLE,,,21,,RBRVS,3.17 ,1.81 ,2.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53270,CPT,EXCISION OR FULGURATION SKENES GLANDS,,,21,,RBRVS,3.14 ,1.78 ,2.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53275,CPT,EXCISION/FULGURATION URETHRAL PROLAPSE,,,21,,RBRVS,4.57 ,2.46 ,2.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53400,CPT,URETHROPLASTY 1ST STG FISTULA/DIVERTICULUM/STRIX,,,21,,RBRVS,14.13 ,7.25 ,7.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53405,CPT,URETHROPLASTY 2ND STAGE W/URINARY DIVERSION,,,21,,RBRVS,15.66 ,7.66 ,7.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53410,CPT,URETHROPLASTY 1 STG RECNST MALE ANTERIOR URETHRA,,,21,,RBRVS,17.68 ,8.45 ,8.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53415,CPT,URTP TRANSPUBIC/PRNL 1 STG RCNSTJ/RPR URT,,,21,,RBRVS,20.70 ,9.43 ,9.43 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
53420,CPT,URTP 2-STG RCNSTJ/RPR PROSTAT/URETHRA 1ST STAGE,,,21,,RBRVS,15.17 ,7.27 ,7.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53425,CPT,URTP 2-STG RCNSTJ/RPR PROSTAT/URETHRA 2ND STAGE,,,21,,RBRVS,17.07 ,7.91 ,7.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53430,CPT,URETHROPLASTY RCNSTJ FEMALE URETHRA,,,21,,RBRVS,17.43 ,8.22 ,8.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53431,CPT,URTP W/TUBULARIZATION POST URT&/LWR BLDR,,,21,,RBRVS,21.18 ,9.59 ,9.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53440,CPT,SLING OPRATION CORRJ MALE URINARY INCONTINENCE,,,21,,RBRVS,13.36 ,6.75 ,6.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53442,CPT,RMVL/REVJ SLING MALE URINARY INCONTINENCE,,,21,,RBRVS,13.49 ,7.46 ,7.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53444,CPT,INSERTION TANDEM CUFF,,,21,,RBRVS,14.19 ,6.98 ,6.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53445,CPT,INSJ INFLATABLE URETHRAL/BLADDER NECK SPHINCTER,,,21,,RBRVS,13.00 ,7.14 ,7.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53446,CPT,REMVL INFLATABLE URETHRAL/BLADDER NECK SPHINCTER,,,21,,RBRVS,11.02 ,6.15 ,6.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53447,CPT,RMVL & RPLCMT NFLTL URETHRAL/BLADDER NECK SPHINC,,,21,,RBRVS,14.28 ,7.32 ,7.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53448,CPT,RMVL & RPLCMT NFLTBL NCK SPHNCTR THRU INFCT FLD,,,21,,RBRVS,23.44 ,10.69 ,10.69 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
53449,CPT,RPR NFLTBL URETHRAL/BLADDER NECK SPHINCTER,,,21,,RBRVS,10.56 ,5.79 ,5.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53450,CPT,URETHROMEATOPLASTY W/MUCOSAL ADVANCEMENT,,,21,,RBRVS,6.77 ,4.17 ,4.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53460,CPT,URETHROMEATOPLASTY W/PRTL EXC DSTL URTL SGM,,,21,,RBRVS,7.75 ,4.50 ,4.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53500,CPT,URETHROLSS TRVG SEC OPN W/CSTO,,,21,,RBRVS,13.00 ,6.96 ,6.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53502,CPT,URETHRORRHAPHY SUTR URETHRAL WOUND/INJ FEMALE,,,21,,RBRVS,8.26 ,4.76 ,4.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53505,CPT,URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PENILE,,,21,,RBRVS,8.26 ,4.74 ,4.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53510,CPT,URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PERINEAL,,,21,,RBRVS,10.96 ,5.91 ,5.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53515,CPT,URTORR SUTR URETHRAL WND/INJ PROSTATOMEMBRANOUS,,,21,,RBRVS,14.22 ,7.02 ,7.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53520,CPT,CLSR URETHROSTOMY/URETHROQ FSTL MALE SPX,,,21,,RBRVS,9.48 ,5.41 ,5.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53600,CPT,DILAT URETHRAL STRIX DILATOR MALE 1ST,,,21,,RBRVS,1.21 ,0.49 ,1.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53601,CPT,DILAT URETHRAL STRIX DILATOR MALE SBSQ,,,21,,RBRVS,0.98 ,0.45 ,1.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53605,CPT,DILAT URETHRAL STRIX/VESICAL NCK DILAT MALE ANES,,,21,,RBRVS,1.28 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53620,CPT,DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE 1ST,,,21,,RBRVS,1.62 ,0.71 ,1.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53621,CPT,DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE SBSQ,,,21,,RBRVS,1.35 ,0.57 ,1.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53660,CPT,DILAT FEMALE URETHRA W/SUPPOSITORY&/INSTLJ INI,,,21,,RBRVS,0.71 ,0.41 ,1.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53661,CPT,DILAT FEMALE URT W/SUPPOSITORY&/INSTLJ SBSQ,,,21,,RBRVS,0.72 ,0.36 ,1.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53665,CPT,DILAT FEMALE URETHRA GENERAL/CNDJ SPINAL ANES,,,21,,RBRVS,0.76 ,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53850,CPT,TRURL DSTRJ PRSTATE TISS MICROWAVE THERMOTH,,,21,,RBRVS,10.08 ,6.19 ,47.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53852,CPT,TRURL DSTRJ PRSTATE TISS RF THERMOTH,,,21,,RBRVS,10.83 ,5.81 ,41.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53855,CPT,INSERT TEMP PROSTATIC URETH STENT W/MEASUREMENT,,,21,,RBRVS,1.64 ,0.55 ,20.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53860,CPT,TRURL RF FEMALE BLADDER NECK STRS URIN INCONT,,,21,,RBRVS,3.97 ,2.05 ,39.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
53899,CPT,UNLISTED PROCEDURE URINARY SYSTEM,,,21,,TotalUnits,,,,4.25 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54000,CPT,SLITTING PREPUCE DORSAL/LATERAL SPX NEWBORN,,,21,,RBRVS,1.59 ,1.33 ,2.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54001,CPT,SLITTING PREPUCE DORSAL/LAT SPX XCP NEWBORN,,,21,,RBRVS,2.24 ,1.48 ,2.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54015,CPT,I&D PENIS DEEP,,,21,,RBRVS,5.36 ,2.83 ,2.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54050,CPT,DSTRJ LESION PENIS SIMPLE CHEMICAL,,,21,,RBRVS,1.29 ,1.57 ,2.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54055,CPT,DSTRJ LESION PENIS SIMPLE ELECTRODESICCATION,,,21,,RBRVS,1.25 ,1.26 ,1.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54056,CPT,DSTRJ LESION PENIS SIMPLE CRYOSURGERY,,,21,,RBRVS,1.29 ,1.72 ,2.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54057,CPT,DSTRJ LESION PENIS SIMPLE LASER,,,21,,RBRVS,1.29 ,1.27 ,2.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54060,CPT,DSTRJ LESION PENIS SIMPLE SURG EXCISION,,,21,,RBRVS,1.98 ,1.52 ,2.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54065,CPT,DSTRJ LESION PENIS EXTENSIVE,,,21,,RBRVS,2.47 ,2.17 ,3.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54100,CPT,BIOPSY PENIS SEPARATE PROCEDURE,,,21,,RBRVS,1.90 ,1.47 ,3.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54105,CPT,BIOPSY PENIS DEEP STRUCTURES,,,21,,RBRVS,3.54 ,2.18 ,3.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54110,CPT,EXCISION OF PENILE PLAQUE,,,21,,RBRVS,10.92 ,5.76 ,5.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54111,CPT,EXC PENILE PLAQUE GRAFT &/5 CM LENGTH,,,21,,RBRVS,14.42 ,6.95 ,6.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54112,CPT,EXC PENILE PLAQUE GRAFT > 5 CM LENGTH,,,21,,RBRVS,16.98 ,8.04 ,8.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54115,CPT,REMOVAL FOREIGN BODY DEEP PENILE TISSUE,,,21,,RBRVS,6.95 ,4.42 ,5.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54120,CPT,AMPUTATION PENIS PARTIAL,,,21,,RBRVS,11.01 ,5.87 ,5.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54125,CPT,AMPUTATION PENIS COMPLETE,,,21,,RBRVS,14.56 ,7.10 ,7.10 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
54130,CPT,AMPUTATION PENIS RADW/BI INGUINOFEMORAL LMPHADE,,,21,,RBRVS,21.84 ,9.97 ,9.97 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
54135,CPT,AMPUTATION PENIS RADICAL W/LYMPH NODES,,,21,,RBRVS,28.17 ,12.10 ,12.10 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
54150,CPT,CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK,,,21,,RBRVS,1.90 ,0.68 ,2.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54160,CPT,CIRCUMCISION NEONATE,,,21,,RBRVS,2.53 ,1.32 ,3.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54161,CPT,CIRCUMCISION AGE >28 DAYS,,,21,,RBRVS,3.32 ,1.95 ,1.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54162,CPT,LYSIS/EXCISION PENILE POSTCIRCUMCISION ADHESIONS,,,21,,RBRVS,3.32 ,2.02 ,3.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54163,CPT,REPAIR INCOMPLETE CIRCUMCISION,,,21,,RBRVS,3.32 ,2.57 ,2.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54164,CPT,FRENULOTOMY PENIS,,,21,,RBRVS,2.82 ,2.41 ,2.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54200,CPT,INJECTION PEYRONIE DISEASE,,,21,,RBRVS,1.11 ,1.17 ,1.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54205,CPT,NJX PEYRONIE W/SURG EXPOS PLAQUE,,,21,,RBRVS,8.97 ,5.29 ,5.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54220,CPT,IRRIGATION CORPORA CAVERNOSA PRIAPISM,,,21,,RBRVS,2.42 ,1.14 ,3.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54230,CPT,INJECTION CORPORA CAVERNOSOGRAPY,,,21,,RBRVS,1.34 ,0.81 ,1.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54231,CPT,DYNAMIC CAVERNOSOMETRY NJX VASOACTIVE DRUGS,,,21,,RBRVS,2.04 ,1.08 ,1.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54235,CPT,NJX C/P/A CAVERNOSA W/PHARMACOLOGIC AGT,,,21,,RBRVS,1.19 ,0.79 ,1.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54240,CPT,PENILE PLETHYSMOGRAPHY,,,21,,RBRVS,1.31 ,1.41 ,1.41 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
54240,CPT,PENILE PLETHYSMOGRAPHY,26,,21,,RBRVS,1.31 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54240,CPT,PENILE PLETHYSMOGRAPHY,TC,,21,,RBRVS,,0.98 ,0.98 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
54250,CPT,NOCTURNAL PENILE TUMESCENCE &/RIGIDITY TEST,,,21,,RBRVS,2.22 ,1.05 ,1.05 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
54250,CPT,NOCTURNAL PENILE TUMESCENCE &/RIGIDITY TEST,26,,21,,RBRVS,2.22 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54250,CPT,NOCTURNAL PENILE TUMESCENCE &/RIGIDITY TEST,TC,,21,,RBRVS,,0.30 ,0.30 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
54300,CPT,PENIS STRAIGHTENING CHORDEE,,,21,,RBRVS,11.20 ,5.94 ,5.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54304,CPT,PENIS CORRJ CHORDEE/1ST STAGE HYPOSPADIAS RPR,,,21,,RBRVS,13.28 ,6.76 ,6.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54308,CPT,URETHROPLASTY 2ND STAGE HYPOSPADIAS RPR <3 CM,,,21,,RBRVS,12.62 ,6.49 ,6.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54312,CPT,URETHROPLASTY 2ND STAGE HYPOSPADIAS RPR > 3 CM,,,21,,RBRVS,14.51 ,7.35 ,7.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54316,CPT,URETHROPLASTY 2ND STAGE HYPOSPADIAS RPR SKIN GRF,,,21,,RBRVS,18.05 ,8.59 ,8.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54318,CPT,URETHROPLASTY 3RD STG HYPOSPADIAS RPR RLS PENIS,,,21,,RBRVS,12.43 ,7.34 ,7.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54322,CPT,1 STG DSTL HYPOSPADIAS RPR W/SMPL MEATAL ADVMNT,,,21,,RBRVS,13.98 ,6.87 ,6.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54324,CPT,1 STG DSTL HYPOSPADIAS RPR W/URTP SKIN FLAPS,,,21,,RBRVS,17.55 ,8.31 ,8.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54326,CPT,1 STG DSTL HYPOSPADIAS RPR URTP SKN FLAPS,,,21,,RBRVS,17.02 ,8.24 ,8.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54328,CPT,1 STAGE DSTL HYPOSPADIAS RPR W/EXTENSIVE DSJ,,,21,,RBRVS,16.89 ,8.20 ,8.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54332,CPT,1 STAGE PROX PENILE/PENOSCROTAL HYPOSPADIAS RPR,,,21,,RBRVS,18.37 ,8.70 ,8.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54336,CPT,1 STG PERINEAL HYPOSPADIAS RPR W/GRF&/FLAP,,,21,,RBRVS,21.62 ,10.11 ,10.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54340,CPT,RPR HYPOSPADIAS COMPLCTJS CLSR INC/EXC SIMPLE,,,21,,RBRVS,9.71 ,5.54 ,5.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54344,CPT,RPR HYPOSPADIAS COMPLCTJS MOBLJ FLAPS & URTP,,,21,,RBRVS,17.06 ,8.25 ,8.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54348,CPT,RPR HYPOSPADIAS COMPLCTJS DSJ & URTP FLAP/GRF,,,21,,RBRVS,18.32 ,9.78 ,9.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54352,CPT,RPR HYPOSPADIAS CRIPPLE W/DSJ & EXC & GRFS/FLAP,,,21,,RBRVS,26.13 ,11.63 ,11.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54360,CPT,PLASTIC RPR PENIS CORRECT ANGULATION,,,21,,RBRVS,12.78 ,6.46 ,6.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54380,CPT,PLASTIC RPR PENIS EPISPADIAS DSTL SPHNCTR,,,21,,RBRVS,14.18 ,7.17 ,7.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54385,CPT,PLASTIC PENIS EPISPADIAS DSTL SPHNCTR W/INCONT,,,21,,RBRVS,16.56 ,10.88 ,10.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54390,CPT,PLASTIC RPR PENIS EPISPADIAS W/EXSTROPHY BLADDER,,,21,,RBRVS,22.77 ,11.55 ,11.55 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
54400,CPT,INSJ PENILE PROSTHESIS NON-INFLATABLE SEMI-RIGID,,,21,,RBRVS,9.17 ,4.98 ,4.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54401,CPT,INSJ PENILE PROSTHESOS INFLATABLE SELF-CONTAINED,,,21,,RBRVS,10.44 ,7.17 ,7.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54405,CPT,INSJ MULTI-COMPONENT INFLATABLE PENILE PROSTH,,,21,,RBRVS,14.52 ,7.06 ,7.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54406,CPT,RMVL INFLATABLE PENILE PROSTH W/O RPLCMT PROSTH,,,21,,RBRVS,12.89 ,6.62 ,6.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54408,CPT,RPR COMPONENT INFLATABLE PENILE PROSTHESIS,,,21,,RBRVS,13.91 ,7.21 ,7.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54410,CPT,RMVL & RPLCMT INFLATABLE PENILE PROSTH SAME SESS,,,21,,RBRVS,15.18 ,7.79 ,7.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54411,CPT,RMVL & RPLCMT NFLTBL PENILE PROSTH INFECTED FIEL,,,21,,RBRVS,18.35 ,9.06 ,9.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54415,CPT,RMVL NON-NFLTBL/NFLTBL PENILE PROSTH W/O RPLCMT,,,21,,RBRVS,8.88 ,5.27 ,5.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54416,CPT,RMVL & RPLCMT NON-NFLTBL/NFLTBL PENILE PROSTHESI,,,21,,RBRVS,12.08 ,6.93 ,6.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54417,CPT,RMVL & RPLCMT PENILE PROSTHESIS INFECTED FIELD,,,21,,RBRVS,16.10 ,7.90 ,7.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54420,CPT,CORPORA CAVERNOSA-SAPHENOUS VEIN SHUNT UNI/BI,,,21,,RBRVS,12.39 ,6.44 ,6.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54430,CPT,CORPORA CAVERNOSA-CORPUS SPONGIOSUM SHUNT UNI/BI,,,21,,RBRVS,11.06 ,6.06 ,6.06 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
54435,CPT,CORPORA CAVERNOSA-GLANS PENIS FSTLJ PRIAPISM,,,21,,RBRVS,6.81 ,4.36 ,4.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54437,CPT,REPAIR OF TRAUMATIC CORPOREAL TEAR(S),,,21,,RBRVS,11.50 ,6.64 ,6.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54438,CPT,REPLANTATION PENIS COMP AMPUTATION W/URETH REP,,,21,,RBRVS,24.50 ,11.63 ,11.63 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
54440,CPT,PLASTIC OPERATION PENIS INJURY,,,21,,TotalUnits,,,,16.20 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54450,CPT,FORESKN MANJ W/LSS PREPUTIAL ADS&STRETCHING,,,21,,RBRVS,1.12 ,0.41 ,0.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54500,CPT,BIOPSY TESTIS NEEDLE SEPARATE PROCEDURE,,,21,,RBRVS,1.31 ,0.69 ,0.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54505,CPT,BIOPSY TESTIS INCISIONAL SEPARATE PROCEDURE,,,21,,RBRVS,3.50 ,2.13 ,2.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54512,CPT,EXC XTRPARENCHYMAL LESION TESTIS,,,21,,RBRVS,9.33 ,5.07 ,5.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54520,CPT,ORCHIECTOMY SIMPLE SCROTAL/INGUINAL APPROACH,,,21,,RBRVS,5.30 ,3.39 ,3.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54522,CPT,ORCHIECTOMY PARTIAL,,,21,,RBRVS,10.25 ,5.53 ,5.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54530,CPT,ORCHIECTOMY RADICAL TUMOR INGUINAL APPROACH,,,21,,RBRVS,8.46 ,5.04 ,5.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54535,CPT,ORCHIECTOMY RADICAL TUMOR W/ABDOMINAL EXPL,,,21,,RBRVS,13.19 ,6.69 ,6.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54550,CPT,EXPL UNDESCENDED TSTIS INGUN/SCROTAL AREA,,,21,,RBRVS,8.41 ,4.76 ,4.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54560,CPT,EXPL UNDESCENDED TESTIS W/ABDOMINAL EXPL,,,21,,RBRVS,12.10 ,6.98 ,6.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54600,CPT,RDCTJ TORSION TSTIS W/WO FIXJ CLAT TESTIS,,,21,,RBRVS,7.64 ,4.49 ,4.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54620,CPT,FIXATION CONTRALATERAL TESTIS SEPARATE PROCEDURE,,,21,,RBRVS,5.21 ,2.82 ,2.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54640,CPT,ORCHIOPEXY INGUINAL APPROACH W/WO HERNIA RPR,,,21,,RBRVS,7.73 ,5.04 ,5.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54650,CPT,ORCHIOPEXY ABDL APPROACH INTRA-ABDOMINAL TESTIS,,,21,,RBRVS,12.39 ,6.64 ,6.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54660,CPT,INSJ TESTICULAR PROSTH SEPARATE PROCEDURE,,,21,,RBRVS,5.74 ,3.85 ,3.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54670,CPT,SUTURE/REPAIR TESTICULAR INJURY,,,21,,RBRVS,6.65 ,4.21 ,4.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54680,CPT,TRANSPLANTATION TESTIS TO THIGH,,,21,,RBRVS,14.04 ,6.98 ,6.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54690,CPT,LAPAROSCOPY SURGICAL ORCHIECTOMY,,,21,,RBRVS,11.70 ,5.86 ,5.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54692,CPT,LAPAROSCOPY ORCHIOPEXY INTRA-ABDOMINAL TESTIS,,,21,,RBRVS,13.74 ,6.52 ,6.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54699,CPT,UNLISTED LAPAROSCOPY PROCEDURE TESTIS,,,21,,TotalUnits,,,,17.56 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54700,CPT,I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE,,,21,,RBRVS,3.47 ,2.24 ,2.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54800,CPT,BIOPSY EPIDIDYMIS NEEDLE,,,21,,RBRVS,2.33 ,1.03 ,1.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54830,CPT,EXCISION LOCAL LESION EPIDIDYMIS,,,21,,RBRVS,6.01 ,3.96 ,3.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54840,CPT,EXCISION SPERMATOCELE W/WO EPIDIDYMECTOMY,,,21,,RBRVS,5.27 ,3.33 ,3.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54860,CPT,EPIDIDYMECTOMY UNILATERAL,,,21,,RBRVS,6.95 ,4.27 ,4.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54861,CPT,EPIDIDYMECTOMY BILATERAL,,,21,,RBRVS,9.70 ,5.44 ,5.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54865,CPT,EXPLORATION EPIDIDYMIS W/WO BIOPSY,,,21,,RBRVS,5.77 ,3.86 ,3.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54900,CPT,EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS UNI,,,21,,RBRVS,14.20 ,8.03 ,8.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
54901,CPT,EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS BI,,,21,,RBRVS,19.10 ,10.16 ,10.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55000,CPT,PNXR ASPIR HYDROCELE TUNICA VAGIS W/WO NJX MED,,,21,,RBRVS,1.43 ,0.85 ,1.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55040,CPT,EXCISION HYDROCELE UNILATERAL,,,21,,RBRVS,5.45 ,3.58 ,3.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55041,CPT,EXCISION HYDROCELE BILATERAL,,,21,,RBRVS,8.54 ,5.09 ,5.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55060,CPT,RPR TUNICA VAGINALIS HYDROCELE BOTTLE TYPE,,,21,,RBRVS,6.15 ,4.03 ,4.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55100,CPT,DRAINAGE SCROTAL WALL ABSCESS,,,21,,RBRVS,2.45 ,2.01 ,3.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55110,CPT,SCROTAL EXPLORATION,,,21,,RBRVS,6.33 ,4.01 ,4.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55120,CPT,REMOVAL FOREIGN BODY SCROTUM,,,21,,RBRVS,5.72 ,3.89 ,3.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55150,CPT,RESECTION SCROTUM,,,21,,RBRVS,8.14 ,5.02 ,5.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55175,CPT,SCROTOPLASTY SIMPLE,,,21,,RBRVS,5.87 ,3.85 ,3.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55180,CPT,SCROTOPLASTY COMPLICATED,,,21,,RBRVS,11.78 ,6.62 ,6.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55200,CPT,VASOTOMY CANNULIZATION W/WO VAS INC UNI/BI SPX,,,21,,RBRVS,4.55 ,2.94 ,7.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55250,CPT,VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS,,,21,,RBRVS,3.37 ,2.77 ,7.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55300,CPT,VASOTOMY VASOGRAMS UNI/BI,,,21,,RBRVS,3.50 ,1.50 ,1.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55400,CPT,VASOVASOSTOMY VASOVASORRHAPHY,,,21,,RBRVS,8.61 ,4.72 ,4.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55450,CPT,LIGATION PRQ VAS DEFERENS UNI/BI SPX,,,21,,RBRVS,4.43 ,2.47 ,5.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55500,CPT,EXC HYDROCELE SPRMATIC CORD UNI SPX,,,21,,RBRVS,6.22 ,4.21 ,4.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55520,CPT,EXC LESION SPERMATIC CORD SEPARATE PROCEDURE,,,21,,RBRVS,6.66 ,4.90 ,4.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55530,CPT,EXC VARICOCELE/LIGATION SPERMATIC VEINS SPX,,,21,,RBRVS,5.75 ,3.67 ,3.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55535,CPT,EXC VARICOCELE/LIGATION SPERMATIC VEINS ABDL,,,21,,RBRVS,7.19 ,4.34 ,4.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55540,CPT,EXC VARICOCELE/LIGATION VEINS W/HERNIA RPR,,,21,,RBRVS,8.30 ,5.66 ,5.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55550,CPT,LAPS LIGATION SPERMATIC VEINS VARICOCELE,,,21,,RBRVS,7.20 ,4.27 ,4.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55559,CPT,UNLISTED LAPROSCOPY PROCEDURE SPERMATIC CORD,,,21,,TotalUnits,,,,11.47 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55600,CPT,VESICULOTOMY,,,21,,RBRVS,7.01 ,4.28 ,4.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55605,CPT,VESICULOTOMY COMPLICATED,,,21,,RBRVS,8.76 ,5.79 ,5.79 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
55650,CPT,VESICULECTOMY ANY APPROACH,,,21,,RBRVS,12.65 ,6.51 ,6.51 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
55680,CPT,EXCISION MULLERIAN DUCT CYST,,,21,,RBRVS,5.67 ,4.01 ,4.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55700,CPT,PROSTATE NEEDLE BIOPSY ANY APPROACH,,,21,,RBRVS,2.58 ,1.14 ,3.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55705,CPT,BIOPSY PROSTATE INCISIONAL ANY APPROACH,,,21,,RBRVS,4.61 ,2.52 ,2.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55706,CPT,BX PROSTATE STRTCTC SATURATION SAMPLING IMG GID,,,21,,RBRVS,6.28 ,3.69 ,3.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55720,CPT,PROSTATOTOMY EXTERNAL DRG ABSCESS SIMPLE,,,21,,RBRVS,7.73 ,4.36 ,4.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55725,CPT,PROSTATOTOMY EXTERNAL DRG ABSCESS COMPLICATED,,,21,,RBRVS,10.05 ,7.03 ,7.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55801,CPT,PROSTATECTOMY PERINEAL SUBTOTAL,,,21,,RBRVS,19.80 ,9.37 ,9.37 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
55810,CPT,PROSTATECTOMY PERINEAL RADICAL,,,21,,RBRVS,24.29 ,10.66 ,10.66 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
55812,CPT,PROSTATECTOMY PERINEAL RADICAL W/LYMPH NODE BX,,,21,,RBRVS,29.89 ,12.99 ,12.99 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
55815,CPT,PROSTATECTOMY PERINEAL RAD W/BI PELVIC LYMPH EXC,,,21,,RBRVS,32.95 ,14.02 ,14.02 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
55821,CPT,PROSTATECTOMY SUPRAPUBIC SUBTOTAL 1/2 STAGES,,,21,,RBRVS,15.76 ,7.55 ,7.55 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
55831,CPT,PROSTATECTOMY RETROPUBIC SUBTOTAL,,,21,,RBRVS,17.19 ,8.03 ,8.03 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
55840,CPT,PROSTATECTOMY RETROPUBIC W/WO NERVE SPARING,,,21,,RBRVS,21.36 ,9.88 ,9.88 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
55842,CPT,PROSTECT RETROPUBIC RAD W/WO NRV SPAR W/LYMPH BX,,,21,,RBRVS,21.36 ,9.87 ,9.87 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
55845,CPT,PROSTECT RETROPUB RAD W/WO NRV SPAR & BI PLV LYM,,,21,,RBRVS,25.18 ,11.16 ,11.16 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
55860,CPT,EXPOS PROSTATE ANY APPROACH INSJ RADIOACT SUBST,,,21,,RBRVS,15.84 ,7.51 ,7.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55862,CPT,EXPOS PROSTATE INSJ RADIOACT SBST W/LYMPH BX,,,21,,RBRVS,20.04 ,10.32 ,10.32 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
55865,CPT,EXPOS PROSTATE INSJ RADIOAC SBST W/BI PELV LYMPH,,,21,,RBRVS,24.57 ,10.99 ,10.99 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
55866,CPT,LAPS PROSTECT RETROPUBIC RAD W/NRV SPARING ROBOT,,,21,,RBRVS,32.06 ,14.17 ,14.17 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
55870,CPT,ELECTROEJACULATION,,,21,,RBRVS,2.58 ,1.22 ,2.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55873,CPT,CRYOSURGICAL ABLATION PROSTATE W/US & MONITORI,,,21,,RBRVS,13.60 ,6.84 ,185.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55875,CPT,TRANSPERINEAL PLMT NDL/CATHS PROSTATE RADJ INSJ,,,21,,RBRVS,13.46 ,6.96 ,6.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55876,CPT,PLMT INTERSTITIAL DEV RADIAT TX PROSTATE 1/MULT,,,21,,RBRVS,1.73 ,0.98 ,1.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55899,CPT,UNLISTED PROCEDURE MALE GENITAL SYSTEM,,,21,,TotalUnits,,,,5.36 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
55920,CPT,PLACEMENT NEEDLE PELVIC ORGAN RADIOELEMENT APPL,,,21,,RBRVS,8.31 ,3.64 ,3.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
56405,CPT,I&D VULVA/PERINEAL ABSCESS,,,21,,RBRVS,1.49 ,1.40 ,1.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
56420,CPT,I&D OF BARTHOLINS GLAND ABSCESS,,,21,,RBRVS,1.44 ,0.97 ,1.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
56440,CPT,MARSUPIALIZATION BARTHOLINS GLAND CYST,,,21,,RBRVS,2.89 ,1.93 ,1.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
56441,CPT,LYSIS LABIAL ADHESIONS,,,21,,RBRVS,2.02 ,1.69 ,1.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
56442,CPT,HYMENOTOMY SIMPLE INCISION,,,21,,RBRVS,0.68 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
56501,CPT,DESTRUCTION LESIONS VULVA SIMPLE,,,21,,RBRVS,1.58 ,1.48 ,1.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
56515,CPT,DESTRUCTION LESIONS VULVA EXTENSIVE,,,21,,RBRVS,3.08 ,2.22 ,2.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
56605,CPT,BIOPSY VULVA/PERINEUM 1 LESION SPX,,,21,,RBRVS,1.10 ,0.48 ,1.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
56606,CPT,BIOPSY VULVA/PERINEUM EACH ADDL LESION,,,21,,RBRVS,0.55 ,0.22 ,0.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
56620,CPT,VULVECTOMY SIMPLE PARTIAL,,,21,,RBRVS,7.53 ,5.95 ,5.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
56625,CPT,VULVECTOMY SIMPLE COMPLETE,,,21,,RBRVS,9.68 ,6.44 ,6.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
56630,CPT,VULVECTOMY RADICAL PARTIAL,,,21,,RBRVS,14.80 ,8.76 ,8.76 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
56631,CPT,VULVECTOMY RAD PRTL UNI INGUINOFEM LMPHADECTOMY,,,21,,RBRVS,18.99 ,10.89 ,10.89 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
56632,CPT,VULVECTOMY RAD PRTL BI INGUINOFEM LMPHADECTOMY,,,21,,RBRVS,21.86 ,13.12 ,13.12 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
56633,CPT,VULVECTOMY RADICAL COMPLETE,,,21,,RBRVS,19.62 ,11.06 ,11.06 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
56634,CPT,VULVECTOMY RAD COMPL UNI INGUINOFEM LMPHADECTOMY,,,21,,RBRVS,20.66 ,11.94 ,11.94 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
56637,CPT,VULVECTOMY RAD COMPL BI INGUINOFEM LMPHADECTOMY,,,21,,RBRVS,24.75 ,13.38 ,13.38 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
56640,CPT,VULVECTOMY RAD COMPL ILIAC & PELVIC LMPHADECTOMY,,,21,,RBRVS,24.78 ,13.26 ,13.26 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
56700,CPT,PRTL HYMENECTOMY/REVJ HYMENAL RING,,,21,,RBRVS,2.84 ,2.12 ,2.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
56740,CPT,EXC BARTHOLINS GLAND/CYST,,,21,,RBRVS,4.88 ,2.97 ,2.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
56800,CPT,PLASTIC REPAIR INTROITUS,,,21,,RBRVS,3.93 ,2.43 ,2.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
56805,CPT,CLITOROPLASTY INTERSEX STATE,,,21,,RBRVS,19.88 ,10.12 ,10.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
56810,CPT,PERINEOPLASTY RPR PERINEUM NONOBSTETRICAL SPX,,,21,,RBRVS,4.29 ,2.55 ,2.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
56820,CPT,COLPOSCOPY VULVA,,,21,,RBRVS,1.50 ,0.74 ,1.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
56821,CPT,COLPOSCOPY VULVA W/BIOPSY,,,21,,RBRVS,2.05 ,0.95 ,1.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57000,CPT,COLPOTOMY W/EXPLORATION,,,21,,RBRVS,3.02 ,1.86 ,1.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57010,CPT,COLPOTOMY W/DRAINAGE PELVIC ABSCESS,,,21,,RBRVS,6.84 ,4.61 ,4.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57020,CPT,COLPOCENTESIS SEPARATE PROCEDURE,,,21,,RBRVS,1.50 ,0.62 ,0.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57022,CPT,I&D VAGINAL HEMATOMA OBSTETRICAL/POSTPARTUM,,,21,,RBRVS,2.73 ,1.71 ,1.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57023,CPT,I&D VAGINAL HEMATOMA NON-OBSTETRICAL,,,21,,RBRVS,5.18 ,3.00 ,3.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57061,CPT,DESTRUCTION VAGINAL LESIONS SIMPLE,,,21,,RBRVS,1.30 ,1.33 ,1.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57065,CPT,DESTRUCTION VAGINAL LESIONS EXTENSIVE,,,21,,RBRVS,2.66 ,1.91 ,2.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57100,CPT,BIOPSY VAGINAL MUCOSA SIMPLE,,,21,,RBRVS,1.20 ,0.53 ,1.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57105,CPT,BIOPSY VAGINAL MUCOSA EXTENSIVE,,,21,,RBRVS,1.74 ,1.60 ,1.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57106,CPT,VAGINECTOMY PARTIAL REMOVAL VAGINAL WALL,,,21,,RBRVS,7.50 ,5.34 ,5.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57107,CPT,VAGINECTOMY PRTL RMVL VAG WALL & PARAVAGINAL T,,,21,,RBRVS,24.56 ,12.55 ,12.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57109,CPT,VAGNC PRTL RMVL VAG WALL W/BI TOT PEL LMPHADEC,,,21,,RBRVS,28.40 ,15.10 ,15.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57110,CPT,VAGINECTOMY COMPLETE REMOVAL VAGINAL WALL,,,21,,RBRVS,15.48 ,8.01 ,8.01 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
57111,CPT,VAGINECTOMY COMPL RMVL VAG WALL & PARAVAG TISS,,,21,,RBRVS,28.40 ,13.58 ,13.58 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
57112,CPT,VAGNC COMPL RMVL VAG WALL TOT PEL LMPHADEC BX,,,21,,RBRVS,30.52 ,16.02 ,16.02 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
57120,CPT,COLPOCLEISIS LE FORT TYPE,,,21,,RBRVS,8.28 ,5.15 ,5.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57130,CPT,EXCISION VAGINAL SEPTUM,,,21,,RBRVS,2.46 ,1.76 ,2.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57135,CPT,EXCISION VAGINAL CYST/TUMOR,,,21,,RBRVS,2.70 ,1.87 ,2.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57150,CPT,IRRIGATION VAGINA&/APPL MEDICAMENT TX DISEASE,,,21,,RBRVS,0.55 ,0.21 ,0.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57155,CPT,INSERTION UTERINE TANDEM&/VAGINAL OVOIDS,,,21,,RBRVS,5.40 ,2.36 ,6.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57156,CPT,INSERTION VAGINAL RADIATION DEVICE,,,21,,RBRVS,2.69 ,1.25 ,2.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57160,CPT,FIT&INSJ PESSARY/OTH INTRAVAGINAL SUPPORT DEVI,,,21,,RBRVS,0.89 ,0.35 ,1.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57170,CPT,DIAPHRAGM/CERVICAL CAP FITTING W/INSTRUCTIONS,,,21,,RBRVS,0.91 ,0.36 ,0.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57180,CPT,INTRO ANY HEMOSTATIC AGENT/PACK VAG HEMRRG SPX,,,21,,RBRVS,1.63 ,1.17 ,2.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57200,CPT,COLPORRHAPHY SUTURE INJURY VAGINA,,,21,,RBRVS,4.42 ,3.52 ,3.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57210,CPT,COLPOPERINEORRHAPHY SUTURE INJ VAGINA&/PERINEU,,,21,,RBRVS,5.71 ,3.98 ,3.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57220,CPT,PLASTIC URETHRAL SPHINCTER VAGINAL APPROACH,,,21,,RBRVS,4.85 ,3.59 ,3.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57230,CPT,PLASTIC REPAIR URETHROCELE,,,21,,RBRVS,6.30 ,4.11 ,4.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57240,CPT,ANT COLPORRHAPHY CYSTOCELE W/WO RPR URETHROCELE,,,21,,RBRVS,11.50 ,6.18 ,6.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57250,CPT,POST COLPORRHAPHY RECTOCELE W/WO PERINEORRHAPHY,,,21,,RBRVS,11.50 ,6.29 ,6.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57260,CPT,COMBINED ANTEROPOSTERIOR COLPORRHAPHY,,,21,,RBRVS,14.44 ,7.45 ,7.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57265,CPT,CMBND ANTEROPOST COLPORRHAPHY W/ENTEROCELE RPR,,,21,,RBRVS,15.94 ,8.02 ,8.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57267,CPT,INSJ MESH/PROSTH PELVIC FLOOR DEFECT EACH SITE,,,21,,RBRVS,4.88 ,1.84 ,1.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57268,CPT,REPAIR ENTEROCELE VAGINAL APPROACH SPX,,,21,,RBRVS,7.57 ,5.18 ,5.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57270,CPT,REPAIR ENTEROCELE ABDOMINAL APPROACH SPX,,,21,,RBRVS,13.67 ,7.25 ,7.25 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
57280,CPT,COLPOPEXY ABDOMINAL APPROACH,,,21,,RBRVS,16.72 ,8.32 ,8.32 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
57282,CPT,COLPOPEXY VAGINAL EXTRAPERITONEAL APPROACH,,,21,,RBRVS,7.97 ,5.27 ,5.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57283,CPT,COLPOPEXY VAGINAL INTRAPERITONEAL APPROACH,,,21,,RBRVS,11.66 ,6.46 ,6.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57284,CPT,PARAVAGINAL DEFECT REPAIR OPEN ABDOMINAL APPR,,,21,,RBRVS,14.33 ,7.12 ,7.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57285,CPT,PARAVAGINAL DEFECT REPAIR VAGINAL APPROACH,,,21,,RBRVS,11.60 ,6.11 ,6.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57287,CPT,RMVL/REVJ SLING STRESS INCONTINENCE,,,21,,RBRVS,11.15 ,6.90 ,6.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57288,CPT,SLING OPERATION STRESS INCONTINENCE,,,21,,RBRVS,12.13 ,6.79 ,6.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57289,CPT,PEREYRA PX W/ANTERIOR COLPORRHAPHY,,,21,,RBRVS,12.80 ,6.67 ,6.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57291,CPT,CONSTRUCTION ARTIFICIAL VAGINA W/O GRAFT,,,21,,RBRVS,8.64 ,5.31 ,5.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57292,CPT,CONSTRUCTION ARTIFICIAL VAGINA W/GRAFT,,,21,,RBRVS,14.01 ,7.43 ,7.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57295,CPT,REVJ/RMVL PROSTHETIC VAGINAL GRAFT VAGINAL APP,,,21,,RBRVS,7.82 ,4.79 ,4.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57296,CPT,REVJ W/RMVL PROSTHETIC VAGINAL GRAFT ABDML APPR,,,21,,RBRVS,16.56 ,7.98 ,7.98 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
57300,CPT,CLSR RECTOVAGINAL FISTULA VAGINAL/TRANSANAL APPR,,,21,,RBRVS,8.71 ,6.02 ,6.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57305,CPT,CLSR RECTOVAGINAL FISTULA ABDOMINAL APPROACH,,,21,,RBRVS,15.35 ,8.56 ,8.56 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
57307,CPT,CLSR RECTOVAG FSTL ABDL APPR W/CONCOMITANT CLST,,,21,,RBRVS,17.17 ,9.67 ,9.67 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
57308,CPT,CLSR RECTOVAG FSTL TPRNL PRNL BDY RCNSTJ,,,21,,RBRVS,10.59 ,6.24 ,6.24 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
57310,CPT,CLOSURE URETHROVAGINAL FISTULA,,,21,,RBRVS,7.65 ,4.68 ,4.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57311,CPT,CLSR URETHROVAG FSTL W/BULBOCAVERNOSUS TRNSPL,,,21,,RBRVS,8.91 ,5.11 ,5.11 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
57320,CPT,CLOSURE VESICOVAGINAL FISTULA VAGINAL APPROACH,,,21,,RBRVS,8.88 ,5.19 ,5.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57330,CPT,CLSR VESICOVAG FSTL TRANSVESICAL&VAG APPR,,,21,,RBRVS,13.21 ,6.52 ,6.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57335,CPT,VAGINOPLASTY INTERSEX STATE,,,21,,RBRVS,20.02 ,10.46 ,10.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57400,CPT,DILATION VAGINA W/ANESTHESIA OTHER THAN LOCAL,,,21,,RBRVS,2.27 ,1.23 ,1.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57410,CPT,PELVIC EXAMINATION W/ANESTHESIA OTHER THAN LOCAL,,,21,,RBRVS,1.75 ,1.08 ,1.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57415,CPT,REMOVAL IMPACTED VAG FB SPX W/ANES OTH/THN LOCAL,,,21,,RBRVS,2.49 ,1.76 ,1.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57420,CPT,COLPOSCOPY ENTIRE VAGINA W/CERVIX IF PRESENT,,,21,,RBRVS,1.60 ,0.78 ,1.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57421,CPT,COLPOSCOPY ENTIRE VAGINA W/VAGINA/CERVIX BX,,,21,,RBRVS,2.20 ,1.02 ,1.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57423,CPT,PARAVAGINAL DEFECT REPAIR LAPAROSCOPIC APPROACH,,,21,,RBRVS,16.08 ,7.88 ,7.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57425,CPT,LAPAROSCOPY COLPOPEXY SUSPENSION VAGINAL APEX,,,21,,RBRVS,17.03 ,8.43 ,8.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57426,CPT,REVISION PROSTHETIC VAGINAL GRAFT LAPAROSCOPIC,,,21,,RBRVS,14.30 ,7.92 ,7.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57452,CPT,COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA,,,21,,RBRVS,1.50 ,0.93 ,1.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57454,CPT,COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE,,,21,,RBRVS,2.33 ,1.26 ,1.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57455,CPT,COLPOSCOPY CERVIX UPPR/ADJCNT VAGINA W/CERVIX BX,,,21,,RBRVS,1.99 ,0.91 ,1.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57456,CPT,COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE,,,21,,RBRVS,1.85 ,0.86 ,1.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57460,CPT,COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX,,,21,,RBRVS,2.83 ,1.45 ,4.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57461,CPT,COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX,,,21,,RBRVS,3.43 ,1.48 ,5.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57500,CPT,BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX,,,21,,RBRVS,1.20 ,0.81 ,2.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57505,CPT,ENDOCERVICAL CURETTAGE W/DILATION & CURETTAGE,,,21,,RBRVS,1.19 ,1.27 ,1.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57510,CPT,CAUTERY CERVIX ELECTRO/THERMAL,,,21,,RBRVS,1.90 ,1.15 ,1.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57511,CPT,CAUTERY CERVIX CRYOCAUTERY INITIAL/REPEAT,,,21,,RBRVS,1.95 ,1.56 ,1.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57513,CPT,CAUTERY CERVIX LASER ABLATION,,,21,,RBRVS,1.95 ,1.59 ,1.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57520,CPT,CONIZATION CERVIX W/WO D&C RPR KNIFE/LASER,,,21,,RBRVS,4.11 ,3.12 ,3.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57522,CPT,CONIZATION CERVIX W/WO D&C RPR ELTRD EXC,,,21,,RBRVS,3.67 ,2.78 ,3.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57530,CPT,TRACHELECTOMY CERVICECTOMY AMP CERVIX SPX,,,21,,RBRVS,5.27 ,3.86 ,3.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57531,CPT,RAD TRACHELECTOMY W/BI PEL LMPHADEC,,,21,,RBRVS,29.95 ,15.97 ,15.97 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
57540,CPT,EXCISION CERVICAL STUMP ABDOMINAL APPROACH,,,21,,RBRVS,13.29 ,7.91 ,7.91 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
57545,CPT,EXC CERVICAL STUMP ABDL APPR W/PELVIC FLOOR RPR,,,21,,RBRVS,14.10 ,7.47 ,7.47 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
57550,CPT,EXCISION CERVICAL STUMP VAGINAL APPROACH,,,21,,RBRVS,6.34 ,4.41 ,4.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57555,CPT,EXC CRV STUMP VAG APPR W/ANT &/POST REPAIR,,,21,,RBRVS,9.94 ,5.87 ,5.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57556,CPT,EXC CRV STUMP VAG APPR W/RPR NTRCL,,,21,,RBRVS,9.36 ,5.61 ,5.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57558,CPT,DILATION & CURETTAGE CERVICAL STUMP,,,21,,RBRVS,1.72 ,1.29 ,1.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57700,CPT,CERCLAGE UTERINE CERVIX NONOBSTETRICAL,,,21,,RBRVS,4.35 ,3.91 ,3.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57720,CPT,TRACHELORRHAPHY PLSTC RPR UTERINE CERVIX VAG,,,21,,RBRVS,4.61 ,3.53 ,3.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
57800,CPT,DILATION CERVICAL CANAL INSTRUMENTAL SPX,,,21,,RBRVS,0.77 ,0.52 ,0.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58100,CPT,ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX,,,21,,RBRVS,1.53 ,0.77 ,1.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58110,CPT,ENDOMETRIAL BX CONJUNCT W/COLPOSCOPY,,,21,,RBRVS,0.77 ,0.31 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58120,CPT,DILATION & CURETTAGE DX&/THER NONOBSTETRIC,,,21,,RBRVS,3.59 ,2.16 ,3.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58140,CPT,MYOMECTOMY 1-4 MYOMAS W/250 GM/< ABDOMINAL APPR,,,21,,RBRVS,15.79 ,8.21 ,8.21 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58145,CPT,MYOMECTOMY 1-4 MYOMAS 250 GM/< VAGINAL APPR,,,21,,RBRVS,8.91 ,5.43 ,5.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58146,CPT,MYOMECTOMY 5/> MYOMAS &/>250 GM ABDOMINA,,,21,,RBRVS,20.34 ,9.84 ,9.84 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58150,CPT,TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY,,,21,,RBRVS,17.31 ,8.92 ,8.92 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58152,CPT,TOT ABD HYST W/WO RMVL TUBE OVARY W/COLPURETHRXY,,,21,,RBRVS,21.86 ,10.79 ,10.79 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58180,CPT,SUPRACERVICAL ABDL HYSTER W/WO RMVL TUBE OVARY,,,21,,RBRVS,16.60 ,8.51 ,8.51 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58200,CPT,TOT ABD HYST W/PARAORTIC & PELVIC LYMPH NODE SAM,,,21,,RBRVS,23.10 ,11.67 ,11.67 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58210,CPT,RAD ABDL HYSTERECTOMY W/BI PELVIC LMPHADENECTOMY,,,21,,RBRVS,30.91 ,15.65 ,15.65 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58240,CPT,PEL EXNTJ GYNECOLOGIC MAL,,,21,,RBRVS,49.33 ,24.54 ,24.54 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58260,CPT,VAGINAL HYSTERECTOMY UTERUS 250 GM/<,,,21,,RBRVS,14.15 ,7.54 ,7.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58262,CPT,VAG HYST 250 GM/< W/RMVL TUBE&/OVARY,,,21,,RBRVS,15.94 ,8.23 ,8.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58263,CPT,VAG HYST 250 GM/< W/RMVL TUBE OVARY W/RPR NTRCL,,,21,,RBRVS,17.23 ,8.72 ,8.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58267,CPT,VAG HYST 250 GM/< W/COLPO-URTCSTOPEXY,,,21,,RBRVS,18.36 ,9.24 ,9.24 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58270,CPT,VAGINAL HYSTERECTOMY 250 GM/< W/RPR ENTEROCELE,,,21,,RBRVS,15.30 ,7.80 ,7.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58275,CPT,VAGINAL HYSTERECTOMY W/TOT/PRTL VAGINECTOMY,,,21,,RBRVS,17.03 ,8.78 ,8.78 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58280,CPT,VAG HYSTER W/TOT/PRTL VAGINECT W/RPR ENTEROCELE,,,21,,RBRVS,18.33 ,9.23 ,9.23 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58285,CPT,VAGINAL HYSTERECTOMY RADICAL SCHAUTA OPERATION,,,21,,RBRVS,23.38 ,12.11 ,12.11 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58290,CPT,VAGINAL HYSTERECTOMY UTERUS > 250 GM,,,21,,RBRVS,20.27 ,9.83 ,9.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58291,CPT,VAG HYST > 250 GM RMVL TUBE&/OVARY,,,21,,RBRVS,22.06 ,10.51 ,10.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58292,CPT,VAG HYST > 250 GM RMVL TUBE&/OVARY W/RPR ENTRCLE,,,21,,RBRVS,23.35 ,11.01 ,11.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58293,CPT,VAG HYST >250 GM COLPOURTCSTOPEXY W/WO NDSC CTR,,,21,,RBRVS,24.33 ,11.39 ,11.39 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58294,CPT,VAGINAL HYSTERECTOMY >250 GM RPR ENTEROCELE,,,21,,RBRVS,21.55 ,10.31 ,10.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58300,CPT,INSERTION INTRAUTERINE DEVICE IUD,,,21,,RBRVS,1.01 ,0.39 ,0.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58301,CPT,REMOVAL INTRAUTERINE DEVICE IUD,,,21,,RBRVS,1.27 ,0.50 ,1.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58321,CPT,ARTIFICIAL INSEMINATION INTRA-CERVICAL,,,21,,RBRVS,0.92 ,0.36 ,1.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58322,CPT,ARTIFICIAL INSEMINATION INTRA-UTERINE,,,21,,RBRVS,1.10 ,0.43 ,1.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58323,CPT,SPERM WASHING ARTIFICIAL INSEMINATION,,,21,,RBRVS,0.23 ,0.09 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58340,CPT,CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI,,,21,,RBRVS,0.88 ,0.68 ,2.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58345,CPT,TRANSCERV FALLOPIAN TUBE CATH W/WO HYSTOSALPING,,,21,,RBRVS,4.70 ,2.64 ,2.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58346,CPT,INSERTION HEYMAN CAPSULES CLINICAL BRACHYTHERAPY,,,21,,RBRVS,7.56 ,4.45 ,4.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58350,CPT,CHROMOTUBATION OVIDUCT W/MATERIALS,,,21,,RBRVS,1.06 ,1.04 ,1.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58353,CPT,ENDOMETRIAL ABLTJ THERMAL W/O HYSTEROSCOPIC GUID,,,21,,RBRVS,3.60 ,2.17 ,24.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58356,CPT,ENDOMETRIAL CRYOABLATION W/US & ENDOMETRIAL CR,,,21,,RBRVS,6.41 ,2.62 ,45.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58400,CPT,UTERINE SUSPENSION W/WO SHORTENING LIGAMENTS SPX,,,21,,RBRVS,7.14 ,4.45 ,4.45 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58410,CPT,UTERINE SUSP W/WO SHORT LIGAMNTS W/SYMPATHECTOMY,,,21,,RBRVS,13.80 ,7.29 ,7.29 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58520,CPT,HYSTERORRHAPHY REPAIR RUPT UTERUS NONOBSTETRICAL,,,21,,RBRVS,13.48 ,7.61 ,7.61 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58540,CPT,HYSTEROPLASTY RPR UTERINE ANOMALY,,,21,,RBRVS,15.71 ,8.11 ,8.11 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58541,CPT,LAPAROSCOPY SUPRACERVICAL HYSTERECTOMY 250 GM/<,,,21,,RBRVS,12.29 ,6.56 ,6.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58542,CPT,LAPS SUPRACRV HYSTERECT 250 GM/< RMVL TUBE/OVAR,,,21,,RBRVS,14.16 ,7.31 ,7.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58543,CPT,LAPS SUPRACERVICAL HYSTERECTOMY >250,,,21,,RBRVS,14.39 ,7.37 ,7.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58544,CPT,LAPS SUPRACRV HYSTEREC >250 G RMVL TUBE/OVARY,,,21,,RBRVS,15.60 ,7.97 ,7.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58545,CPT,LAPS MYOMECTOMY EXC 1-4 MYOMAS 250 GM/<,,,21,,RBRVS,15.55 ,7.92 ,7.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58546,CPT,LAPS MYOMECTOMY EXC 5/> MYOMAS >250 GRAMS,,,21,,RBRVS,19.94 ,9.49 ,9.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58548,CPT,LAPS W/RAD HYST W/BILAT LMPHADEC RMVL TUBE/OVARY,,,21,,RBRVS,31.63 ,16.30 ,16.30 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58550,CPT,LAPS VAGINAL HYSTERECTOMY UTERUS 250 GM/<,,,21,,RBRVS,15.10 ,8.05 ,8.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58552,CPT,LAPS W/VAG HYSTERECT 250 GM/&RMVL TUBE&/OVARIES,,,21,,RBRVS,16.91 ,8.81 ,8.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58553,CPT,LAPS W/VAGINAL HYSTERECTOMY > 250 GRAMS,,,21,,RBRVS,20.06 ,9.56 ,9.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58554,CPT,LAPS VAGINAL HYSTERECT > 250 GM RMVL TUBE&/OVAR,,,21,,RBRVS,23.11 ,11.29 ,11.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58555,CPT,HYSTEROSCOPY DIAGNOSTIC SEPARATE PROCEDURE,,,21,,RBRVS,3.33 ,1.65 ,4.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58558,CPT,HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C,,,21,,RBRVS,4.74 ,2.24 ,5.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58559,CPT,HYSTEROSCOPY LYSIS INTRAUTERINE ADHESIONS,,,21,,RBRVS,6.16 ,2.77 ,2.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58560,CPT,HYSTEROSCOPY DIV/RESCJ INTRAUTERINE SEPTUM,,,21,,RBRVS,6.99 ,3.12 ,3.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58561,CPT,HYSTEROSCOPY REMOVAL LEIOMYOMATA,,,21,,RBRVS,9.99 ,4.28 ,4.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58562,CPT,HYSTEROSCOPY REMOVAL IMPACTED FOREIGN BODY,,,21,,RBRVS,5.20 ,2.39 ,5.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58563,CPT,HYSTEROSCOPY ENDOMETRIAL ABLATION,,,21,,RBRVS,6.16 ,2.79 ,39.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58565,CPT,HYSTEROSCOPY BI TUBE OCCLUSION W/PERM IMPLNTS,,,21,,RBRVS,7.12 ,4.27 ,44.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58570,CPT,LAPAROSCOPY W TOTAL HYSTERECTOMY UTERUS 250 GM/<,,,21,,RBRVS,13.36 ,7.04 ,7.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58571,CPT,LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUBE/OVARY,,,21,,RBRVS,15.00 ,8.00 ,8.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58572,CPT,LAPAROSCOPY TOTAL HYSTERECTOMY UTERUS >250 GM,,,21,,RBRVS,17.71 ,8.82 ,8.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58573,CPT,LAPAROSCOPY TOT HYSTERECTOMY >250 G W/TUBE/OVAR,,,21,,RBRVS,20.79 ,10.34 ,10.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58578,CPT,UNLISTED LAPAROSCOPY PROCEDURE UTERUS,,,21,,TotalUnits,,,,25.72 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58579,CPT,UNLISTED HYSTEROSCOPY PROCEDURE UTERUS,,,21,,TotalUnits,,,,8.93 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58600,CPT,LIG/TRNSXJ FLP TUBE ABDL/VAG APPR UNI/BI,,,21,,RBRVS,5.91 ,3.67 ,3.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58605,CPT,LIG/TRNSXJ FLP TUBE ABDL/VAG POSTPARTUM SPX,,,21,,RBRVS,5.28 ,3.40 ,3.40 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58611,CPT,LIG/TRNSXJ FALOPIAN TUBE CESAREAN DEL/ABDML SURG,,,21,,RBRVS,1.45 ,0.57 ,0.57 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58615,CPT,OCCLUSION FLP TUBE DEV VAG/SUPRAPUBIC APPR,,,21,,RBRVS,3.94 ,2.49 ,2.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58660,CPT,LAPAROSCOPY W/LYSIS OF ADHESIONS,,,21,,RBRVS,11.59 ,5.95 ,5.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58661,CPT,LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES,,,21,,RBRVS,11.35 ,5.48 ,5.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58662,CPT,LAPS FULG/EXC OVARY VISCERA/PERITONEAL SURFACE,,,21,,RBRVS,12.15 ,6.33 ,6.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58670,CPT,LAPAROSCOPY FULGURATION OVIDUCTS,,,21,,RBRVS,5.91 ,3.68 ,3.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58671,CPT,LAPAROSCOPY W/PLMT OCCLUSION DEVICE OVIDUCTS,,,21,,RBRVS,5.91 ,3.68 ,3.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58672,CPT,LAPAROSCOPY FIMBRIOPLASTY,,,21,,RBRVS,12.91 ,6.34 ,6.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58673,CPT,LAPAROSCOPY SALPINGOSTOMY,,,21,,RBRVS,14.04 ,6.89 ,6.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58679,CPT,UNLISTED LAPAROSCOPY PROCEDURE OVIDUCT/OVARY,,,21,,TotalUnits,,,,16.83 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58700,CPT,SALPINGECTOMY COMPLETE/PARTIAL UNI/BI SPX,,,21,,RBRVS,12.95 ,7.23 ,7.23 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58720,CPT,SALPINGO-OOPHORECTOMY COMPL/PRTL UNI/BI SPX,,,21,,RBRVS,12.16 ,6.79 ,6.79 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58740,CPT,LYSIS OF ADHESIONS SALPINX/OVARY,,,21,,RBRVS,14.90 ,7.97 ,7.97 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58750,CPT,TUBOTUBAL ANASTATOMOSIS,,,21,,RBRVS,15.64 ,8.32 ,8.32 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58752,CPT,TUBOUTERINE IMPLANTATION,,,21,,RBRVS,15.64 ,8.02 ,8.02 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58760,CPT,FIMBRIOPLASTY,,,21,,RBRVS,13.93 ,7.30 ,7.30 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58770,CPT,SALPINGOSTOMY,,,21,,RBRVS,14.77 ,7.57 ,7.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58800,CPT,DRAINAGE OVARIAN CYST UNI/BI SPX VAGINAL APPR,,,21,,RBRVS,4.62 ,3.26 ,3.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58805,CPT,DRAINAGE OVARIAN CYST UNI/BI SPX ABDOMINAL,,,21,,RBRVS,6.42 ,4.24 ,4.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58820,CPT,DRAINAGE OVARIAN ABSCESS VAGINAL APPR OPEN,,,21,,RBRVS,4.70 ,3.56 ,3.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58822,CPT,DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH,,,21,,RBRVS,11.81 ,6.57 ,6.57 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58825,CPT,TRANSPOSITION OVARY,,,21,,RBRVS,11.78 ,7.13 ,7.13 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58900,CPT,BIOPSY OVARY UNI/BI SEPARATE PROCEDURE,,,21,,RBRVS,6.59 ,4.30 ,4.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58920,CPT,WEDGE RESCJ/BISCTJ OVARY UNI/BI,,,21,,RBRVS,11.95 ,6.84 ,6.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58925,CPT,OVARIAN CYSTECTOMY UNI/BI,,,21,,RBRVS,12.43 ,6.89 ,6.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58940,CPT,OOPHORECTOMY PARTIAL/TOTAL UNI/BI,,,21,,RBRVS,8.22 ,5.33 ,5.33 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58943,CPT,OOPHORECTOMY PRTL/TOT UNI/BI OVARIAN MALIGNANCY,,,21,,RBRVS,19.52 ,10.22 ,10.22 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58950,CPT,RESCJ OVARIAN/TUBAL/PERITONEAL MALIGNANCY W/BSO,,,21,,RBRVS,18.37 ,10.23 ,10.23 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58951,CPT,RESCJ PRIM PRTL MAL W/BSO & OMNTC TAH & LMPHAD,,,21,,RBRVS,24.26 ,12.44 ,12.44 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58952,CPT,RESCJ PRIM PRTL MAL W/BSO & OMNTC RAD DEBULKING,,,21,,RBRVS,27.29 ,14.20 ,14.20 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58953,CPT,BSO W/OMENTECTOMY TAH&RAD DEBULKING DISSECTION,,,21,,RBRVS,34.13 ,17.13 ,17.13 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58954,CPT,BSO W/OMENTECTOMY TAH DEBULKING W/LMPHADECTOMY,,,21,,RBRVS,37.13 ,18.44 ,18.44 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58956,CPT,BSO W/TOT OMENTECTOMY & HYSTERECTOMY MALIGNANC,,,21,,RBRVS,22.80 ,12.22 ,12.22 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58957,CPT,RESECJ RECUR OVARIAN/TUBAL/PERITONEAL MALIGNANCY,,,21,,RBRVS,26.22 ,13.84 ,13.84 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58958,CPT,RESECTION RECRT MAL W/OMENTECTOMY PEL LMPHADEC,,,21,,RBRVS,29.22 ,14.93 ,14.93 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58960,CPT,LAPT STG/RESTG OVARIAN TUBAL/PRIM MAL 2ND LOOK,,,21,,RBRVS,15.79 ,8.84 ,8.84 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
58970,CPT,FOLLICLE PUNCTURE OOCYTE RETRIEVAL ANY METHOD,,,21,,RBRVS,3.52 ,1.75 ,2.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58974,CPT,EMBRYO TRANSFER INTRAUTERINE,,,21,,TotalUnits,,,,4.03 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58976,CPT,GAMETE ZYGOTE/EMBRYO FALLOPIAN TRANSFER ANY METH,,,21,,RBRVS,3.82 ,1.88 ,2.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
58999,CPT,UNLISTED PX FEMALE GENITAL SYSTEM NONOBSTETRICAL,,,21,,TotalUnits,,,,3.39 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59000,CPT,AMNIOCENTESIS DIAGNOSIC,,,12,,RBRVS,1.30 ,0.71 ,1.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59001,CPT,AMNIOCENTESIS THER AMNIOTIC FLUID RDCTJ US GUID,,,12,,RBRVS,3.00 ,1.44 ,1.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59012,CPT,CORDOCENTESIS INTRAUTERINE,,,12,,RBRVS,3.44 ,1.55 ,1.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59015,CPT,CHORIONIC VILLUS SAMPLING,,,12,,RBRVS,2.20 ,1.07 ,1.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59020,CPT,FETAL CONTRACTION STRESS TEST,,,12,,RBRVS,0.66 ,1.21 ,1.21 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
59020,CPT,FETAL CONTRACTION STRESS TEST,26,,12,,RBRVS,0.66 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59020,CPT,FETAL CONTRACTION STRESS TEST,TC,,12,,RBRVS,,0.95 ,0.95 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
59025,CPT,FETAL NONSTRESS TEST,,,12,,RBRVS,0.53 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
59025,CPT,FETAL NONSTRESS TEST,26,,12,,RBRVS,0.53 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59025,CPT,FETAL NONSTRESS TEST,TC,,12,,RBRVS,,0.51 ,0.51 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
59030,CPT,FETAL SCALP BLOOD SAMPLING,,,12,,RBRVS,1.99 ,0.76 ,0.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59050,CPT,FETAL MONITORING LABOR PHYS WRITTEN REPORT,,,12,,RBRVS,0.89 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59051,CPT,FETAL MONITR LABOR PHYS WRTTN REPRT INTERPJ ONLY,,,12,,RBRVS,0.74 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59070,CPT,TRANSABDOMINAL AMNIOINFUSION W/ULTRSND GUIDANCE,,,12,,RBRVS,5.24 ,2.42 ,5.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59072,CPT,FETAL UMBILICAL CORD OCCLUSION W/ULTRSND GUIDNCE,,,12,,RBRVS,8.99 ,3.83 ,3.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59074,CPT,FETAL FLUID DRAINAGE W/ULTRASOUND GUIDANCE,,,12,,RBRVS,5.24 ,2.43 ,4.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59076,CPT,FETAL SHUNT PLACEMENT W/ULTRASOUND GUIDANCE,,,12,,RBRVS,8.99 ,3.83 ,3.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59100,CPT,HYSTEROTOMY ABDOMINAL,,,12,,RBRVS,13.37 ,7.28 ,7.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59120,CPT,TX ECTOPIC PREGNANCY ABDOMINAL/VAGINAL APPR,,,12,,RBRVS,12.67 ,7.00 ,7.00 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
59121,CPT,TX ECTOPIC PREGNANCY W/O SALPING&/OOPHORECTOMY,,,12,,RBRVS,12.74 ,6.94 ,6.94 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
59130,CPT,TX ECTOPIC PREGNANCY ABDL PREGNANCY,,,12,,RBRVS,15.08 ,8.00 ,8.00 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
59135,CPT,TX ECTOPIC PREGNANCY NTRSTL REQ TOT HYST,,,12,,RBRVS,14.92 ,7.87 ,7.87 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
59136,CPT,TX ECTOPIC PREGNANCY NTRSTL PRTL RESCJ UTER,,,12,,RBRVS,14.25 ,7.47 ,7.47 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
59140,CPT,TX ECTOPIC PREGNANCY CERVICAL W/EVACUATION,,,12,,RBRVS,5.94 ,4.08 ,4.08 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
59150,CPT,LAPS TX ECTOPIC PREG W/O SALPING&/OOPHORECTOMY,,,12,,RBRVS,12.29 ,6.77 ,6.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59151,CPT,LAPS TX ECTOPIC PREG W/SALPING&/OOPHORECTOMY,,,12,,RBRVS,12.11 ,6.39 ,6.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59160,CPT,CURETTAGE POSTPARTUM,,,12,,RBRVS,2.76 ,1.54 ,2.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59200,CPT,INSERTION CERVICAL DILATOR SEPARATE PROCEDURE,,,12,,RBRVS,0.79 ,0.31 ,1.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59300,CPT,EPISIOTOMY/VAG RPR OTH/THN ATTENDING,,,12,,RBRVS,2.41 ,1.28 ,2.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59320,CPT,CERCLAGE CERVIX PREGNANCY VAGINAL,,,12,,RBRVS,2.48 ,1.30 ,1.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59325,CPT,CERCLAGE CERVIX PREGNANCY ABDOMINAL,,,12,,RBRVS,4.06 ,1.93 ,1.93 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
59350,CPT,HYSTERORRHAPHY RUPTURED UTERUS,,,12,,RBRVS,4.94 ,1.95 ,1.95 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
59400,CPT,OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM,,,13,,RBRVS,32.16 ,20.21 ,20.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59409,CPT,VAGINAL DELIVERY ONLY,,,13,,RBRVS,14.37 ,5.73 ,5.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59410,CPT,VAGINAL DELIVERY ONLY W/POSTPARTUM CARE,,,13,,RBRVS,18.01 ,7.68 ,7.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59412,CPT,EXTERNAL CEPHALIC VERSION W/WO TOCOLYSIS,,,13,,RBRVS,1.71 ,0.85 ,0.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59414,CPT,DELIVERY PLACENTA SEPARATE PROCEDURE,,,13,,RBRVS,1.61 ,0.63 ,0.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59425,CPT,ANTEPARTUM CARE ONLY 4-6 VISITS,,,13,,RBRVS,6.31 ,2.50 ,5.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59426,CPT,ANTEPARTUM CARE ONLY 7/> VISITS,,,13,,RBRVS,11.16 ,4.42 ,9.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59430,CPT,POSTPARTUM CARE ONLY SEPARATE PROCEDURE,,,13,,RBRVS,2.47 ,0.98 ,2.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59510,CPT,OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM,,,11,,RBRVS,35.64 ,22.01 ,22.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59514,CPT,CESAREAN DELIVERY ONLY,,,11,,RBRVS,16.13 ,6.40 ,6.40 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
59515,CPT,CESAREAN DELIVERY ONLY W/POSTPARTUM CARE,,,11,,RBRVS,21.47 ,9.58 ,9.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59525,CPT,STOT/TOT HYSTERECTOMY AFTER CESAREAN DELIVERY,,,21,,RBRVS,8.53 ,3.34 ,3.34 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
59610,CPT,ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB,,,13,,RBRVS,33.87 ,20.69 ,20.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59612,CPT,VAGINAL DELIVERY AFTER CESAREAN DELIVERY,,,13,,RBRVS,16.09 ,6.31 ,6.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59614,CPT,VAGINAL DELIVERY & POSTPARTUM CARE VBAC,,,13,,RBRVS,19.73 ,8.21 ,8.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59618,CPT,ROUTINE OBSTETRICAL CARE ATTEMPTED VBAC,,,11,,RBRVS,36.16 ,22.16 ,22.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59620,CPT,CESAREAN DELIVERY ATTEMPTED VBAC,,,11,,RBRVS,16.66 ,6.54 ,6.54 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
59622,CPT,CESAREAN DLVRY & POSTPARTUM CARE ATTEMPTED VBA,,,11,,RBRVS,22.00 ,9.82 ,9.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59812,CPT,TX INCOMPLETE ABORTION ANY TRIMESTER SURGICAL,,,12,,RBRVS,4.44 ,2.96 ,3.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59820,CPT,TX MISSED ABORTION FIRST TRIMESTER SURGICAL,,,12,,RBRVS,4.84 ,4.16 ,4.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59821,CPT,TX MISSED ABORTION SECOND TRIMESTER SURGICAL,,,12,,RBRVS,5.09 ,3.87 ,4.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59830,CPT,TX SEPTIC ABORTION SURGICAL,,,12,,RBRVS,6.59 ,4.29 ,4.29 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
59840,CPT,INDUCED ABORTION DILATION AND CURETTAGE,,,12,,RBRVS,3.01 ,2.22 ,2.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59841,CPT,INDUCED ABORTION DILATION & EVACUATION,,,12,,RBRVS,5.65 ,3.30 ,3.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59850,CPT,INDUCED ABORTION 1/> AMNIOTIC INJX W/D&C/EVACJ,,,12,,RBRVS,5.90 ,3.66 ,3.66 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
59851,CPT,INDUCE ABORT 1/> AMNIOT NJXS DLVR FETUS D&C,,,12,,RBRVS,5.92 ,4.03 ,4.03 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
59852,CPT,INDUCE ABORT 1/> AMNIOT NJXS DLVR FETUS HYSTOTM,,,12,,RBRVS,8.23 ,5.63 ,5.63 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
59855,CPT,INDUCED ABORT 1/> VAG SUPPOSITORIES DLVR FETUS,,,12,,RBRVS,6.43 ,3.88 ,3.88 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
59856,CPT,INDUCED ABORT 1/> VAG SUPP DLVR FETUS D&C &/EVAC,,,12,,RBRVS,7.79 ,4.27 ,4.27 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
59857,CPT,INDUCED ABORT 1/> VAG SUPPOS DLVR FETUS HYSTOT,,,12,,RBRVS,9.33 ,4.85 ,4.85 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
59866,CPT,MULTIFETAL PREGNANCY REDUCTION,,,12,,RBRVS,3.99 ,1.95 ,1.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59870,CPT,UTERINE EVACUATION & CURETTAGE HYDATIDIFORM MOLE,,,12,,RBRVS,6.57 ,5.31 ,5.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59871,CPT,REMOVAL CERCLAGE SUTURE UNDER ANESTHESIA,,,12,,RBRVS,2.13 ,1.20 ,1.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59897,CPT,UNLISTED FETAL INVASIVE PX W/ULTRASOUND,,,12,,TotalUnits,,,,1.25 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59898,CPT,UNLISTED LAPAROSCOPY PX MATERNITY CARE&DELIVERY,,,12,,TotalUnits,,,,18.50 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
59899,CPT,UNLISTED PROCEDURE MATERNITY CARE & DELIVERY,,,12,,TotalUnits,,,,1.25 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
60000,CPT,I&D THYROGLOSSAL DUCT CYST INFECTED,,,21,,RBRVS,1.81 ,2.04 ,2.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
60100,CPT,BIOPSY THYROID PERCUTANEOUS CORE NEEDLE,,,21,,RBRVS,1.56 ,0.57 ,1.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
60200,CPT,EXC CYST/ADENOMA THYROID/TRANSECTION ISTHMUS,,,21,,RBRVS,10.02 ,7.14 ,7.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
60210,CPT,PRTL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY,,,21,,RBRVS,11.23 ,6.99 ,6.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
60212,CPT,PRTL THYROID LOBEC UNI W/CONTRATLAT STOT LOBEC,,,21,,RBRVS,16.43 ,9.53 ,9.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
60220,CPT,TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY,,,21,,RBRVS,11.19 ,7.12 ,7.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
60225,CPT,TOTAL THYROID LOBEC UNI W/CONTRALAT STOT LOBEC,,,21,,RBRVS,14.79 ,9.25 ,9.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
60240,CPT,THYROIDECTOMY TOTAL/COMPLETE,,,21,,RBRVS,15.04 ,8.54 ,8.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
60252,CPT,THYROIDECTOMY TOTAL/SUBTOTAL LMTD NECK DISSECT,,,21,,RBRVS,22.01 ,11.83 ,11.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
60254,CPT,THYROIDECTOMY TOTAL/SUBTOTAL RAD NECK DISSECT,,,21,,RBRVS,28.42 ,14.80 ,14.80 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
60260,CPT,THYROIDECTOMY RMVL REMAINING TISS FLWG PRTL RMVL,,,21,,RBRVS,18.26 ,9.88 ,9.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
60270,CPT,THYROIDECT W/SUBSTERNAL SPLIT/TRANSTHORACIC,,,21,,RBRVS,23.20 ,11.77 ,11.77 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
60271,CPT,THYROIDECTOMY SUBSTERNAL CERVICAL APPROACH,,,21,,RBRVS,17.62 ,9.58 ,9.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
60280,CPT,EXCISION THYROGLOSSAL DUCT CYST/SINUS,,,21,,RBRVS,6.16 ,5.63 ,5.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
60281,CPT,EXCISION THYROGLOSSAL DUCT CYST/SINUS RECURRENT,,,21,,RBRVS,8.82 ,6.83 ,6.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
60300,CPT,ASPIRATION AND/OR INJECTION THYROID CYST,,,21,,RBRVS,0.97 ,0.36 ,2.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
60500,CPT,PARATHYROIDECTOMY/EXPLORATION PARATHYROIDS,,,21,,RBRVS,15.60 ,9.05 ,9.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
60502,CPT,PARATHYROIDECTOMY/EXPLOR PARATHYROIDS RE-EXPLOR,,,21,,RBRVS,21.15 ,11.61 ,11.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
60505,CPT,PARATHYRDEC/EXPL PARATHYR MEDSTNL STERNAL/TTHRC,,,21,,RBRVS,23.06 ,12.69 ,12.69 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
60512,CPT,PARATHYROID AUTOTRANSPLANTATION ADD-ON,,,21,,RBRVS,4.44 ,1.71 ,1.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
60520,CPT,THYMECTOMY PRTL/TOT TRANSCERVICAL APPR SPX,,,21,,RBRVS,17.16 ,9.21 ,9.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
60521,CPT,THYMECTOMY PRTL/TOT W/O RAD MEDSTNL DSJ SPX,,,21,,RBRVS,19.18 ,9.04 ,9.04 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
60522,CPT,THYMECTOMY PRTL/TOT RAD MEDSTNL DSJ SPX,,,21,,RBRVS,23.48 ,10.65 ,10.65 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
60540,CPT,ADRENALECTOMY W/EXPL W/WO BX ABDL/LMBR/DRSAL SPX,,,21,,RBRVS,18.02 ,9.14 ,9.14 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
60545,CPT,ADRENALECTOMY EXPL W/EXC RETROPERTINEAL TUMOR,,,21,,RBRVS,20.93 ,10.15 ,10.15 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
60600,CPT,EXC CAROTID BODY TUMOR W/O EXC CAROTID ARTERY,,,21,,RBRVS,25.09 ,9.85 ,9.85 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
60605,CPT,EXC CAROTID BODY TUMOR W EXC CAROTID ARTERY,,,21,,RBRVS,31.96 ,18.39 ,18.39 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
60650,CPT,LAPAROSCOPY ADRENALECTOMY PRTL/COMPL TABDL,,,21,,RBRVS,20.73 ,9.58 ,9.58 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
60659,CPT,UNLISTED LAPAROSCOPY PROCEDURE ENDOCRINE SYSTEM,,,21,,TotalUnits,,,,30.31 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
60699,CPT,UNLISTED PROCEDURE ENDOCRINE SYSTEM,,,21,,TotalUnits,,,,18.31 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61000,CPT,SUBDURAL TAP FONTANELLE/SUTUR INFANT UNI/BI INIT,,,21,,RBRVS,1.58 ,0.89 ,0.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61001,CPT,SUBDURAL TAP FONTANELLE/SUTUR INFANT UNI/BI SBSQ,,,21,,RBRVS,1.49 ,0.76 ,0.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61020,CPT,VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/O NJX,,,21,,RBRVS,1.51 ,1.04 ,1.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61026,CPT,VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/INJ,,,21,,RBRVS,1.69 ,1.02 ,1.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61050,CPT,CISTERNAL/LATERAL C1-C2 PUNCTURE W/O INJ SPX,,,21,,RBRVS,1.51 ,0.78 ,0.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61055,CPT,CISTERNAL/LATERAL C1-C2 PUNCTURE W/INJECTION,,,21,,RBRVS,2.10 ,1.05 ,1.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61070,CPT,PUNCTURE SHUNT TUBE/RESERVOIR ASPIRATION/INJ PX,,,21,,RBRVS,0.89 ,0.61 ,0.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61105,CPT,TWIST DRILL HOLE SUBDURAL/VENTRICULAR PUNCTURE,,,21,,RBRVS,5.45 ,5.91 ,5.91 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61107,CPT,TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE,,,21,,RBRVS,4.99 ,2.33 ,2.33 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61108,CPT,TWIST DRILL HOLE EVAC&/DRG SUBDURAL HEMATOMA,,,21,,RBRVS,11.64 ,10.39 ,10.39 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61120,CPT,BURR HOLE VENTRICULAR PUNCTURE,,,21,,RBRVS,9.60 ,8.43 ,8.43 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61140,CPT,BURR HOLE/TREPHINE W/BX BRAIN/INTRACRNIAL LESION,,,21,,RBRVS,17.23 ,12.95 ,12.95 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61150,CPT,BURR HOLE/TREPHINE W/DRG BRAIN ABSCESS/CYST,,,21,,RBRVS,18.90 ,13.26 ,13.26 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61151,CPT,BURR HOLE/TREPHINE W/SBSQ TAPPING ICRA ABSC/CST,,,21,,RBRVS,13.49 ,10.24 ,10.24 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61154,CPT,BURR HOLE W/EVAC&/DRG HEMATOMA XDRL/SDRL,,,21,,RBRVS,17.07 ,13.39 ,13.39 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61156,CPT,BURR HOLE W/ASPIR HEMATOMA/CYST INTRACEREBRAL,,,21,,RBRVS,17.45 ,12.08 ,12.08 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61210,CPT,BURR HOLE IMPLANT VENTRICULAR CATH/OTHER DEVICE,,,21,,RBRVS,5.83 ,2.73 ,2.73 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61215,CPT,INSJ SUBQ RSVR PUMP/INFUSION SYSTEM VENTRIC CATH,,,21,,RBRVS,5.85 ,6.53 ,6.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61250,CPT,BURR HOLE/TREPHINE SUPRATENTORIAL W/O OTH SURG,,,21,,RBRVS,11.49 ,9.32 ,9.32 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61253,CPT,BURR HOLE/TREPHINE INFRATENTORIAL UNI/BI,,,21,,RBRVS,13.49 ,8.14 ,8.14 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61304,CPT,CRANIECTOMY/CRANIOTOMY EXPL SUPRATENTORIAL,,,21,,RBRVS,23.41 ,15.59 ,15.59 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61305,CPT,CRANIECTOMY/CRANIOTOMY EXPL INFRATENTORIAL,,,21,,RBRVS,28.64 ,18.85 ,18.85 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61312,CPT,CRANIECTOMY HMTMA SUPRATENTORIAL EXTRA/SUBDURAL,,,21,,RBRVS,30.17 ,18.93 ,18.93 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61313,CPT,CRANIECTOMY HMTMA SUPRATENTORIAL INTRACEREBRAL,,,21,,RBRVS,28.09 ,18.98 ,18.98 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61314,CPT,CRANIECTOMY HMTMA INFRATENTORIAL EXTRA/SUBDURAL,,,21,,RBRVS,25.90 ,17.43 ,17.43 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61315,CPT,CRANIECTOMY HMTMA SUPRATENTORIAL INTRACEREBRAL,,,21,,RBRVS,29.65 ,19.27 ,19.27 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61316,CPT,INCISION & SUBCUTANEOUS PLMT CRANIAL BONE GRAF,,,21,,RBRVS,1.39 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61320,CPT,CRANIECTOMY/CRANIOTMY DRG ABSCESS SUPRATENTORIAL,,,21,,RBRVS,27.42 ,17.53 ,17.53 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61321,CPT,CRANIECTOMY/CRANIOTMY DRG ABSCESS INFRATENTORIAL,,,21,,RBRVS,30.53 ,19.74 ,19.74 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61322,CPT,CRANIECT/CRANIOT W/WO DURAPLASTY W/O LOBECTOMY,,,21,,RBRVS,34.26 ,21.85 ,21.85 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61323,CPT,CRANIECT/CRANIOT W/WO DURAPLASTY W/LOBECTOMY,,,21,,RBRVS,35.06 ,21.14 ,21.14 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61330,CPT,DECOMPRESSION ORBIT ONLY TRANSCRANIAL APPROACH,,,21,,RBRVS,25.30 ,17.23 ,17.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61332,CPT,EXPLORATION ORBIT TRANSCRANIAL APPROACH W/BIOPSY,,,21,,RBRVS,28.60 ,20.63 ,20.63 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61333,CPT,EXPL ORBIT TRANSCRANIAL APPROACH W/RMVL LESION,,,21,,RBRVS,29.27 ,21.05 ,21.05 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61340,CPT,SUBTEMPORAL CRANIAL DECOMPRESSION,,,21,,RBRVS,20.11 ,14.23 ,14.23 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61343,CPT,CRNEC SUBOCCIPITAL CRV LAM DCMPRN MEDULLA & CORD,,,21,,RBRVS,31.86 ,20.09 ,20.09 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61345,CPT,OTHER CRANIAL DECOMPRESSION POSTERIOR FOSSA,,,21,,RBRVS,29.23 ,18.93 ,18.93 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61450,CPT,CRNEC STPL SCTJ COMPRESSION/DCMPRN GANGLION,,,21,,RBRVS,27.69 ,17.66 ,17.66 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61458,CPT,CRNEC SOPL EXPL/DCMPRN CRNL NRV,,,21,,RBRVS,28.84 ,18.64 ,18.64 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61460,CPT,CRANIECTOMY SUBOCCIPITAL SECTION 1/> CRANIAL NR,,,21,,RBRVS,30.24 ,19.40 ,19.40 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61480,CPT,CRNEC SUBOCPTL MESENCEPHAL TRCOTOMY/PEDUNCULOTMY,,,21,,RBRVS,28.05 ,17.67 ,17.67 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61500,CPT,CRANIECTOMY W/EXCISION TUMOR/LESION SKULL,,,21,,RBRVS,19.18 ,13.30 ,13.30 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61501,CPT,CRANIECTOMY OSTEOMYELITIS,,,21,,RBRVS,16.35 ,12.24 ,12.24 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61510,CPT,CRANIEC TREPHINE BONE FLP BRAIN TUMOR SUPRTENTOR,,,21,,RBRVS,30.83 ,21.06 ,21.06 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61512,CPT,CRNEC TREPHINE BONE FLAP MENINGIOMA SUPRATENTOR,,,21,,RBRVS,37.14 ,22.99 ,22.99 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61514,CPT,CRNEC TREPHINE BONE FLAP BRAIN ABSC SUPRATENTOR,,,21,,RBRVS,27.23 ,17.88 ,17.88 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61516,CPT,CRNEC TREPHINE BONE FLAP FENEST CYST SUPRATENTOR,,,21,,RBRVS,26.58 ,17.58 ,17.58 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61517,CPT,IMPLTJ BRAIN INTRACAVITARY CHEMOTHERAPY AGENT,,,21,,RBRVS,1.38 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61518,CPT,CRNEC EXC BRAIN TUMOR INFRATENTORIAL/POST FOSSA,,,21,,RBRVS,39.89 ,25.25 ,25.25 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61519,CPT,CRNEC EXC TUM INFRATENTOR/POST FOSSA MENINGIOMA,,,21,,RBRVS,43.43 ,25.89 ,25.89 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61520,CPT,CRNEC TUM INFRATTL/POSTFOSSA CRBLOPNT ANGLE TUM,,,21,,RBRVS,57.09 ,32.34 ,32.34 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61521,CPT,CRNEC TUM INFRATTL/PFOSSA MIDLINE TUM BASE SKULL,,,21,,RBRVS,46.99 ,27.44 ,27.44 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61522,CPT,CRNEC INFRATNTORIAL/POST FOSSA EXC BRAIN ABSCESS,,,21,,RBRVS,31.54 ,20.01 ,20.01 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61524,CPT,CRNEC INFRATNTOR/POSTFOSSA EXC/FENESTRATION CYST,,,21,,RBRVS,29.89 ,19.24 ,19.24 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61526,CPT,CRNEC TRANSTEMPOR EXC CEREBELLOPONTINE ANGLE TUM,,,21,,RBRVS,54.08 ,31.47 ,31.47 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61530,CPT,CRNEC EXC CEREBELLOPNTIN ANGLE TUM MID/POSTFOSSA,,,21,,RBRVS,45.56 ,26.57 ,26.57 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61531,CPT,SUBDURAL IMPLTJ ELECTRODES SEIZURE MONITORING,,,21,,RBRVS,16.41 ,12.82 ,12.82 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61533,CPT,CRANIOT SUBDURAL IMPLT ELCTRD SEIZURE MONITORING,,,21,,RBRVS,21.46 ,14.50 ,14.50 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61534,CPT,CRANIOT EPILEPTOGENIC FOC W/O ELECTRCORTICOGRPHY,,,21,,RBRVS,23.01 ,16.01 ,16.01 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61535,CPT,CRANIOT RMVL EPID/SUBDURL ELCTRD W/O EXC TIS SPX,,,21,,RBRVS,13.15 ,10.84 ,10.84 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61536,CPT,CRANIOT EPILEPTOGENIC FOCUS W/ELECTROCORTCOGRPHY,,,21,,RBRVS,37.72 ,22.90 ,22.90 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61537,CPT,CRANIOT TEMPORAL LOBE W/O ELECTROCORTICOGRAPHY,,,21,,RBRVS,36.45 ,21.36 ,21.36 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61538,CPT,CRANIOT LOBEC TEMPORAL LOBE W/ELECTROCORTCOGRPHY,,,21,,RBRVS,39.45 ,23.15 ,23.15 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61539,CPT,CRANIOT LOBECTOMY OTH/THN TEMPORAL LOBE W/ECOG,,,21,,RBRVS,34.28 ,21.30 ,21.30 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61540,CPT,CRANIOT LOBECTOMY OTH/THN TEMPORAL LOBE W/O ECOG,,,21,,RBRVS,31.43 ,20.05 ,20.05 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61541,CPT,CRANIOTOMY TRANSECTION CORPUS CALLOSUM,,,21,,RBRVS,30.94 ,19.73 ,19.73 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61543,CPT,CRANIOTOMY PARTIAL/SUBTOTAL HEMISPHERECTOMY,,,21,,RBRVS,31.31 ,19.90 ,19.90 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61544,CPT,CRANIOTOMY EXCISION/COAGULATION CHOROID PLEXUS,,,21,,RBRVS,27.36 ,17.50 ,17.50 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61545,CPT,CRANIOTOMY EXCISION CRANIOPHARYNGIOMA,,,21,,RBRVS,46.43 ,28.46 ,28.46 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61546,CPT,CRANIOT HYPOPHYSEC/EXC PITUITARY TUMOR ICRL APPR,,,21,,RBRVS,33.44 ,20.90 ,20.90 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61548,CPT,HYPOPHYSEC/EXC PITUITARY TUM TRANSNASAL/SEPTAL,,,21,,RBRVS,23.37 ,14.63 ,14.63 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61550,CPT,CRANIECTOMY CRANIOSYNOSTOSIS 1 CRANIAL SUTURE,,,21,,RBRVS,15.59 ,9.95 ,9.95 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61552,CPT,CRANIECT CRANIOSYNOSTOSIS MULT CRANIAL SUTURES,,,21,,RBRVS,20.40 ,10.34 ,10.34 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61556,CPT,CRANIEC CRANIOSYNOSTOSIS FRONT/PARIET BONE FLAP,,,21,,RBRVS,24.09 ,16.23 ,16.23 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61557,CPT,CRANIECTOMY CRANIOSYNOSTOSIS BIFRONTAL BONE FLAP,,,21,,RBRVS,23.31 ,16.63 ,16.63 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61558,CPT,XTN CRANIECT MULTIPLE SUTURE CRANIOSYNOSTOSIS,,,21,,RBRVS,26.50 ,11.61 ,11.61 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61559,CPT,XTN CRNEC MLT SUTR CRANIOSYNOSTOSIS W/BONE GRAFT,,,21,,RBRVS,34.02 ,22.50 ,22.50 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61563,CPT,EXC BENIGN TUM CRANIAL BONE W/O OPTIC NRV DCMPRN,,,21,,RBRVS,28.44 ,18.26 ,18.26 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61564,CPT,EXC BENIGN TUM CRANIAL BONE W/OPTIC NRV DCMPRN,,,21,,RBRVS,34.74 ,21.97 ,21.97 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61566,CPT,CRANIOTOMY SELECTIVE AMYGDALOHIPPOCAMPECTOMY,,,21,,RBRVS,32.45 ,20.53 ,20.53 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61567,CPT,CRANIOTOMY MULTIPLE SUBPIAL TRANSECTIONS W/ECOG,,,21,,RBRVS,37.00 ,17.00 ,17.00 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61570,CPT,CRANIECTOMY/CRANIOTOMY EXC FOREIGN BODY BRAIN,,,21,,RBRVS,26.51 ,17.66 ,17.66 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61571,CPT,CRANIECTOMY/CRANIOTOMY TX PENETRATNG WOUND BRAIN,,,21,,RBRVS,28.42 ,18.54 ,18.54 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61575,CPT,TRNSRAL SKULL BSE/BR STEM/CORD BX/DCOMPR/EXC LES,,,21,,RBRVS,36.56 ,22.35 ,22.35 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61576,CPT,TRNSRL SKUL BSE/BR STM/CORD BX/DCMP/ SPLT TONGUE,,,21,,RBRVS,55.31 ,35.45 ,35.45 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61580,CPT,CRANIOFACIAL ANT CRANIAL FOSSA W/O ORBITAL EXNTJ,,,21,,RBRVS,34.51 ,29.56 ,29.56 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61581,CPT,CRANIOFACIAL ANT CRANIAL FOSSA W/ORBITAL EXNTJ,,,21,,RBRVS,39.13 ,31.39 ,31.39 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61582,CPT,CRANFCL ANT CRANIAL FOSSA UNI/BI CRANIOT/OSTEOT,,,21,,RBRVS,35.14 ,38.53 ,38.53 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61583,CPT,CRANFCL ANT CRANIAL FOSSA UNI/BIFRNTL ELEV LOBE,,,21,,RBRVS,38.50 ,31.28 ,31.28 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61584,CPT,ORBITOCRANIAL ANT CRANIAL FOSSA W/O ORBIT EXNTJ,,,21,,RBRVS,37.70 ,31.14 ,31.14 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61585,CPT,ORBITOCRANIAL ANT CRANIAL FOSSA W/ORBITAL EXNTJ,,,21,,RBRVS,42.57 ,34.43 ,34.43 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61586,CPT,BICORONAL TRANSZYGMTC&/LEFORT I W/O BONE GRFT,,,21,,RBRVS,27.48 ,31.94 ,31.94 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61590,CPT,INFRATEMPORAL MID CRANIAL FOSSA W/WO DISARTICLTN,,,21,,RBRVS,47.04 ,31.93 ,31.93 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61591,CPT,INFRATEMPO MID CRANIAL FOSSA W/WO DCOMPR&/MOBI,,,21,,RBRVS,47.02 ,32.27 ,32.27 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61592,CPT,ORBITOCRNL APPR MID CRANIAL FOSSA TEMPORAL LOBE,,,21,,RBRVS,43.08 ,33.63 ,33.63 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61595,CPT,TRANSTEMP APPR POST CRAN FOSSA DCOMPR SINUS/NRV,,,21,,RBRVS,33.74 ,26.64 ,26.64 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61596,CPT,TRANSCOCHLR POST CRNL FOSSA W/WO MOBIL NRV/ART,,,21,,RBRVS,39.43 ,25.53 ,25.53 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61597,CPT,TRNSCONDLR POST CRNL FOSSA DCOMPR ART W/WO MOBIL,,,21,,RBRVS,40.82 ,27.14 ,27.14 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61598,CPT,TRANSPTRSAL POST CRNL FOSSA CLIVUS/FORAMN MAGNUM,,,21,,RBRVS,36.53 ,31.84 ,31.84 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61600,CPT,RESCJ/EXC LES BASE ANT CRANIAL FOSSA EXTRADURAL,,,21,,RBRVS,30.01 ,24.92 ,24.92 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61601,CPT,RESCJ/EXC LES BASE ANT CRNL FOSSA INDRL W/WO GRF,,,21,,RBRVS,31.14 ,27.52 ,27.52 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61605,CPT,RESCJ/EXC LES INFRATEMPOR FOSSA SPACE APEX XDRL,,,21,,RBRVS,32.57 ,24.89 ,24.89 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61606,CPT,RESCJ/EXC LES ITPRL FOSSA SPACE APEX IDRL W/RPR,,,21,,RBRVS,42.05 ,29.85 ,29.85 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61607,CPT,RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB XDRL,,,21,,RBRVS,40.93 ,26.93 ,26.93 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61608,CPT,RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB IDRL,,,21,,RBRVS,45.54 ,32.56 ,32.56 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61610,CPT,TRNSXJ/LIG CAROTID ARTERY SINUS W/RPR ANAST/GRFT,,,21,,RBRVS,29.63 ,13.16 ,13.16 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61611,CPT,TRNSXJ/LIG CAROTID ARTERY PETROUS CANAL W/O RPR,,,21,,RBRVS,7.41 ,2.84 ,2.84 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61612,CPT,TRNSXJ/LIG CRTD ART PETROUS CANAL RPR ANAST/GRF,,,21,,RBRVS,27.84 ,10.60 ,10.60 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61613,CPT,OBLTRJ CAROTID ARYSM ARTVEN CAROTID FISTULA DSJ,,,21,,RBRVS,45.03 ,33.17 ,33.17 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61615,CPT,RESCJ/EXC LES BASE POST CRNL FOSSA JUG FRMN XDRL,,,21,,RBRVS,35.77 ,28.61 ,28.61 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61616,CPT,RESCJ/EXC LES BASE PCF FORAMEN VRT BODIES IDRL,,,21,,RBRVS,46.74 ,34.12 ,34.12 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61618,CPT,SECONDARY RPR DURA CSF LEAK FREE TISSUE GRAFT,,,21,,RBRVS,18.69 ,12.87 ,12.87 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61619,CPT,SEC RPR DURA CSF LEAK LOCAL/REGIONALIZED FLAP,,,21,,RBRVS,22.10 ,13.88 ,13.88 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61623,CPT,EVASC TEMP BALLOON ARTL OCCLUSION HEAD/NECK,,,21,,RBRVS,9.95 ,3.97 ,3.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61624,CPT,TCAT PERMANENT OCCLUSION/EMBOLIZATION PRQ CNS,,,21,,RBRVS,20.12 ,7.91 ,7.91 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61626,CPT,TCAT PERMANT OCCLUSION/EMBOLIZATION PRQ NON-CNS,,,21,,RBRVS,16.60 ,5.82 ,5.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61630,CPT,BALLOON ANGIOPLASTY INTRACRANIAL PERCUTANEOUS,,,21,,RBRVS,22.07 ,10.65 ,10.65 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61635,CPT,TCAT PLMT IV STENT ICRA W/BALO ANGIOP IF PFRMD,,,21,,RBRVS,24.28 ,10.95 ,10.95 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61640,CPT,BALLOON DILAT INTRACRANIAL VASOSPASM PRQ INITIAL,,,21,,RBRVS,12.32 ,4.68 ,4.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61641,CPT,BALLOON DILAT INCRNL VASOSPSM PRQ EA VESSEL,,,21,,RBRVS,4.33 ,1.66 ,1.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61642,CPT,BALLOON DILAT INCRNL VASOSPSM PRQ EA VESSEL,,,21,,RBRVS,8.66 ,3.29 ,3.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61645,CPT,PERQ ART TRLUML M-THROMBEC &/NFS INTRACRANIAL,,,21,,RBRVS,15.00 ,4.51 ,4.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61650,CPT,EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART 1ST,,,21,,RBRVS,10.00 ,3.24 ,3.24 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61651,CPT,EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART ADDL,,,21,,RBRVS,4.25 ,1.38 ,1.38 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61680,CPT,INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL SMPL,,,21,,RBRVS,32.55 ,20.72 ,20.72 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61682,CPT,INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL CMPL,,,21,,RBRVS,63.41 ,34.06 ,34.06 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61684,CPT,INTRACRANIAL ARVEN MALFRMJ INFRATENTRL SMPL,,,21,,RBRVS,41.64 ,25.20 ,25.20 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61686,CPT,INTRACRANIAL ARVEN MALFRMJ INFRATENTRL CMPL,,,21,,RBRVS,67.50 ,37.75 ,37.75 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61690,CPT,INTRACRANIAL ARVEN MALFRMJ DURAL SMPL,,,21,,RBRVS,31.34 ,20.26 ,20.26 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61692,CPT,INTRACRANIAL ARVEN MALFRMJ DURAL CMPL,,,21,,RBRVS,54.59 ,31.13 ,31.13 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61697,CPT,COMPLX INTRACRANIAL ARYSM CAROTID CIRCULATION,,,21,,RBRVS,63.40 ,35.57 ,35.57 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61698,CPT,CPLX INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ,,,21,,RBRVS,69.63 ,38.75 ,38.75 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61700,CPT,SIMPLE INTRACRANIAL ARYSM CAROTID CIRCULATION,,,21,,RBRVS,50.62 ,29.49 ,29.49 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61702,CPT,SIMPLE INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ,,,21,,RBRVS,60.04 ,34.27 ,34.27 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61703,CPT,ICRA CRV APPL OCCLUDING CLAMP CRV CRTD ART,,,21,,RBRVS,18.80 ,13.50 ,13.50 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61705,CPT,ARYSM VASC MALFRMJ/CRTD-OCCLUSION CRTD ART,,,21,,RBRVS,38.10 ,23.07 ,23.07 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61708,CPT,ARYSM VASC MALFRMJ/ICRA ELECTROTHROMBOSIS,,,21,,RBRVS,37.20 ,22.65 ,22.65 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61710,CPT,ARYSM VASC MALFRMJ IA EMBOLIZATION,,,21,,RBRVS,31.29 ,19.34 ,19.34 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61711,CPT,ANAST ARTL EXTRACRANIAL-INTRACRANIAL ARTERIES,,,21,,RBRVS,38.23 ,22.84 ,22.84 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61720,CPT,CRTJ LES STRTCTC BURR GLOBUS PALLIDUS/THALAMUS,,,21,,RBRVS,17.62 ,12.55 ,12.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61735,CPT,CRTJ LES STRTCTC BURR SUBCORTICAL STRUX OTH/THN,,,21,,RBRVS,22.35 ,15.33 ,15.33 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61750,CPT,STEREOTACTIC BX ASPIR/EXC BURR INTRACRANIAL LES,,,21,,RBRVS,19.83 ,13.40 ,13.40 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61751,CPT,STRTCTC BX ASPIR/EXC BURR ICRA LESION W/CT&I/MR,,,21,,RBRVS,18.79 ,14.06 ,14.06 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61760,CPT,STRTCTC IMPLTJ ELTRD CEREBRUM SEIZURE MONITORING,,,21,,RBRVS,22.39 ,15.01 ,15.01 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61770,CPT,STRTCTC LOCLZJ INSJ CATH/PRB PLMT RADJ SRC,,,21,,RBRVS,23.19 ,15.17 ,15.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61781,CPT,STRTCTC CPTR ASSTD PX CRANIAL INTRADURAL,,,21,,RBRVS,3.75 ,1.75 ,1.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
61782,CPT,STRTCTC CPTR ASSTD PX EXTRADURAL CRANIAL,,,21,,RBRVS,3.18 ,1.42 ,1.42 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
61783,CPT,STEREOTACTIC COMPUTER ASSISTED PX SPINAL,,,21,,RBRVS,3.75 ,1.78 ,1.78 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
61790,CPT,CREATE LESION STRTCTC PRQ NEUROLYTIC GASSERIAN,,,21,,RBRVS,11.60 ,9.47 ,9.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61791,CPT,CREATE LES STRTCTC PRQ NEUROLYTIC TRIGEMINAL TRC,,,21,,RBRVS,15.41 ,11.36 ,11.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61796,CPT,STEREOTACTIC RADIOSURGERY 1 SIMPLE CRANIAL LES,,,21,,RBRVS,13.93 ,10.25 ,10.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61797,CPT,STRTCTC RADIOSURGERY EA ADDL CRANIAL LES SIMPLE,,,21,,RBRVS,3.48 ,1.63 ,1.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61798,CPT,STEREOTACTIC RADIOSURGERY 1 COMPLEX CRANIAL LES,,,21,,RBRVS,19.85 ,12.95 ,12.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61799,CPT,STRTCTC RADIOSURGERY EA ADDL CRANIAL LES COMPLEX,,,21,,RBRVS,4.81 ,2.25 ,2.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61800,CPT,APPL STRTCTC HEADFRAME STEREOTACTIC RADIOSURGERY,,,21,,RBRVS,2.25 ,1.40 ,1.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61850,CPT,TWIST/BURR HOLE IMPLTJ NSTIM ELTRD CORTICAL,,,21,,RBRVS,13.34 ,10.08 ,10.08 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61860,CPT,CRNEC/CRX IMPLTJ NSTIM ELTRD CERE CORTICAL,,,21,,RBRVS,22.26 ,14.73 ,14.73 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61863,CPT,STRTCTC IMPLTJ NSTIM ELTRD W/O RECORD 1ST ARRAY,,,21,,RBRVS,20.71 ,15.12 ,15.12 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61864,CPT,STRTCTC IMPLTJ NSTIM ELTRD W/O RECORD EA ARRAY,,,21,,RBRVS,4.49 ,2.11 ,2.11 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61867,CPT,STRTCTC IMPLTJ NSTIM ELTRD W/RECORD 1ST ARRAY,,,21,,RBRVS,33.03 ,20.74 ,20.74 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61868,CPT,STRTCTC IMPLTJ NSTIM ELTRD W/RECORD EA ARRAY,,,21,,RBRVS,7.91 ,3.67 ,3.67 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61870,CPT,CRNEC IMPLTJ NSTIM ELTRD CEREBELLAR CORTICAL,,,21,,RBRVS,16.34 ,11.80 ,11.80 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
61880,CPT,REVJ/RMVL INTRACRANIAL NEUROSTIMULATOR ELTRDS,,,21,,RBRVS,6.95 ,6.97 ,6.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61885,CPT,INSJ/RPLCMT CRANIAL NEUROSTIM PULSE GENERATOR,,,21,,RBRVS,6.05 ,6.73 ,6.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61886,CPT,INSJ/RPLCMT CRANIAL NEUROSTIM GENER 2/> ELTRDS,,,21,,RBRVS,9.93 ,10.84 ,10.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
61888,CPT,REVJ/RMVL NEUROSTIMULATOR PULSE GENERATOR,,,21,,RBRVS,5.23 ,4.30 ,4.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62000,CPT,ELEVATION DEPRESSED SKULL FX SIMPLE EXTRADURAL,,,21,,RBRVS,13.93 ,10.66 ,10.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62005,CPT,ELVTN DEPRS SKL FX COMPOUND/COMMIND XDRL,,,21,,RBRVS,17.63 ,12.56 ,12.56 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62010,CPT,ELVTN DEPRS SKL FX W/RPR DURA&/DBRDMT BRN,,,21,,RBRVS,21.43 ,14.90 ,14.90 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62100,CPT,CRX RPR DURAL/CSF LEAK RHINORRHEA/OTORRHEA,,,21,,RBRVS,23.53 ,15.01 ,15.01 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62115,CPT,RDCTJ CRANIOMEGALIC SKULL W/O GRAFT/CRANIOPLASTY,,,21,,RBRVS,22.91 ,13.55 ,13.55 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62117,CPT,RDCTJ CRANIOMEGALIC CRANIO&RECNSTJ W/WO GRAFT,,,21,,RBRVS,28.35 ,17.88 ,17.88 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62120,CPT,RPR ENCEPHALOCELE SKULL VAULT W/CRANIOPLASTY,,,21,,RBRVS,24.59 ,19.82 ,19.82 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62121,CPT,CRANIOTOMY FOR ENCEPHALOCELE REPAIR SKULL BASE,,,21,,RBRVS,23.03 ,17.68 ,17.68 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62140,CPT,CRANIOPLASTY SKULL DEFECT </5 CM DIAMETER,,,21,,RBRVS,14.55 ,10.54 ,10.54 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62141,CPT,CRANIOPLASTY SKULL DEFECT >5 CM DIAMETER,,,21,,RBRVS,16.07 ,11.50 ,11.50 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62142,CPT,RMVL BONE FLAP/PROSTHETIC PLATE SKULL,,,21,,RBRVS,11.83 ,9.58 ,9.58 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62143,CPT,RPLCMT BONE FLAP/PROSTHETIC PLATE SKULL,,,21,,RBRVS,14.15 ,10.86 ,10.86 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62145,CPT,CRANIOPLASTY SKULL DEFECT REPARATIVE BRAIN SURG,,,21,,RBRVS,20.09 ,13.63 ,13.63 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62146,CPT,CRANIOPLASTY W/AUTOGRAFT </ 5 CM DIAMETER,,,21,,RBRVS,17.28 ,11.73 ,11.73 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62147,CPT,CRANIOPLASTY W/AUTOGRAFT > 5 CM DIAMETER,,,21,,RBRVS,20.67 ,13.81 ,13.81 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62148,CPT,INCISE&RETRIEVAL SUBQ CRANIOPLASTY BONE GRAFT,,,21,,RBRVS,2.00 ,0.94 ,0.94 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62160,CPT,NUNDSC ICRA PLMT/RPLCMT VENTR CATH SHUNT SYS,,,21,,RBRVS,3.00 ,1.41 ,1.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62161,CPT,NUNDSC ICRA DSJ ADS FENESTRATION SEPTUM CSTS,,,21,,RBRVS,21.23 ,14.81 ,14.81 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62162,CPT,NUNDSC ICRA FENESTEXC CYST W/VENTRIC CATH DRG,,,21,,RBRVS,26.80 ,17.90 ,17.90 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62163,CPT,NEUROENDOSCOPY ICRA W/RETRIEVAL FOREIGN BODY,,,21,,RBRVS,16.53 ,12.72 ,12.72 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62164,CPT,NEUROENDOSCOPY ICRA W/RETRIEVAL FOREIGN BODY,,,21,,RBRVS,29.43 ,20.06 ,20.06 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62165,CPT,NUNDSC ICRA EXC PITUITRY TUM TRNSNSL/SPHENOID,,,21,,RBRVS,23.23 ,14.76 ,14.76 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62180,CPT,VENTRICULOCISTERNOSTOMY,,,21,,RBRVS,22.58 ,15.33 ,15.33 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62190,CPT,CRTJ SHUNT SARACH/SDRL-ATR-JUG-AUR,,,21,,RBRVS,12.17 ,3.82 ,3.82 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62192,CPT,CRTJ SHUNT SARACH/SDRL-PRTL-PLEURAL OTH,,,21,,RBRVS,13.35 ,10.18 ,10.18 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62194,CPT,RPLCMT/IRRG SUBARACHNOID/SUBDURAL CATHETER,,,21,,RBRVS,5.78 ,6.12 ,6.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62200,CPT,VENTRICULOCISTERNOSTOMY 3RD VENTRICLE,,,21,,RBRVS,19.29 ,13.34 ,13.34 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62201,CPT,VENTRICULOCISTERNOSTOMY 3RD VNTRC NEURONDSC,,,21,,RBRVS,16.04 ,12.77 ,12.77 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62220,CPT,CRTJ SHUNT VENTRICULO-ATR-JUG-AUR,,,21,,RBRVS,14.10 ,10.49 ,10.49 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62223,CPT,CRTJ SHUNT VENTRICULO-PERITNEAL-PLEURAL TERMINUS,,,21,,RBRVS,14.05 ,11.34 ,11.34 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62225,CPT,RPLCMT/IRRIGATION VENTRICULAR CATHETER,,,21,,RBRVS,6.19 ,6.68 ,6.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62230,CPT,RPLCMT/REVJ CSF SHUNT VALVE/CATH SHUNT SYS,,,21,,RBRVS,11.43 ,8.87 ,8.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62252,CPT,REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT,,,21,,RBRVS,0.74 ,1.45 ,1.45 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
62252,CPT,REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT,26,,21,,RBRVS,0.74 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62252,CPT,REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT,TC,,21,,RBRVS,,1.10 ,1.10 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
62256,CPT,RMVL COMPL CSF SHUNT SYSTEM W/O RPLCMT SHUNT,,,21,,RBRVS,7.38 ,7.25 ,7.25 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62258,CPT,RMVL COMPLETE CSF SHUNT SYSTEM W/RPLCMT SHUNT,,,21,,RBRVS,15.64 ,11.25 ,11.25 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
62263,CPT,PRQ LYSIS EPIDURAL ADHESIONS MULT SESS 2/> DAYS,,,21,,RBRVS,5.00 ,4.18 ,12.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62264,CPT,PRQ LYSIS EPIDURAL ADHESIONS MULT SESSIONS 1 DAY,,,21,,RBRVS,4.42 ,2.05 ,7.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62267,CPT,PRQ ASPIR PULPOSUS/INTERVERTEBRAL DISC/PVRT TISS,,,21,,RBRVS,3.00 ,1.34 ,3.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62268,CPT,PERCUTANEOUS ASPIRATION SPINAL CORD CYST/SYRINX,,,21,,RBRVS,4.73 ,2.39 ,2.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62269,CPT,BIOPSY SPINAL CORD PERCUTANEOUS NEEDLE,,,21,,RBRVS,5.01 ,2.30 ,2.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62270,CPT,SPINAL PUNCTURE LUMBAR DIAGNOSTIC,,,21,,RBRVS,1.37 ,0.69 ,2.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62272,CPT,SPINAL PUNCTURE THER DRAIN CEREBROSPINAL FLUID,,,21,,RBRVS,1.35 ,0.78 ,4.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62273,CPT,INJECTION EPIDURAL BLOOD/CLOT PATCH,,,21,,RBRVS,2.15 ,0.94 ,2.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62280,CPT,INJX/INFUSION NEUROLYTIC SUBSTANCE SUBARACHNOID,,,21,,RBRVS,2.63 ,1.60 ,5.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62281,CPT,INJX/INFUS NEUROLYT SUBST EPIDURAL CERV/THORACIC,,,21,,RBRVS,2.66 ,1.43 ,3.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62282,CPT,INJX/INFUS NEUROLYT SBST EPIDURAL LUMBAR/SACRAL,,,21,,RBRVS,2.33 ,1.60 ,5.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62284,CPT,INJECTION PROCEDURE MYELOGRAPHY/CT LUMBAR,,,21,,RBRVS,1.54 ,0.78 ,3.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62287,CPT,DCMPRN PERQ NUCLEUS PULPOSUS 1/> LEVELS LUMBAR,,,21,,RBRVS,9.03 ,6.33 ,6.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62290,CPT,INJECTION PX DISCOGRAPHY EACH LEVEL LUMBAR,,,21,,RBRVS,3.00 ,1.68 ,6.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62291,CPT,INJECTION PX DISCOGRPHY EA LVL CERVICAL/THORACIC,,,21,,RBRVS,2.91 ,1.79 ,6.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62292,CPT,INJECTION PX DISCOGRPHY EA LVL CERVICAL/THORACIC,,,21,,RBRVS,9.24 ,6.76 ,6.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62294,CPT,NJX ARTERIAL OCCLUSION ARVEN MALFRMJ SPINAL,,,21,,RBRVS,12.87 ,8.69 ,8.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62302,CPT,MYELOGRAPHY VIA LUMBAR INJECTION RS&I CERVICAL,,,20,,RBRVS,2.29 ,1.05 ,4.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62303,CPT,MYELOGRAPHY VIA LUMBAR INJECTION RS&I THORACIC,,,20,,RBRVS,2.29 ,1.10 ,4.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62304,CPT,MYELOGRAPHY VIA LUMBAR INJECT RS&I LUMBOSACRAL,,,20,,RBRVS,2.25 ,1.03 ,4.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62305,CPT,MYELOGRAPHY VIA LUMBAR INJECTION RS&I 2+ REGIONS,,,20,,RBRVS,2.35 ,1.09 ,4.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62310,CPT,NJX DX/THER SBST EPIDURAL/SUBRACH CERV/THORACIC,,,21,,RBRVS,1.91 ,1.06 ,4.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62311,CPT,NJX DX/THER SBST EPIDURAL/SUBARACH LUMBAR/SACRAL,,,21,,RBRVS,1.54 ,0.90 ,4.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62318,CPT,NJXS INFUS/BOLUS DX/SBST EDRL/SUBARACH CRV/THRC,,,21,,RBRVS,2.04 ,0.66 ,4.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62319,CPT,NJX INFUS/BOLUS DX/SBST EDRL/SUBARACH LUM/SACRAL,,,21,,RBRVS,1.87 ,0.73 ,2.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62350,CPT,IMPLTJ REVJ/RPSG ITHCL/EDRL CATH PMP W/O LAM,,,21,,RBRVS,6.05 ,4.41 ,4.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62351,CPT,IMPLTJ REVJ/RPSG ITHCL/EDRL CATH W/LAM,,,21,,RBRVS,11.66 ,9.91 ,9.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62355,CPT,RMVL PREVIOUSLY IMPLTED ITHCL/EDRL CATH,,,21,,RBRVS,3.55 ,3.50 ,3.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62360,CPT,IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS SUBQ RSVR,,,21,,RBRVS,4.33 ,3.61 ,3.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62361,CPT,IMPLTJ/RPLCMT FS NON-PRGRBL PUMP,,,21,,RBRVS,5.00 ,5.47 ,5.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62362,CPT,IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS PRGRBL PUMP,,,21,,RBRVS,5.60 ,4.37 ,4.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62365,CPT,RMVL SUBQ RSVR/PUMP INTRATHECAL/EPIDURAL INFUS,,,21,,RBRVS,3.93 ,3.75 ,3.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62367,CPT,ELECT ANLYS IMPLT ITHCL/EDRL PMP W/O REPRG/REFIL,,,21,,RBRVS,0.48 ,0.20 ,0.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62368,CPT,ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG,,,21,,RBRVS,0.67 ,0.28 ,0.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62369,CPT,ELECT ANLYS IMPLT ITHCL/EDRL PMP W/REPRG&REFIL,,,21,,RBRVS,0.67 ,0.29 ,2.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
62370,CPT,ELEC ANLYS IMPLT ITHCL/EDRL PMP W/REPR PHYS/QHP,,,21,,RBRVS,0.90 ,0.36 ,2.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63001,CPT,LAM W/O FACETEC FORAMOT/DSKC 1/2 VRT SEG CRV,,,21,,RBRVS,17.61 ,12.34 ,12.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63003,CPT,LAMINECTOMY W/O FFD 1/2 VERT SEG THORACIC,,,21,,RBRVS,17.74 ,12.34 ,12.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63005,CPT,LAMINECTOMY W/O FFD 1/2 VERT SEG LUMBAR,,,21,,RBRVS,16.43 ,12.44 ,12.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63011,CPT,LAMINECTOMY W/O FFD 1/2 VERT SEG SACRAL,,,21,,RBRVS,15.91 ,11.61 ,11.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63012,CPT,LAMINECTOMY W/RMVL ABNORMAL FACETS LUMBAR,,,21,,RBRVS,16.85 ,12.36 ,12.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63015,CPT,LAMINECTOMY W/O FFD > 2 VERT SEG CERVICAL,,,21,,RBRVS,20.85 ,14.92 ,14.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63016,CPT,LAMINECTOMY W/O FFD > 2 VERT SEG THORACIC,,,21,,RBRVS,22.03 ,14.86 ,14.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63017,CPT,LAMINECTOMY W/O FFD > 2 VERT SEG LUMBAR,,,21,,RBRVS,17.33 ,13.12 ,13.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63020,CPT,LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC CERVC,,,21,,RBRVS,16.20 ,12.49 ,12.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63030,CPT,LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR,,,21,,RBRVS,13.18 ,10.95 ,10.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63035,CPT,LAMNOTMY W/DCMPRSN NRV EACH ADDL CRVCL/LMBR,,,21,,RBRVS,3.15 ,1.53 ,1.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63040,CPT,LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC CERVICAL,,,21,,RBRVS,20.31 ,13.93 ,13.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63042,CPT,LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC LUMBAR,,,21,,RBRVS,18.76 ,13.57 ,13.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63043,CPT,LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC EA CRV,,,21,,TotalUnits,,,,17.59 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63044,CPT,LAMOT W/PRTL FFD HRNA8 REEXPL 1 NTRSPC EA LMBR,,,21,,TotalUnits,,,,16.71 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63045,CPT,LAM FACETECTOMY & FORAMOTOMY 1 SEGMENT CERVICAL,,,21,,RBRVS,17.95 ,13.00 ,13.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63046,CPT,LAM FACETECTOMY & FORAMOTOMY 1 SEGMENT THORACIC,,,21,,RBRVS,17.25 ,12.52 ,12.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63047,CPT,LAM FACETECTOMY & FORAMOTOMY 1 SEGMENT LUMBAR,,,21,,RBRVS,15.37 ,12.01 ,12.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63048,CPT,LAM FACETECTOMY&FORAMTOMY 1 SGM EA CRV THRC/LMBR,,,21,,RBRVS,3.47 ,1.68 ,1.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63050,CPT,LAMOP CERVICAL W/DCMPRN SPI CORD 2/> VERT SEG,,,21,,RBRVS,22.01 ,14.89 ,14.89 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63051,CPT,LAMOPLASTY CERVICAL DCMPRN CORD 2/> SEG RCNSTJ,,,21,,RBRVS,25.51 ,16.73 ,16.73 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63055,CPT,TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG THORACIC,,,21,,RBRVS,23.55 ,15.69 ,15.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63056,CPT,TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG LUMBAR,,,21,,RBRVS,21.86 ,14.66 ,14.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63057,CPT,TRANSPEDICULAR DCMPRN 1 SEG EA THORACIC/LUMBAR,,,21,,RBRVS,5.25 ,2.55 ,2.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63064,CPT,COSTOVERTEBRAL DCMPRN SPINAL CORD THORACIC 1 SEG,,,21,,RBRVS,26.22 ,16.86 ,16.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63066,CPT,COSTOVERTEBRAL DCMPRN SPINE CORD THORACIC EA SEG,,,21,,RBRVS,3.26 ,1.53 ,1.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63075,CPT,DISCECTOMY ANT DCMPRN CORD CERVICAL 1 NTRSPC,,,21,,RBRVS,19.60 ,13.71 ,13.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63076,CPT,DISCECTOMY ANT DCMPRN CORD CERVICAL EA NTRSPC,,,21,,RBRVS,4.04 ,1.92 ,1.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63077,CPT,DISCECTOMY ANT DCMPRN CORD THORACIC 1 NTRSPC,,,21,,RBRVS,22.88 ,14.26 ,14.26 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63078,CPT,DISCECTOMY ANT DCMPRN CORD THORACIC EA NTRSPC,,,21,,RBRVS,3.28 ,1.59 ,1.59 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63081,CPT,VERTEBRAL CORPECTOMY ANT DCMPRN CERVICAL 1 SEG,,,21,,RBRVS,26.10 ,17.04 ,17.04 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63082,CPT,VERTEBRAL CORPECTOMY DCMPRN CERVICAL EA SEG,,,21,,RBRVS,4.36 ,2.10 ,2.10 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63085,CPT,VERTEBRAL CORPECTOMY DCMPRN CORD THORACIC 1 SEG,,,21,,RBRVS,29.47 ,17.44 ,17.44 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63086,CPT,VERTEBRAL CORPECTOMY DCMPRN CORD THORACIC EA SEG,,,21,,RBRVS,3.19 ,1.45 ,1.45 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63087,CPT,VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR 1 SEG,,,21,,RBRVS,37.53 ,21.59 ,21.59 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63088,CPT,VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR EA SEG,,,21,,RBRVS,4.32 ,2.03 ,2.03 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63090,CPT,VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC 1 SEG,,,21,,RBRVS,30.93 ,18.56 ,18.56 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63091,CPT,VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC EA SEG,,,21,,RBRVS,3.03 ,1.45 ,1.45 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63101,CPT,VERTEB CORPECT LAT XTRCAVITARY DCMPRN THRC 1 SEG,,,21,,RBRVS,34.10 ,22.14 ,22.14 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63102,CPT,VERTEB CORPECT LAT XTRCAVITARY DCMPRN LMBR 1 SEG,,,21,,RBRVS,34.10 ,22.02 ,22.02 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63103,CPT,VCRPEC LAT XTRCAVITARY DCMPRN THRC/LMBR EA SEG,,,21,,RBRVS,4.82 ,2.32 ,2.32 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63170,CPT,LAM W/MYELOTOMY CERVICAL/THORACIC/THORACOLUMBAR,,,21,,RBRVS,22.21 ,15.60 ,15.60 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63172,CPT,LAM W/DRG INTRMEDULLARY CYST/SYRINX SUBARACHNOID,,,21,,RBRVS,19.76 ,13.90 ,13.90 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63173,CPT,LAM W/DRG INTRMEDULRY CYST/SYRINX PRTL/PLEURAL,,,21,,RBRVS,24.31 ,16.57 ,16.57 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63180,CPT,LAM&SCTJ DENTATE LIG W/WO DURAL GRF CRV 1/2 SEG,,,21,,RBRVS,20.53 ,14.82 ,14.82 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63182,CPT,LAM&SCTJ DENTATE LIG W/WO DURAL GRF CRV >2 SEG,,,21,,RBRVS,22.82 ,15.87 ,15.87 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63185,CPT,LAMINECTOMY W/RHIZOTOMY 1/2 SEGMENTS,,,21,,RBRVS,16.49 ,12.17 ,12.17 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63190,CPT,LAMINECTOMY W/RHIZOTOMY > 2 SEGMENTS,,,21,,RBRVS,18.89 ,13.15 ,13.15 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63191,CPT,LAMINECTOMY W/SECTION SPINAL ACCESSORY NERVE,,,21,,RBRVS,18.92 ,13.90 ,13.90 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63194,CPT,LAM CORDOTOMY SCTJ 1 SPINOTHALMIC TRACT CERVICAL,,,21,,RBRVS,22.10 ,15.88 ,15.88 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63195,CPT,LAM CORDOTOMY SCTJ 1 SPINOTHALMIC TRACT THORACIC,,,21,,RBRVS,21.64 ,10.52 ,10.52 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63196,CPT,LAM CORDOTOMY SCTJ BOTH SPINOTHALMIC TRACTS CRV,,,21,,RBRVS,25.27 ,12.09 ,12.09 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63197,CPT,LAM CORDOTOMY SCTJ BOTH SPINOTHALMIC TRACT THRC,,,21,,RBRVS,24.08 ,16.46 ,16.46 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63198,CPT,LAM CORDOTOMY SCTJ BOTH TRACTS 2 STAGES CERVICAL,,,21,,RBRVS,29.90 ,14.10 ,14.10 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63199,CPT,LAM CORDOTOMY SCTJ BOTH TRACTS 2 STAGES THORACIC,,,21,,RBRVS,31.47 ,14.70 ,14.70 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63200,CPT,LAMINECTOMY RELEASE TETHERED SPINAL CORD LUMBAR,,,21,,RBRVS,21.44 ,15.19 ,15.19 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63250,CPT,LAM EXC/OCCLUSION AVM SPINAL CORD CERVICAL,,,21,,RBRVS,43.86 ,25.77 ,25.77 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63251,CPT,LAM EXC/OCCLUSION AVM SPINAL CORD THORACIC,,,21,,RBRVS,44.64 ,26.61 ,26.61 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63252,CPT,LAM EXC/OCCLUSION AVM SPI CORD THORACOLUMBAR,,,21,,RBRVS,44.63 ,26.61 ,26.61 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63265,CPT,LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL CERVICAL,,,21,,RBRVS,23.82 ,16.22 ,16.22 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63266,CPT,LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL THORACIC,,,21,,RBRVS,24.68 ,16.58 ,16.58 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63267,CPT,LAM EXC/EVAC ISPI LESION OTH/THN NEO XDRL LUMBAR,,,21,,RBRVS,19.45 ,13.99 ,13.99 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63268,CPT,LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL SACRAL,,,21,,RBRVS,20.02 ,14.14 ,14.14 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63270,CPT,LAM EXC ISPI LES OTH/THN NEO IDRL CERVICAL,,,21,,RBRVS,29.80 ,19.19 ,19.19 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63271,CPT,LAM EXC ISPI LES OTH/THN NEO IDRL THORACIC,,,21,,RBRVS,29.92 ,19.18 ,19.18 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63272,CPT,LAM EXC ISPI LES OTH/THN NEO IDRL LUMBAR,,,21,,RBRVS,27.50 ,17.87 ,17.87 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63273,CPT,LAM EXC ISPI LES OTH/THN NEO IDRL SACRAL,,,21,,RBRVS,26.47 ,17.64 ,17.64 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63275,CPT,LAMINECTOMY BX/EXC ISPI NEO XDRL CERVICAL,,,21,,RBRVS,25.86 ,17.20 ,17.20 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63276,CPT,LAMINECTOMY BX/EXC ISPI NEO XDRL THORACIC,,,21,,RBRVS,25.69 ,17.09 ,17.09 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63277,CPT,LAMINECTOMY BX/EXC ISPI NEO XDRL LUMBAR,,,21,,RBRVS,22.39 ,15.41 ,15.41 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63278,CPT,LAMINECTOMY BX/EXC ISPI NEO XDRL SACRAL,,,21,,RBRVS,22.12 ,15.60 ,15.60 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63280,CPT,LAM BX/EXC ISPI NEO IDRL XMED CERVICAL,,,21,,RBRVS,30.29 ,19.88 ,19.88 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63281,CPT,LAM BX/EXC ISPI NEO IDRL XMED THORACIC,,,21,,RBRVS,29.99 ,19.66 ,19.66 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63282,CPT,LAM BX/EXC ISPI NEO IDRL XMED LUMBAR,,,21,,RBRVS,28.15 ,18.77 ,18.77 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63283,CPT,LAM BX/EXC ISPI NEO IDRL SACRAL,,,21,,RBRVS,26.76 ,18.24 ,18.24 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63285,CPT,LAM BX/EXC ISPI NEO IDRL IMED CERVICAL,,,21,,RBRVS,38.05 ,23.52 ,23.52 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63286,CPT,LAM BX/EXC ISPI NEO IDRL IMED THORACIC,,,21,,RBRVS,37.62 ,23.27 ,23.27 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63287,CPT,LAM BX/EXC ISPI NEO IDRL IMED THORACOLMBR,,,21,,RBRVS,40.08 ,24.48 ,24.48 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63290,CPT,LAM BX/EXC ISPI NEO XDRL-IDRL LES ANY LVL,,,21,,RBRVS,40.82 ,24.83 ,24.83 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63295,CPT,OSTPL RCNSTJ DORSAL SPI ELMNTS FLWG ISPI PX,,,21,,RBRVS,5.25 ,2.47 ,2.47 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63300,CPT,VCRPEC LES 1 SGM XDRL CERVICAL,,,21,,RBRVS,26.80 ,17.42 ,17.42 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63301,CPT,VCRPEC LES 1 SGM XDRL THORACIC TTHRC,,,21,,RBRVS,31.57 ,18.95 ,18.95 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63302,CPT,VCRPEC LES 1 SEG XDRL THRC THORACOLMBR,,,21,,RBRVS,31.15 ,20.30 ,20.30 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63303,CPT,VCRPEC LES 1 SEG XDRL LMBR/SAC TRANSPRTL/RPR,,,21,,RBRVS,33.55 ,20.96 ,20.96 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63304,CPT,VERTEBRAL CORPECTOMY EXC LES 1 SEG IDRL CERVICAL,,,21,,RBRVS,33.85 ,21.57 ,21.57 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63305,CPT,VERTEBRAL CORPECTOMY LES 1 SEG IDRL THRC TTHRC,,,21,,RBRVS,36.24 ,22.67 ,22.67 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63306,CPT,VERTEBRL CORPECT LES 1 SEG IDRL THRC THORACOLMBR,,,21,,RBRVS,35.55 ,14.25 ,14.25 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63307,CPT,VCRPEC LES 1 SEG IDRL LMBR/SAC TRANSPRTL/RPR,,,21,,RBRVS,34.96 ,21.53 ,21.53 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63308,CPT,VERTEBRAL CORPECTOMY EXC INDRL LES EACH SEG,,,21,,RBRVS,5.24 ,2.46 ,2.46 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63600,CPT,CREATION LES SPINAL CORD STEREOTACTIC METHOD PRQ,,,21,,RBRVS,15.12 ,9.61 ,9.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63610,CPT,STRTCTC STIMJ SPI CORD PRQ SPX N/FLWD OTH SURG,,,21,,RBRVS,8.72 ,1.83 ,1.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63615,CPT,STRTCTC BX ASPIRAT/EXC LESION SPINAL CORD,,,21,,RBRVS,17.32 ,12.02 ,12.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63620,CPT,STEREOTACTIC RADIOSURGERY 1 SPINAL LESION,,,21,,RBRVS,15.60 ,10.95 ,10.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63621,CPT,STEREOTACTIC RADIOSURGERY EA ADDL SPINAL LESION,,,21,,RBRVS,4.00 ,1.88 ,1.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63650,CPT,PRQ IMPLTJ NSTIM ELECTRODE ARRAY EPIDURAL,,,21,,RBRVS,7.15 ,4.06 ,29.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63655,CPT,LAM IMPLTJ NSTIM ELTRDS PLATE/PADDLE EDRL,,,21,,RBRVS,10.92 ,9.53 ,9.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63661,CPT,RMVL SPINAL NSTIM ELTRD PRQ ARRAY INCL FLUOR,,,21,,RBRVS,5.08 ,3.44 ,10.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63662,CPT,RMVL SPINAL NSTIM ELTRD PLATE/PADDLE INCL FLUOR,,,21,,RBRVS,11.00 ,9.69 ,9.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63663,CPT,REVJ INCL RPLCMT NSTIM ELTRD PRQ RA INCL FLUOR,,,21,,RBRVS,7.75 ,4.34 ,13.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63664,CPT,REVJ INCL RPLCMT NSTIM ELTRD PLT/PDLE INCL FLUOR,,,21,,RBRVS,11.52 ,9.73 ,9.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63685,CPT,INSJ/RPLCMT SPI NPGR DIR/INDUXIVE COUPLING,,,21,,RBRVS,5.19 ,4.29 ,4.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63688,CPT,REVJ/RMVL IMPLANTED SPINAL NEUROSTIM GENERATOR,,,21,,RBRVS,5.30 ,4.28 ,4.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63700,CPT,REPAIR MENINGOCELE < 5 CM DIAMETER,,,21,,RBRVS,17.47 ,12.75 ,12.75 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63702,CPT,REPAIR MENINGOCELE > 5 CM DIAMETER,,,21,,RBRVS,19.41 ,13.73 ,13.73 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63704,CPT,REPAIR MYELOMENINGOCELE < 5 CM DIAMETER,,,21,,RBRVS,22.43 ,15.99 ,15.99 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63706,CPT,REPAIR MYELOMENINGOCELE > 5 CM DIAMETER,,,21,,RBRVS,25.35 ,18.26 ,18.26 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63707,CPT,RPR DURAL/CEREBROSPINAL FLUID LEAK X REQ LAM,,,21,,RBRVS,12.65 ,10.17 ,10.17 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63709,CPT,RPR DURAL/CSF LEAK/PSEUDOMENINGOCELE W/LAM,,,21,,RBRVS,15.65 ,11.59 ,11.59 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63710,CPT,DURAL GRAFT SPINAL,,,21,,RBRVS,15.40 ,11.50 ,11.50 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63740,CPT,CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL/OTH W/LAM,,,21,,RBRVS,12.63 ,10.23 ,10.23 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
63741,CPT,CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL PRQ X LAM,,,21,,RBRVS,9.12 ,7.59 ,7.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63744,CPT,RPLCMT IRRIGATION/REVJ LUMBOSARACH SHUNT,,,21,,RBRVS,8.94 ,7.56 ,7.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
63746,CPT,RMVL ENTIRE LUMBOSARACH SHUNT SYS W/O RPLCMT,,,21,,RBRVS,7.33 ,7.27 ,7.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64400,CPT,NJX ANES TRIGEMINAL NRV ANY DIV/BRANCH,,,21,,RBRVS,1.11 ,0.71 ,2.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64402,CPT,INJECTION ANESTHETIC AGENT FACIAL NERVE,,,21,,RBRVS,1.25 ,0.73 ,2.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64405,CPT,INJECTION ANESTHETIC AGENT GREATER OCCIPITAL NRV,,,21,,RBRVS,0.94 ,0.69 ,1.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64408,CPT,INJECTION ANESTHETIC AGENT VAGUS NERVE,,,21,,RBRVS,1.41 ,0.92 ,1.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64410,CPT,INJECTION ANESTHETIC AGENT PHRENIC NERVE,,,21,,RBRVS,1.43 ,0.43 ,1.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64413,CPT,INJECTION ANESTHETIC AGENT CERVICAL PLEXUS,,,21,,RBRVS,1.40 ,0.75 ,2.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64415,CPT,SINGLE NERVE BLOCK INJECTION ARM NERVE,,,21,,RBRVS,1.48 ,0.26 ,1.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64416,CPT,INJECTION ANES BRACHIAL PLEXUS CONT NFS CATH,,,21,,RBRVS,1.81 ,0.31 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64417,CPT,INJECTION ANESTHETIC AGENT AXILLARY NERVE,,,21,,RBRVS,1.44 ,0.46 ,2.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64418,CPT,INJECTION ANESTHETIC AGENT SUPRASCAPULAR NERVE,,,21,,RBRVS,1.32 ,0.74 ,2.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64420,CPT,INJECTION ANESTHETIC AGENT 1 INTERCOSTAL NERVE,,,21,,RBRVS,1.18 ,0.66 ,1.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64421,CPT,MULTIPLE NERVE BLOCK INJECTIONS RIB NERVES,,,21,,RBRVS,1.68 ,0.80 ,2.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64425,CPT,INJECTION ANES ILIOINGUINAL ILIOHYPOGASTRIC NRVS,,,21,,RBRVS,1.75 ,0.75 ,1.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64430,CPT,INJECTION ANESTHETIC AGENT PUDENDAL NERVE,,,21,,RBRVS,1.46 ,0.77 ,2.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64435,CPT,INJECTION ANESTHETIC PARACERVICAL UTERINE NERVE,,,21,,RBRVS,1.45 ,0.77 ,2.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64445,CPT,INJECTION ANESTHETIC AGENT SCIATIC NRV SINGLE,,,21,,RBRVS,1.48 ,0.43 ,2.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64446,CPT,INJECTION ANES SCIATIC NERVE CONT INFUSION CATH,,,21,,RBRVS,1.81 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64447,CPT,INJECTION ANESTHETIC AGENT FEMORAL NERVE SINGLE,,,21,,RBRVS,1.50 ,0.27 ,1.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64448,CPT,INJECTION ANES FEMORAL NERVE CONT INFUSION CATH,,,21,,RBRVS,1.63 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64449,CPT,INJECTION ANES LUMBAR PLEXUS POST CONT NFS CATH,,,21,,RBRVS,1.81 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64450,CPT,INJECTION ANES OTHER PERIPHERAL NERVE/BRANCH,,,21,,RBRVS,0.75 ,0.49 ,1.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64455,CPT,NJX ANES&/STEROID PLANTAR COMMON DIGITAL NERVE,,,21,,RBRVS,0.75 ,0.19 ,0.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64461,CPT,PVB THORACIC SINGLE INJECTION SITE W/IMG GID,,,21,,RBRVS,1.75 ,0.59 ,2.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64462,CPT,PVB THORACIC SECOND & ADDL INJ SITE W/IMG GID,,,21,,RBRVS,1.10 ,0.37 ,1.20 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
64463,CPT,PVB THORACIC CONT CATHETER INFUSION W/IMG GID,,,21,,RBRVS,1.81 ,0.50 ,2.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64479,CPT,NJX ANES&/STRD W/IMG TFRML EDRL CRV/THRC 1 LVL,,,21,,RBRVS,2.29 ,1.32 ,4.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64480,CPT,NJX ANES&/STRD W/IMG TFRML EDRL CRV/THRC EA LV,,,21,,RBRVS,1.20 ,0.51 ,1.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64483,CPT,NJX ANES&/STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL,,,21,,RBRVS,1.90 ,1.19 ,4.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64484,CPT,NJX ANES&/STRD W/IMG TFRML EDRL LMBR/SAC EA LV,,,21,,RBRVS,1.00 ,0.42 ,1.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64486,CPT,TAP BLOCK UNILATERAL BY INJECTION(S),,,21,,RBRVS,1.27 ,0.44 ,2.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64487,CPT,TAP BLOCK UNILATERAL BY CONTINUOUS INFUSION(S),,,21,,RBRVS,1.48 ,0.49 ,2.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64488,CPT,TAP BLOCK BILATERAL BY INJECTION(S),,,21,,RBRVS,1.60 ,0.55 ,2.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64489,CPT,TAP BLOCK BILATERAL BY CONTINUOUS INFUSION(S),,,21,,RBRVS,1.80 ,0.60 ,4.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64490,CPT,NJX DX/THER AGT PVRT FACET JT CRV/THRC 1 LEVEL,,,21,,RBRVS,1.82 ,1.09 ,3.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64491,CPT,NJX DX/THER AGT PVRT FACET JT CRV/THRC 2ND LEVEL,,,21,,RBRVS,1.16 ,0.48 ,1.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64492,CPT,NJX DX/THER AGT PVRT FACET JT CRV/THRC 3+ LEVEL,,,21,,RBRVS,1.16 ,0.50 ,1.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64493,CPT,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL,,,21,,RBRVS,1.52 ,0.97 ,3.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64494,CPT,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 2ND LEVEL,,,21,,RBRVS,1.00 ,0.41 ,1.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64495,CPT,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 3+ LEVEL,,,21,,RBRVS,1.00 ,0.43 ,1.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64505,CPT,INJECTION ANES AGENT SPHENOPALATINE GANGLION,,,21,,RBRVS,1.36 ,0.98 ,1.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64508,CPT,INJECTION ANESTHETIC AGENT CAROTID SINUS SPX,,,21,,RBRVS,1.12 ,0.72 ,0.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64510,CPT,NJX ANES STELLATE GANGLION CRV SYMPATHETIC,,,21,,RBRVS,1.22 ,0.80 ,2.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64517,CPT,INJECTION ANES SUPERIOR HYPOGASTRIC PLEXUS,,,21,,RBRVS,2.20 ,1.15 ,2.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64520,CPT,INJECTION ANES LMBR/THRC PARAVERTBRL SYMPATHETIC,,,21,,RBRVS,1.35 ,0.86 ,3.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64530,CPT,INJX ANES CELIAC PLEXUS W/WO RADIOLOGIC MONITRNG,,,21,,RBRVS,1.58 ,0.94 ,3.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64550,CPT,APPLICATION SURFACE NEUROSTIMULATOR,,,21,,RBRVS,0.18 ,0.06 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64553,CPT,PRQ IMPLTJ NEUROSTIMULATOR ELTRD CRANIAL NERVE,,,21,,RBRVS,2.36 ,2.05 ,3.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64555,CPT,PRQ IMPLTJ NEUROSTIMULATOR ELTRD PERIPHERAL NRV,,,21,,RBRVS,2.32 ,1.88 ,3.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64561,CPT,PRQ IMPLTJ NEUROSTIM ELTRD SACRAL NRVE W/IMAGING,,,21,,RBRVS,5.44 ,2.63 ,17.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64565,CPT,PRQ IMPLTJ NSTIM ELTRD NEUROMUSCULAR,,,21,,RBRVS,1.81 ,1.77 ,3.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64566,CPT,POST TIB NEUROSTIMULATION PRQ NEEDLE ELECTRODE,,,21,,RBRVS,0.60 ,0.21 ,2.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64568,CPT,INC IMPLTJ CRNL NRV NSTIM ELTRDS & PULSE GENER,,,21,,RBRVS,9.00 ,7.32 ,7.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64569,CPT,REVISION/REPLMT NEUROSTIMLATOR ELTRD CRANIAL NRV,,,21,,RBRVS,11.00 ,8.35 ,8.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64570,CPT,REMOVAL CRNL NRV NSTIM ELTRDS & PULSE GENERATO,,,21,,RBRVS,9.10 ,7.47 ,7.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64575,CPT,INC IMPLTJ PERIPH NERVE NEUROSTIMULATOR ELTRD,,,21,,RBRVS,4.42 ,3.85 ,3.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64580,CPT,INC IMPLTJ NSTIM ELTRD NEUROMUSCULAR,,,21,,RBRVS,4.19 ,3.50 ,3.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64581,CPT,INC IMPLTJ NEUROSTIMULATOR ELTRD SACRAL NERVE,,,21,,RBRVS,12.20 ,5.41 ,5.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64585,CPT,REVJ/RMVL PERIPHERAL NEUROSTIMULATOR ELECTRODE,,,21,,RBRVS,2.11 ,1.75 ,4.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64590,CPT,INSERTION/RPLCMT PERIPHERAL/GASTRIC NPGR,,,21,,RBRVS,2.45 ,1.86 ,4.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64595,CPT,REVISION/RMVL PERIPHERAL/GASTRIC NPGR,,,21,,RBRVS,1.78 ,1.62 ,4.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64600,CPT,DSTRJ TRIGEMINAL NRV SUPRAORB INFRAORB BRANCH,,,21,,RBRVS,3.49 ,2.20 ,6.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64605,CPT,DSTRJ NEUROLYTIC TRIGEMINAL NRV 2/3 DIV BRANCH,,,21,,RBRVS,5.65 ,3.54 ,10.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64610,CPT,DSTRJ NEURLYTIC TRIGEM NRV 2/3 DIV RADIO MONITOR,,,21,,RBRVS,7.20 ,4.55 ,11.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64611,CPT,CHEMODENERV PAROTID&SUBMANDIBL SALIVARY GLNDS,,,21,,RBRVS,1.03 ,1.51 ,1.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64612,CPT,CHEMODNRVTJ MUSC MUSC INNERVATED FACIAL NRV UNIL,,,21,,RBRVS,1.41 ,1.65 ,2.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64615,CPT,CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE,,,21,,RBRVS,1.85 ,1.12 ,1.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64616,CPT,CHEMODENERVATION MUSCLE NECK UNILAT FOR DYSTONIA,,,21,,RBRVS,1.53 ,1.09 ,1.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64617,CPT,CHEMODENERVATION MUSCLE LARYNX UNILAT W/EMG,,,21,,RBRVS,1.90 ,1.12 ,3.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64620,CPT,DSTRJ NEUROLYTIC AGENT INTERCOSTAL NERVE,,,21,,RBRVS,2.89 ,1.83 ,2.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64630,CPT,DSTRJ NEUROLYTIC AGENT PUDENDAL NERVE,,,21,,RBRVS,3.05 ,2.06 ,3.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64632,CPT,DSTRJ NEUROLYTIC PLANTAR COMMON DIGITAL NERVE,,,21,,RBRVS,1.23 ,0.66 ,1.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64633,CPT,DSTR NROLYTC AGNT PARVERTEB FCT SNGL CRVCL/THORA,,,21,,RBRVS,3.84 ,2.38 ,7.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64634,CPT,DSTR NROLYTC AGNT PARVERTEB FCT ADDL CRVCL/THORA,,,21,,RBRVS,1.32 ,0.54 ,3.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64635,CPT,DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL,,,21,,RBRVS,3.78 ,2.36 ,7.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64636,CPT,DSTR NROLYTC AGNT PARVERTEB FCT ADDL LMBR/SACRAL,,,21,,RBRVS,1.16 ,0.48 ,3.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64640,CPT,DSTRJ NEUROLYTIC AGENT OTHER PERIPHERAL NERVE,,,21,,RBRVS,1.23 ,1.34 ,2.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64642,CPT,CHEMODENERVATION ONE EXTREMITY 1-4 MUSCLE,,,21,,RBRVS,1.65 ,1.10 ,2.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64643,CPT,CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE,,,21,,RBRVS,1.22 ,0.61 ,1.16 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
64644,CPT,CHEMODENERVATION 1 EXTREMITY 5 OR MORE MUSCLES,,,21,,RBRVS,1.82 ,1.18 ,2.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64645,CPT,CHEMODENERVATION 1 EXTREMITY EA ADDL 5/> MUSCLES,,,21,,RBRVS,1.39 ,0.69 ,1.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
64646,CPT,CHEMODENERVATION OF TRUNK MUSCLE 1-5 MUSCLES,,,21,,RBRVS,1.80 ,1.17 ,2.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64647,CPT,CHEMODENERVATION OF TRUNK 6 OR MORE MUSCLES,,,21,,RBRVS,2.11 ,1.33 ,2.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64650,CPT,CHEMODENERVATION ECCRINE GLANDS BOTH AXILLAE,,,21,,RBRVS,0.70 ,0.38 ,1.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64653,CPT,CHEMODENERVATION ECCRINE GLANDS OTH AREA PER DAY,,,21,,RBRVS,0.88 ,0.43 ,1.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64680,CPT,DSTRJ NEUROLYTIC W/WO RAD MONITOR CELIAC PLEXUS,,,21,,RBRVS,2.67 ,1.89 ,5.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64681,CPT,DSTRJ NULYT W/WORAD MNTR SUPRIOR HYPOGSTR PLEXUS,,,21,,RBRVS,3.78 ,2.55 ,7.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64702,CPT,NEUROPLASTY DIGITAL 1/BOTH SAME DIGIT,,,21,,RBRVS,6.26 ,6.98 ,6.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64704,CPT,NEUROPLASTY NERVE HAND/FOOT,,,21,,RBRVS,4.69 ,3.88 ,3.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64708,CPT,NEURP MAJOR PRPH NRV ARM/LEG OPN OTH/THN SPEC,,,21,,RBRVS,6.36 ,6.76 ,6.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64712,CPT,NEURP MAJOR PRPH NRV OPN ARM/LEG SCIATIC NRV,,,21,,RBRVS,8.07 ,6.84 ,6.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64713,CPT,NEURP MAJOR PRPH NRV OPN ARM/LEG BRACH PLEXUS,,,21,,RBRVS,11.40 ,7.29 ,7.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64714,CPT,NEURP MAJOR PRPH NRV OPN ARM/LEG LMBR PLEXUS,,,21,,RBRVS,10.55 ,6.60 ,6.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64716,CPT,NEUROPLASTY &/TRANSPOSITION CRANIAL NERVE,,,21,,RBRVS,6.99 ,7.24 ,7.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64718,CPT,NEUROPLASTY &/TRANSPOSITION ULNAR NERVE ELBOW,,,21,,RBRVS,7.26 ,8.26 ,8.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64719,CPT,NEUROPLASTY &/TRANSPOSITION ULNAR NERVE WRIST,,,21,,RBRVS,4.97 ,5.52 ,5.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64721,CPT,NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE,,,21,,RBRVS,4.97 ,6.24 ,6.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64722,CPT,DECOMPRESSION UNSPECIFIED NERVE,,,21,,RBRVS,4.82 ,4.89 ,4.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64726,CPT,DECOMPRESSION PLANTAR DIGITAL NERVE,,,21,,RBRVS,4.27 ,3.23 ,3.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64727,CPT,INTERNAL NEUROLYSIS REQ OPERATING MICROSCOPE,,,21,,RBRVS,3.10 ,1.58 ,1.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64732,CPT,TRANSECTION/AVULSION SUPRAORBITAL NERVE,,,21,,RBRVS,4.89 ,5.20 ,5.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64734,CPT,TRANSECTION/AVULSION INFRAORBITAL NERVE,,,21,,RBRVS,5.55 ,6.75 ,6.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64736,CPT,TRANSECTION/AVULSION MENTAL NERVE,,,21,,RBRVS,5.23 ,5.35 ,5.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64738,CPT,TRANSECTION/AVULSION INF ALVEOLAR NRV W/OSTEO,,,21,,RBRVS,6.36 ,5.82 ,5.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64740,CPT,TRANSECTION/AVULSION LINGUAL NERVE,,,21,,RBRVS,6.22 ,5.98 ,5.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64742,CPT,TRANSECTION/AVULSION FACIAL NRV DIFFERENT/CMPL,,,21,,RBRVS,6.85 ,5.30 ,5.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64744,CPT,TRANSECTION/AVULSION GREATER OCCIPITAL NERVE,,,21,,RBRVS,5.72 ,6.36 ,6.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64746,CPT,TRANSECTION/AVULSION PHRENIC NERVE,,,21,,RBRVS,6.56 ,4.38 ,4.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64755,CPT,TRANSECTION/AVULSION VAGUS NERVES,,,21,,RBRVS,15.05 ,7.93 ,7.93 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
64760,CPT,TRANSECTION/AVULSION VAGUS NERVE ABDOMINAL,,,21,,RBRVS,7.59 ,5.42 ,5.42 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
64763,CPT,TRNSXJ/AVLSN OBTURAT NRV XPELV W/WO TENOTOMY,,,21,,RBRVS,7.56 ,5.31 ,5.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64766,CPT,TRNSXJ/AVLSN OBTURAT NRV INPELV W/WO TENOTOMY,,,21,,RBRVS,9.47 ,5.69 ,5.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64771,CPT,TRANSECTION/AVULSION OTH CRANIAL NRV XDRL,,,21,,RBRVS,8.15 ,7.63 ,7.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64772,CPT,TRANSECTION/AVULSION OTH SPINAL NRV XDRL,,,21,,RBRVS,7.84 ,6.81 ,6.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64774,CPT,EXC NEUROMA CUTAN NRV SURGLY IDENTIFIABLE,,,21,,RBRVS,5.80 ,5.05 ,5.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64776,CPT,EXC NEUROMA DIGITAL NERVE 1 OR BOTH SAME DIGIT,,,21,,RBRVS,5.60 ,4.76 ,4.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64778,CPT,EXCISION NEUROMA DIGITAL NRV EA ADDL DIGIT,,,21,,RBRVS,3.11 ,0.76 ,0.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64782,CPT,EXC NEUROMA HAND/FOOT XCP DIGITAL NERVE,,,21,,RBRVS,6.86 ,5.16 ,5.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64783,CPT,EXC NEUROMA HAND/FOOT EA NRV XCP SM DGT,,,21,,RBRVS,3.71 ,2.08 ,2.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64784,CPT,EXC NEUROMA MAJOR PERIPHERAL NRV XCP SCIATIC,,,21,,RBRVS,10.62 ,8.49 ,8.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64786,CPT,EXCISION NEUROMA SCIATIC NERVE,,,21,,RBRVS,16.25 ,11.63 ,11.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64787,CPT,IMPLANTATION NERVE END BONE/MUSCLE,,,21,,RBRVS,4.29 ,2.12 ,2.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64788,CPT,EXC NEUROFIBROMA/NEUROLEMMOMA CUTAN NRV,,,21,,RBRVS,5.24 ,5.32 ,5.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64790,CPT,EXC NEUROFIBROMA/NEUROLEMMOMA MAJOR PRPH NRV,,,21,,RBRVS,12.10 ,9.11 ,9.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64792,CPT,EXC NEUROFIBROMA/NEUROLEMMOMA EXTNSV,,,21,,RBRVS,15.86 ,12.53 ,12.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64795,CPT,BIOPSY NERVE,,,21,,RBRVS,3.01 ,1.77 ,1.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64802,CPT,SYMPATHECTOMY CERVICAL,,,21,,RBRVS,10.37 ,7.96 ,7.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64804,CPT,SYMPATHECTOMY CERVICOTHORACIC,,,21,,RBRVS,15.91 ,7.41 ,7.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64809,CPT,SYMPATHECTOMY THORACOLUMBAR,,,21,,RBRVS,14.71 ,11.19 ,11.19 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
64818,CPT,SYMPATHECTOMY LUMBAR,,,21,,RBRVS,11.34 ,3.68 ,3.68 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
64820,CPT,SYMPATHECTOMY DIGITAL ARTERIES EACH DIGIT,,,21,,RBRVS,10.74 ,8.48 ,8.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64821,CPT,SYMPATHECTOMY RADIAL ARTERY,,,21,,RBRVS,9.33 ,8.94 ,8.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64822,CPT,SYMPATHECTOMY ULNAR ARTERY,,,21,,RBRVS,9.33 ,8.94 ,8.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64823,CPT,SYMPATHECTOMY SUPERFICIAL PALMAR ARCH,,,21,,RBRVS,10.94 ,9.50 ,9.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64831,CPT,SUTURE DIGITAL NERVE HAND/FOOT 1 NERVE,,,21,,RBRVS,9.16 ,8.88 ,8.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64832,CPT,SUTR DIGITAL NRV HAND/FOOT EA DGTAL NRV,,,21,,RBRVS,5.65 ,3.12 ,3.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64834,CPT,SUTURE 1 NERVE HAND/FOOT COMMON SENSORY NERVE,,,21,,RBRVS,10.81 ,8.57 ,8.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64835,CPT,SUTURE 1 NERVE MEDIAN MOTOR THENAR,,,21,,RBRVS,11.73 ,9.36 ,9.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64836,CPT,SUTURE 1 NERVE ULNAR MOTOR,,,21,,RBRVS,11.73 ,9.88 ,9.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64837,CPT,SUTURE EACH ADDITIONAL NERVE HAND/FOOT,,,21,,RBRVS,6.25 ,3.67 ,3.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64840,CPT,SUTURE POSTERIOR TIBIAL NERVE,,,21,,RBRVS,14.02 ,11.52 ,11.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64856,CPT,SUTR PRPH NRV ARM/LEG XCP SCIATIC W/TRPOS,,,21,,RBRVS,15.07 ,11.20 ,11.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64857,CPT,SUTR PRPH NRV ARM/LEG XCP SCIATIC W/O TRPOS,,,21,,RBRVS,15.82 ,11.47 ,11.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64858,CPT,SUTURE SCIATIC NERVE,,,21,,RBRVS,17.82 ,12.54 ,12.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64859,CPT,SUTURE EACH ADDITIONAL PERIPHERAL NERVE,,,21,,RBRVS,4.25 ,2.39 ,2.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64861,CPT,SUTURE BRACHIAL PLEXUS,,,21,,RBRVS,20.89 ,12.18 ,12.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64862,CPT,SUTURE LUMBAR PLEXUS,,,21,,RBRVS,21.09 ,10.57 ,10.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64864,CPT,SUTURE FACIAL NERVE EXTRACRANIAL,,,21,,RBRVS,13.41 ,9.71 ,9.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64865,CPT,SUTURE FACIAL NERVE INFRATEMPORAL W/WO GRAFT,,,21,,RBRVS,16.09 ,13.53 ,13.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64866,CPT,ANASTOMOSIS FACIAL-SPINAL ACCESSORY,,,21,,RBRVS,16.83 ,13.86 ,13.86 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
64868,CPT,ANASTOMOSIS FACIAL HYPOGLOSSAL,,,21,,RBRVS,14.90 ,12.20 ,12.20 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
64872,CPT,SUTURE NERVE REQ SECONDARY/DELAYED SUTURE,,,21,,RBRVS,1.99 ,1.01 ,1.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64874,CPT,SUTURE NERVE REQ XTNSV MOBIL/TRPOS NERVE,,,21,,RBRVS,2.98 ,1.33 ,1.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64876,CPT,SUTURE NERVE REQ SHORTENING BONE EXTREMITY,,,21,,RBRVS,3.37 ,1.29 ,1.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64885,CPT,NERVE GRAFT HEAD/NECK </ 4 CM,,,21,,RBRVS,17.60 ,12.08 ,12.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64886,CPT,NERVE GRAFT HEAD/NECK >4 CM,,,21,,RBRVS,20.82 ,13.54 ,13.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64890,CPT,NERVE GRAFT 1 STRAND HAND/FOOT </4 CM,,,21,,RBRVS,16.24 ,12.54 ,12.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64891,CPT,NRV GRF 1 STRAND HAND/FOOT >4 CM,,,21,,RBRVS,17.35 ,13.29 ,13.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64892,CPT,NERVE GRAFT 1 STRAND ARM/LEG <4 CM,,,21,,RBRVS,15.74 ,11.37 ,11.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64893,CPT,NERVE GRAFT 1 STRAND ARM/LEG >4 CM,,,21,,RBRVS,16.87 ,13.01 ,13.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64895,CPT,NERVE GRAFT MLT STRANDS HAND/FOOT </4 CM,,,21,,RBRVS,20.39 ,15.10 ,15.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64896,CPT,NERVE GRAFT MLT STRANDS HAND/FOOT > 4 CM,,,21,,RBRVS,21.96 ,15.60 ,15.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64897,CPT,NERVE GRAFT MLT STRANDS ARM/LEG </4 CM,,,21,,RBRVS,19.38 ,14.15 ,14.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64898,CPT,NERVE GRAFT MLT STRANDS ARM/LEG >4 CM,,,21,,RBRVS,20.97 ,15.16 ,15.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64901,CPT,NERVE GRAFT EACH NERVE 1 STRAND,,,21,,RBRVS,10.20 ,4.52 ,4.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64902,CPT,NERVE GRAFT EACH NERVE MULTIPLE STRANDS,,,21,,RBRVS,11.81 ,5.24 ,5.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64905,CPT,NERVE PEDICLE TRANSFER FIRST STAGE,,,21,,RBRVS,15.11 ,11.87 ,11.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64907,CPT,NERVE PEDICAL TRANSFER SECOND STAGE,,,21,,RBRVS,20.03 ,14.08 ,14.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64910,CPT,NERVE REPAIR W/CONDUIT EACH NERVE,,,21,,RBRVS,11.39 ,10.29 ,10.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64911,CPT,NERVE REPAIR W/AUTOGENOUS VEIN GRAFT EA NERVE,,,21,,RBRVS,14.39 ,12.41 ,12.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
64999,CPT,UNLISTED PROCEDURE NERVOUS SYSTEM,,,21,,TotalUnits,,,,3.92 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65091,CPT,EVISCERATION OCULAR CONTENTS W/O IMPLANT,,,21,,RBRVS,7.26 ,10.13 ,10.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65093,CPT,EVISCERATION OCULAR CONTENTS W/IMPLANT,,,21,,RBRVS,7.04 ,10.15 ,10.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65101,CPT,ENUCLEATION OF EYE W/O IMPLANT,,,21,,RBRVS,8.30 ,11.92 ,11.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65103,CPT,ENUCLEATION EYE IMPLT MUSC X ATTACHED IMPLT,,,21,,RBRVS,8.84 ,12.20 ,12.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65105,CPT,ENUCLEATION EYE IMPLT MUSC ATTACHED IMPLT,,,21,,RBRVS,9.93 ,13.31 ,13.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65110,CPT,EXENTERATION ORBIT REMVL ORBITAL CONTENTS ONLY,,,21,,RBRVS,15.70 ,17.65 ,17.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65112,CPT,EXENTERATION ORBIT RMVL ORBIT CONTENTS & BONE,,,21,,RBRVS,18.51 ,20.15 ,20.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65114,CPT,EXNTJ ORBIT RMVL ORB CNTS W/MUSC/MYOQ FLAP,,,21,,RBRVS,19.65 ,20.86 ,20.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65125,CPT,MODIFICAJ OC IMPLT W/PLMT/RPLCMT PEGS SPX,,,21,,RBRVS,3.27 ,4.75 ,9.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65130,CPT,INSJ OC IMPLT SEC AFTER EVSC SCLL SHELL,,,21,,RBRVS,8.42 ,11.61 ,11.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65135,CPT,INSJ OC IMPLT AFTER ENCL MUSC X ATTACHED,,,21,,RBRVS,8.60 ,11.72 ,11.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65140,CPT,INSJ OC IMPLT AFTER ENCL MUSC ATTACHED,,,21,,RBRVS,9.46 ,12.64 ,12.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65150,CPT,REINSERTION OCULAR IMPLT W/WO CONJUNCTIVAL GRAFT,,,21,,RBRVS,6.43 ,9.39 ,9.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65155,CPT,REINSERTION OCULAR IMPLT RNFCMT &/ ATTACH MUSCLE,,,21,,RBRVS,10.10 ,13.04 ,13.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65175,CPT,REMOVAL OCULAR IMPLANT,,,21,,RBRVS,7.40 ,10.61 ,10.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65205,CPT,REMOVAL FB EYE CONJUNCTIVAL SUPERFICIAL,,,21,,RBRVS,0.71 ,0.50 ,0.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65210,CPT,RMVL FB XTRNL EYE EMBED SCJNCL/SCLERAL NONPERFOR,,,21,,RBRVS,0.84 ,0.62 ,1.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65220,CPT,RMVL FB XTRNL EYE CORNEAL W/O SLIT LAMP,,,21,,RBRVS,0.71 ,0.41 ,0.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65222,CPT,RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP,,,21,,RBRVS,0.84 ,0.59 ,1.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65235,CPT,RMVL FB INTRAOCULAR ANT CHAMBER EYE/LENS,,,21,,RBRVS,9.01 ,10.45 ,10.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65260,CPT,RMVL FB IO FROM POST SEG MAG XTRJ ANT/POST ROUTE,,,21,,RBRVS,12.54 ,13.62 ,13.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65265,CPT,RMVL FB IO FROM POST SEG NONMAGNETIC XTRJ,,,21,,RBRVS,14.34 ,15.11 ,15.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65270,CPT,RPR LAC CJNC W/WO NONPERFOR LAC SCLERA DIR CLSR,,,21,,RBRVS,1.95 ,1.89 ,5.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65272,CPT,RPR LAC CJNC MOBLJ& REARGMT W/O HOSPITALIZATION,,,21,,RBRVS,4.62 ,4.97 ,9.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65273,CPT,RPR LAC CJNC MOBLJ & REARGMT W/HOSPIZATION,,,21,,RBRVS,5.16 ,5.23 ,5.23 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
65275,CPT,RPR LAC CORNEA NONPERFOR W/WO RMVL FOREIGN BODY,,,21,,RBRVS,6.29 ,6.33 ,9.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65280,CPT,RPR LAC CORNEA&/SCLERA PERFOR X INVG UVEAL TIS,,,21,,RBRVS,9.10 ,9.25 ,9.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65285,CPT,RPR LAC CORN&/SCLRA PERF W/REPOS/RESCJ UVEAL T,,,21,,RBRVS,15.36 ,14.88 ,14.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65286,CPT,RPR LAC APPL TISSUE GLUE WOUND CORNEA&/SCLERA,,,21,,RBRVS,6.63 ,6.92 ,12.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65290,CPT,RPR WND EXTRAOCULAR MUSCLE TENDON&/TENON CAPSU,,,21,,RBRVS,6.53 ,6.86 ,6.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65400,CPT,EXCISION LESION CORNEA XCP PTERYGIUM,,,21,,RBRVS,7.50 ,9.03 ,11.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65410,CPT,BIOPSY CORNEA,,,21,,RBRVS,1.47 ,1.39 ,2.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65420,CPT,EXCISION/TRANSPOSITION PTERYGIUM W/O GRAFT,,,21,,RBRVS,4.36 ,5.99 ,9.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65426,CPT,EXCISION/TRANSPOSITION PTERYGIUM W/GRAFG,,,21,,RBRVS,6.05 ,7.05 ,11.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65430,CPT,CORNEA SCRAPING DIAGNOSTIC SMEAR &/CULTURE,,,21,,RBRVS,1.47 ,1.36 ,1.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65435,CPT,RMVL CORNEAL EPITHELIUM W/WO CHEMOCAUTERIZATION,,,21,,RBRVS,0.92 ,0.99 ,1.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65436,CPT,RMVL CORNEAL EPITHELIUM W/APPL CHELATING AGENT,,,21,,RBRVS,4.82 ,5.34 ,5.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65450,CPT,DSTRJ LESION CRYOTHER PHOTO/THERMOCAUTZATION,,,21,,RBRVS,3.47 ,5.36 ,5.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65600,CPT,MULTIPLE PUNCTURES ANTERIOR CORNEA,,,21,,RBRVS,4.20 ,5.23 ,6.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65710,CPT,KERATOPLASTY ANTERIOR LAMELLAR,,,21,,RBRVS,14.45 ,15.78 ,15.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65730,CPT,KERATOPLASTY PENTRG EXCEPT APHAKIA/PSEUDOPHAKIA,,,21,,RBRVS,16.35 ,17.16 ,17.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65750,CPT,KERATOPLASTY PENETRAING APHAKIA,,,21,,RBRVS,16.90 ,16.76 ,16.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65755,CPT,KERATOPLASTY PENETRATING PSEUDOPHAKIA,,,21,,RBRVS,16.79 ,16.69 ,16.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65756,CPT,KERATOPLASTY ENDOTHELIAL,,,21,,RBRVS,16.84 ,15.46 ,15.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65757,CPT,BACKBENCH PREPJ CORNEAL ENDOTHELIAL ALLOGRAFT,,,21,,TotalUnits,,,,6.23 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
65760,CPT,KERATOMILEUSIS,,,21,,TotalUnits,,,,18.46 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65765,CPT,KERATOPHAKIA,,,21,,RBRVS,23.53 ,19.96 ,19.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65767,CPT,EPIKERATOPLASTY,,,21,,RBRVS,21.91 ,18.59 ,18.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65770,CPT,KERATOPROSTHESIS,,,21,,RBRVS,19.74 ,18.60 ,18.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65771,CPT,RADIAL KERATOTOMY,,,21,,TotalUnits,,,,10.15 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65772,CPT,CRNL RELAXING INC CORRJ INDUCED ASTIGMATISM,,,21,,RBRVS,5.09 ,6.04 ,7.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65775,CPT,CRNL WEDGE RESCJ CORRJ INDUCED ASTIGMATISM,,,21,,RBRVS,6.91 ,8.19 ,8.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65778,CPT,PLACE AMNIOTIC MEMBRA OCULAR SURFACE W/O SUTURES,,,21,,RBRVS,1.19 ,0.73 ,37.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65779,CPT,PLACE AMNIOTIC MEMBRANE OCULAR SURFACE SUTURED,,,21,,RBRVS,3.92 ,3.81 ,30.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65780,CPT,OCULAR SURFACE RECONSTRUCTION AMNIOTIC MEMBRANE,,,21,,RBRVS,10.73 ,13.63 ,13.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65781,CPT,OCULAR SURFACE RECONSTRUCTION LIMBAL ALLOGRAFT,,,21,,RBRVS,18.14 ,18.25 ,18.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65782,CPT,OCCULAR SURFACE RECONSTRUCTION LIMBAL AUTOGRAFT,,,21,,RBRVS,15.43 ,15.99 ,15.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65785,CPT,IMPLANTATION INTRASTROMAL CORNEAL RING SEGMENTS,,,21,,RBRVS,5.39 ,4.91 ,53.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65800,CPT,PARACENTSIS ANT CHAMB EYE ASPIR AQUEOUS SPX,,,21,,RBRVS,1.53 ,0.96 ,1.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65810,CPT,PARACENTSIS ANT CHAM RMVL VITREOUS W/WO AIR INJX,,,21,,RBRVS,5.82 ,6.91 ,6.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65815,CPT,PARACEN ANT CHAM RMVL BLOOD W/WO IRRIG&/AIR IN,,,21,,RBRVS,6.00 ,7.07 ,11.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65820,CPT,GONIOTOMY,,,21,,RBRVS,8.91 ,11.59 ,11.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65850,CPT,TRABECULOTOMY AB EXTERNO,,,21,,RBRVS,11.39 ,11.52 ,11.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65855,CPT,TRABECULOPLASTY BY LASER SURGERY,,,21,,RBRVS,3.99 ,4.13 ,5.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65860,CPT,SEVERING ADHESIONS ANTERIOR SEGMENT LASER SPX,,,21,,RBRVS,3.59 ,3.31 ,4.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65865,CPT,SEVERING ADS ANT SEG INCAL TQ SPX GONIOSYNECHIAE,,,21,,RBRVS,5.77 ,7.18 ,7.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65870,CPT,SEVERING ADS ANT SEG INCAL SPX ANT SYNECHIAE,,,21,,RBRVS,7.39 ,8.79 ,8.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65875,CPT,SEVERING ADS ANT SEG INCAL SPX POST SYNECHIAE,,,21,,RBRVS,7.81 ,9.43 ,9.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65880,CPT,SEVERING ADS ANT SEG INCAL SPX CORNEOVITREAL,,,21,,RBRVS,8.36 ,9.78 ,9.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65900,CPT,RMVL EPITHELIAL DOWNGROWTH ANT CHAMBER EYE,,,21,,RBRVS,12.51 ,13.82 ,13.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65920,CPT,RMVL IMPLANTED MATERIAL ANTERIO SEGMENT EYE,,,21,,RBRVS,9.99 ,11.57 ,11.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
65930,CPT,RMVL BLOOD CLOT ANTERIOR SEGMENT EYE,,,21,,RBRVS,8.39 ,9.03 ,9.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66020,CPT,INJX ANTERIOR CHAMBER EYE AIR/LIQUID SPX,,,21,,RBRVS,1.64 ,1.97 ,3.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66030,CPT,INJX ANTERIOR CHAMBER EYE MEDICATION SPX,,,21,,RBRVS,1.30 ,1.74 ,3.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66130,CPT,EXCISION LESION SCLERA,,,21,,RBRVS,7.83 ,7.71 ,11.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66150,CPT,FSTLJ SCLERA GLAUCOMA TREPHIN W/IRIDECTOMY,,,21,,RBRVS,10.53 ,13.34 ,13.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66155,CPT,FSTLJ SCLERA GLAUCOMA THERMOCAUT IRRIDEC,,,21,,RBRVS,10.52 ,13.47 ,13.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66160,CPT,FSTLJ SCLERA SCLERECTOMY PUNCH/SCISSORS IRIDECT,,,21,,RBRVS,12.39 ,14.64 ,14.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66170,CPT,FSTLJ SCLERA GLAUCOMA TRABECULECT AB EXTERNO,,,21,,RBRVS,15.02 ,17.82 ,17.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66172,CPT,FSTLJ SCLERA GLC TRBEC AB EXTERNO SCARRING,,,21,,RBRVS,18.86 ,22.58 ,22.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66174,CPT,TRLUML DILAT AQUEOUS CANAL W/O DEVICE/STENT,,,21,,RBRVS,12.85 ,13.01 ,13.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66175,CPT,TRLUML DILAT AQUEOUS CANAL W/DEVICE/STENT,,,21,,RBRVS,13.60 ,13.48 ,13.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66179,CPT,AQUEOUS SHUNT EXTRAOCULAR RESERVOIR W/O GRAFT,,,21,,RBRVS,14.00 ,15.46 ,15.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66180,CPT,AQUEOUS SHUNT EXTRAOC EQUAT PLATE RSVR W/GRAFT,,,21,,RBRVS,15.00 ,16.07 ,16.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66183,CPT,INSERT ANTER DRAINAGE DEV W/O EXTRAOC RESERVOIR,,,21,,RBRVS,13.20 ,14.97 ,14.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66184,CPT,REVJ SHUNT EXTRAOCULAR RESERVOIR W/O GRAFT,,,21,,RBRVS,9.58 ,11.91 ,11.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66185,CPT,REVJ AQUEOUS SHUNT EXTRAOCULAR RESERVOIR W/GRAFT,,,21,,RBRVS,10.58 ,12.54 ,12.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66220,CPT,REPAIR SCLERAL STAPHYLOMA W/O GRAFT,,,21,,RBRVS,9.21 ,11.13 ,11.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66225,CPT,REPAIR SCLERAL STAPHYLOMA W/GRAFT,,,21,,RBRVS,12.63 ,12.80 ,12.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66250,CPT,REVJ/RPR OPRATIVE WOUND ANTERIOR SEGMENT,,,21,,RBRVS,7.10 ,8.15 ,13.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66500,CPT,IRIDOTOMY STAB INC SPX XCP TRANSFIXION,,,21,,RBRVS,3.83 ,5.89 ,5.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66505,CPT,IRIDOTOMY STAB INC SPX TRANSFIXION,,,21,,RBRVS,4.22 ,6.43 ,6.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66600,CPT,IRDEC CRNLSCLRL/CRNL SCTJ RMVL LES,,,21,,RBRVS,10.12 ,12.67 ,12.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66605,CPT,IRDEC CRNLSCLRL/CRNL SCTJ CYCLECTOMY,,,21,,RBRVS,14.22 ,14.62 ,14.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66625,CPT,IRDEC CRNLSCLRL/CRNL SCTJ PRPH GLC SPX,,,21,,RBRVS,5.30 ,6.45 ,6.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66630,CPT,IRDEC CRNLSCLRL/CRNL SCTJ SECTOR GLC SPX,,,21,,RBRVS,7.28 ,8.30 ,8.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66635,CPT,IRDEC CRNLSCLRL/CRNL SCTJ OPTICAL SPX,,,21,,RBRVS,7.37 ,8.36 ,8.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66680,CPT,REPAIR IRIS CILIARY BODY,,,21,,RBRVS,6.39 ,7.78 ,7.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66682,CPT,SUTURE IRIS CILIARY BODY SPX RETRIEVAL SUTURE,,,21,,RBRVS,7.33 ,10.15 ,10.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66700,CPT,CILIARY BODY DESTRUCTION DIATHERMY,,,21,,RBRVS,5.14 ,5.61 ,7.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66710,CPT,CILIARY BODY DSTRJ CYCLOPHOTOCOAG TRANSSCERAL,,,21,,RBRVS,5.14 ,5.61 ,6.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66711,CPT,CILIARY BODY DSTRJ CYCLOPHOTOCOAG ENDOSCOPIC,,,21,,RBRVS,7.93 ,9.65 ,9.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66720,CPT,CILIARY BODY DESTRUCTION CRYOTHERAPY,,,21,,RBRVS,5.00 ,6.63 ,8.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66740,CPT,CILIARY BODY DESTRUCTION CYCLODIAL,,,21,,RBRVS,5.14 ,5.60 ,6.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66761,CPT,IRIDOTOMY/IRRIDECTOMY LASER SURG PER SESSION,,,21,,RBRVS,3.00 ,3.45 ,5.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66762,CPT,IRIDOPLASTY PHOTOCOAGULATION 1/> SESSIONS,,,21,,RBRVS,5.38 ,6.28 ,7.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66770,CPT,DSTRJ CYST/LESION IRIS/CILIARY BODY,,,21,,RBRVS,6.13 ,7.11 ,8.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66820,CPT,DISCISSION SECONDARY MEMBRANOUS CATARACT,,,21,,RBRVS,4.01 ,6.81 ,6.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66821,CPT,POST-CATARACT LASER SURGERY,,,21,,RBRVS,3.42 ,5.12 ,5.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66825,CPT,REPOSITIONING IO LENS PROSTHESIS REQ INC SPX,,,21,,RBRVS,9.01 ,11.80 ,11.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66830,CPT,RMVL SEC MEMBRANOUS CTRC CORNEO-SCLL SCTJ,,,21,,RBRVS,9.47 ,9.98 ,9.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66840,CPT,RMVL LENS MATERIAL ASPIR TQ 1/> STAGES,,,21,,RBRVS,9.18 ,9.85 ,9.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66850,CPT,RMVL LENS MATERIAL PHACOFRAGMENTATION ASPIR,,,21,,RBRVS,10.55 ,11.09 ,11.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66852,CPT,RMVL LENS MATERIAL PARS PLANA W/WO VITRECTOMY,,,21,,RBRVS,11.41 ,11.64 ,11.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66920,CPT,RMVL LENS MATERIAL INTRACAPSULAR,,,21,,RBRVS,10.13 ,10.46 ,10.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66930,CPT,REMOVAL LENS MATRL INTRACAPSULAR DISLOCATED LENS,,,21,,RBRVS,11.61 ,11.77 ,11.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66940,CPT,REMOVAL LENS MATERIAL EXTRACAPSULAR,,,21,,RBRVS,10.37 ,10.99 ,10.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66982,CPT,XCAPSULAR CATARACT RMVL INSJ LENS PROSTH 1 STG,,,21,,RBRVS,11.08 ,10.61 ,10.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66983,CPT,ICAPSULAR CATARACT XTRJ INSJ IO LENS PRSTH 1 STG,,,21,,RBRVS,10.43 ,9.71 ,9.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66984,CPT,CATARACT REMOVAL INSERTION OF LENS,,,21,,RBRVS,8.52 ,8.97 ,8.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66985,CPT,INSJ IO LENS PROSTHESIS NOT W/CONCURRENT RMVL,,,21,,RBRVS,9.98 ,11.07 ,11.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66986,CPT,EXCHANGE INTRAOCULAR LENS,,,21,,RBRVS,12.26 ,12.54 ,12.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66990,CPT,USE OPHTHALMIC ENDOSCOPE,,,21,,RBRVS,1.51 ,0.95 ,0.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
66999,CPT,UNLISTED PROCEDURE ANTERIOR SEGMENT EYE,,,21,,TotalUnits,,,,17.49 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67005,CPT,RMVL VITREOUS ANT APPR PARTIAL REMOVAL,,,21,,RBRVS,5.89 ,7.04 ,7.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67010,CPT,RMVL VITREOUS ANT APPR SUBTOT RMVL MECH VITRECT,,,21,,RBRVS,7.06 ,7.78 ,7.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67015,CPT,ASPIRATION/RELEASE VITREOUS SUBRETINAL/CHOROIDAL,,,21,,RBRVS,7.14 ,8.75 ,8.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67025,CPT,INJ SUBSTITUTE PARS PLANA/LIMBL W/WO ASPIR SPX,,,21,,RBRVS,8.11 ,9.21 ,11.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67027,CPT,IMPLTJ INTRAVITREAL DRUG DLVR SYS RMVL VTS,,,21,,RBRVS,11.62 ,11.63 ,11.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67028,CPT,INTRAVITREAL NJX PHARMACOLOGIC AGT SPX,,,21,,RBRVS,1.44 ,1.29 ,1.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67030,CPT,DISCISSION VITREOUS STRANS PARS PLANA APPROACH,,,21,,RBRVS,6.11 ,8.49 ,8.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67031,CPT,SEVERING VITREOUS STRANS LASER 1/> STAGES,,,21,,RBRVS,4.47 ,5.28 ,6.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67036,CPT,VITRECTOMY MECHANICAL PARS PLANA,,,21,,RBRVS,12.13 ,12.48 ,12.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67039,CPT,VITRECTOMY MCHNL PARS PLNA FOCAL ENDOLASER PC,,,21,,RBRVS,13.20 ,13.15 ,13.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67040,CPT,VTRECTOMY MCHNL PARS PLNA ENDOLASER PANRTA PC,,,21,,RBRVS,14.50 ,13.96 ,13.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67041,CPT,VITRECTOMY PARS PLANA REMOVE PRERETINAL MEMBRANE,,,21,,RBRVS,16.33 ,15.11 ,15.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67042,CPT,VITRECTOMY PARS PLANA REMOVE INT MEMB RETINA,,,21,,RBRVS,16.33 ,15.11 ,15.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67043,CPT,VITRECTOMY PARS PLANA REMOVE SUBRETINAL MEMBRANE,,,21,,RBRVS,17.40 ,15.76 ,15.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67101,CPT,RPR RETINAL DTCHMNT 1/>SES CRYOTX/DTHRM INCL DRG,,,21,,RBRVS,8.80 ,9.62 ,12.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67105,CPT,RPR RETINAL DTCHMNT 1/> SES PC INCL SUBRETI DRG,,,21,,RBRVS,8.53 ,9.08 ,11.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67107,CPT,REPAIR RETINAL DETACHMENT SCLERAL BUCKLING,,,21,,RBRVS,16.71 ,16.44 ,16.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67108,CPT,RPR RETINAL DTCHMNT W/VITRECTOMY ANY METH,,,21,,RBRVS,22.89 ,20.84 ,20.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67110,CPT,RPR RETINAL DTCHMNT INJECTION AIR/OTHER GAS,,,21,,RBRVS,10.25 ,10.91 ,13.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67113,CPT,RPR COMPLEX RETINA DETACH VITRECT &MEMBRANE PEEL,,,21,,RBRVS,25.35 ,22.14 ,22.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67115,CPT,RELEASE ENCIRCLING MATERIAL POSTERIOR SEGMENT,,,21,,RBRVS,6.11 ,7.57 ,7.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67120,CPT,RMVL IMPLNT MATL POSTERIOR SEGMENT EXTRAOCULAR,,,21,,RBRVS,7.10 ,8.18 ,10.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67121,CPT,RMVL IMPLT MATRL POSTERIOR SEGMENT INTRAOCULAR,,,21,,RBRVS,12.25 ,12.56 ,12.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67141,CPT,PROPH RTA DTCHMNT W/O DRG 1/> SESS CRTX DTHRM,,,21,,RBRVS,6.15 ,7.20 ,8.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67145,CPT,PROPH RTA DTCHMNT W/O DRG 1/> SESS,,,21,,RBRVS,6.32 ,7.30 ,8.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67208,CPT,DSTRJ LOCLZD LESION RETINA 1/> SESS CRTX DTHRM,,,21,,RBRVS,7.65 ,8.13 ,8.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67210,CPT,DSTRJ LOCLZD LESION RETINA 1/> SESS PC,,,21,,RBRVS,6.36 ,7.33 ,7.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67218,CPT,DSTRJ LESION RETINA 1/> SESS RADJ IMPLTJ,,,21,,RBRVS,20.36 ,17.25 ,17.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67220,CPT,DSTRJ LESION CHOROID PC 1/> SESS,,,21,,RBRVS,6.36 ,7.33 ,8.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67221,CPT,DSTRJ LESION CHOROID PHOTODYNAMIC THERAPY,,,21,,RBRVS,3.45 ,2.36 ,4.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67225,CPT,DSTRJ LESION CHOROID PDT 2ND EYE 1 SESSION,,,21,,RBRVS,0.47 ,0.29 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67227,CPT,DESTRUCTION RETINOPATHY CRYOTHERAPY DIATHERMY,,,21,,RBRVS,7.53 ,8.08 ,9.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67228,CPT,TREATMENT EXTENSIVE RETINOPATHY PHOTOCOAGULATION,,,21,,RBRVS,13.82 ,11.97 ,13.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67229,CPT,EXTENSIVE RETINOPATHY 1/> SESS PRETERM INFANT,,,21,,RBRVS,16.30 ,15.50 ,15.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67250,CPT,SCLERAL REINFORCEMENT SPX W/O GRAFT,,,21,,RBRVS,9.61 ,11.75 ,11.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67255,CPT,SCLERAL REINFORCEMENT SPX W/GRAFT,,,21,,RBRVS,8.38 ,10.33 ,10.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67299,CPT,UNLISTED PROCEDURE POSTERIOR SEGMENT,,,21,,TotalUnits,,,,2.78 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67311,CPT,STRABISMUS RECESSION/RESCJ 1 HRZNTL MUSC,,,21,,RBRVS,7.77 ,8.60 ,8.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67312,CPT,STRABISMUS RECESSION/RESCJ 2 HRZNTL MUSC,,,21,,RBRVS,9.66 ,9.76 ,9.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67314,CPT,STRABISMUS RECESSION/RESCJ 1 VER MUSC,,,21,,RBRVS,8.79 ,9.61 ,9.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67316,CPT,STRABISMUS RECESSION/RESCJ 2/MORE VER MUSC,,,21,,RBRVS,10.93 ,10.95 ,10.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67318,CPT,STRABISMUS ANY SUPERIOR OBLIQUE MUSCLE,,,21,,RBRVS,9.12 ,10.14 ,10.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67320,CPT,TRANSPOSITION PROCEDURE EXTRAOCULAR MUSC,,,21,,RBRVS,5.40 ,3.36 ,3.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67331,CPT,STRABISMUS PREVIOUS EYE X INVOLVE EO MUSC,,,21,,RBRVS,5.13 ,3.17 ,3.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67332,CPT,STRABISMUS SCARRING EO MUSC/RSTCV MYOPATHY,,,21,,RBRVS,5.56 ,3.45 ,3.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67334,CPT,STRABISMUS POST FIXJ SUTR TQ W/WO MUSC RECESSION,,,21,,RBRVS,5.05 ,3.14 ,3.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67335,CPT,PLACEMENT ADJUSTABLE SUTURE STRABISMUS,,,21,,RBRVS,2.49 ,1.56 ,1.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67340,CPT,STRABISMUS EXPL&/RPR DETACHED EXTROCULAR MUSC,,,21,,RBRVS,6.00 ,3.73 ,3.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67343,CPT,RLS XTNSV SCAR TISS W/O DETACHING EO MUSC SPX,,,21,,RBRVS,8.47 ,9.37 ,9.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67345,CPT,CHEMODENERVATION EXTRAOCULAR MUSCLE,,,21,,RBRVS,3.01 ,2.79 ,3.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67346,CPT,BIOPSY EXTRAOCULAR MUSCLE,,,21,,RBRVS,2.87 ,2.43 ,2.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67399,CPT,UNLISTED PROCEDURE EXTRAOCULAR MUSCLE,,,21,,TotalUnits,,,,16.37 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67400,CPT,ORBITOTOMY W/O BONE FLAP EXPL W/WO BIOPSY,,,21,,RBRVS,11.20 ,14.23 ,14.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67405,CPT,ORBITOTOMY W/O BONE FLAP EXPL W/DRAINAGE ONLY,,,21,,RBRVS,9.20 ,12.44 ,12.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67412,CPT,ORBITOTOMY W/O BONE FLAP W/REMOVAL LESION,,,21,,RBRVS,10.30 ,12.96 ,12.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67413,CPT,ORBITOTOMY W/O BONE FLAP W/RMVL FOREIGN BODY,,,21,,RBRVS,10.24 ,13.13 ,13.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67414,CPT,ORBITOTOMY W/O BONE FLAP W/RMVL BONE DCMPRN,,,21,,RBRVS,17.94 ,18.16 ,18.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67415,CPT,FINE NEEDLE ASPIRATION ORBITAL CONTENTS,,,21,,RBRVS,1.76 ,1.09 ,1.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67420,CPT,ORBITOTOMY BONE FLAP/WINDOW LAT RMVL LESION,,,21,,RBRVS,21.87 ,21.99 ,21.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67430,CPT,ORBITOTOMY BONE FLAP/WINDOW LATERAL RMVL FB,,,21,,RBRVS,15.29 ,18.81 ,18.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67440,CPT,ORBITOTOMY BONE FLAP/WINDOW LATERAL W/DRG,,,21,,RBRVS,14.84 ,18.14 ,18.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67445,CPT,ORBITOTOMY BONE FLAP/WINDOW LAT RMVL BONE DCMPRN,,,21,,RBRVS,19.12 ,19.03 ,19.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67450,CPT,ORBITOTOMY BONE FLAP/WINDOW LAT EXPL W/WO BX,,,21,,RBRVS,15.41 ,18.74 ,18.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67500,CPT,RETROBULBAR INJECTION MEDICATION SPX,,,21,,RBRVS,1.44 ,0.50 ,0.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67505,CPT,RETROBULBAR INJECTION ALCOHOL,,,21,,RBRVS,1.27 ,0.95 ,1.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67515,CPT,INJECTION MEDICATION/OTHER SUBST TENON CAPSULE,,,21,,RBRVS,1.40 ,1.03 ,1.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67550,CPT,ORBITAL IMPLANT INSERTION,,,21,,RBRVS,11.77 ,14.54 ,14.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67560,CPT,ORBITAL IMPLANT REMOVAL/REVISION,,,21,,RBRVS,12.18 ,14.81 ,14.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67570,CPT,OPTIC NERVE DECOMPRESSION,,,21,,RBRVS,14.40 ,16.57 ,16.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67599,CPT,UNLISTED PROCEDURE ORBIT,,,21,,TotalUnits,,,,2.62 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67700,CPT,BLEPHAROTOMY DRAINAGE ABSCESS EYELID,,,21,,RBRVS,1.40 ,1.79 ,6.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67710,CPT,SEVERING TARSORRHAPHY,,,21,,RBRVS,1.07 ,1.61 ,5.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67715,CPT,CANTHOTOMY SEPARATE PROCEDURE,,,21,,RBRVS,1.27 ,1.69 ,5.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67800,CPT,EXCISION CHALAZION SINGLE,,,21,,RBRVS,1.41 ,1.42 ,2.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67801,CPT,EXCISION CHALAZION MULTIPLE SAME LID,,,21,,RBRVS,1.91 ,1.74 ,2.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67805,CPT,EXCISION CHALAZION MULTIPLE DIFFERENT LIDS,,,21,,RBRVS,2.27 ,2.24 ,3.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67808,CPT,EXC CHALAZION ANES REQ HOSPIZATION SINGLE/MULT,,,21,,RBRVS,4.60 ,5.46 ,5.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67810,CPT,INCISIONAL BIOPSY EYELID SKIN & LID MARGIN,,,21,,RBRVS,1.18 ,0.72 ,3.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67820,CPT,CORRECTION TRICHIASIS EPILATION FORCEPS ONLY,,,21,,RBRVS,0.71 ,0.76 ,0.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67825,CPT,CORRECTION TRICHIASIS EPILATION OTH/THAN FORCEPS,,,21,,RBRVS,1.43 ,1.92 ,2.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67830,CPT,CORRECTION TRICHIASIS INCCISION LID MARGIN,,,21,,RBRVS,1.75 ,2.03 ,5.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67835,CPT,CORRJ TRICHIASIS INC LID MRGN W/FR MUC MEMB GRF,,,21,,RBRVS,5.70 ,6.30 ,6.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67840,CPT,EXC LESION EYELID W/O CLSR/W/SIMPLE DIR CLOSURE,,,21,,RBRVS,2.09 ,2.24 ,5.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67850,CPT,DESTRUCTION LESION LID MARGIN </ 1 CM,,,21,,RBRVS,1.74 ,1.94 ,4.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67875,CPT,TEMPORARY CLOSURE EYELIDS SUTURE,,,21,,RBRVS,1.35 ,1.31 ,3.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67880,CPT,CONSTJ INTERMARGIN ADHES/TARSORRH/CANTHORRHAPY,,,21,,RBRVS,4.60 ,5.47 ,7.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67882,CPT,CONSTJ INTERMARGIN ADHES/TARSOR/CANTHOR W/TRPOS,,,21,,RBRVS,6.02 ,6.89 ,9.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67900,CPT,REPAIR BROW PTOSIS,,,21,,RBRVS,6.82 ,7.00 ,10.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67901,CPT,RPR BLEPHAROPTOSIS FRONTALIS MUSC SUTR/OTH MATRL,,,21,,RBRVS,7.59 ,8.15 ,13.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67902,CPT,RPR BLEPHAROPT FRONTALIS MUSC AUTOL FASCAL SLING,,,21,,RBRVS,9.82 ,9.84 ,9.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67903,CPT,RPR BLEPHAROPTOSIS LEVATOR RESCJ/ADVMNT INTERNAL,,,21,,RBRVS,6.51 ,6.65 ,9.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67904,CPT,RPR BLEPHAROPTOSIS LEVATOR RESCJ/ADVMNT XTRNL,,,21,,RBRVS,7.97 ,8.31 ,12.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67906,CPT,RPR BLEPHAROPTOSIS SUPERIOR RECTUS FASCIAL SLING,,,21,,RBRVS,6.93 ,6.95 ,6.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67908,CPT,RPR BLPOS CONJUNCTIVO-TARSO-MUSC-LEVATOR RESCJ,,,21,,RBRVS,5.30 ,6.31 ,8.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67909,CPT,REDUCTION OVERCORRECTION PTOSIS,,,21,,RBRVS,5.57 ,6.39 ,9.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67911,CPT,CORRECTION LID RETRACTION,,,21,,RBRVS,7.50 ,7.84 ,7.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67912,CPT,CORRJ LAGOPHTHALMOS IMPLTJ UPR EYELID LID LOAD,,,21,,RBRVS,6.36 ,6.90 ,17.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67914,CPT,REPAIR ECTROPION SUTURE,,,21,,RBRVS,3.75 ,5.22 ,9.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67915,CPT,REPAIR ECTROPION THERMOCAUTERIZATION,,,21,,RBRVS,2.03 ,3.41 ,6.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67916,CPT,REPAIR ECTROPION EXCISION TARSAL WEDGE,,,21,,RBRVS,5.48 ,6.28 ,10.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67917,CPT,REPAIR ECTROPION EXTENSIVE,,,21,,RBRVS,5.93 ,6.57 ,10.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67921,CPT,REPAIR ENTROPION SUTURE,,,21,,RBRVS,3.47 ,5.04 ,9.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67922,CPT,REPAIR ENTROPION THERMOCAUTERIZATION,,,21,,RBRVS,2.03 ,3.39 ,5.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67923,CPT,REPAIR ENTROPION EXCISION TARSAL WEDGE,,,21,,RBRVS,5.48 ,6.29 ,10.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67924,CPT,REPAIR ENTROPION EXTENSIVE,,,21,,RBRVS,5.93 ,6.58 ,11.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67930,CPT,SUTR WND EYELID/MARGIN/TARSUS/CONJUNC PRTL THICK,,,21,,RBRVS,3.65 ,2.89 ,6.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67935,CPT,SUTR WND EYELID/MARGIN/TARSUS/CONJUNC FULL THICK,,,21,,RBRVS,6.36 ,5.62 ,9.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67938,CPT,REMOVAL EMBEDDED FOREIGN BODY EYELID,,,21,,RBRVS,1.38 ,1.80 ,5.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67950,CPT,CANTHOPLASTY,,,21,,RBRVS,5.99 ,6.63 ,9.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67961,CPT,EXCISION & REPAIR EYELID > ONE-FOURTH LID MARGIN,,,21,,RBRVS,5.86 ,6.56 ,9.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67966,CPT,EXCISION & REPAIR EYELID ONE-FOURTH LID MARGIN,,,21,,RBRVS,8.97 ,8.95 ,12.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67971,CPT,RCNSTJ EYELID FULL THICKNESS </TWO-THIRDS 1 STG,,,21,,RBRVS,10.01 ,9.71 ,9.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67973,CPT,RCNSTJ EYELID FULL THICKNESS LOWER EYELID 1 STG,,,21,,RBRVS,13.13 ,12.22 ,12.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67974,CPT,RCNSTJ EYELID FULL THICKNESS UPPER EYELID 1 STG,,,21,,RBRVS,13.10 ,12.21 ,12.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67975,CPT,RCNSTJ EYELID FULL THICKNESS SECOND STAGE,,,21,,RBRVS,9.35 ,9.32 ,9.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
67999,CPT,UNLISTED PROCEDURE EYELIDS,,,21,,TotalUnits,,,,7.20 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68020,CPT,INCISION CONJUNCTIVA DRAINAGE OF CYST,,,21,,RBRVS,1.42 ,1.61 ,1.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68040,CPT,EXPRESSION CONJUNCTIVAL FOLLICLES,,,21,,RBRVS,0.85 ,0.54 ,0.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68100,CPT,BIOPSY CONJUNCTIVA,,,21,,RBRVS,1.35 ,1.31 ,3.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68110,CPT,EXCISION LESION CONJUNCTIVA </1 CM,,,21,,RBRVS,1.82 ,2.27 ,4.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68115,CPT,EXCISION LESION CONJUNCTIVA > 1 CM,,,21,,RBRVS,2.41 ,2.63 ,6.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68130,CPT,EXCISION LESION CONJUNCTIVA ADJACENT SCLERA,,,21,,RBRVS,5.10 ,6.18 ,9.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68135,CPT,DESTRUCTION LESION CONJUNCTIVA,,,21,,RBRVS,1.89 ,2.26 ,2.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68200,CPT,SUBCONJUNCTIVAL INJECTION,,,21,,RBRVS,0.49 ,0.46 ,0.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68320,CPT,CONJUNCTIVOPLASTY W/GRF/XTNSV REARRANGEMENT,,,21,,RBRVS,6.64 ,8.12 ,13.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68325,CPT,CONJUNCTIVOPLASTY W/BUCCAL MUC MEMB GRAFT,,,21,,RBRVS,8.63 ,9.36 ,9.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68326,CPT,CJP RCNSTJ CUL-DE-SAC BUCCAL GRF/XTNSV REARRGMT,,,21,,RBRVS,8.42 ,9.24 ,9.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68328,CPT,CONJUNCTPL CUL-DE-SAC W/BUCCAL MUC MEMB GRAFT,,,21,,RBRVS,9.45 ,9.84 ,9.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68330,CPT,RPR SYMBLEPHARON CONJUNCTIVOPLASTY W/O GRAFT,,,21,,RBRVS,5.78 ,6.84 ,10.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68335,CPT,RPR SYMBLEPHARON FR GRF CJNC/BUCCAL MUC MEMB,,,21,,RBRVS,8.46 ,9.26 ,9.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68340,CPT,RPR & DIV SYMBLEPHARON W/WO CONFORM/CONTACT LE,,,21,,RBRVS,4.97 ,5.96 ,10.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68360,CPT,CONJUNCTIVAL FLAP BRIDGE/PARTIAL SPX,,,21,,RBRVS,5.17 ,6.09 ,9.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68362,CPT,CONJUNCTIVAL FLAP TOTAL,,,21,,RBRVS,8.61 ,9.35 ,9.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68371,CPT,HARVESTING CONJUNCIVAL ALLOGRAPHY LIVING DONOR,,,21,,RBRVS,5.09 ,6.22 ,6.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68399,CPT,UNLISTED PROCEDURE CONJUNCTIVA,,,21,,TotalUnits,,,,1.11 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68400,CPT,INCISION DRAINAGE LACRIMAL GLAND,,,21,,RBRVS,1.74 ,1.89 ,6.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68420,CPT,INCISION DRAINAGE LACRIMAL SAC,,,21,,RBRVS,2.35 ,2.24 ,6.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68440,CPT,SNIP INCISION LACRIMAL PUNCTUM,,,21,,RBRVS,0.99 ,1.75 ,1.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68500,CPT,EXCISION LACRIMAL GLAND XCPT TUMOR TOTAL,,,21,,RBRVS,12.77 ,13.88 ,13.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68505,CPT,EXCISION LACRIMAL GLAND XCPT TUMOR PRTL,,,21,,RBRVS,12.69 ,13.83 ,13.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68510,CPT,BIOPSY LACRIMAL GLAND,,,21,,RBRVS,4.60 ,3.36 ,7.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68520,CPT,EXCISION LACRIMAL SAC,,,21,,RBRVS,8.78 ,9.96 ,9.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68525,CPT,BIOPSY LACRIMAL SAC,,,21,,RBRVS,4.42 ,2.74 ,2.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68530,CPT,RMVL FB/DACRYOLITH LACRIMAL PASSAGES,,,21,,RBRVS,3.70 ,3.31 ,8.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68540,CPT,EXC LACRIMAL GLAND TUMOR FRONTAL APPROACH,,,21,,RBRVS,12.18 ,13.21 ,13.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68550,CPT,EXC LACRIMAL GLAND TUMOR W/OSTEOTOMY,,,21,,RBRVS,15.16 ,11.69 ,11.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68700,CPT,PLASTIC REPAIR CANALICULI,,,21,,RBRVS,7.87 ,8.64 ,8.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68705,CPT,CORRECTION EVERTED PUNCTUM CAUTERY,,,21,,RBRVS,2.11 ,2.45 ,4.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68720,CPT,DACRYOCSTORHINOSTOMY,,,21,,RBRVS,9.96 ,10.66 ,10.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68745,CPT,CONJUNCTIVORHINOSTOMY W/O TUBE,,,21,,RBRVS,9.90 ,10.86 ,10.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68750,CPT,CONJUNCTIVORHINOSTOMY INSJ TUBE/STENT,,,21,,RBRVS,10.10 ,11.36 ,11.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68760,CPT,CLSR LACRIMAL PUNCTUM THERMOCAUT LIG/LASER,,,21,,RBRVS,1.78 ,2.24 ,3.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68761,CPT,CLSR LACRIMAL PUNCTUM PLUG EACH,,,21,,RBRVS,1.41 ,1.87 ,2.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68770,CPT,CLOSURE LACRIMAL FISTULA SPX,,,21,,RBRVS,8.29 ,8.91 ,8.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68801,CPT,DILATION LACRIMAL PUNCTUM W/WO IRRGATION,,,21,,RBRVS,1.00 ,1.99 ,2.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68810,CPT,PROBE NASOLACRIMAL DUCT W/WO IRRIGATION,,,21,,RBRVS,2.15 ,3.01 ,4.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68811,CPT,PROBE NASOLACRIMAL DUCT W/WO IRRIG REQ GEN ANES,,,21,,RBRVS,2.45 ,3.20 ,3.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68815,CPT,PROBE NASOLACRIMAL DUCT W/WO IRRG INSJ TUBE/STNT,,,21,,RBRVS,3.30 ,3.72 ,9.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68816,CPT,PROBE NASOLACRIMAL DUCT WITH CATHETER DILATION,,,21,,RBRVS,3.06 ,3.79 ,17.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68840,CPT,PROBE LACRIMAL CANALICULI W/WO IRRIGATION,,,21,,RBRVS,1.30 ,1.92 ,2.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68850,CPT,INJECTION CONTRAST MEDIUM DACRYOCYSTOGRAPY,,,21,,RBRVS,0.80 ,0.72 ,0.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
68899,CPT,UNLISTED PROCEDURE LACRIMAL SYSTEM,,,21,,TotalUnits,,,,4.07 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69000,CPT,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE,,,21,,RBRVS,1.50 ,1.72 ,3.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69005,CPT,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA CMPLX,,,21,,RBRVS,2.16 ,2.05 ,3.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69020,CPT,DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS,,,21,,RBRVS,1.53 ,2.34 ,4.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69090,CPT,EAR PIERCING,,,14,,TotalUnits,,,,0.99 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69100,CPT,BIOPSY EXTERNAL EAR,,,21,,RBRVS,0.81 ,0.49 ,1.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69105,CPT,BIOPSY EXTERNAL AUDITORY CANAL,,,21,,RBRVS,0.85 ,0.86 ,3.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69110,CPT,EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR,,,21,,RBRVS,3.53 ,5.21 ,9.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69120,CPT,EXCISION EXTERNAL EAR COMPLETE AMPUTATION,,,21,,RBRVS,4.14 ,6.85 ,6.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69140,CPT,EXCISION EXOSTOSIS EXTERNAL AUDITORY CANAL,,,21,,RBRVS,8.14 ,15.87 ,15.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69145,CPT,EXCISION SOFT TIS LESION EXTERNAL AUDITORY CANAL,,,21,,RBRVS,2.70 ,4.06 ,8.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69150,CPT,RAD EXC XTRNL AUDITORY CANAL LES W/O NCK DSJ,,,21,,RBRVS,13.61 ,14.45 ,14.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69155,CPT,RAD EXC XTRNL AUDITORY CANAL LES NCK DSJ,,,21,,RBRVS,23.35 ,21.17 ,21.17 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
69200,CPT,RMVL FB XTRNL AUDITORY CANAL W/O ANES,,,21,,RBRVS,0.77 ,0.79 ,2.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69205,CPT,RMVL FB XTRNL AUDITORY CANAL ANES,,,21,,RBRVS,1.21 ,1.54 ,1.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69209,CPT,REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT,,,21,,RBRVS,,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69210,CPT,REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT,,,21,,RBRVS,0.61 ,0.26 ,0.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69220,CPT,DEBRIDEMENT MASTOIDECTOMY CAVITY SIMPLE,,,21,,RBRVS,0.83 ,0.84 ,2.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69222,CPT,DEBRIDEMENT MASTOIDECTOMY CAVITY CMPLX,,,21,,RBRVS,1.45 ,2.27 ,4.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69300,CPT,OTOPLASTY PROTRUDING EAR W/WO SIZE RDCTJ,,,21,,RBRVS,6.69 ,6.00 ,13.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69310,CPT,RECONSTRUCTION EXTERNAL AUDITORY CANAL SPX,,,21,,RBRVS,10.97 ,18.71 ,18.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69320,CPT,RCNSTJ XTRNL AUD CANAL CONGENITAL ATRESIA 1 STG,,,21,,RBRVS,17.18 ,24.27 ,24.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69399,CPT,UNLISTED PROCEDURE EXTERNAL EAR,,,21,,TotalUnits,,,,1.32 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69420,CPT,MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ,,,21,,RBRVS,1.38 ,1.89 ,3.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69421,CPT,MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ ANES,,,21,,RBRVS,1.78 ,2.25 ,2.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69424,CPT,VENTILATING TUBE RMVL REQUIRING GENERAL ANES,,,21,,RBRVS,0.85 ,0.82 ,2.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69433,CPT,TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA,,,21,,RBRVS,1.57 ,2.01 ,3.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69436,CPT,TYMPANOSTOMY GENERAL ANESTHESIA,,,21,,RBRVS,2.01 ,2.32 ,2.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69440,CPT,MIDDLE EAR EXPL THRU POSTAUR/EAR CANAL INC,,,21,,RBRVS,7.71 ,10.97 ,10.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69450,CPT,TYMPANOLYSIS TRANSCANAL,,,21,,RBRVS,5.69 ,9.14 ,9.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69501,CPT,TRANSMASTOID ANTROTOMY,,,21,,RBRVS,9.21 ,10.50 ,10.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69502,CPT,MASTOIDECTOMY COMPLETE,,,21,,RBRVS,12.56 ,13.58 ,13.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69505,CPT,MASTOIDECTOMY MODIFIED RADICAL,,,21,,RBRVS,13.17 ,19.53 ,19.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69511,CPT,MASTOIDECTOMY RADICAL,,,21,,RBRVS,13.70 ,19.77 ,19.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69530,CPT,PETROUS APICECTOMY RADICAL MASTOIDECTOMY,,,21,,RBRVS,20.38 ,24.23 ,24.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69535,CPT,RESCJ TEMPORAL BONE EXTERNAL APPROACH,,,21,,RBRVS,37.42 ,33.92 ,33.92 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
69540,CPT,EXCISION AURAL POLYP,,,21,,RBRVS,1.25 ,2.22 ,4.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69550,CPT,EXCISION AURAL GLOMUS TUMOR TRANSCANAL,,,21,,RBRVS,11.15 ,17.17 ,17.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69552,CPT,EXCISION AURAL GLOMUS TUMOR TRANSMASTOID,,,21,,RBRVS,19.81 ,22.48 ,22.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69554,CPT,EXCISION AURAL GLOMUS TUMOR EXTENDED,,,21,,RBRVS,35.97 ,31.40 ,31.40 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
69601,CPT,REVJ MASTOIDECTOMY RSLTG COMPL MASTOIDECTOMY,,,21,,RBRVS,13.45 ,14.71 ,14.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69602,CPT,REVJ MASTOIDECTOMY RSLTG MODF RAD MSTDC,,,21,,RBRVS,13.76 ,15.56 ,15.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69603,CPT,REVJ MASTOIDECTOMY RSLTG RAD MASTOIDECTOMY,,,21,,RBRVS,14.20 ,19.99 ,19.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69604,CPT,REVJ MASTOIDECTOMY RSLTG TYMPANOPLASTY,,,21,,RBRVS,14.20 ,15.73 ,15.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69605,CPT,REVJ MASTOIDECTOMY W/APICECTOMY,,,21,,RBRVS,18.69 ,23.47 ,23.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69610,CPT,TYMPANIC MEMB RPR W/WO PREPJ PERFOR PATCH,,,21,,RBRVS,4.47 ,3.26 ,5.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69620,CPT,MYRINGOPLASTY,,,21,,RBRVS,6.03 ,7.16 ,12.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69631,CPT,TYMPANOPLASTY W/O MASTOIDECT W/O OSSICLE RECNSTJ,,,21,,RBRVS,10.05 ,13.92 ,13.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69632,CPT,TYMPNOPLSTY W/O MSTDC 1ST/REVJ W/OSICLE RECNSTJ,,,21,,RBRVS,12.96 ,16.14 ,16.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69633,CPT,TYMPANOPLASTY W/O MASTOIDEC 1ST/REVJ PROSTH TORP,,,21,,RBRVS,12.31 ,15.89 ,15.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69635,CPT,TYMPP ANTRT/MASTOID W/O OSSICULAR CHAIN RECNSTJ,,,21,,RBRVS,13.51 ,19.91 ,19.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69636,CPT,TYMPP ANTRT/MASTOID W/OSSICULAR CHAIN RECNSTJ,,,21,,RBRVS,15.43 ,22.02 ,22.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69637,CPT,TMPP ANTRT/MASTOIDOTOMY PROSTHESIS TORP,,,21,,RBRVS,15.32 ,22.48 ,22.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69641,CPT,TMPP MASTOIDECTOMY W/O OSSICULAR CHAIN RECNSTJ,,,21,,RBRVS,12.89 ,15.20 ,15.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69642,CPT,TMPP MASTOIDECTOMY W/OSSICULAR CHAIN RECNSTJ,,,21,,RBRVS,17.06 ,18.94 ,18.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69643,CPT,TMPP MASTOIDECT NTC/RCNSTED WALL W/O OCR,,,21,,RBRVS,15.59 ,17.35 ,17.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69644,CPT,TMPP MASTOIDECT NTC/RCNSTED CANAL WALL OCR,,,21,,RBRVS,17.23 ,22.86 ,22.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69645,CPT,TYMPANOPLASTY MASTOIDECTOMY RAD/COMPL W/O OCR,,,21,,RBRVS,16.71 ,22.67 ,22.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69646,CPT,TYMPANOPLASTY MASTOIDECTOMY RAD/COMPL W/OCR,,,21,,RBRVS,18.37 ,23.37 ,23.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69650,CPT,STAPES MOBILIZATION,,,21,,RBRVS,9.80 ,11.89 ,11.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69660,CPT,STAPEDECTOMY/STAPEDOTOMY,,,21,,RBRVS,12.03 ,12.93 ,12.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69661,CPT,STAPEDECTOMY/STAPEDOTOMY W/FOOTPLATE DRILL OUT,,,21,,RBRVS,15.92 ,16.51 ,16.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69662,CPT,REVISION STAPEDECTOMY/STAPEDOTOMY,,,21,,RBRVS,15.60 ,15.51 ,15.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69666,CPT,REPAIR OVAL WINDOW FISTULA,,,21,,RBRVS,9.89 ,11.99 ,11.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69667,CPT,REPAIR ROUND WINDOW FISTULA,,,21,,RBRVS,9.90 ,11.96 ,11.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69670,CPT,MASTOID OBLITERATION SEPARATE PROCEDURE,,,21,,RBRVS,11.73 ,13.71 ,13.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69676,CPT,TYMPANIC NEURECTOMY,,,21,,RBRVS,9.69 ,12.80 ,12.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69700,CPT,CLOSURE POSTAURICULAR FISTULA MASTOID SPX,,,21,,RBRVS,8.37 ,10.12 ,10.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69710,CPT,IMPLTJ/RPLCMT EMGNT BONE CNDJ DEV TEMPORAL BONE,,,21,,TotalUnits,,,,19.59 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69711,CPT,RMVL/RPR EMGNT BONE CNDJ DEV TEMPORAL BONE,,,21,,RBRVS,10.62 ,12.64 ,12.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69714,CPT,IMPLTJ OSSEOINTEGRATED TEMPORAL BONE W/MASTOID,,,21,,RBRVS,14.45 ,14.46 ,14.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69715,CPT,IMPLJ OSSEOINTEGRATED TEMPORAL BONE W/O MASTOID,,,21,,RBRVS,18.96 ,16.55 ,16.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69717,CPT,RPLMCT OSSEOINTEGRATE IMPLNT W/O MASTOIDECTOMY,,,21,,RBRVS,15.43 ,14.85 ,14.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69718,CPT,RPLMCT OSSEOINTEGRATE IMPLNT W/MASTOIDECTOMY,,,21,,RBRVS,19.21 ,16.66 ,16.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69720,CPT,DCMPRN FACIAL NRV INTRATEMPORAL LAT GANGLION,,,21,,RBRVS,14.71 ,17.67 ,17.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69725,CPT,DCMPRN NRV INTRATEMPORAL MEDIAL GENICULATE,,,21,,RBRVS,27.64 ,22.51 ,22.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69740,CPT,SUTR NRV ITPRL W/WO GRF/DCMPRN LAT GENICULATE,,,21,,RBRVS,16.27 ,14.99 ,14.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69745,CPT,SUTR NRV ITPRL W/WO GRF/DCMPRN MEDIAL GENICULATE,,,21,,RBRVS,17.02 ,16.26 ,16.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69799,CPT,UNLISTED PROCEDURE MIDDLE EAR,,,21,,TotalUnits,,,,5.47 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69801,CPT,LABYRINTHOTOMY TRANSCANAL,,,21,,RBRVS,2.06 ,1.27 ,3.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69805,CPT,ENDOLYMPHATIC SAC W/O SHUNT,,,21,,RBRVS,14.71 ,13.51 ,13.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69806,CPT,ENDOLYMPHATIC SAC SHUNT,,,21,,RBRVS,12.63 ,12.76 ,12.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69820,CPT,FENESTRATION SEMICIRCULAR CANAL,,,21,,RBRVS,10.52 ,12.60 ,12.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69840,CPT,REVISION FENESTRATION OPERATION,,,21,,RBRVS,10.44 ,15.02 ,15.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69905,CPT,LABYRINTHECTOMY TRANSCANAL,,,21,,RBRVS,11.26 ,13.50 ,13.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69910,CPT,LABYRINTHECTOMY W/MASTOIDECTOMY,,,21,,RBRVS,13.91 ,13.35 ,13.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69915,CPT,VESTIBULAR NRV SECTION TRANSLABYRINTHINE APPR,,,21,,RBRVS,22.77 ,18.24 ,18.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69930,CPT,COCHLEAR DEVICE IMPLANTATION W/WO MASTOIDECTOMY,,,21,,RBRVS,17.73 ,14.98 ,14.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69949,CPT,UNLISTED PROCEDURE INNER EAR,,,21,,TotalUnits,,,,32.71 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69950,CPT,VESTIBULAR NRV SECTION TRANSCRANIAL APPROACH,,,21,,RBRVS,27.63 ,19.74 ,19.74 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
69955,CPT,TOTAL FACIAL NERVE DECOMPRESSION &/REPAIR,,,21,,RBRVS,29.42 ,23.32 ,23.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69960,CPT,DECOMPRESSION INTERNAL AUDITORY CANAL,,,21,,RBRVS,29.42 ,21.80 ,21.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69970,CPT,REMOVAL TUMOR TEMPORAL BONE,,,21,,RBRVS,32.41 ,24.64 ,24.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69979,CPT,UNLISTED PROCEDURE TEMPORAL BONE MIDDLE FOSSA,,,21,,TotalUnits,,,,52.74 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
69990,CPT,MICROSURG TQS REQ USE OPERATING MICROSCOPE,,,21,,RBRVS,3.46 ,1.63 ,1.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70010,CPT,MYELOGRAPY POST FOSSA RS&I,,,20,,RBRVS,1.19 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70010,CPT,MYELOGRAPY POST FOSSA RS&I,26,,20,,RBRVS,0.31 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70010,CPT,MYELOGRAPY POST FOSSA RS&I,TC,,20,,RBRVS,0.88 ,0.44 ,0.44 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70015,CPT,CISTERNOGRAPHY POSITIVE CONTRAST RS&I,,,20,,RBRVS,1.19 ,3.07 ,3.07 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70015,CPT,CISTERNOGRAPHY POSITIVE CONTRAST RS&I,26,,20,,RBRVS,1.19 ,0.45 ,0.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70015,CPT,CISTERNOGRAPHY POSITIVE CONTRAST RS&I,TC,,20,,RBRVS,,2.62 ,2.62 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70030,CPT,RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY,,,20,,RBRVS,0.17 ,0.58 ,0.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70030,CPT,RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY,26,,20,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70030,CPT,RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY,TC,,20,,RBRVS,,0.52 ,0.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70100,CPT,RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS,,,20,,RBRVS,0.18 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70100,CPT,RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS,26,,20,,RBRVS,0.18 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70100,CPT,RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS,TC,,20,,RBRVS,,0.65 ,0.65 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70110,CPT,RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS,,,20,,RBRVS,0.25 ,0.79 ,0.79 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70110,CPT,RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS,26,,20,,RBRVS,0.25 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70110,CPT,RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS,TC,,20,,RBRVS,,0.69 ,0.69 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70120,CPT,RADIOLOGIC EXAM MASTOIDS < 3 VIEWS PER SIDE,,,20,,RBRVS,0.18 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70120,CPT,RADIOLOGIC EXAM MASTOIDS < 3 VIEWS PER SIDE,26,,20,,RBRVS,0.18 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70120,CPT,RADIOLOGIC EXAM MASTOIDS < 3 VIEWS PER SIDE,TC,,20,,RBRVS,,0.68 ,0.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70130,CPT,RADEX MASTOIDS COMPL MINIMUM 3 VIEWS PR SIDE,,,20,,RBRVS,0.34 ,1.16 ,1.16 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70130,CPT,RADEX MASTOIDS COMPL MINIMUM 3 VIEWS PR SIDE,26,,20,,RBRVS,0.34 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70130,CPT,RADEX MASTOIDS COMPL MINIMUM 3 VIEWS PR SIDE,TC,,20,,RBRVS,,1.03 ,1.03 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70134,CPT,RADEX INTERNAL AUDITORY MEATI COMPLETE,,,20,,RBRVS,0.34 ,1.08 ,1.08 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70134,CPT,RADEX INTERNAL AUDITORY MEATI COMPLETE,26,,20,,RBRVS,0.34 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70134,CPT,RADEX INTERNAL AUDITORY MEATI COMPLETE,TC,,20,,RBRVS,,0.93 ,0.93 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70140,CPT,RADEX FACIAL BONES < 3 VIEWS,,,20,,RBRVS,0.19 ,0.62 ,0.62 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70140,CPT,RADEX FACIAL BONES < 3 VIEWS,26,,20,,RBRVS,0.19 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70140,CPT,RADEX FACIAL BONES < 3 VIEWS,TC,,20,,RBRVS,,0.52 ,0.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70150,CPT,RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS,,,20,,RBRVS,0.26 ,0.88 ,0.88 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70150,CPT,RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS,26,,20,,RBRVS,0.26 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70150,CPT,RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS,TC,,20,,RBRVS,,0.77 ,0.77 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70160,CPT,RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS,,,20,,RBRVS,0.17 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70160,CPT,RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS,26,,20,,RBRVS,0.17 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70160,CPT,RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS,TC,,20,,RBRVS,,0.65 ,0.65 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70170,CPT,DACRYOCSTOGRAPY NASOLACRIMAL DUCT RS&I,,,20,,TotalUnits,,,,1.03 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70170,CPT,DACRYOCSTOGRAPY NASOLACRIMAL DUCT RS&I,26,,20,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70170,CPT,DACRYOCSTOGRAPY NASOLACRIMAL DUCT RS&I,TC,,20,,TotalUnits,,,,0.62 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70190,CPT,RADEX OPTIC FORAMINA,,,20,,RBRVS,0.21 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70190,CPT,RADEX OPTIC FORAMINA,26,,20,,RBRVS,0.21 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70190,CPT,RADEX OPTIC FORAMINA,TC,,20,,RBRVS,,0.65 ,0.65 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70200,CPT,RADEX ORBITS COMPLETE MINIMUM 4 VIEWS,,,20,,RBRVS,0.28 ,0.88 ,0.88 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70200,CPT,RADEX ORBITS COMPLETE MINIMUM 4 VIEWS,26,,20,,RBRVS,0.28 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70200,CPT,RADEX ORBITS COMPLETE MINIMUM 4 VIEWS,TC,,20,,RBRVS,,0.77 ,0.77 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70210,CPT,RADEX SINUSES PARANASAL <3 VIEWS,,,20,,RBRVS,0.17 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70210,CPT,RADEX SINUSES PARANASAL <3 VIEWS,26,,20,,RBRVS,0.17 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70210,CPT,RADEX SINUSES PARANASAL <3 VIEWS,TC,,20,,RBRVS,,0.57 ,0.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70220,CPT,RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS,,,20,,RBRVS,0.25 ,0.77 ,0.77 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70220,CPT,RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS,26,,20,,RBRVS,0.25 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70220,CPT,RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS,TC,,20,,RBRVS,,0.67 ,0.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70240,CPT,RADIOLOGIC EXAMINATION SELLA TURCICA,,,20,,RBRVS,0.19 ,0.62 ,0.62 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70240,CPT,RADIOLOGIC EXAMINATION SELLA TURCICA,26,,20,,RBRVS,0.19 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70240,CPT,RADIOLOGIC EXAMINATION SELLA TURCICA,TC,,20,,RBRVS,,0.54 ,0.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70250,CPT,RADIOLOGIC EXAMINATION SKULL 4/> VIEWS,,,20,,RBRVS,0.24 ,0.74 ,0.74 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70250,CPT,RADIOLOGIC EXAMINATION SKULL 4/> VIEWS,26,,20,,RBRVS,0.24 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70250,CPT,RADIOLOGIC EXAMINATION SKULL 4/> VIEWS,TC,,20,,RBRVS,,0.63 ,0.63 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70260,CPT,RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS,,,20,,RBRVS,0.34 ,0.90 ,0.90 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70260,CPT,RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS,26,,20,,RBRVS,0.34 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70260,CPT,RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS,TC,,20,,RBRVS,,0.76 ,0.76 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70300,CPT,RADIOLOGIC EXAMINATION TEETH 1 VIEW,,,20,,RBRVS,0.10 ,0.30 ,0.30 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70300,CPT,RADIOLOGIC EXAMINATION TEETH 1 VIEW,26,,20,,RBRVS,0.10 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70300,CPT,RADIOLOGIC EXAMINATION TEETH 1 VIEW,TC,,20,,RBRVS,,0.24 ,0.24 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70310,CPT,RADIOLOGIC EXAM TEETH PRTL EXAM < FULL MOUTH,,,20,,RBRVS,0.16 ,0.90 ,0.90 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70310,CPT,RADIOLOGIC EXAM TEETH PRTL EXAM < FULL MOUTH,26,,20,,RBRVS,0.16 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70310,CPT,RADIOLOGIC EXAM TEETH PRTL EXAM < FULL MOUTH,TC,,20,,RBRVS,,0.83 ,0.83 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70320,CPT,RADIOLOGIC EXAM TEETH COMPLETE FULL MOUTH,,,20,,RBRVS,0.22 ,1.24 ,1.24 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70320,CPT,RADIOLOGIC EXAM TEETH COMPLETE FULL MOUTH,26,,20,,RBRVS,0.22 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70320,CPT,RADIOLOGIC EXAM TEETH COMPLETE FULL MOUTH,TC,,20,,RBRVS,,1.13 ,1.13 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70328,CPT,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH UNILAT,,,20,,RBRVS,0.18 ,0.67 ,0.67 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70328,CPT,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH UNILAT,26,,20,,RBRVS,0.18 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70328,CPT,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH UNILAT,TC,,20,,RBRVS,,0.59 ,0.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70330,CPT,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT,,,20,,RBRVS,0.24 ,1.05 ,1.05 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70330,CPT,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT,26,,20,,RBRVS,0.24 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70330,CPT,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT,TC,,20,,RBRVS,,0.94 ,0.94 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70332,CPT,TEMPOROMANDBLE JT ARTHROGRAPHY RS&I,,,20,,RBRVS,0.54 ,1.69 ,1.69 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70332,CPT,TEMPOROMANDBLE JT ARTHROGRAPHY RS&I,26,,20,,RBRVS,0.54 ,0.31 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70332,CPT,TEMPOROMANDBLE JT ARTHROGRAPHY RS&I,TC,,20,,RBRVS,,1.38 ,1.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70336,CPT,MRI TEMPOROMANDIBULAR JOINT,,,20,,RBRVS,1.48 ,7.41 ,7.41 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70336,CPT,MRI TEMPOROMANDIBULAR JOINT,26,,20,,RBRVS,1.48 ,0.54 ,0.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70336,CPT,MRI TEMPOROMANDIBULAR JOINT,TC,,20,,RBRVS,,6.87 ,6.87 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70350,CPT,CEPHALOGRAM ORTHODONTIC,,,20,,RBRVS,0.17 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70350,CPT,CEPHALOGRAM ORTHODONTIC,26,,20,,RBRVS,0.17 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70350,CPT,CEPHALOGRAM ORTHODONTIC,TC,,20,,RBRVS,,0.25 ,0.25 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70355,CPT,ORTHOPANTOGRAM,,,20,,RBRVS,0.20 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70355,CPT,ORTHOPANTOGRAM,26,,20,,RBRVS,0.20 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70355,CPT,ORTHOPANTOGRAM,TC,,20,,RBRVS,,0.24 ,0.24 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70360,CPT,RADIOLOGIC EXAMINATION NECK SOFT TISSUE,,,20,,RBRVS,0.17 ,0.59 ,0.59 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70360,CPT,RADIOLOGIC EXAMINATION NECK SOFT TISSUE,26,,20,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70360,CPT,RADIOLOGIC EXAMINATION NECK SOFT TISSUE,TC,,20,,RBRVS,,0.53 ,0.53 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70370,CPT,RADEX PHARYNX/LARX W/FLUOR&/MAGNIFICATION TQ,,,20,,RBRVS,0.32 ,1.90 ,1.90 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70370,CPT,RADEX PHARYNX/LARX W/FLUOR&/MAGNIFICATION TQ,26,,20,,RBRVS,0.32 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70370,CPT,RADEX PHARYNX/LARX W/FLUOR&/MAGNIFICATION TQ,TC,,20,,RBRVS,,1.79 ,1.79 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70371,CPT,CPLX DYNAMIC PHARYNGEAL&SP EVAL C/V REC,,,20,,RBRVS,0.84 ,1.65 ,1.65 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70371,CPT,CPLX DYNAMIC PHARYNGEAL&SP EVAL C/V REC,26,,20,,RBRVS,0.84 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70371,CPT,CPLX DYNAMIC PHARYNGEAL&SP EVAL C/V REC,TC,,20,,RBRVS,,1.32 ,1.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70380,CPT,RADIOLOGIC EXAMINATION SALIVARY GLAND CALCULUS,,,20,,RBRVS,0.17 ,0.81 ,0.81 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70380,CPT,RADIOLOGIC EXAMINATION SALIVARY GLAND CALCULUS,26,,20,,RBRVS,0.17 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70380,CPT,RADIOLOGIC EXAMINATION SALIVARY GLAND CALCULUS,TC,,20,,RBRVS,,0.73 ,0.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70390,CPT,SIALOGRAPHY RS&I,,,20,,RBRVS,0.38 ,2.22 ,2.22 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70390,CPT,SIALOGRAPHY RS&I,26,,20,,RBRVS,0.38 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70390,CPT,SIALOGRAPHY RS&I,TC,,20,,RBRVS,,2.08 ,2.08 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70450,CPT,CT HEAD/BRAIN W/O CONTRAST MATERIAL,,,20,,RBRVS,0.85 ,2.35 ,2.35 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70450,CPT,CT HEAD/BRAIN W/O CONTRAST MATERIAL,26,,20,,RBRVS,0.85 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70450,CPT,CT HEAD/BRAIN W/O CONTRAST MATERIAL,TC,,20,,RBRVS,,2.03 ,2.03 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70460,CPT,CT HEAD/BRAIN W/CONTRAST MATERIAL,,,20,,RBRVS,1.13 ,3.34 ,3.34 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70460,CPT,CT HEAD/BRAIN W/CONTRAST MATERIAL,26,,20,,RBRVS,1.13 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70460,CPT,CT HEAD/BRAIN W/CONTRAST MATERIAL,TC,,20,,RBRVS,,2.92 ,2.92 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70470,CPT,CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL,,,20,,RBRVS,1.27 ,4.03 ,4.03 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70470,CPT,CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL,26,,20,,RBRVS,1.27 ,0.48 ,0.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70470,CPT,CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL,TC,,20,,RBRVS,,3.55 ,3.55 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70480,CPT,CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL,,,20,,RBRVS,1.28 ,5.18 ,5.18 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70480,CPT,CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL,26,,20,,RBRVS,1.28 ,0.48 ,0.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70480,CPT,CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL,TC,,20,,RBRVS,,4.70 ,4.70 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70481,CPT,CT ORBIT SELLA/POST FOSSA/EAR W/CONTRAST MATRL,,,20,,RBRVS,1.38 ,6.26 ,6.26 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70481,CPT,CT ORBIT SELLA/POST FOSSA/EAR W/CONTRAST MATRL,26,,20,,RBRVS,1.38 ,0.51 ,0.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70481,CPT,CT ORBIT SELLA/POST FOSSA/EAR W/CONTRAST MATRL,TC,,20,,RBRVS,,5.75 ,5.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70482,CPT,CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR,,,20,,RBRVS,1.45 ,6.92 ,6.92 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70482,CPT,CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR,26,,20,,RBRVS,1.45 ,0.54 ,0.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70482,CPT,CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR,TC,,20,,RBRVS,,6.38 ,6.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70486,CPT,CT MAXILLOFACIAL W/O CONTRAST MATERIAL,,,20,,RBRVS,0.85 ,3.02 ,3.02 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70486,CPT,CT MAXILLOFACIAL W/O CONTRAST MATERIAL,26,,20,,RBRVS,0.85 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70486,CPT,CT MAXILLOFACIAL W/O CONTRAST MATERIAL,TC,,20,,RBRVS,,2.70 ,2.70 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70487,CPT,CT MAXILLOFACIAL W/CONTRAST MATERIAL,,,20,,RBRVS,1.13 ,3.52 ,3.52 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70487,CPT,CT MAXILLOFACIAL W/CONTRAST MATERIAL,26,,20,,RBRVS,1.13 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70487,CPT,CT MAXILLOFACIAL W/CONTRAST MATERIAL,TC,,20,,RBRVS,,3.10 ,3.10 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70488,CPT,CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL,,,20,,RBRVS,1.27 ,4.40 ,4.40 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70488,CPT,CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL,26,,20,,RBRVS,1.27 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70488,CPT,CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL,TC,,20,,RBRVS,,3.93 ,3.93 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70490,CPT,CT SOFT TISSUE NECK W/O CONTRAST MATERIAL,,,20,,RBRVS,1.28 ,4.05 ,4.05 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70490,CPT,CT SOFT TISSUE NECK W/O CONTRAST MATERIAL,26,,20,,RBRVS,1.28 ,0.48 ,0.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70490,CPT,CT SOFT TISSUE NECK W/O CONTRAST MATERIAL,TC,,20,,RBRVS,,3.57 ,3.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70491,CPT,CT SOFT TISSUE NECK W/CONTRAST MATERIAL,,,20,,RBRVS,1.38 ,5.14 ,5.14 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70491,CPT,CT SOFT TISSUE NECK W/CONTRAST MATERIAL,26,,20,,RBRVS,1.38 ,0.52 ,0.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70491,CPT,CT SOFT TISSUE NECK W/CONTRAST MATERIAL,TC,,20,,RBRVS,,4.62 ,4.62 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70492,CPT,CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL,,,20,,RBRVS,1.45 ,6.25 ,6.25 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70492,CPT,CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL,26,,20,,RBRVS,1.45 ,0.54 ,0.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70492,CPT,CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL,TC,,20,,RBRVS,,5.71 ,5.71 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70496,CPT,CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST,,,20,,RBRVS,1.75 ,6.41 ,6.41 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70496,CPT,CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST,26,,20,,RBRVS,1.75 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70496,CPT,CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST,TC,,20,,RBRVS,,5.76 ,5.76 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70498,CPT,CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST,,,20,,RBRVS,1.75 ,6.36 ,6.36 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70498,CPT,CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST,26,,20,,RBRVS,1.75 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70498,CPT,CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST,TC,,20,,RBRVS,,5.72 ,5.72 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70540,CPT,MRI ORBIT FACE &/NECK W/O CONTRAST,,,20,,RBRVS,1.35 ,8.60 ,8.60 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70540,CPT,MRI ORBIT FACE &/NECK W/O CONTRAST,26,,20,,RBRVS,1.35 ,0.49 ,0.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70540,CPT,MRI ORBIT FACE &/NECK W/O CONTRAST,TC,,20,,RBRVS,,8.11 ,8.11 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70542,CPT,MRI ORBIT FACE & NECK W/CONTRAST MATERIAL,,,20,,RBRVS,1.62 ,9.56 ,9.56 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70542,CPT,MRI ORBIT FACE & NECK W/CONTRAST MATERIAL,26,,20,,RBRVS,1.62 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70542,CPT,MRI ORBIT FACE & NECK W/CONTRAST MATERIAL,TC,,20,,RBRVS,,8.96 ,8.96 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70543,CPT,MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL,,,20,,RBRVS,2.15 ,11.51 ,11.51 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70543,CPT,MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL,26,,20,,RBRVS,2.15 ,0.79 ,0.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70543,CPT,MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL,TC,,20,,RBRVS,,10.72 ,10.72 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70544,CPT,MRA HEAD W/O CONTRST MATERIAL,,,20,,RBRVS,1.20 ,9.72 ,9.72 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70544,CPT,MRA HEAD W/O CONTRST MATERIAL,26,,20,,RBRVS,1.20 ,0.45 ,0.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70544,CPT,MRA HEAD W/O CONTRST MATERIAL,TC,,20,,RBRVS,,9.27 ,9.27 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70545,CPT,MRA HEAD W/CONTRAST MATERIAL,,,20,,RBRVS,1.20 ,9.55 ,9.55 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70545,CPT,MRA HEAD W/CONTRAST MATERIAL,26,,20,,RBRVS,1.20 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70545,CPT,MRA HEAD W/CONTRAST MATERIAL,TC,,20,,RBRVS,,9.11 ,9.11 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70546,CPT,MRA HEAD W/O & W/CONTRAST MATERIAL,,,20,,RBRVS,1.80 ,14.90 ,14.90 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70546,CPT,MRA HEAD W/O & W/CONTRAST MATERIAL,26,,20,,RBRVS,1.80 ,0.67 ,0.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70546,CPT,MRA HEAD W/O & W/CONTRAST MATERIAL,TC,,20,,RBRVS,,14.23 ,14.23 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70547,CPT,MRA NECK W/O CONTRST MATERIAL,,,20,,RBRVS,1.20 ,9.77 ,9.77 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70547,CPT,MRA NECK W/O CONTRST MATERIAL,26,,20,,RBRVS,1.20 ,0.45 ,0.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70547,CPT,MRA NECK W/O CONTRST MATERIAL,TC,,20,,RBRVS,,9.32 ,9.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70548,CPT,MRA NECK W/CONTRAST MATERIAL,,,20,,RBRVS,1.20 ,10.31 ,10.31 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70548,CPT,MRA NECK W/CONTRAST MATERIAL,26,,20,,RBRVS,1.20 ,0.45 ,0.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70548,CPT,MRA NECK W/CONTRAST MATERIAL,TC,,20,,RBRVS,,9.86 ,9.86 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70549,CPT,MRA NECK W/O &W/CONTRAST MATERIAL,,,20,,RBRVS,1.80 ,14.97 ,14.97 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70549,CPT,MRA NECK W/O &W/CONTRAST MATERIAL,26,,20,,RBRVS,1.80 ,0.67 ,0.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70549,CPT,MRA NECK W/O &W/CONTRAST MATERIAL,TC,,20,,RBRVS,,14.30 ,14.30 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70551,CPT,MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL,,,20,,RBRVS,1.48 ,4.88 ,4.88 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70551,CPT,MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL,26,,20,,RBRVS,1.48 ,0.55 ,0.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70551,CPT,MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL,TC,,20,,RBRVS,,4.33 ,4.33 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70552,CPT,MRI BRAIN BRAIN STEM W/CONTRAST MATERIAL,,,20,,RBRVS,1.78 ,7.07 ,7.07 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70552,CPT,MRI BRAIN BRAIN STEM W/CONTRAST MATERIAL,26,,20,,RBRVS,1.78 ,0.67 ,0.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70552,CPT,MRI BRAIN BRAIN STEM W/CONTRAST MATERIAL,TC,,20,,RBRVS,,6.40 ,6.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70553,CPT,MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL,,,20,,RBRVS,2.29 ,8.15 ,8.15 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70553,CPT,MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL,26,,20,,RBRVS,2.29 ,0.85 ,0.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70553,CPT,MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL,TC,,20,,RBRVS,,7.30 ,7.30 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70554,CPT,MRI BRAIN FUNCTIONAL W/O PHYSICIAN ADMNISTRATION,,,20,,RBRVS,2.11 ,10.37 ,10.37 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70554,CPT,MRI BRAIN FUNCTIONAL W/O PHYSICIAN ADMNISTRATION,26,,20,,RBRVS,2.11 ,0.80 ,0.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70554,CPT,MRI BRAIN FUNCTIONAL W/O PHYSICIAN ADMNISTRATION,TC,,20,,RBRVS,,9.57 ,9.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70555,CPT,MRI BRAIN FUNCTIONAL W/PHYSICIAN ADMNISTRATION,,,20,,TotalUnits,,,,21.35 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70555,CPT,MRI BRAIN FUNCTIONAL W/PHYSICIAN ADMNISTRATION,26,,20,,TotalUnits,,,,3.48 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70555,CPT,MRI BRAIN FUNCTIONAL W/PHYSICIAN ADMNISTRATION,TC,,20,,TotalUnits,,,,17.87 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70557,CPT,MRI BRAIN OPEN INTRACRANIAL PX W/O CONTRAST MATL,,,20,,TotalUnits,,,,37.06 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70557,CPT,MRI BRAIN OPEN INTRACRANIAL PX W/O CONTRAST MATL,26,,20,,TotalUnits,,,,3.99 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70557,CPT,MRI BRAIN OPEN INTRACRANIAL PX W/O CONTRAST MATL,TC,,20,,TotalUnits,,,,33.07 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70558,CPT,MRI BRAIN OPEN INTRACRANIAL PX W/CONTRAST MATL,,,20,,TotalUnits,,,,40.63 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70558,CPT,MRI BRAIN OPEN INTRACRANIAL PX W/CONTRAST MATL,26,,20,,TotalUnits,,,,4.41 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70558,CPT,MRI BRAIN OPEN INTRACRANIAL PX W/CONTRAST MATL,TC,,20,,TotalUnits,,,,36.22 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
70559,CPT,MRI BRAIN OPEN INTRACRANIAL PX W/O & W/CONTRAST,,,20,,TotalUnits,,,,51.80 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
70559,CPT,MRI BRAIN OPEN INTRACRANIAL PX W/O & W/CONTRAST,26,,20,,TotalUnits,,,,4.41 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
70559,CPT,MRI BRAIN OPEN INTRACRANIAL PX W/O & W/CONTRAST,TC,,20,,TotalUnits,,,,47.39 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
71010,CPT,RADIOLOGIC EXAMINATION CHEST SINGLE VIEW FRONTAL,,,20,,RBRVS,0.18 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
71010,CPT,RADIOLOGIC EXAMINATION CHEST SINGLE VIEW FRONTAL,26,,20,,RBRVS,0.18 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
71010,CPT,RADIOLOGIC EXAMINATION CHEST SINGLE VIEW FRONTAL,TC,,20,,RBRVS,,0.36 ,0.36 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
71015,CPT,RADIOLOGIC EXAMINATION CHEST STERO FRONTAL,,,20,,RBRVS,0.21 ,0.54 ,0.54 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
71015,CPT,RADIOLOGIC EXAMINATION CHEST STERO FRONTAL,26,,20,,RBRVS,0.21 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
71015,CPT,RADIOLOGIC EXAMINATION CHEST STERO FRONTAL,TC,,20,,RBRVS,,0.45 ,0.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
71020,CPT,RADIOLOGIC EXAM CHEST 2 VIEWS FRONTAL&LATERAL,,,20,,RBRVS,0.22 ,0.54 ,0.54 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
71020,CPT,RADIOLOGIC EXAM CHEST 2 VIEWS FRONTAL&LATERAL,26,,20,,RBRVS,0.22 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
71020,CPT,RADIOLOGIC EXAM CHEST 2 VIEWS FRONTAL&LATERAL,TC,,20,,RBRVS,,0.46 ,0.46 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
71021,CPT,RADEX CH 2 VIEWS FRNT & LAT APICAL LORDOTIC PX,,,20,,RBRVS,0.27 ,0.66 ,0.66 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
71021,CPT,RADEX CH 2 VIEWS FRNT & LAT APICAL LORDOTIC PX,26,,20,,RBRVS,0.27 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
71021,CPT,RADEX CH 2 VIEWS FRNT & LAT APICAL LORDOTIC PX,TC,,20,,RBRVS,,0.55 ,0.55 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
71022,CPT,RADEX CH 2 VIEWS FRONTAL & LATERAL OBLIQUE PRJCJ,,,20,,RBRVS,0.31 ,0.84 ,0.84 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
71022,CPT,RADEX CH 2 VIEWS FRONTAL & LATERAL OBLIQUE PRJCJ,26,,20,,RBRVS,0.31 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
71022,CPT,RADEX CH 2 VIEWS FRONTAL & LATERAL OBLIQUE PRJCJ,TC,,20,,RBRVS,,0.69 ,0.69 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
71023,CPT,RADEX CH 2 VIEWS FRONTAL & LATERAL W/FLUORO,,,20,,RBRVS,0.38 ,1.36 ,1.36 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
71023,CPT,RADEX CH 2 VIEWS FRONTAL & LATERAL W/FLUORO,26,,20,,RBRVS,0.38 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
71023,CPT,RADEX CH 2 VIEWS FRONTAL & LATERAL W/FLUORO,TC,,20,,RBRVS,,1.22 ,1.22 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
71030,CPT,RADEX CHEST COMPLETE MINIMUM 4 VIEWS,,,20,,RBRVS,0.31 ,0.83 ,0.83 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
71030,CPT,RADEX CHEST COMPLETE MINIMUM 4 VIEWS,26,,20,,RBRVS,0.31 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
71030,CPT,RADEX CHEST COMPLETE MINIMUM 4 VIEWS,TC,,20,,RBRVS,,0.71 ,0.71 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
71034,CPT,RADEX CHEST COMPLETE MINIMUM 4 VIEWS W/FLUORO,,,20,,RBRVS,0.46 ,1.86 ,1.86 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
71034,CPT,RADEX CHEST COMPLETE MINIMUM 4 VIEWS W/FLUORO,26,,20,,RBRVS,0.46 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
71034,CPT,RADEX CHEST COMPLETE MINIMUM 4 VIEWS W/FLUORO,TC,,20,,RBRVS,,1.69 ,1.69 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
71035,CPT,RADEX CHEST SPECIAL VIEWS,,,20,,RBRVS,0.18 ,0.71 ,0.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
71035,CPT,RADEX CHEST SPECIAL VIEWS,26,,20,,RBRVS,0.18 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
71035,CPT,RADEX CHEST SPECIAL VIEWS,TC,,20,,RBRVS,,0.64 ,0.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
71100,CPT,RADEX RIBS UNILATERAL 2 VIEWS,,,20,,RBRVS,0.22 ,0.61 ,0.61 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
71100,CPT,RADEX RIBS UNILATERAL 2 VIEWS,26,,20,,RBRVS,0.22 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
71100,CPT,RADEX RIBS UNILATERAL 2 VIEWS,TC,,20,,RBRVS,,0.52 ,0.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
71101,CPT,RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS,,,20,,RBRVS,0.27 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
71101,CPT,RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS,26,,20,,RBRVS,0.27 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
71101,CPT,RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS,TC,,20,,RBRVS,,0.62 ,0.62 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
71110,CPT,RADEX RIBS BILATERAL 3 VIEWS,,,20,,RBRVS,0.27 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
71110,CPT,RADEX RIBS BILATERAL 3 VIEWS,26,,20,,RBRVS,0.27 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
71110,CPT,RADEX RIBS BILATERAL 3 VIEWS,TC,,20,,RBRVS,,0.64 ,0.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
71111,CPT,RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS,,,20,,RBRVS,0.32 ,0.98 ,0.98 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
71111,CPT,RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS,26,,20,,RBRVS,0.32 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
71111,CPT,RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS,TC,,20,,RBRVS,,0.85 ,0.85 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
71120,CPT,RADEX STERNUM MINIMUM 2 VIEWS,,,20,,RBRVS,0.20 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
71120,CPT,RADEX STERNUM MINIMUM 2 VIEWS,26,,20,,RBRVS,0.20 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
71120,CPT,RADEX STERNUM MINIMUM 2 VIEWS,TC,,20,,RBRVS,,0.52 ,0.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
71130,CPT,RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS,,,20,,RBRVS,0.22 ,0.76 ,0.76 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
71130,CPT,RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS,26,,20,,RBRVS,0.22 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
71130,CPT,RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS,TC,,20,,RBRVS,,0.67 ,0.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
71250,CPT,CT THORAX W/O CONTRAST MATERIAL,,,20,,RBRVS,1.02 ,3.96 ,3.96 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
71250,CPT,CT THORAX W/O CONTRAST MATERIAL,26,,20,,RBRVS,1.02 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
71250,CPT,CT THORAX W/O CONTRAST MATERIAL,TC,,20,,RBRVS,,3.58 ,3.58 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
71260,CPT,CT THORAX W/CONTRAST MATERIAL,,,20,,RBRVS,1.24 ,5.11 ,5.11 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
71260,CPT,CT THORAX W/CONTRAST MATERIAL,26,,20,,RBRVS,1.24 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
71260,CPT,CT THORAX W/CONTRAST MATERIAL,TC,,20,,RBRVS,,4.64 ,4.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
71270,CPT,CT THORAX W/O & W/CONTRAST MATERIAL,,,20,,RBRVS,1.38 ,6.24 ,6.24 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
71270,CPT,CT THORAX W/O & W/CONTRAST MATERIAL,26,,20,,RBRVS,1.38 ,0.51 ,0.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
71270,CPT,CT THORAX W/O & W/CONTRAST MATERIAL,TC,,20,,RBRVS,,5.73 ,5.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
71275,CPT,CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST,,,20,,RBRVS,1.82 ,6.47 ,6.47 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
71275,CPT,CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST,26,,20,,RBRVS,1.82 ,0.68 ,0.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
71275,CPT,CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST,TC,,20,,RBRVS,,5.79 ,5.79 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
71550,CPT,MRI CHEST W/O CONTRAST MATERIAL,,,20,,RBRVS,1.46 ,10.06 ,10.06 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
71550,CPT,MRI CHEST W/O CONTRAST MATERIAL,26,,20,,RBRVS,1.46 ,0.54 ,0.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
71550,CPT,MRI CHEST W/O CONTRAST MATERIAL,TC,,20,,RBRVS,,9.52 ,9.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
71551,CPT,MRI CHEST W/CONTRAST MATERIAL,,,20,,RBRVS,1.73 ,10.97 ,10.97 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
71551,CPT,MRI CHEST W/CONTRAST MATERIAL,26,,20,,RBRVS,1.73 ,0.63 ,0.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
71551,CPT,MRI CHEST W/CONTRAST MATERIAL,TC,,20,,RBRVS,,10.34 ,10.34 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
71552,CPT,MRI CHEST W/O & W/CONTRAST MATERIAL,,,20,,RBRVS,2.26 ,13.84 ,13.84 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
71552,CPT,MRI CHEST W/O & W/CONTRAST MATERIAL,26,,20,,RBRVS,2.26 ,0.84 ,0.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
71552,CPT,MRI CHEST W/O & W/CONTRAST MATERIAL,TC,,20,,RBRVS,,13.00 ,13.00 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
71555,CPT,MRA CHEST W/O & W/CONTRAST MATERIAL,,,20,,RBRVS,1.81 ,9.23 ,9.23 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
71555,CPT,MRA CHEST W/O & W/CONTRAST MATERIAL,26,,20,,RBRVS,1.81 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
71555,CPT,MRA CHEST W/O & W/CONTRAST MATERIAL,TC,,20,,RBRVS,,8.58 ,8.58 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72020,CPT,RADEX SPINE 1 VIEW SPECIFY LEVEL,,,20,,RBRVS,0.15 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72020,CPT,RADEX SPINE 1 VIEW SPECIFY LEVEL,26,,20,,RBRVS,0.15 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72020,CPT,RADEX SPINE 1 VIEW SPECIFY LEVEL,TC,,20,,RBRVS,,0.38 ,0.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72040,CPT,RADEX SPINE CERVICAL 2 OR 3 VIEWS,,,20,,RBRVS,0.22 ,0.68 ,0.68 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72040,CPT,RADEX SPINE CERVICAL 2 OR 3 VIEWS,26,,20,,RBRVS,0.22 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72040,CPT,RADEX SPINE CERVICAL 2 OR 3 VIEWS,TC,,20,,RBRVS,,0.59 ,0.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72050,CPT,RADEX SPINE CERVICAL 4 OR 5 VIEWS,,,20,,RBRVS,0.31 ,0.91 ,0.91 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72050,CPT,RADEX SPINE CERVICAL 4 OR 5 VIEWS,26,,20,,RBRVS,0.31 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72050,CPT,RADEX SPINE CERVICAL 4 OR 5 VIEWS,TC,,20,,RBRVS,,0.79 ,0.79 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72052,CPT,RADEX SPINE CERVICAL 6 OR MORE VIEWS,,,20,,RBRVS,0.36 ,1.17 ,1.17 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72052,CPT,RADEX SPINE CERVICAL 6 OR MORE VIEWS,26,,20,,RBRVS,0.36 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72052,CPT,RADEX SPINE CERVICAL 6 OR MORE VIEWS,TC,,20,,RBRVS,,1.03 ,1.03 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72070,CPT,RADEX SPINE THORACIC 2 VIEWS,,,20,,RBRVS,0.22 ,0.63 ,0.63 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72070,CPT,RADEX SPINE THORACIC 2 VIEWS,26,,20,,RBRVS,0.22 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72070,CPT,RADEX SPINE THORACIC 2 VIEWS,TC,,20,,RBRVS,,0.54 ,0.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72072,CPT,RADEX SPINE THORACIC 3 VIEWS,,,20,,RBRVS,0.22 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72072,CPT,RADEX SPINE THORACIC 3 VIEWS,26,,20,,RBRVS,0.22 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72072,CPT,RADEX SPINE THORACIC 3 VIEWS,TC,,20,,RBRVS,,0.64 ,0.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72074,CPT,RADEX SPINE THORACIC MINIMUM 4 VIEWS,,,20,,RBRVS,0.22 ,0.85 ,0.85 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72074,CPT,RADEX SPINE THORACIC MINIMUM 4 VIEWS,26,,20,,RBRVS,0.22 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72074,CPT,RADEX SPINE THORACIC MINIMUM 4 VIEWS,TC,,20,,RBRVS,,0.77 ,0.77 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72080,CPT,RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS,,,20,,RBRVS,0.22 ,0.68 ,0.68 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72080,CPT,RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS,26,,20,,RBRVS,0.22 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72080,CPT,RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS,TC,,20,,RBRVS,,0.59 ,0.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72081,CPT,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW,,,20,,RBRVS,0.26 ,0.80 ,0.80 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72081,CPT,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW,26,,20,,RBRVS,0.26 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72081,CPT,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW,TC,,20,,RBRVS,,0.70 ,0.70 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72082,CPT,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW,,,20,,RBRVS,0.31 ,1.41 ,1.41 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72082,CPT,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW,26,,20,,RBRVS,0.31 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72082,CPT,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW,TC,,20,,RBRVS,,1.28 ,1.28 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72083,CPT,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW,,,20,,RBRVS,0.35 ,1.52 ,1.52 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72083,CPT,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW,26,,20,,RBRVS,0.35 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72083,CPT,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW,TC,,20,,RBRVS,,1.39 ,1.39 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72084,CPT,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW,,,20,,RBRVS,0.41 ,1.82 ,1.82 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72084,CPT,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW,26,,20,,RBRVS,0.41 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72084,CPT,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW,TC,,20,,RBRVS,,1.67 ,1.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72100,CPT,RADEX SPINE LUMBOSACRAL 2/3 VIEWS,,,20,,RBRVS,0.22 ,0.73 ,0.73 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72100,CPT,RADEX SPINE LUMBOSACRAL 2/3 VIEWS,26,,20,,RBRVS,0.22 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72100,CPT,RADEX SPINE LUMBOSACRAL 2/3 VIEWS,TC,,20,,RBRVS,,0.64 ,0.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72110,CPT,RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS,,,20,,RBRVS,0.31 ,1.02 ,1.02 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72110,CPT,RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS,26,,20,,RBRVS,0.31 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72110,CPT,RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS,TC,,20,,RBRVS,,0.90 ,0.90 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72114,CPT,RADEX SPINE LUMBSCRL COMPL W/BENDING VIEWS MIN 6,,,20,,RBRVS,0.32 ,1.39 ,1.39 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72114,CPT,RADEX SPINE LUMBSCRL COMPL W/BENDING VIEWS MIN 6,26,,20,,RBRVS,0.32 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72114,CPT,RADEX SPINE LUMBSCRL COMPL W/BENDING VIEWS MIN 6,TC,,20,,RBRVS,,1.26 ,1.26 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72120,CPT,RADEX SPINE LUMBOSACRAL ONLY BENDING 2/3 VIEWS,,,20,,RBRVS,0.22 ,0.87 ,0.87 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72120,CPT,RADEX SPINE LUMBOSACRAL ONLY BENDING 2/3 VIEWS,26,,20,,RBRVS,0.22 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72120,CPT,RADEX SPINE LUMBOSACRAL ONLY BENDING 2/3 VIEWS,TC,,20,,RBRVS,,0.78 ,0.78 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72125,CPT,CT CERVICAL SPINE W/O CONTRAST MATERIAL,,,20,,RBRVS,1.07 ,4.03 ,4.03 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72125,CPT,CT CERVICAL SPINE W/O CONTRAST MATERIAL,26,,20,,RBRVS,1.07 ,0.40 ,0.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72125,CPT,CT CERVICAL SPINE W/O CONTRAST MATERIAL,TC,,20,,RBRVS,,3.63 ,3.63 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72126,CPT,CT CERVICAL SPINE W/CONTRAST MATERIAL,,,20,,RBRVS,1.22 ,5.12 ,5.12 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72126,CPT,CT CERVICAL SPINE W/CONTRAST MATERIAL,26,,20,,RBRVS,1.22 ,0.45 ,0.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72126,CPT,CT CERVICAL SPINE W/CONTRAST MATERIAL,TC,,20,,RBRVS,,4.67 ,4.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72127,CPT,CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL,,,20,,RBRVS,1.27 ,6.23 ,6.23 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72127,CPT,CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL,26,,20,,RBRVS,1.27 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72127,CPT,CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL,TC,,20,,RBRVS,,5.76 ,5.76 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72128,CPT,CT THORACIC SPINE W/O CONTRAST MATERIAL,,,20,,RBRVS,1.00 ,3.98 ,3.98 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72128,CPT,CT THORACIC SPINE W/O CONTRAST MATERIAL,26,,20,,RBRVS,1.00 ,0.37 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72128,CPT,CT THORACIC SPINE W/O CONTRAST MATERIAL,TC,,20,,RBRVS,,3.61 ,3.61 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72129,CPT,CT THORACIC SPINE W/CONTRAST MATERIAL,,,20,,RBRVS,1.22 ,5.13 ,5.13 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72129,CPT,CT THORACIC SPINE W/CONTRAST MATERIAL,26,,20,,RBRVS,1.22 ,0.45 ,0.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72129,CPT,CT THORACIC SPINE W/CONTRAST MATERIAL,TC,,20,,RBRVS,,4.68 ,4.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72130,CPT,CT THORACIC SPINE W/O & W/CONTRAST MATERIAL,,,20,,RBRVS,1.27 ,6.24 ,6.24 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72130,CPT,CT THORACIC SPINE W/O & W/CONTRAST MATERIAL,26,,20,,RBRVS,1.27 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72130,CPT,CT THORACIC SPINE W/O & W/CONTRAST MATERIAL,TC,,20,,RBRVS,,5.77 ,5.77 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72131,CPT,CT LUMBAR SPINE W/O CONTRAST MATERIAL,,,20,,RBRVS,1.00 ,3.95 ,3.95 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72131,CPT,CT LUMBAR SPINE W/O CONTRAST MATERIAL,26,,20,,RBRVS,1.00 ,0.37 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72131,CPT,CT LUMBAR SPINE W/O CONTRAST MATERIAL,TC,,20,,RBRVS,,3.58 ,3.58 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72132,CPT,CT LUMBAR SPINE W/CONTRAST MATERIAL,,,20,,RBRVS,1.22 ,5.10 ,5.10 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72132,CPT,CT LUMBAR SPINE W/CONTRAST MATERIAL,26,,20,,RBRVS,1.22 ,0.45 ,0.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72132,CPT,CT LUMBAR SPINE W/CONTRAST MATERIAL,TC,,20,,RBRVS,,4.65 ,4.65 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72133,CPT,CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL,,,20,,RBRVS,1.27 ,6.23 ,6.23 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72133,CPT,CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL,26,,20,,RBRVS,1.27 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72133,CPT,CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL,TC,,20,,RBRVS,,5.76 ,5.76 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72141,CPT,MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL,,,20,,RBRVS,1.48 ,4.69 ,4.69 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72141,CPT,MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL,26,,20,,RBRVS,1.48 ,0.55 ,0.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72141,CPT,MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL,TC,,20,,RBRVS,,4.14 ,4.14 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72142,CPT,MRI SPINAL CANAL CERVICAL W/CONTRAST MATRL,,,20,,RBRVS,1.78 ,7.18 ,7.18 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72142,CPT,MRI SPINAL CANAL CERVICAL W/CONTRAST MATRL,26,,20,,RBRVS,1.78 ,0.67 ,0.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72142,CPT,MRI SPINAL CANAL CERVICAL W/CONTRAST MATRL,TC,,20,,RBRVS,,6.51 ,6.51 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72146,CPT,MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL,,,20,,RBRVS,1.48 ,4.69 ,4.69 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72146,CPT,MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL,26,,20,,RBRVS,1.48 ,0.55 ,0.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72146,CPT,MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL,TC,,20,,RBRVS,,4.14 ,4.14 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72147,CPT,MRI SPINAL CANAL THORACIC W/CONTRAST MATRL,,,20,,RBRVS,1.78 ,7.12 ,7.12 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72147,CPT,MRI SPINAL CANAL THORACIC W/CONTRAST MATRL,26,,20,,RBRVS,1.78 ,0.67 ,0.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72147,CPT,MRI SPINAL CANAL THORACIC W/CONTRAST MATRL,TC,,20,,RBRVS,,6.45 ,6.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72148,CPT,MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL,,,20,,RBRVS,1.48 ,4.66 ,4.66 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72148,CPT,MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL,26,,20,,RBRVS,1.48 ,0.56 ,0.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72148,CPT,MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL,TC,,20,,RBRVS,,4.10 ,4.10 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72149,CPT,MRI SPINAL CANAL LUMBAR W/CONTRAST MATERIAL,,,20,,RBRVS,1.78 ,7.07 ,7.07 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72149,CPT,MRI SPINAL CANAL LUMBAR W/CONTRAST MATERIAL,26,,20,,RBRVS,1.78 ,0.67 ,0.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72149,CPT,MRI SPINAL CANAL LUMBAR W/CONTRAST MATERIAL,TC,,20,,RBRVS,,6.40 ,6.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72156,CPT,MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL,,,20,,RBRVS,2.29 ,8.21 ,8.21 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72156,CPT,MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL,26,,20,,RBRVS,2.29 ,0.85 ,0.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72156,CPT,MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL,TC,,20,,RBRVS,,7.36 ,7.36 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72157,CPT,MRI SPINAL CANAL THORACIC W/O & W/CONTR MATRL,,,20,,RBRVS,2.29 ,8.22 ,8.22 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72157,CPT,MRI SPINAL CANAL THORACIC W/O & W/CONTR MATRL,26,,20,,RBRVS,2.29 ,0.85 ,0.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72157,CPT,MRI SPINAL CANAL THORACIC W/O & W/CONTR MATRL,TC,,20,,RBRVS,,7.37 ,7.37 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72158,CPT,MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL,,,20,,RBRVS,2.29 ,8.16 ,8.16 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72158,CPT,MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL,26,,20,,RBRVS,2.29 ,0.85 ,0.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72158,CPT,MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL,TC,,20,,RBRVS,,7.31 ,7.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72159,CPT,MRA SPINAL CANAL W/WO CONTRAST MATERIAL,,,20,,RBRVS,1.80 ,9.77 ,9.77 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72159,CPT,MRA SPINAL CANAL W/WO CONTRAST MATERIAL,26,,20,,RBRVS,1.80 ,0.68 ,0.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72159,CPT,MRA SPINAL CANAL W/WO CONTRAST MATERIAL,TC,,20,,RBRVS,,9.09 ,9.09 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72170,CPT,RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS,,,20,,RBRVS,0.17 ,0.57 ,0.57 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72170,CPT,RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS,26,,20,,RBRVS,0.17 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72170,CPT,RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS,TC,,20,,RBRVS,,0.50 ,0.50 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72190,CPT,RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS,,,20,,RBRVS,0.21 ,0.83 ,0.83 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72190,CPT,RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS,26,,20,,RBRVS,0.21 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72190,CPT,RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS,TC,,20,,RBRVS,,0.74 ,0.74 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72191,CPT,CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST,,,20,,RBRVS,1.81 ,6.60 ,6.60 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72191,CPT,CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST,26,,20,,RBRVS,1.81 ,0.66 ,0.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72191,CPT,CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST,TC,,20,,RBRVS,,5.94 ,5.94 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72192,CPT,CT PELVIS W/O CONTRAST MATERIAL,,,20,,RBRVS,1.09 ,2.95 ,2.95 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72192,CPT,CT PELVIS W/O CONTRAST MATERIAL,26,,20,,RBRVS,1.09 ,0.41 ,0.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72192,CPT,CT PELVIS W/O CONTRAST MATERIAL,TC,,20,,RBRVS,,2.54 ,2.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72193,CPT,CT PELVIS W/CONTRAST MATERIAL,,,20,,RBRVS,1.16 ,5.09 ,5.09 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72193,CPT,CT PELVIS W/CONTRAST MATERIAL,26,,20,,RBRVS,1.16 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72193,CPT,CT PELVIS W/CONTRAST MATERIAL,TC,,20,,RBRVS,,4.66 ,4.66 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72194,CPT,CT PELVIS W/O & W/CONTRAST MATERIAL,,,20,,RBRVS,1.22 ,6.00 ,6.00 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72194,CPT,CT PELVIS W/O & W/CONTRAST MATERIAL,26,,20,,RBRVS,1.22 ,0.45 ,0.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72194,CPT,CT PELVIS W/O & W/CONTRAST MATERIAL,TC,,20,,RBRVS,,5.55 ,5.55 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72195,CPT,MRI PELVIS W/O CONTRAST MATERIAL,,,20,,RBRVS,1.46 ,8.98 ,8.98 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72195,CPT,MRI PELVIS W/O CONTRAST MATERIAL,26,,20,,RBRVS,1.46 ,0.55 ,0.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72195,CPT,MRI PELVIS W/O CONTRAST MATERIAL,TC,,20,,RBRVS,,8.43 ,8.43 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72196,CPT,MRI PELVIS W/CONTRAST MATERIAL,,,20,,RBRVS,1.73 ,9.68 ,9.68 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72196,CPT,MRI PELVIS W/CONTRAST MATERIAL,26,,20,,RBRVS,1.73 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72196,CPT,MRI PELVIS W/CONTRAST MATERIAL,TC,,20,,RBRVS,,9.03 ,9.03 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72197,CPT,MRI PELVIS W/O & W/CONTRAST MATERIAL,,,20,,RBRVS,2.26 ,11.77 ,11.77 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72197,CPT,MRI PELVIS W/O & W/CONTRAST MATERIAL,26,,20,,RBRVS,2.26 ,0.84 ,0.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72197,CPT,MRI PELVIS W/O & W/CONTRAST MATERIAL,TC,,20,,RBRVS,,10.93 ,10.93 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72198,CPT,MRA PELVIS W/WO CONTRAST MATERIAL,,,20,,RBRVS,1.80 ,9.35 ,9.35 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72198,CPT,MRA PELVIS W/WO CONTRAST MATERIAL,26,,20,,RBRVS,1.80 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72198,CPT,MRA PELVIS W/WO CONTRAST MATERIAL,TC,,20,,RBRVS,,8.70 ,8.70 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72200,CPT,RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS,,,20,,RBRVS,0.17 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72200,CPT,RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS,26,,20,,RBRVS,0.17 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72200,CPT,RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS,TC,,20,,RBRVS,,0.53 ,0.53 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72202,CPT,RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS,,,20,,RBRVS,0.19 ,0.71 ,0.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72202,CPT,RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS,26,,20,,RBRVS,0.19 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72202,CPT,RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS,TC,,20,,RBRVS,,0.64 ,0.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72220,CPT,RADEX SACRUM & COCCYX MINIMUM 2 VIEWS,,,20,,RBRVS,0.17 ,0.59 ,0.59 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72220,CPT,RADEX SACRUM & COCCYX MINIMUM 2 VIEWS,26,,20,,RBRVS,0.17 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72220,CPT,RADEX SACRUM & COCCYX MINIMUM 2 VIEWS,TC,,20,,RBRVS,,0.52 ,0.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72240,CPT,MYELOGRAPHY CERVICAL RS&I,,,20,,RBRVS,0.91 ,1.78 ,1.78 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72240,CPT,MYELOGRAPHY CERVICAL RS&I,26,,20,,RBRVS,0.91 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72240,CPT,MYELOGRAPHY CERVICAL RS&I,TC,,20,,RBRVS,,1.44 ,1.44 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72255,CPT,MYELOGRAPHY THORACIC RS&I,,,20,,RBRVS,0.91 ,1.77 ,1.77 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72255,CPT,MYELOGRAPHY THORACIC RS&I,26,,20,,RBRVS,0.91 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72255,CPT,MYELOGRAPHY THORACIC RS&I,TC,,20,,RBRVS,,1.42 ,1.42 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72265,CPT,MYELOGRAPY LUMBOSACRAL RS&I,,,20,,RBRVS,0.83 ,1.69 ,1.69 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72265,CPT,MYELOGRAPY LUMBOSACRAL RS&I,26,,20,,RBRVS,0.83 ,0.31 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72265,CPT,MYELOGRAPY LUMBOSACRAL RS&I,TC,,20,,RBRVS,,1.38 ,1.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72270,CPT,MYELOGRAPY 2/MORE REGIONS RS&I,,,20,,RBRVS,1.33 ,2.16 ,2.16 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72270,CPT,MYELOGRAPY 2/MORE REGIONS RS&I,26,,20,,RBRVS,1.33 ,0.50 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72270,CPT,MYELOGRAPY 2/MORE REGIONS RS&I,TC,,20,,RBRVS,,1.66 ,1.66 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72275,CPT,EPIDUROGRAPY RS&I,,,20,,RBRVS,0.76 ,2.43 ,2.43 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72275,CPT,EPIDUROGRAPY RS&I,26,,20,,RBRVS,0.76 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72275,CPT,EPIDUROGRAPY RS&I,TC,,20,,RBRVS,,2.11 ,2.11 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72285,CPT,DISKOGRAPY CERVICAL/THORACIC RS&I,,,20,,RBRVS,1.16 ,1.97 ,1.97 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72285,CPT,DISKOGRAPY CERVICAL/THORACIC RS&I,26,,20,,RBRVS,1.16 ,0.51 ,0.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72285,CPT,DISKOGRAPY CERVICAL/THORACIC RS&I,TC,,20,,RBRVS,,1.46 ,1.46 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
72295,CPT,DISKOGRAPY LUMBAR RS&I,,,20,,RBRVS,0.83 ,1.87 ,1.87 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
72295,CPT,DISKOGRAPY LUMBAR RS&I,26,,20,,RBRVS,0.83 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
72295,CPT,DISKOGRAPY LUMBAR RS&I,TC,,20,,RBRVS,,1.52 ,1.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73000,CPT,RADEX CLAVICLE COMPLETE,,,20,,RBRVS,0.16 ,0.59 ,0.59 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73000,CPT,RADEX CLAVICLE COMPLETE,26,,20,,RBRVS,0.16 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73000,CPT,RADEX CLAVICLE COMPLETE,TC,,20,,RBRVS,,0.52 ,0.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73010,CPT,RADEX SCAPULA COMPLETE,,,20,,RBRVS,0.17 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73010,CPT,RADEX SCAPULA COMPLETE,26,,20,,RBRVS,0.17 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73010,CPT,RADEX SCAPULA COMPLETE,TC,,20,,RBRVS,,0.56 ,0.56 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73020,CPT,RADEX SHOULDER 1 VIEW,,,20,,RBRVS,0.15 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73020,CPT,RADEX SHOULDER 1 VIEW,26,,20,,RBRVS,0.15 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73020,CPT,RADEX SHOULDER 1 VIEW,TC,,20,,RBRVS,,0.41 ,0.41 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73030,CPT,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,,,20,,RBRVS,0.18 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73030,CPT,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,26,,20,,RBRVS,0.18 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73030,CPT,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,TC,,20,,RBRVS,,0.52 ,0.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73040,CPT,RADEX SHOULDER ARTHROGRAPHY RS&I,,,20,,RBRVS,0.54 ,2.23 ,2.23 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73040,CPT,RADEX SHOULDER ARTHROGRAPHY RS&I,26,,20,,RBRVS,0.54 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73040,CPT,RADEX SHOULDER ARTHROGRAPHY RS&I,TC,,20,,RBRVS,,2.02 ,2.02 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73050,CPT,RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ,,,20,,RBRVS,0.20 ,0.77 ,0.77 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73050,CPT,RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ,26,,20,,RBRVS,0.20 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73050,CPT,RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ,TC,,20,,RBRVS,,0.68 ,0.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73060,CPT,RADEX HUMERUS MINIMUM 2 VIEWS,,,20,,RBRVS,0.17 ,0.55 ,0.55 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73060,CPT,RADEX HUMERUS MINIMUM 2 VIEWS,26,,20,,RBRVS,0.17 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73060,CPT,RADEX HUMERUS MINIMUM 2 VIEWS,TC,,20,,RBRVS,,0.48 ,0.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73070,CPT,RADEX ELBOW 2 VIEWS,,,20,,RBRVS,0.15 ,0.59 ,0.59 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73070,CPT,RADEX ELBOW 2 VIEWS,26,,20,,RBRVS,0.15 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73070,CPT,RADEX ELBOW 2 VIEWS,TC,,20,,RBRVS,,0.52 ,0.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73080,CPT,RADEX ELBOW COMPLETE MINIMUM 3 VIEWS,,,20,,RBRVS,0.17 ,0.68 ,0.68 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73080,CPT,RADEX ELBOW COMPLETE MINIMUM 3 VIEWS,26,,20,,RBRVS,0.17 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73080,CPT,RADEX ELBOW COMPLETE MINIMUM 3 VIEWS,TC,,20,,RBRVS,,0.61 ,0.61 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73085,CPT,RADEX ELBOW ARTHROGRAPHY RS&I,,,20,,RBRVS,0.54 ,2.18 ,2.18 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73085,CPT,RADEX ELBOW ARTHROGRAPHY RS&I,26,,20,,RBRVS,0.54 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73085,CPT,RADEX ELBOW ARTHROGRAPHY RS&I,TC,,20,,RBRVS,,1.94 ,1.94 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73090,CPT,RADEX FOREARM 2 VIEWS,,,20,,RBRVS,0.16 ,0.54 ,0.54 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73090,CPT,RADEX FOREARM 2 VIEWS,26,,20,,RBRVS,0.16 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73090,CPT,RADEX FOREARM 2 VIEWS,TC,,20,,RBRVS,,0.47 ,0.47 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73092,CPT,RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS,,,20,,RBRVS,0.16 ,0.58 ,0.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73092,CPT,RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS,26,,20,,RBRVS,0.16 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73092,CPT,RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS,TC,,20,,RBRVS,,0.52 ,0.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73100,CPT,RADEX WRIST 2 VIEWS,,,20,,RBRVS,0.16 ,0.63 ,0.63 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73100,CPT,RADEX WRIST 2 VIEWS,26,,20,,RBRVS,0.16 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73100,CPT,RADEX WRIST 2 VIEWS,TC,,20,,RBRVS,,0.56 ,0.56 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73110,CPT,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,,,20,,RBRVS,0.17 ,0.79 ,0.79 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73110,CPT,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,26,,20,,RBRVS,0.17 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73110,CPT,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,TC,,20,,RBRVS,,0.72 ,0.72 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73115,CPT,RADEX WRIST ARTHROGRAPHY RS&I,,,20,,RBRVS,0.54 ,2.41 ,2.41 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73115,CPT,RADEX WRIST ARTHROGRAPHY RS&I,26,,20,,RBRVS,0.54 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73115,CPT,RADEX WRIST ARTHROGRAPHY RS&I,TC,,20,,RBRVS,,2.18 ,2.18 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73120,CPT,RADEX HAND 2 VIEWS,,,20,,RBRVS,0.16 ,0.55 ,0.55 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73120,CPT,RADEX HAND 2 VIEWS,26,,20,,RBRVS,0.16 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73120,CPT,RADEX HAND 2 VIEWS,TC,,20,,RBRVS,,0.48 ,0.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73130,CPT,RADEX HAND MINIMUM 3 VIEWS,,,20,,RBRVS,0.17 ,0.66 ,0.66 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73130,CPT,RADEX HAND MINIMUM 3 VIEWS,26,,20,,RBRVS,0.17 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73130,CPT,RADEX HAND MINIMUM 3 VIEWS,TC,,20,,RBRVS,,0.59 ,0.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73140,CPT,RADEX FINGR MINIMUM 2 VIEWS,,,20,,RBRVS,0.13 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73140,CPT,RADEX FINGR MINIMUM 2 VIEWS,26,,20,,RBRVS,0.13 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73140,CPT,RADEX FINGR MINIMUM 2 VIEWS,TC,,20,,RBRVS,,0.66 ,0.66 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73200,CPT,CT UPPER EXTREMITY W/O CONTRAST MATERIAL,,,20,,RBRVS,1.00 ,3.95 ,3.95 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73200,CPT,CT UPPER EXTREMITY W/O CONTRAST MATERIAL,26,,20,,RBRVS,1.00 ,0.37 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73200,CPT,CT UPPER EXTREMITY W/O CONTRAST MATERIAL,TC,,20,,RBRVS,,3.58 ,3.58 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73201,CPT,CT UPPER EXTREMITY W/CONTRAST MATERIAL,,,20,,RBRVS,1.16 ,5.00 ,5.00 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73201,CPT,CT UPPER EXTREMITY W/CONTRAST MATERIAL,26,,20,,RBRVS,1.16 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73201,CPT,CT UPPER EXTREMITY W/CONTRAST MATERIAL,TC,,20,,RBRVS,,4.57 ,4.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73202,CPT,CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL,,,20,,RBRVS,1.22 ,6.49 ,6.49 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73202,CPT,CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL,26,,20,,RBRVS,1.22 ,0.45 ,0.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73202,CPT,CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL,TC,,20,,RBRVS,,6.04 ,6.04 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73206,CPT,CT ANGIOGRAPHY UPPER EXTREMITY,,,20,,RBRVS,1.81 ,7.22 ,7.22 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73206,CPT,CT ANGIOGRAPHY UPPER EXTREMITY,26,,20,,RBRVS,1.81 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73206,CPT,CT ANGIOGRAPHY UPPER EXTREMITY,TC,,20,,RBRVS,,6.57 ,6.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73218,CPT,MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL,,,20,,RBRVS,1.35 ,8.77 ,8.77 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73218,CPT,MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL,26,,20,,RBRVS,1.35 ,0.50 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73218,CPT,MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL,TC,,20,,RBRVS,,8.27 ,8.27 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73219,CPT,MRI UPPER EXTREMITY OTH THAN JT W/CONTR MATRL,,,20,,RBRVS,1.62 ,9.57 ,9.57 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73219,CPT,MRI UPPER EXTREMITY OTH THAN JT W/CONTR MATRL,26,,20,,RBRVS,1.62 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73219,CPT,MRI UPPER EXTREMITY OTH THAN JT W/CONTR MATRL,TC,,20,,RBRVS,,8.97 ,8.97 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73220,CPT,MRI UPPER EXTREM OTHER THAN JT W/O & W/CONTRAS,,,20,,RBRVS,2.15 ,11.71 ,11.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73220,CPT,MRI UPPER EXTREM OTHER THAN JT W/O & W/CONTRAS,26,,20,,RBRVS,2.15 ,0.80 ,0.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73220,CPT,MRI UPPER EXTREM OTHER THAN JT W/O & W/CONTRAS,TC,,20,,RBRVS,,10.91 ,10.91 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73221,CPT,MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL,,,20,,RBRVS,1.35 ,5.17 ,5.17 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73221,CPT,MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL,26,,20,,RBRVS,1.35 ,0.52 ,0.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73221,CPT,MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL,TC,,20,,RBRVS,,4.65 ,4.65 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73222,CPT,MRI ANY JT UPPER EXTREMITY W/CONTRAST MATRL,,,20,,RBRVS,1.62 ,8.89 ,8.89 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73222,CPT,MRI ANY JT UPPER EXTREMITY W/CONTRAST MATRL,26,,20,,RBRVS,1.62 ,0.61 ,0.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73222,CPT,MRI ANY JT UPPER EXTREMITY W/CONTRAST MATRL,TC,,20,,RBRVS,,8.28 ,8.28 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73223,CPT,MRI ANY JT UPPER EXTREMITY W/O & W/CONTR MATRL,,,20,,RBRVS,2.15 ,10.86 ,10.86 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73223,CPT,MRI ANY JT UPPER EXTREMITY W/O & W/CONTR MATRL,26,,20,,RBRVS,2.15 ,0.80 ,0.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73223,CPT,MRI ANY JT UPPER EXTREMITY W/O & W/CONTR MATRL,TC,,20,,RBRVS,,10.06 ,10.06 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73225,CPT,MRA UPPER EXTREMITY W/WO CONTRAST MATERIAL,,,20,,RBRVS,1.73 ,9.46 ,9.46 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73225,CPT,MRA UPPER EXTREMITY W/WO CONTRAST MATERIAL,26,,20,,RBRVS,1.73 ,0.59 ,0.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73225,CPT,MRA UPPER EXTREMITY W/WO CONTRAST MATERIAL,TC,,20,,RBRVS,,8.87 ,8.87 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73501,CPT,RADEX HIP UNILATERAL WITH PELVIS 1 VIEW,,,20,,RBRVS,0.18 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73501,CPT,RADEX HIP UNILATERAL WITH PELVIS 1 VIEW,26,,20,,RBRVS,0.18 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73501,CPT,RADEX HIP UNILATERAL WITH PELVIS 1 VIEW,TC,,20,,RBRVS,,0.56 ,0.56 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73502,CPT,RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS,,,20,,RBRVS,0.22 ,0.92 ,0.92 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73502,CPT,RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS,26,,20,,RBRVS,0.22 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73502,CPT,RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS,TC,,20,,RBRVS,,0.83 ,0.83 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73503,CPT,RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS,,,20,,RBRVS,0.27 ,1.15 ,1.15 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73503,CPT,RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS,26,,20,,RBRVS,0.27 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73503,CPT,RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS,TC,,20,,RBRVS,,1.03 ,1.03 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73521,CPT,RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS,,,20,,RBRVS,0.22 ,0.88 ,0.88 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73521,CPT,RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS,26,,20,,RBRVS,0.22 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73521,CPT,RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS,TC,,20,,RBRVS,,0.78 ,0.78 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73522,CPT,RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS,,,20,,RBRVS,0.29 ,1.05 ,1.05 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73522,CPT,RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS,26,,20,,RBRVS,0.29 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73522,CPT,RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS,TC,,20,,RBRVS,,0.93 ,0.93 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73523,CPT,RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS,,,20,,RBRVS,0.31 ,1.25 ,1.25 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73523,CPT,RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS,26,,20,,RBRVS,0.31 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73523,CPT,RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS,TC,,20,,RBRVS,,1.12 ,1.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73525,CPT,RADEX HIP ARTHROGRAPHY RS&I,,,20,,RBRVS,0.54 ,2.26 ,2.26 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73525,CPT,RADEX HIP ARTHROGRAPHY RS&I,26,,20,,RBRVS,0.54 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73525,CPT,RADEX HIP ARTHROGRAPHY RS&I,TC,,20,,RBRVS,,2.02 ,2.02 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73551,CPT,RADIOLOGIC EXAMINATION FEMUR 1 VIEW,,,20,,RBRVS,0.16 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73551,CPT,RADIOLOGIC EXAMINATION FEMUR 1 VIEW,26,,20,,RBRVS,0.16 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73551,CPT,RADIOLOGIC EXAMINATION FEMUR 1 VIEW,TC,,20,,RBRVS,,0.53 ,0.53 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73552,CPT,RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS,,,20,,RBRVS,0.18 ,0.71 ,0.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73552,CPT,RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS,26,,20,,RBRVS,0.18 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73552,CPT,RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS,TC,,20,,RBRVS,,0.63 ,0.63 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73560,CPT,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,,,20,,RBRVS,0.17 ,0.62 ,0.62 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73560,CPT,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,26,,20,,RBRVS,0.17 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73560,CPT,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,TC,,20,,RBRVS,,0.54 ,0.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73562,CPT,RADIOLOGIC EXAMINATION KNEE 3 VIEWS,,,20,,RBRVS,0.18 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73562,CPT,RADIOLOGIC EXAMINATION KNEE 3 VIEWS,26,,20,,RBRVS,0.18 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73562,CPT,RADIOLOGIC EXAMINATION KNEE 3 VIEWS,TC,,20,,RBRVS,,0.67 ,0.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73564,CPT,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,,,20,,RBRVS,0.22 ,0.86 ,0.86 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73564,CPT,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,26,,20,,RBRVS,0.22 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73564,CPT,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,TC,,20,,RBRVS,,0.77 ,0.77 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73565,CPT,RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST,,,20,,RBRVS,0.17 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73565,CPT,RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST,26,,20,,RBRVS,0.17 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73565,CPT,RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST,TC,,20,,RBRVS,,0.64 ,0.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73580,CPT,RADIOLOGIC EXAM KNEE ARTHROGRAPHY RS&I,,,20,,RBRVS,0.54 ,2.64 ,2.64 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73580,CPT,RADIOLOGIC EXAM KNEE ARTHROGRAPHY RS&I,26,,20,,RBRVS,0.54 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73580,CPT,RADIOLOGIC EXAM KNEE ARTHROGRAPHY RS&I,TC,,20,,RBRVS,,2.41 ,2.41 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73590,CPT,RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS,,,20,,RBRVS,0.17 ,0.55 ,0.55 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73590,CPT,RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS,26,,20,,RBRVS,0.17 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73590,CPT,RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS,TC,,20,,RBRVS,,0.48 ,0.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73592,CPT,RADEX LOWER EXTREMITY INFANT MINIMUM 2 VIEWS,,,20,,RBRVS,0.16 ,0.58 ,0.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73592,CPT,RADEX LOWER EXTREMITY INFANT MINIMUM 2 VIEWS,26,,20,,RBRVS,0.16 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73592,CPT,RADEX LOWER EXTREMITY INFANT MINIMUM 2 VIEWS,TC,,20,,RBRVS,,0.52 ,0.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73600,CPT,RADIOLOGIC EXAMINATION ANKLE 2 VIEWS,,,20,,RBRVS,0.16 ,0.58 ,0.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73600,CPT,RADIOLOGIC EXAMINATION ANKLE 2 VIEWS,26,,20,,RBRVS,0.16 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73600,CPT,RADIOLOGIC EXAMINATION ANKLE 2 VIEWS,TC,,20,,RBRVS,,0.51 ,0.51 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73610,CPT,RADEX ANKLE COMPLETE MINIMUM 3 VIEWS,,,20,,RBRVS,0.17 ,0.68 ,0.68 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73610,CPT,RADEX ANKLE COMPLETE MINIMUM 3 VIEWS,26,,20,,RBRVS,0.17 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73610,CPT,RADEX ANKLE COMPLETE MINIMUM 3 VIEWS,TC,,20,,RBRVS,,0.61 ,0.61 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73615,CPT,RADEX ANKLE ARTHROGRAPHY RS&I,,,20,,RBRVS,0.54 ,2.17 ,2.17 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73615,CPT,RADEX ANKLE ARTHROGRAPHY RS&I,26,,20,,RBRVS,0.54 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73615,CPT,RADEX ANKLE ARTHROGRAPHY RS&I,TC,,20,,RBRVS,,1.93 ,1.93 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73620,CPT,RADIOLOGIC EXAMINATION FOOT 2 VIEWS,,,20,,RBRVS,0.16 ,0.54 ,0.54 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73620,CPT,RADIOLOGIC EXAMINATION FOOT 2 VIEWS,26,,20,,RBRVS,0.16 ,0.05 ,0.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73620,CPT,RADIOLOGIC EXAMINATION FOOT 2 VIEWS,TC,,20,,RBRVS,,0.49 ,0.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73630,CPT,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,,,20,,RBRVS,0.17 ,0.62 ,0.62 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73630,CPT,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,26,,20,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73630,CPT,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,TC,,20,,RBRVS,,0.56 ,0.56 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73650,CPT,RADEX CALCANEUS MINIMUM 2 VIEWS,,,20,,RBRVS,0.16 ,0.57 ,0.57 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73650,CPT,RADEX CALCANEUS MINIMUM 2 VIEWS,26,,20,,RBRVS,0.16 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73650,CPT,RADEX CALCANEUS MINIMUM 2 VIEWS,TC,,20,,RBRVS,,0.51 ,0.51 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73660,CPT,RADEX TOE MINIMUM 2 VIEWS,,,20,,RBRVS,0.13 ,0.63 ,0.63 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73660,CPT,RADEX TOE MINIMUM 2 VIEWS,26,,20,,RBRVS,0.13 ,0.05 ,0.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73660,CPT,RADEX TOE MINIMUM 2 VIEWS,TC,,20,,RBRVS,,0.58 ,0.58 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73700,CPT,CT LOWER EXTREMITY W/O CONTRAST MATERIAL,,,20,,RBRVS,1.00 ,3.95 ,3.95 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73700,CPT,CT LOWER EXTREMITY W/O CONTRAST MATERIAL,26,,20,,RBRVS,1.00 ,0.37 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73700,CPT,CT LOWER EXTREMITY W/O CONTRAST MATERIAL,TC,,20,,RBRVS,,3.58 ,3.58 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73701,CPT,CT LOWER EXTREMITY W/CONTRAST MATERIAL,,,20,,RBRVS,1.16 ,5.09 ,5.09 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73701,CPT,CT LOWER EXTREMITY W/CONTRAST MATERIAL,26,,20,,RBRVS,1.16 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73701,CPT,CT LOWER EXTREMITY W/CONTRAST MATERIAL,TC,,20,,RBRVS,,4.66 ,4.66 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73702,CPT,CT LOWER EXTREMITY W/O & W/CONTRAST MATRL,,,20,,RBRVS,1.22 ,6.37 ,6.37 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73702,CPT,CT LOWER EXTREMITY W/O & W/CONTRAST MATRL,26,,20,,RBRVS,1.22 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73702,CPT,CT LOWER EXTREMITY W/O & W/CONTRAST MATRL,TC,,20,,RBRVS,,5.93 ,5.93 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73706,CPT,CT ANGIOGRAPHY LOWER EXTREMITY,,,20,,RBRVS,1.90 ,7.83 ,7.83 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73706,CPT,CT ANGIOGRAPHY LOWER EXTREMITY,26,,20,,RBRVS,1.90 ,0.69 ,0.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73706,CPT,CT ANGIOGRAPHY LOWER EXTREMITY,TC,,20,,RBRVS,,7.14 ,7.14 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73718,CPT,MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL,,,20,,RBRVS,1.35 ,8.79 ,8.79 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73718,CPT,MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL,26,,20,,RBRVS,1.35 ,0.50 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73718,CPT,MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL,TC,,20,,RBRVS,,8.29 ,8.29 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73719,CPT,MRI LOWER EXTREM OTH/THN JT W/CONTRAST MATRL,,,20,,RBRVS,1.62 ,9.61 ,9.61 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73719,CPT,MRI LOWER EXTREM OTH/THN JT W/CONTRAST MATRL,26,,20,,RBRVS,1.62 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73719,CPT,MRI LOWER EXTREM OTH/THN JT W/CONTRAST MATRL,TC,,20,,RBRVS,,9.01 ,9.01 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73720,CPT,MRI LOWER EXTREM OTH/THN JT W/O & W/CONTR MATR,,,20,,RBRVS,2.15 ,11.80 ,11.80 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73720,CPT,MRI LOWER EXTREM OTH/THN JT W/O & W/CONTR MATR,26,,20,,RBRVS,2.15 ,0.80 ,0.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73720,CPT,MRI LOWER EXTREM OTH/THN JT W/O & W/CONTR MATR,TC,,20,,RBRVS,,11.00 ,11.00 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73721,CPT,MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL,,,20,,RBRVS,1.35 ,5.16 ,5.16 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73721,CPT,MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL,26,,20,,RBRVS,1.35 ,0.51 ,0.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73721,CPT,MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL,TC,,20,,RBRVS,,4.65 ,4.65 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73722,CPT,MRI ANY JT LOWER EXTREM W/CONTRAST MATERIAL,,,20,,RBRVS,1.62 ,8.97 ,8.97 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73722,CPT,MRI ANY JT LOWER EXTREM W/CONTRAST MATERIAL,26,,20,,RBRVS,1.62 ,0.61 ,0.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73722,CPT,MRI ANY JT LOWER EXTREM W/CONTRAST MATERIAL,TC,,20,,RBRVS,,8.36 ,8.36 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73723,CPT,MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL,,,20,,RBRVS,2.15 ,10.92 ,10.92 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73723,CPT,MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL,26,,20,,RBRVS,2.15 ,0.80 ,0.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73723,CPT,MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL,TC,,20,,RBRVS,,10.12 ,10.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
73725,CPT,MRA LOWER EXTREMITY W/WO CONTRAST MATERIAL,,,20,,RBRVS,1.82 ,9.36 ,9.36 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
73725,CPT,MRA LOWER EXTREMITY W/WO CONTRAST MATERIAL,26,,20,,RBRVS,1.82 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
73725,CPT,MRA LOWER EXTREMITY W/WO CONTRAST MATERIAL,TC,,20,,RBRVS,,8.71 ,8.71 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74000,CPT,RADEX ABDOMEN 1 ANTEROPOSTERIOR VIEW,,,20,,RBRVS,0.18 ,0.46 ,0.46 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74000,CPT,RADEX ABDOMEN 1 ANTEROPOSTERIOR VIEW,26,,20,,RBRVS,0.18 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74000,CPT,RADEX ABDOMEN 1 ANTEROPOSTERIOR VIEW,TC,,20,,RBRVS,,0.39 ,0.39 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74010,CPT,RADEX ABD ANTEROPOST&ADDL OBLQ&CONE VIEWS,,,20,,RBRVS,0.23 ,0.73 ,0.73 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74010,CPT,RADEX ABD ANTEROPOST&ADDL OBLQ&CONE VIEWS,26,,20,,RBRVS,0.23 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74010,CPT,RADEX ABD ANTEROPOST&ADDL OBLQ&CONE VIEWS,TC,,20,,RBRVS,,0.64 ,0.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74020,CPT,RADEX ABDOMEN COMPL W/DCBTS&/ERC VIEWS,,,20,,RBRVS,0.27 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74020,CPT,RADEX ABDOMEN COMPL W/DCBTS&/ERC VIEWS,26,,20,,RBRVS,0.27 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74020,CPT,RADEX ABDOMEN COMPL W/DCBTS&/ERC VIEWS,TC,,20,,RBRVS,,0.65 ,0.65 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74022,CPT,RADEX ABD COMPL AQT ABD W/S/E/D VIEWS 1 VIEW CH,,,20,,RBRVS,0.32 ,0.89 ,0.89 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
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,$0.00,1,0,1,1,1,1,20161001,,,,
74022,CPT,RADEX ABD COMPL AQT ABD W/S/E/D VIEWS 1 VIEW CH,TC,,20,,RBRVS,,0.77 ,0.77 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74150,CPT,CT ABDOMEN W/O CONTRAST MATERIAL,,,20,,RBRVS,1.19 ,2.94 ,2.94 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74150,CPT,CT ABDOMEN W/O CONTRAST MATERIAL,26,,20,,RBRVS,1.19 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74150,CPT,CT ABDOMEN W/O CONTRAST MATERIAL,TC,,20,,RBRVS,,2.50 ,2.50 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74160,CPT,CT ABDOMEN W/CONTRAST MATERIAL,,,20,,RBRVS,1.27 ,5.12 ,5.12 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74160,CPT,CT ABDOMEN W/CONTRAST MATERIAL,26,,20,,RBRVS,1.27 ,0.48 ,0.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74160,CPT,CT ABDOMEN W/CONTRAST MATERIAL,TC,,20,,RBRVS,,4.64 ,4.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74170,CPT,CT ABDOMEN W/O & W/CONTRAST MATERIAL,,,20,,RBRVS,1.40 ,5.87 ,5.87 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74170,CPT,CT ABDOMEN W/O & W/CONTRAST MATERIAL,26,,20,,RBRVS,1.40 ,0.52 ,0.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74170,CPT,CT ABDOMEN W/O & W/CONTRAST MATERIAL,TC,,20,,RBRVS,,5.35 ,5.35 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74174,CPT,CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMG,,,20,,RBRVS,2.20 ,8.54 ,8.54 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74174,CPT,CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMG,26,,20,,RBRVS,2.20 ,0.79 ,0.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74174,CPT,CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMG,TC,,20,,RBRVS,,7.75 ,7.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74175,CPT,CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST,,,20,,RBRVS,1.82 ,6.66 ,6.66 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74175,CPT,CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST,26,,20,,RBRVS,1.82 ,0.66 ,0.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74175,CPT,CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST,TC,,20,,RBRVS,,6.00 ,6.00 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74176,CPT,CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL,,,20,,RBRVS,1.74 ,3.77 ,3.77 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74176,CPT,CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL,26,,20,,RBRVS,1.74 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74176,CPT,CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL,TC,,20,,RBRVS,,3.12 ,3.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74177,CPT,CT ABDOMEN & PELVIS W/CONTRAST MATERIAL,,,20,,RBRVS,1.82 ,6.80 ,6.80 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74177,CPT,CT ABDOMEN & PELVIS W/CONTRAST MATERIAL,26,,20,,RBRVS,1.82 ,0.68 ,0.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74177,CPT,CT ABDOMEN & PELVIS W/CONTRAST MATERIAL,TC,,20,,RBRVS,,6.12 ,6.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74178,CPT,CT ABDOMEN & PELVIS W/O CONTRST 1/> BODY RE,,,20,,RBRVS,2.01 ,7.76 ,7.76 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74178,CPT,CT ABDOMEN & PELVIS W/O CONTRST 1/> BODY RE,26,,20,,RBRVS,2.01 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74178,CPT,CT ABDOMEN & PELVIS W/O CONTRST 1/> BODY RE,TC,,20,,RBRVS,,7.01 ,7.01 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74181,CPT,MRI ABDOMEN W/O CONTRAST MATERIAL,,,20,,RBRVS,1.46 ,7.78 ,7.78 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74181,CPT,MRI ABDOMEN W/O CONTRAST MATERIAL,26,,20,,RBRVS,1.46 ,0.54 ,0.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74181,CPT,MRI ABDOMEN W/O CONTRAST MATERIAL,TC,,20,,RBRVS,,7.24 ,7.24 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74182,CPT,MRI ABDOMEN W/CONTRAST MATERIAL,,,20,,RBRVS,1.73 ,10.90 ,10.90 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74182,CPT,MRI ABDOMEN W/CONTRAST MATERIAL,26,,20,,RBRVS,1.73 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74182,CPT,MRI ABDOMEN W/CONTRAST MATERIAL,TC,,20,,RBRVS,,10.26 ,10.26 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74183,CPT,MRI ABDOMEN W/O & W/CONTRAST MATERIAL,,,20,,RBRVS,2.26 ,11.80 ,11.80 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74183,CPT,MRI ABDOMEN W/O & W/CONTRAST MATERIAL,26,,20,,RBRVS,2.26 ,0.84 ,0.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74183,CPT,MRI ABDOMEN W/O & W/CONTRAST MATERIAL,TC,,20,,RBRVS,,10.96 ,10.96 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74185,CPT,MRA ABDOMEN W/WO CONTRAST MATERIAL,,,20,,RBRVS,1.80 ,9.38 ,9.38 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74185,CPT,MRA ABDOMEN W/WO CONTRAST MATERIAL,26,,20,,RBRVS,1.80 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74185,CPT,MRA ABDOMEN W/WO CONTRAST MATERIAL,TC,,20,,RBRVS,,8.73 ,8.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74190,CPT,PERITONEOGRAM RS&I,,,20,,TotalUnits,,,,1.37 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74190,CPT,PERITONEOGRAM RS&I,26,,20,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74190,CPT,PERITONEOGRAM RS&I,TC,,20,,TotalUnits,,,,0.73 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74210,CPT,RADEX PHARYNX&/CERVICAL ESOPHAGUS,,,20,,RBRVS,0.36 ,1.78 ,1.78 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74210,CPT,RADEX PHARYNX&/CERVICAL ESOPHAGUS,26,,20,,RBRVS,0.36 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74210,CPT,RADEX PHARYNX&/CERVICAL ESOPHAGUS,TC,,20,,RBRVS,,1.65 ,1.65 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74220,CPT,RADEX ESOPHAGUS,,,20,,RBRVS,0.46 ,1.98 ,1.98 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74220,CPT,RADEX ESOPHAGUS,26,,20,,RBRVS,0.46 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74220,CPT,RADEX ESOPHAGUS,TC,,20,,RBRVS,,1.81 ,1.81 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74230,CPT,SWALLOWING FUNCJ W/CINERADIOGRAPY/VIDRADIOG,,,20,,RBRVS,0.53 ,3.03 ,3.03 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74230,CPT,SWALLOWING FUNCJ W/CINERADIOGRAPY/VIDRADIOG,26,,20,,RBRVS,0.53 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74230,CPT,SWALLOWING FUNCJ W/CINERADIOGRAPY/VIDRADIOG,TC,,20,,RBRVS,,2.83 ,2.83 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74235,CPT,RMVL FB ESOPHAGEAL W/USE BALLOON CATH RS&I,,,20,,TotalUnits,,,,4.99 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74235,CPT,RMVL FB ESOPHAGEAL W/USE BALLOON CATH RS&I,26,,20,,TotalUnits,,,,1.73 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74235,CPT,RMVL FB ESOPHAGEAL W/USE BALLOON CATH RS&I,TC,,20,,TotalUnits,,,,3.26 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74240,CPT,RADEX GI TRACT UPPER W/WO DELAYED IMAGES W/O KUB,,,20,,RBRVS,0.69 ,2.44 ,2.44 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74240,CPT,RADEX GI TRACT UPPER W/WO DELAYED IMAGES W/O KUB,26,,20,,RBRVS,0.69 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74240,CPT,RADEX GI TRACT UPPER W/WO DELAYED IMAGES W/O KUB,TC,,20,,RBRVS,,2.18 ,2.18 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74241,CPT,RADEX GI TRACT UPPER W/WO DELAYED IMAGES W/KUB,,,20,,RBRVS,0.69 ,2.56 ,2.56 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74241,CPT,RADEX GI TRACT UPPER W/WO DELAYED IMAGES W/KUB,26,,20,,RBRVS,0.69 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74241,CPT,RADEX GI TRACT UPPER W/WO DELAYED IMAGES W/KUB,TC,,20,,RBRVS,,2.30 ,2.30 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74245,CPT,RADEX GI TRACT UPR W/SM INT W/MULT SERIAL IMAGES,,,20,,RBRVS,0.91 ,3.83 ,3.83 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74245,CPT,RADEX GI TRACT UPR W/SM INT W/MULT SERIAL IMAGES,26,,20,,RBRVS,0.91 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74245,CPT,RADEX GI TRACT UPR W/SM INT W/MULT SERIAL IMAGES,TC,,20,,RBRVS,,3.49 ,3.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74246,CPT,RADEX UPPER GI W/WO GLUCAGON/DELAY IMGES W/O KUB,,,20,,RBRVS,0.69 ,2.83 ,2.83 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74246,CPT,RADEX UPPER GI W/WO GLUCAGON/DELAY IMGES W/O KUB,26,,20,,RBRVS,0.69 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74246,CPT,RADEX UPPER GI W/WO GLUCAGON/DELAY IMGES W/O KUB,TC,,20,,RBRVS,,2.57 ,2.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74247,CPT,RADEX UPPER GI W/WO GLUCAGON/DELAY IMAGES W/KUB,,,20,,RBRVS,0.69 ,3.21 ,3.21 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74247,CPT,RADEX UPPER GI W/WO GLUCAGON/DELAY IMAGES W/KUB,26,,20,,RBRVS,0.69 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74247,CPT,RADEX UPPER GI W/WO GLUCAGON/DELAY IMAGES W/KUB,TC,,20,,RBRVS,,2.95 ,2.95 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74249,CPT,RADEX GI UPR W/WO GLUCOSE W/SM INTEST FOLLW-THRU,,,20,,RBRVS,0.91 ,4.17 ,4.17 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74249,CPT,RADEX GI UPR W/WO GLUCOSE W/SM INTEST FOLLW-THRU,26,,20,,RBRVS,0.91 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74249,CPT,RADEX GI UPR W/WO GLUCOSE W/SM INTEST FOLLW-THRU,TC,,20,,RBRVS,,3.83 ,3.83 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74250,CPT,RADEX SMALL INTESTINE W/MULTIPLE SERIAL IMAGES,,,20,,RBRVS,0.47 ,2.41 ,2.41 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74250,CPT,RADEX SMALL INTESTINE W/MULTIPLE SERIAL IMAGES,26,,20,,RBRVS,0.47 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74250,CPT,RADEX SMALL INTESTINE W/MULTIPLE SERIAL IMAGES,TC,,20,,RBRVS,,2.23 ,2.23 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74251,CPT,RADEX SM INT W/MLT SRL IMGES VIA ENTEROCLSS TUBE,,,20,,RBRVS,0.69 ,10.99 ,10.99 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74251,CPT,RADEX SM INT W/MLT SRL IMGES VIA ENTEROCLSS TUBE,26,,20,,RBRVS,0.69 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74251,CPT,RADEX SM INT W/MLT SRL IMGES VIA ENTEROCLSS TUBE,TC,,20,,RBRVS,,10.73 ,10.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74260,CPT,DUODENOGRAPY HYPOTONIC,,,20,,RBRVS,0.50 ,9.26 ,9.26 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74260,CPT,DUODENOGRAPY HYPOTONIC,26,,20,,RBRVS,0.50 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74260,CPT,DUODENOGRAPY HYPOTONIC,TC,,20,,RBRVS,,9.07 ,9.07 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74261,CPT,CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST,,,20,,RBRVS,2.40 ,11.07 ,11.07 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74261,CPT,CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST,26,,20,,RBRVS,2.40 ,0.90 ,0.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74261,CPT,CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST,TC,,20,,RBRVS,,10.17 ,10.17 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74262,CPT,CT COLONOGRPHY DX IMAGE POSTPROCESS W/CONTRAST,,,20,,RBRVS,2.50 ,12.57 ,12.57 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74262,CPT,CT COLONOGRPHY DX IMAGE POSTPROCESS W/CONTRAST,26,,20,,RBRVS,2.50 ,0.93 ,0.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74262,CPT,CT COLONOGRPHY DX IMAGE POSTPROCESS W/CONTRAST,TC,,20,,RBRVS,,11.64 ,11.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74263,CPT,CT COLONOGRAPHY SCREENING IMAGE POSTPROCESSING,,,20,,RBRVS,2.28 ,18.78 ,18.78 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74263,CPT,CT COLONOGRAPHY SCREENING IMAGE POSTPROCESSING,26,,20,,RBRVS,2.28 ,0.87 ,0.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74263,CPT,CT COLONOGRAPHY SCREENING IMAGE POSTPROCESSING,TC,,20,,RBRVS,,17.91 ,17.91 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74270,CPT,RADEX COLON BARIUM ENEMA W/WO KUB,,,20,,RBRVS,0.69 ,3.46 ,3.46 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74270,CPT,RADEX COLON BARIUM ENEMA W/WO KUB,26,,20,,RBRVS,0.69 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74270,CPT,RADEX COLON BARIUM ENEMA W/WO KUB,TC,,20,,RBRVS,,3.20 ,3.20 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74280,CPT,RADEX COLON W/SPEC HI DNS BARIUM W/WO GLUCAGON,,,20,,RBRVS,0.99 ,4.89 ,4.89 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74280,CPT,RADEX COLON W/SPEC HI DNS BARIUM W/WO GLUCAGON,26,,20,,RBRVS,0.99 ,0.37 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74280,CPT,RADEX COLON W/SPEC HI DNS BARIUM W/WO GLUCAGON,TC,,20,,RBRVS,,4.52 ,4.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74283,CPT,THERAPEUTIC ENEMA RDCTJ INTUSSUSCEPTION/OBSTRCJ,,,20,,RBRVS,2.02 ,3.61 ,3.61 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74283,CPT,THERAPEUTIC ENEMA RDCTJ INTUSSUSCEPTION/OBSTRCJ,26,,20,,RBRVS,2.02 ,0.77 ,0.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74283,CPT,THERAPEUTIC ENEMA RDCTJ INTUSSUSCEPTION/OBSTRCJ,TC,,20,,RBRVS,,2.84 ,2.84 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74290,CPT,CHOLECYSTOGRAPHY ORAL CONTRST,,,20,,RBRVS,0.32 ,1.61 ,1.61 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74290,CPT,CHOLECYSTOGRAPHY ORAL CONTRST,26,,20,,RBRVS,0.32 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74290,CPT,CHOLECYSTOGRAPHY ORAL CONTRST,TC,,20,,RBRVS,,1.49 ,1.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74300,CPT,CHOLANGIOGRAPHY&/PANCREATOGRAPHY NTRAOP RS&I,,,20,,TotalUnits,,,,1.54 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74300,CPT,CHOLANGIOGRAPHY&/PANCREATOGRAPHY NTRAOP RS&I,26,,20,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74300,CPT,CHOLANGIOGRAPHY&/PANCREATOGRAPHY NTRAOP RS&I,TC,,20,,TotalUnits,,,,1.05 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74301,CPT,CHOLANGIO&/PANCREATOGRAPHY ADDL SET INTRAOP RS,,,20,,TotalUnits,,,,1.05 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74301,CPT,CHOLANGIO&/PANCREATOGRAPHY ADDL SET INTRAOP RS,26,,20,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74301,CPT,CHOLANGIO&/PANCREATOGRAPHY ADDL SET INTRAOP RS,TC,,20,,TotalUnits,,,,0.77 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74328,CPT,ENDOSCOPIC CATHJ BILIARY DUCTAL SYSTEM RS&I,,,20,,TotalUnits,,,,3.66 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74328,CPT,ENDOSCOPIC CATHJ BILIARY DUCTAL SYSTEM RS&I,26,,20,,TotalUnits,,,,0.98 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74328,CPT,ENDOSCOPIC CATHJ BILIARY DUCTAL SYSTEM RS&I,TC,,20,,TotalUnits,,,,2.68 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74329,CPT,ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS RS&I,,,20,,TotalUnits,,,,2.98 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74329,CPT,ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS RS&I,26,,20,,TotalUnits,,,,0.98 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74329,CPT,ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS RS&I,TC,,20,,TotalUnits,,,,2.00 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74330,CPT,CMBN NDSC CATHJ BILIARY&PNCRTC DUCTAL SYS RS&I,,,20,,TotalUnits,,,,4.47 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74330,CPT,CMBN NDSC CATHJ BILIARY&PNCRTC DUCTAL SYS RS&I,26,,20,,TotalUnits,,,,1.25 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74330,CPT,CMBN NDSC CATHJ BILIARY&PNCRTC DUCTAL SYS RS&I,TC,,20,,TotalUnits,,,,3.22 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74340,CPT,INTRO LONG GI TUBE W/MULT FLUORO & IMAGES RS&I,,,20,,TotalUnits,,,,2.17 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74340,CPT,INTRO LONG GI TUBE W/MULT FLUORO & IMAGES RS&I,26,,20,,TotalUnits,,,,0.74 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74340,CPT,INTRO LONG GI TUBE W/MULT FLUORO & IMAGES RS&I,TC,,20,,TotalUnits,,,,1.43 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74355,CPT,PERCUTANEOUS PLACEMENT ENTEROCLYSIS TUBE RS&I,,,20,,RBRVS,0.76 ,3.17 ,3.17 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74355,CPT,PERCUTANEOUS PLACEMENT ENTEROCLYSIS TUBE RS&I,26,,20,,RBRVS,0.76 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74355,CPT,PERCUTANEOUS PLACEMENT ENTEROCLYSIS TUBE RS&I,TC,,20,,RBRVS,,2.88 ,2.88 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74360,CPT,INTRALUMINAL DILATION STRICTURES&/OBSTRCJS RS&I,,,20,,TotalUnits,,,,3.32 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74360,CPT,INTRALUMINAL DILATION STRICTURES&/OBSTRCJS RS&I,26,,20,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74360,CPT,INTRALUMINAL DILATION STRICTURES&/OBSTRCJS RS&I,TC,,20,,TotalUnits,,,,2.56 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74363,CPT,PRQ TRANSHEPATC DILAT BILIARY DUCT STRICTRE RS&I,,,20,,TotalUnits,,,,3.17 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74363,CPT,PRQ TRANSHEPATC DILAT BILIARY DUCT STRICTRE RS&I,26,,20,,TotalUnits,,,,1.17 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74363,CPT,PRQ TRANSHEPATC DILAT BILIARY DUCT STRICTRE RS&I,TC,,20,,TotalUnits,,,,2.00 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74400,CPT,UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY,,,20,,RBRVS,0.49 ,2.54 ,2.54 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74400,CPT,UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY,26,,20,,RBRVS,0.49 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74400,CPT,UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY,TC,,20,,RBRVS,,2.36 ,2.36 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74410,CPT,UROGRAPHY INFUSION DRIP &/BOLUS TECHNIQUE,,,20,,RBRVS,0.49 ,2.47 ,2.47 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74410,CPT,UROGRAPHY INFUSION DRIP &/BOLUS TECHNIQUE,26,,20,,RBRVS,0.49 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74410,CPT,UROGRAPHY INFUSION DRIP &/BOLUS TECHNIQUE,TC,,20,,RBRVS,,2.30 ,2.30 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74415,CPT,UROGRAPY INFUSION DRIP &/BOLUS TECHQ W/WO TOMO,,,20,,RBRVS,0.49 ,3.30 ,3.30 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74415,CPT,UROGRAPY INFUSION DRIP &/BOLUS TECHQ W/WO TOMO,26,,20,,RBRVS,0.49 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74415,CPT,UROGRAPY INFUSION DRIP &/BOLUS TECHQ W/WO TOMO,TC,,20,,RBRVS,,3.12 ,3.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74420,CPT,X-RAY URINARY TRACT EXAM WITH CONTRAST MATERIAL,,,20,,TotalUnits,,,,2.53 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74420,CPT,X-RAY URINARY TRACT EXAM WITH CONTRAST MATERIAL,26,,20,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74420,CPT,X-RAY URINARY TRACT EXAM WITH CONTRAST MATERIAL,TC,,20,,TotalUnits,,,,2.04 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74425,CPT,UROGRAPHY ANTEGRADE RS&I,,,20,,TotalUnits,,,,1.83 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74425,CPT,UROGRAPHY ANTEGRADE RS&I,26,,20,,TotalUnits,,,,0.48 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74425,CPT,UROGRAPHY ANTEGRADE RS&I,TC,,20,,TotalUnits,,,,1.35 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74430,CPT,CYSTOGRAPHY MINIMUM 3 VIEWS RS&I,,,20,,RBRVS,0.32 ,0.70 ,0.70 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74430,CPT,CYSTOGRAPHY MINIMUM 3 VIEWS RS&I,26,,20,,RBRVS,0.32 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74430,CPT,CYSTOGRAPHY MINIMUM 3 VIEWS RS&I,TC,,20,,RBRVS,,0.58 ,0.58 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74440,CPT,VASOGRAPY VESICULOGRAPY/EPIDIDYMOGRAPY RS&I,,,20,,RBRVS,0.38 ,1.83 ,1.83 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74440,CPT,VASOGRAPY VESICULOGRAPY/EPIDIDYMOGRAPY RS&I,26,,20,,RBRVS,0.38 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74440,CPT,VASOGRAPY VESICULOGRAPY/EPIDIDYMOGRAPY RS&I,TC,,20,,RBRVS,,1.70 ,1.70 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74445,CPT,CORPORA CAVERNOSOGRAPY RS&I,,,20,,TotalUnits,,,,2.95 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74445,CPT,CORPORA CAVERNOSOGRAPY RS&I,26,,20,,TotalUnits,,,,1.54 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74445,CPT,CORPORA CAVERNOSOGRAPY RS&I,TC,,20,,TotalUnits,,,,1.41 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74450,CPT,URETHROCYSTOGRAPHY RETROGRADE RS&I,,,20,,TotalUnits,,,,2.06 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74450,CPT,URETHROCYSTOGRAPHY RETROGRADE RS&I,26,,20,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74450,CPT,URETHROCYSTOGRAPHY RETROGRADE RS&I,TC,,20,,TotalUnits,,,,1.61 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74455,CPT,URETHROCYSTOGRAPHY VOIDING RS&I,,,20,,RBRVS,0.33 ,1.93 ,1.93 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74455,CPT,URETHROCYSTOGRAPHY VOIDING RS&I,26,,20,,RBRVS,0.33 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74455,CPT,URETHROCYSTOGRAPHY VOIDING RS&I,TC,,20,,RBRVS,,1.81 ,1.81 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74470,CPT,RADEX RENAL CYST STUDY TRANSLUMBAR RS&I,,,20,,TotalUnits,,,,2.44 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74470,CPT,RADEX RENAL CYST STUDY TRANSLUMBAR RS&I,26,,20,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74470,CPT,RADEX RENAL CYST STUDY TRANSLUMBAR RS&I,TC,,20,,TotalUnits,,,,1.74 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74485,CPT,DILATION NEPHROSTOMY/URETER/URETHRA RS&I,,,20,,RBRVS,0.54 ,2.01 ,2.01 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74485,CPT,DILATION NEPHROSTOMY/URETER/URETHRA RS&I,26,,20,,RBRVS,0.54 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74485,CPT,DILATION NEPHROSTOMY/URETER/URETHRA RS&I,TC,,20,,RBRVS,,1.83 ,1.83 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74710,CPT,PELVIMETRY W/WOPLACENTAL LOCALIZATION,,,20,,RBRVS,0.34 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74710,CPT,PELVIMETRY W/WOPLACENTAL LOCALIZATION,26,,20,,RBRVS,0.34 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74710,CPT,PELVIMETRY W/WOPLACENTAL LOCALIZATION,TC,,20,,RBRVS,,0.61 ,0.61 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74712,CPT,FETAL MRI W/PLACNTL MATRNL PLVC IMG SING/1ST GES,,,20,,RBRVS,3.00 ,10.34 ,10.34 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74712,CPT,FETAL MRI W/PLACNTL MATRNL PLVC IMG SING/1ST GES,26,,20,,RBRVS,3.00 ,1.12 ,1.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74712,CPT,FETAL MRI W/PLACNTL MATRNL PLVC IMG SING/1ST GES,TC,,20,,RBRVS,,9.22 ,9.22 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74713,CPT,FETAL MRI W/PLACNTL MATRNL PLVC IMG EA ADDL GES,,,20,,RBRVS,1.78 ,4.61 ,4.61 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74713,CPT,FETAL MRI W/PLACNTL MATRNL PLVC IMG EA ADDL GES,26,,20,,RBRVS,1.78 ,0.66 ,0.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74713,CPT,FETAL MRI W/PLACNTL MATRNL PLVC IMG EA ADDL GES,TC,,20,,RBRVS,,3.95 ,3.95 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74740,CPT,HYSTEROSALPINGOGRAPHY RS&I,,,20,,RBRVS,0.38 ,1.69 ,1.69 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74740,CPT,HYSTEROSALPINGOGRAPHY RS&I,26,,20,,RBRVS,0.38 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74740,CPT,HYSTEROSALPINGOGRAPHY RS&I,TC,,20,,RBRVS,,1.55 ,1.55 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74742,CPT,TRANSCERVICAL CATHJ FALLOPIAN TUBE RS&I,,,20,,TotalUnits,,,,3.06 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74742,CPT,TRANSCERVICAL CATHJ FALLOPIAN TUBE RS&I,26,,20,,TotalUnits,,,,0.84 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74742,CPT,TRANSCERVICAL CATHJ FALLOPIAN TUBE RS&I,TC,,20,,TotalUnits,,,,2.22 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
74775,CPT,PERINEOGRAM,,,20,,TotalUnits,,,,3.38 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
74775,CPT,PERINEOGRAM,26,,20,,TotalUnits,,,,0.85 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
74775,CPT,PERINEOGRAM,TC,,20,,TotalUnits,,,,2.53 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75557,CPT,CARDIAC MRI MORPHOLOGY & FUNCTION W/O CONTRAST,,,20,,RBRVS,2.35 ,6.44 ,6.44 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75557,CPT,CARDIAC MRI MORPHOLOGY & FUNCTION W/O CONTRAST,26,,20,,RBRVS,2.35 ,0.84 ,0.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75557,CPT,CARDIAC MRI MORPHOLOGY & FUNCTION W/O CONTRAST,TC,,20,,RBRVS,,5.60 ,5.60 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75559,CPT,CARDIAC MRI W/O CONTRAST W/STRESS IMAGING,,,20,,RBRVS,2.95 ,9.08 ,9.08 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75559,CPT,CARDIAC MRI W/O CONTRAST W/STRESS IMAGING,26,,20,,RBRVS,2.95 ,1.00 ,1.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75559,CPT,CARDIAC MRI W/O CONTRAST W/STRESS IMAGING,TC,,20,,RBRVS,,8.08 ,8.08 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75561,CPT,CARDIAC MRI W/WO CONTRAST & FURTHER SEQ,,,20,,RBRVS,2.60 ,9.15 ,9.15 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75561,CPT,CARDIAC MRI W/WO CONTRAST & FURTHER SEQ,26,,20,,RBRVS,2.60 ,0.92 ,0.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75561,CPT,CARDIAC MRI W/WO CONTRAST & FURTHER SEQ,TC,,20,,RBRVS,,8.23 ,8.23 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75563,CPT,CARDIAC MRI W/W/O CONTRAST W/STRESS,,,20,,RBRVS,3.00 ,10.96 ,10.96 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75563,CPT,CARDIAC MRI W/W/O CONTRAST W/STRESS,26,,20,,RBRVS,3.00 ,1.06 ,1.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75563,CPT,CARDIAC MRI W/W/O CONTRAST W/STRESS,TC,,20,,RBRVS,,9.90 ,9.90 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75565,CPT,CARDIAC MRI FOR VELOCITY FLOW MAPPING,,,20,,RBRVS,0.25 ,1.28 ,1.28 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75565,CPT,CARDIAC MRI FOR VELOCITY FLOW MAPPING,26,,20,,RBRVS,0.25 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75565,CPT,CARDIAC MRI FOR VELOCITY FLOW MAPPING,TC,,20,,RBRVS,,1.19 ,1.19 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75571,CPT,CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM,,,20,,RBRVS,0.58 ,2.20 ,2.20 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75571,CPT,CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM,26,,20,,RBRVS,0.58 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75571,CPT,CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM,TC,,20,,RBRVS,,1.99 ,1.99 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75572,CPT,CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH,,,20,,RBRVS,1.75 ,6.12 ,6.12 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75572,CPT,CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH,26,,20,,RBRVS,1.75 ,0.63 ,0.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75572,CPT,CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH,TC,,20,,RBRVS,,5.49 ,5.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75573,CPT,CT HRT CONTRST CARDIAC STRUCT&MORPH CONG HRT D,,,20,,RBRVS,2.55 ,8.24 ,8.24 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75573,CPT,CT HRT CONTRST CARDIAC STRUCT&MORPH CONG HRT D,26,,20,,RBRVS,2.55 ,0.90 ,0.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75573,CPT,CT HRT CONTRST CARDIAC STRUCT&MORPH CONG HRT D,TC,,20,,RBRVS,,7.34 ,7.34 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75574,CPT,CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST,,,20,,RBRVS,2.40 ,9.21 ,9.21 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75574,CPT,CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST,26,,20,,RBRVS,2.40 ,0.85 ,0.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75574,CPT,CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST,TC,,20,,RBRVS,,8.36 ,8.36 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75600,CPT,AORTOGRAPHY THORACIC W/O SERIALOGRAPHY RS&I,,,20,,RBRVS,0.49 ,5.02 ,5.02 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75600,CPT,AORTOGRAPHY THORACIC W/O SERIALOGRAPHY RS&I,26,,20,,RBRVS,0.49 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75600,CPT,AORTOGRAPHY THORACIC W/O SERIALOGRAPHY RS&I,TC,,20,,RBRVS,,4.87 ,4.87 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75605,CPT,AORTOGRAPHY THORACIC SERIALOGRAPHY RS&I,,,20,,RBRVS,1.14 ,2.65 ,2.65 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75605,CPT,AORTOGRAPHY THORACIC SERIALOGRAPHY RS&I,26,,20,,RBRVS,1.14 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75605,CPT,AORTOGRAPHY THORACIC SERIALOGRAPHY RS&I,TC,,20,,RBRVS,,2.30 ,2.30 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75625,CPT,AORTOGRAPHY ABDOMINAL SERIALOGRAPHY RS&I,,,20,,RBRVS,1.14 ,2.61 ,2.61 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75625,CPT,AORTOGRAPHY ABDOMINAL SERIALOGRAPHY RS&I,26,,20,,RBRVS,1.14 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75625,CPT,AORTOGRAPHY ABDOMINAL SERIALOGRAPHY RS&I,TC,,20,,RBRVS,,2.29 ,2.29 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75630,CPT,AORTOGRAPHY ABDL BI ILIOFEM LOW EXTREM CATH RS&I,,,20,,RBRVS,1.79 ,2.83 ,2.83 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75630,CPT,AORTOGRAPHY ABDL BI ILIOFEM LOW EXTREM CATH RS&I,26,,20,,RBRVS,1.79 ,0.54 ,0.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75630,CPT,AORTOGRAPHY ABDL BI ILIOFEM LOW EXTREM CATH RS&I,TC,,20,,RBRVS,,2.29 ,2.29 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75635,CPT,CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP,,,20,,RBRVS,2.40 ,8.08 ,8.08 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75635,CPT,CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP,26,,20,,RBRVS,2.40 ,0.86 ,0.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75635,CPT,CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP,TC,,20,,RBRVS,,7.22 ,7.22 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75658,CPT,ANIOGRAPHY BRACHIAL RETROGRADE RS&I,,,20,,RBRVS,1.31 ,3.16 ,3.16 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75658,CPT,ANIOGRAPHY BRACHIAL RETROGRADE RS&I,26,,20,,RBRVS,1.31 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75658,CPT,ANIOGRAPHY BRACHIAL RETROGRADE RS&I,TC,,20,,RBRVS,,2.81 ,2.81 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75705,CPT,ANGIOGRAPHY SPINAL SELECTIVE RS&I,,,20,,RBRVS,2.18 ,4.35 ,4.35 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75705,CPT,ANGIOGRAPHY SPINAL SELECTIVE RS&I,26,,20,,RBRVS,2.18 ,0.77 ,0.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75705,CPT,ANGIOGRAPHY SPINAL SELECTIVE RS&I,TC,,20,,RBRVS,,3.58 ,3.58 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75710,CPT,ANGIOGRAPHY EXTREMITY UNILATERAL RS&I,,,20,,RBRVS,1.14 ,3.30 ,3.30 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75710,CPT,ANGIOGRAPHY EXTREMITY UNILATERAL RS&I,26,,20,,RBRVS,1.14 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75710,CPT,ANGIOGRAPHY EXTREMITY UNILATERAL RS&I,TC,,20,,RBRVS,,2.97 ,2.97 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75716,CPT,ANGIOGRAPHY EXTREMITY BILATERAL RS&I,,,20,,RBRVS,1.31 ,3.77 ,3.77 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75716,CPT,ANGIOGRAPHY EXTREMITY BILATERAL RS&I,26,,20,,RBRVS,1.31 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75716,CPT,ANGIOGRAPHY EXTREMITY BILATERAL RS&I,TC,,20,,RBRVS,,3.39 ,3.39 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75726,CPT,ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS&I,,,20,,RBRVS,1.14 ,2.97 ,2.97 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75726,CPT,ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS&I,26,,20,,RBRVS,1.14 ,0.36 ,0.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75726,CPT,ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS&I,TC,,20,,RBRVS,,2.61 ,2.61 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75731,CPT,ANGIOGRAPHY ADRENAL UNILATERAL SLCTV RS&I,,,20,,RBRVS,1.14 ,3.60 ,3.60 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75731,CPT,ANGIOGRAPHY ADRENAL UNILATERAL SLCTV RS&I,26,,20,,RBRVS,1.14 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75731,CPT,ANGIOGRAPHY ADRENAL UNILATERAL SLCTV RS&I,TC,,20,,RBRVS,,3.17 ,3.17 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75733,CPT,ANGIOGRAPHY ADRENAL BILATERAL SLCTV RS&I,,,20,,RBRVS,1.31 ,3.76 ,3.76 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75733,CPT,ANGIOGRAPHY ADRENAL BILATERAL SLCTV RS&I,26,,20,,RBRVS,1.31 ,0.45 ,0.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75733,CPT,ANGIOGRAPHY ADRENAL BILATERAL SLCTV RS&I,TC,,20,,RBRVS,,3.31 ,3.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75736,CPT,ANGIOGRAPHY PELVIC SLCTV/SUPRASLCTV RS&I,,,20,,RBRVS,1.14 ,3.25 ,3.25 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75736,CPT,ANGIOGRAPHY PELVIC SLCTV/SUPRASLCTV RS&I,26,,20,,RBRVS,1.14 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75736,CPT,ANGIOGRAPHY PELVIC SLCTV/SUPRASLCTV RS&I,TC,,20,,RBRVS,,2.91 ,2.91 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75741,CPT,ANGIOGRAPHY PULMONARY UNILATERAL SLCTV RS&I,,,20,,RBRVS,1.31 ,2.87 ,2.87 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75741,CPT,ANGIOGRAPHY PULMONARY UNILATERAL SLCTV RS&I,26,,20,,RBRVS,1.31 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75741,CPT,ANGIOGRAPHY PULMONARY UNILATERAL SLCTV RS&I,TC,,20,,RBRVS,,2.45 ,2.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75743,CPT,ANGIOGRAPHY PULMONARY BILATERAL SLCTV RS&I,,,20,,RBRVS,1.66 ,3.01 ,3.01 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75743,CPT,ANGIOGRAPHY PULMONARY BILATERAL SLCTV RS&I,26,,20,,RBRVS,1.66 ,0.53 ,0.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75743,CPT,ANGIOGRAPHY PULMONARY BILATERAL SLCTV RS&I,TC,,20,,RBRVS,,2.48 ,2.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75746,CPT,ANGRPH PULMONARY NONSLCTV CATH/VEN NJX RS&I,,,20,,RBRVS,1.14 ,3.12 ,3.12 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75746,CPT,ANGRPH PULMONARY NONSLCTV CATH/VEN NJX RS&I,26,,20,,RBRVS,1.14 ,0.40 ,0.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75746,CPT,ANGRPH PULMONARY NONSLCTV CATH/VEN NJX RS&I,TC,,20,,RBRVS,,2.72 ,2.72 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75756,CPT,ANGIOGRAPHY INTERNAL MAMMARY RS&I,,,20,,RBRVS,1.14 ,3.41 ,3.41 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75756,CPT,ANGIOGRAPHY INTERNAL MAMMARY RS&I,26,,20,,RBRVS,1.14 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75756,CPT,ANGIOGRAPHY INTERNAL MAMMARY RS&I,TC,,20,,RBRVS,,3.09 ,3.09 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75774,CPT,ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I,,,20,,RBRVS,0.36 ,2.06 ,2.06 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75774,CPT,ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I,26,,20,,RBRVS,0.36 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75774,CPT,ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I,TC,,20,,RBRVS,,1.95 ,1.95 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75791,CPT,ANGIOGRPHY AV SHUNT COMPLETE EVAL FLUOR RS&I,,,20,,RBRVS,1.71 ,7.16 ,7.16 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75791,CPT,ANGIOGRPHY AV SHUNT COMPLETE EVAL FLUOR RS&I,26,,20,,RBRVS,1.71 ,0.51 ,0.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75791,CPT,ANGIOGRPHY AV SHUNT COMPLETE EVAL FLUOR RS&I,TC,,20,,RBRVS,,6.65 ,6.65 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75801,CPT,LYMPHANGIOGRAPHY EXTREMITY ONLY UNILATERAL RS&I,,,20,,TotalUnits,,,,6.99 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75801,CPT,LYMPHANGIOGRAPHY EXTREMITY ONLY UNILATERAL RS&I,26,,20,,TotalUnits,,,,1.10 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75801,CPT,LYMPHANGIOGRAPHY EXTREMITY ONLY UNILATERAL RS&I,TC,,20,,TotalUnits,,,,5.89 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75803,CPT,LYMPHANGIOGRAPHY EXTREMITY ONLY BILATERAL RS&I,,,20,,RBRVS,1.17 ,6.24 ,6.24 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75803,CPT,LYMPHANGIOGRAPHY EXTREMITY ONLY BILATERAL RS&I,26,,20,,RBRVS,1.17 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75803,CPT,LYMPHANGIOGRAPHY EXTREMITY ONLY BILATERAL RS&I,TC,,20,,RBRVS,,5.80 ,5.80 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75805,CPT,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL UNILAT RS&I,,,20,,RBRVS,0.81 ,6.66 ,6.66 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75805,CPT,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL UNILAT RS&I,26,,20,,RBRVS,0.81 ,0.30 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75805,CPT,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL UNILAT RS&I,TC,,20,,RBRVS,,6.36 ,6.36 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75807,CPT,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL BILATERAL RS&I,,,20,,TotalUnits,,,,8.11 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75807,CPT,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL BILATERAL RS&I,26,,20,,TotalUnits,,,,1.61 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75807,CPT,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL BILATERAL RS&I,TC,,20,,TotalUnits,,,,6.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75809,CPT,SHUNTOGRAM INDWELLING NONVASCULAR SHUNT RS&I,,,20,,RBRVS,0.47 ,2.28 ,2.28 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75809,CPT,SHUNTOGRAM INDWELLING NONVASCULAR SHUNT RS&I,26,,20,,RBRVS,0.47 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75809,CPT,SHUNTOGRAM INDWELLING NONVASCULAR SHUNT RS&I,TC,,20,,RBRVS,,2.10 ,2.10 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75810,CPT,SPLENOPORTOGRAPY RS&I,,,20,,RBRVS,1.14 ,13.34 ,13.34 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75810,CPT,SPLENOPORTOGRAPY RS&I,26,,20,,RBRVS,1.14 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75810,CPT,SPLENOPORTOGRAPY RS&I,TC,,20,,RBRVS,,12.91 ,12.91 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75820,CPT,VENOGRAPHY EXTREMITY UNILATERAL RS&I,,,20,,RBRVS,0.70 ,2.47 ,2.47 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75820,CPT,VENOGRAPHY EXTREMITY UNILATERAL RS&I,26,,20,,RBRVS,0.70 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75820,CPT,VENOGRAPHY EXTREMITY UNILATERAL RS&I,TC,,20,,RBRVS,,2.24 ,2.24 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75822,CPT,VENOGRAPHY EXTREMITY BILATERAL RS&I,,,20,,RBRVS,1.06 ,2.71 ,2.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75822,CPT,VENOGRAPHY EXTREMITY BILATERAL RS&I,26,,20,,RBRVS,1.06 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75822,CPT,VENOGRAPHY EXTREMITY BILATERAL RS&I,TC,,20,,RBRVS,,2.37 ,2.37 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75825,CPT,VENOGRAPHY CAVAL INFERIOR SERIALOGRAPHY RS&I,,,20,,RBRVS,1.14 ,2.57 ,2.57 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75825,CPT,VENOGRAPHY CAVAL INFERIOR SERIALOGRAPHY RS&I,26,,20,,RBRVS,1.14 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75825,CPT,VENOGRAPHY CAVAL INFERIOR SERIALOGRAPHY RS&I,TC,,20,,RBRVS,,2.23 ,2.23 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75827,CPT,VENOGRAPHY CAVAL SUPERIOR SERIALOGRAPHY RS&I,,,20,,RBRVS,1.14 ,2.62 ,2.62 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75827,CPT,VENOGRAPHY CAVAL SUPERIOR SERIALOGRAPHY RS&I,26,,20,,RBRVS,1.14 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75827,CPT,VENOGRAPHY CAVAL SUPERIOR SERIALOGRAPHY RS&I,TC,,20,,RBRVS,,2.29 ,2.29 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75831,CPT,VENOGRAPHY RENAL UNILATERAL SELECTIVE RS&I,,,20,,RBRVS,1.14 ,2.74 ,2.74 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75831,CPT,VENOGRAPHY RENAL UNILATERAL SELECTIVE RS&I,26,,20,,RBRVS,1.14 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75831,CPT,VENOGRAPHY RENAL UNILATERAL SELECTIVE RS&I,TC,,20,,RBRVS,,2.40 ,2.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75833,CPT,VENOGRAPHY RENAL BILATERAL SELECTIVE RS&I,,,20,,RBRVS,1.49 ,2.94 ,2.94 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75833,CPT,VENOGRAPHY RENAL BILATERAL SELECTIVE RS&I,26,,20,,RBRVS,1.49 ,0.39 ,0.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75833,CPT,VENOGRAPHY RENAL BILATERAL SELECTIVE RS&I,TC,,20,,RBRVS,,2.55 ,2.55 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75840,CPT,VENOGRAPHY ADRENAL UNILATERAL SELECTIVE RS&I,,,20,,RBRVS,1.14 ,2.97 ,2.97 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75840,CPT,VENOGRAPHY ADRENAL UNILATERAL SELECTIVE RS&I,26,,20,,RBRVS,1.14 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75840,CPT,VENOGRAPHY ADRENAL UNILATERAL SELECTIVE RS&I,TC,,20,,RBRVS,,2.54 ,2.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75842,CPT,VENOGRAPHY ADRENAL BILATERAL SELECTIVE RS&I,,,20,,RBRVS,1.49 ,3.49 ,3.49 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75842,CPT,VENOGRAPHY ADRENAL BILATERAL SELECTIVE RS&I,26,,20,,RBRVS,1.49 ,0.56 ,0.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75842,CPT,VENOGRAPHY ADRENAL BILATERAL SELECTIVE RS&I,TC,,20,,RBRVS,,2.93 ,2.93 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75860,CPT,VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I,,,20,,RBRVS,1.14 ,2.80 ,2.80 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75860,CPT,VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I,26,,20,,RBRVS,1.14 ,0.36 ,0.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75860,CPT,VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I,TC,,20,,RBRVS,,2.44 ,2.44 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75870,CPT,VENOGRAPHY SUPERIOR SAGITTAL SINUS RS&I,,,20,,RBRVS,1.14 ,2.96 ,2.96 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75870,CPT,VENOGRAPHY SUPERIOR SAGITTAL SINUS RS&I,26,,20,,RBRVS,1.14 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75870,CPT,VENOGRAPHY SUPERIOR SAGITTAL SINUS RS&I,TC,,20,,RBRVS,,2.53 ,2.53 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75872,CPT,VENOGRAPHY EPIDURAL RS&I,,,20,,RBRVS,1.14 ,2.98 ,2.98 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75872,CPT,VENOGRAPHY EPIDURAL RS&I,26,,20,,RBRVS,1.14 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75872,CPT,VENOGRAPHY EPIDURAL RS&I,TC,,20,,RBRVS,,2.55 ,2.55 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75880,CPT,VENOGRAPHY ORBITAL RS&I,,,20,,RBRVS,0.70 ,3.37 ,3.37 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75880,CPT,VENOGRAPHY ORBITAL RS&I,26,,20,,RBRVS,0.70 ,0.30 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75880,CPT,VENOGRAPHY ORBITAL RS&I,TC,,20,,RBRVS,,3.07 ,3.07 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75885,CPT,PRQ TRANSHEPATC PORTOGRAPY HEMODYN EVAL RS&I,,,20,,RBRVS,1.44 ,2.90 ,2.90 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75885,CPT,PRQ TRANSHEPATC PORTOGRAPY HEMODYN EVAL RS&I,26,,20,,RBRVS,1.44 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75885,CPT,PRQ TRANSHEPATC PORTOGRAPY HEMODYN EVAL RS&I,TC,,20,,RBRVS,,2.46 ,2.46 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75887,CPT,PRQ TRANSHEPATC PORTOGRAPY W/O HEMODYN EVL INTRP,,,20,,RBRVS,1.44 ,2.96 ,2.96 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75887,CPT,PRQ TRANSHEPATC PORTOGRAPY W/O HEMODYN EVL INTRP,26,,20,,RBRVS,1.44 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75887,CPT,PRQ TRANSHEPATC PORTOGRAPY W/O HEMODYN EVL INTRP,TC,,20,,RBRVS,,2.49 ,2.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75889,CPT,HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I,,,20,,RBRVS,1.14 ,2.84 ,2.84 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75889,CPT,HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I,26,,20,,RBRVS,1.14 ,0.36 ,0.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75889,CPT,HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I,TC,,20,,RBRVS,,2.48 ,2.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75891,CPT,HEPATC VNGRPH WDG/FR W/O HEMODYN EVAL RS&I,,,20,,RBRVS,1.14 ,2.89 ,2.89 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75891,CPT,HEPATC VNGRPH WDG/FR W/O HEMODYN EVAL RS&I,26,,20,,RBRVS,1.14 ,0.39 ,0.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75891,CPT,HEPATC VNGRPH WDG/FR W/O HEMODYN EVAL RS&I,TC,,20,,RBRVS,,2.50 ,2.50 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75893,CPT,VENOUS SAMPLING THRU CATH W/WO ANGIOGRAPHY RS&,,,20,,RBRVS,0.54 ,2.76 ,2.76 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75893,CPT,VENOUS SAMPLING THRU CATH W/WO ANGIOGRAPHY RS&,26,,20,,RBRVS,0.54 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75893,CPT,VENOUS SAMPLING THRU CATH W/WO ANGIOGRAPHY RS&,TC,,20,,RBRVS,,2.56 ,2.56 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75894,CPT,TRANSCATHETER EMBOLIZATION ANY METH RS&I,,,20,,TotalUnits,,,,26.22 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75894,CPT,TRANSCATHETER EMBOLIZATION ANY METH RS&I,26,,20,,TotalUnits,,,,1.73 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75894,CPT,TRANSCATHETER EMBOLIZATION ANY METH RS&I,TC,,20,,TotalUnits,,,,24.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75898,CPT,ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS,,,20,,TotalUnits,,,,3.57 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75898,CPT,ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS,26,,20,,TotalUnits,,,,2.21 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75898,CPT,ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS,TC,,20,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75901,CPT,MECHANICAL RMVL PERICATHETER OBSTR MATRL RS&I,,,20,,RBRVS,0.49 ,4.39 ,4.39 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75901,CPT,MECHANICAL RMVL PERICATHETER OBSTR MATRL RS&I,26,,20,,RBRVS,0.49 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75901,CPT,MECHANICAL RMVL PERICATHETER OBSTR MATRL RS&I,TC,,20,,RBRVS,,4.24 ,4.24 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75902,CPT,MECHANICAL RMVL INTRALUMINAL OBSTR MATRL RS&I,,,20,,RBRVS,0.39 ,1.58 ,1.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75902,CPT,MECHANICAL RMVL INTRALUMINAL OBSTR MATRL RS&I,26,,20,,RBRVS,0.39 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75902,CPT,MECHANICAL RMVL INTRALUMINAL OBSTR MATRL RS&I,TC,,20,,RBRVS,,1.46 ,1.46 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75952,CPT,EVASC RPR INFRARENAL AAA/DISSECTION RS&I,,,20,,RBRVS,4.49 ,1.14 ,1.14 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75952,CPT,EVASC RPR INFRARENAL AAA/DISSECTION RS&I,26,,20,,RBRVS,4.49 ,1.14 ,1.14 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
75953,CPT,PLMT XTN PROSTH EVASC RPR INFRARENAL RS&I,,,20,,TotalUnits,,,,3.05 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75953,CPT,PLMT XTN PROSTH EVASC RPR INFRARENAL RS&I,26,,20,,TotalUnits,,,,1.70 ,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
75953,CPT,PLMT XTN PROSTH EVASC RPR INFRARENAL RS&I,TC,,20,,TotalUnits,,,,1.35 ,,$0.00,$0.00,1,1,0,0,1,1,20161001,,,,
75954,CPT,EVASC RPR ILIAC ART W/ILIO-ILIAC PROSTH RS&I,,,20,,RBRVS,2.25 ,0.58 ,0.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75954,CPT,EVASC RPR ILIAC ART W/ILIO-ILIAC PROSTH RS&I,26,,20,,RBRVS,2.25 ,0.58 ,0.58 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
75956,CPT,EVASC RPR DESCND THORCIC AORTA SUBCLAV ORIG RS&I,,,20,,RBRVS,7.00 ,1.73 ,1.73 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75956,CPT,EVASC RPR DESCND THORCIC AORTA SUBCLAV ORIG RS&I,26,,20,,RBRVS,7.00 ,1.73 ,1.73 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
75957,CPT,EVASC RPR DESCND THORCIC AORTA CELIAC ORIG RS&I,,,20,,RBRVS,6.00 ,1.47 ,1.47 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75957,CPT,EVASC RPR DESCND THORCIC AORTA CELIAC ORIG RS&I,26,,20,,RBRVS,6.00 ,1.47 ,1.47 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
75958,CPT,PLMT PROX XTN PRSTH EVASC DESC THORAC AORTA RS&I,,,20,,RBRVS,4.00 ,0.98 ,0.98 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75958,CPT,PLMT PROX XTN PRSTH EVASC DESC THORAC AORTA RS&I,26,,20,,RBRVS,4.00 ,0.98 ,0.98 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
75959,CPT,PLMT DSTL XTN PRSTH EVASC DESC THORAC AORTA RS&I,,,20,,RBRVS,3.50 ,0.70 ,0.70 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75959,CPT,PLMT DSTL XTN PRSTH EVASC DESC THORAC AORTA RS&I,26,,20,,RBRVS,3.50 ,0.70 ,0.70 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
75962,CPT,TRANSLUMINAL BALLOON ANGIOP PERIPHERAL ART RSI,,,20,,RBRVS,0.54 ,3.30 ,3.30 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75962,CPT,TRANSLUMINAL BALLOON ANGIOP PERIPHERAL ART RSI,26,,20,,RBRVS,0.54 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75962,CPT,TRANSLUMINAL BALLOON ANGIOP PERIPHERAL ART RSI,TC,,20,,RBRVS,,3.14 ,3.14 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75964,CPT,TRLUML BALOON ANGIOP PERIPHER EA ADDL ART RS&I,,,20,,RBRVS,0.36 ,2.01 ,2.01 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75964,CPT,TRLUML BALOON ANGIOP PERIPHER EA ADDL ART RS&I,26,,20,,RBRVS,0.36 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75964,CPT,TRLUML BALOON ANGIOP PERIPHER EA ADDL ART RS&I,TC,,20,,RBRVS,,1.92 ,1.92 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75966,CPT,TRLUML BALO ANGIOPLASTY RENAL/OTH VISC ART RS&I,,,20,,RBRVS,1.31 ,3.37 ,3.37 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75966,CPT,TRLUML BALO ANGIOPLASTY RENAL/OTH VISC ART RS&I,26,,20,,RBRVS,1.31 ,0.39 ,0.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75966,CPT,TRLUML BALO ANGIOPLASTY RENAL/OTH VISC ART RS&I,TC,,20,,RBRVS,,2.98 ,2.98 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75968,CPT,TRLUML BALO ANGIOPLASTY EA VISCERAL ART RS&I,,,20,,RBRVS,0.36 ,2.10 ,2.10 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75968,CPT,TRLUML BALO ANGIOPLASTY EA VISCERAL ART RS&I,26,,20,,RBRVS,0.36 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75968,CPT,TRLUML BALO ANGIOPLASTY EA VISCERAL ART RS&I,TC,,20,,RBRVS,,1.98 ,1.98 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75970,CPT,TRANSCATHETER BIOPSY RS&I,,,20,,TotalUnits,,,,13.79 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75970,CPT,TRANSCATHETER BIOPSY RS&I,26,,20,,TotalUnits,,,,1.09 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75970,CPT,TRANSCATHETER BIOPSY RS&I,TC,,20,,TotalUnits,,,,12.70 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75978,CPT,TRANSLUMINAL BALLOON ANGIOPLASTY VENOUS RS&I,,,20,,RBRVS,0.54 ,3.26 ,3.26 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75978,CPT,TRANSLUMINAL BALLOON ANGIOPLASTY VENOUS RS&I,26,,20,,RBRVS,0.54 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75978,CPT,TRANSLUMINAL BALLOON ANGIOPLASTY VENOUS RS&I,TC,,20,,RBRVS,,3.10 ,3.10 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75984,CPT,CHANGE PRQ TUBE/DRAINAGE CATH W CONTRAST RS&I,,,20,,RBRVS,0.72 ,2.22 ,2.22 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75984,CPT,CHANGE PRQ TUBE/DRAINAGE CATH W CONTRAST RS&I,26,,20,,RBRVS,0.72 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75984,CPT,CHANGE PRQ TUBE/DRAINAGE CATH W CONTRAST RS&I,TC,,20,,RBRVS,,1.98 ,1.98 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
75989,CPT,RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I,,,20,,RBRVS,1.19 ,2.12 ,2.12 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
75989,CPT,RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I,26,,20,,RBRVS,1.19 ,0.40 ,0.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
75989,CPT,RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I,TC,,20,,RBRVS,,1.72 ,1.72 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76000,CPT,FLUOROSCOPY SPX UP TO 1 HOUR PHYS/QHP TIME,,,20,,RBRVS,0.17 ,1.12 ,1.12 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76000,CPT,FLUOROSCOPY SPX UP TO 1 HOUR PHYS/QHP TIME,26,,20,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76000,CPT,FLUOROSCOPY SPX UP TO 1 HOUR PHYS/QHP TIME,TC,,20,,RBRVS,,1.06 ,1.06 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76001,CPT,FLUOROSCOPY SPX >1 HOUR PHYS/QHP TIME,,,20,,RBRVS,0.67 ,3.23 ,3.23 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76001,CPT,FLUOROSCOPY SPX >1 HOUR PHYS/QHP TIME,26,,20,,RBRVS,0.67 ,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76001,CPT,FLUOROSCOPY SPX >1 HOUR PHYS/QHP TIME,TC,,20,,RBRVS,,2.96 ,2.96 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76010,CPT,RADEX FROM NOSE RECTUM FOREIGN BODY 1 VIEW CHLD,,,20,,RBRVS,0.18 ,0.53 ,0.53 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76010,CPT,RADEX FROM NOSE RECTUM FOREIGN BODY 1 VIEW CHLD,,PC,20,,RBRVS,0.18 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
76010,CPT,RADEX FROM NOSE RECTUM FOREIGN BODY 1 VIEW CHLD,,TC,20,,RBRVS,,0.46 ,0.46 ,,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
76080,CPT,RADEX ABSCESS/FISTULA/SINUS TRACT RS&I,,,20,,RBRVS,0.54 ,0.97 ,0.97 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76080,CPT,RADEX ABSCESS/FISTULA/SINUS TRACT RS&I,,PC,20,,RBRVS,0.54 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
76080,CPT,RADEX ABSCESS/FISTULA/SINUS TRACT RS&I,,TC,20,,RBRVS,,0.79 ,0.79 ,,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
76098,CPT,RADIOLOGICAL EXAMINATION SURGICAL SPECIMEN,,,20,,RBRVS,0.16 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76098,CPT,RADIOLOGICAL EXAMINATION SURGICAL SPECIMEN,,PC,20,,RBRVS,0.16 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
76098,CPT,RADIOLOGICAL EXAMINATION SURGICAL SPECIMEN,,TC,20,,RBRVS,,0.22 ,0.22 ,,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
76100,CPT,RADEX 1 PLNE BODY SECTION OTH/THN W/UROGRAPY,,,20,,RBRVS,0.58 ,1.96 ,1.96 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76100,CPT,RADEX 1 PLNE BODY SECTION OTH/THN W/UROGRAPY,,PC,20,,RBRVS,0.58 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
76100,CPT,RADEX 1 PLNE BODY SECTION OTH/THN W/UROGRAPY,,TC,20,,RBRVS,,1.68 ,1.68 ,,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
76101,CPT,RADEX CPLX MOTION BDY SCTJ OTH/THN UROGRAPY UNI,,,20,,RBRVS,0.58 ,3.06 ,3.06 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76101,CPT,RADEX CPLX MOTION BDY SCTJ OTH/THN UROGRAPY UNI,,PC,20,,RBRVS,0.58 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
76101,CPT,RADEX CPLX MOTION BDY SCTJ OTH/THN UROGRAPY UNI,,TC,20,,RBRVS,,2.71 ,2.71 ,,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
76102,CPT,RADEX CPLX MOTION BDY SCTJ OTH/THN UROGRAPY BI,,,20,,RBRVS,0.58 ,4.22 ,4.22 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76102,CPT,RADEX CPLX MOTION BDY SCTJ OTH/THN UROGRAPY BI,,PC,20,,RBRVS,0.58 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
76102,CPT,RADEX CPLX MOTION BDY SCTJ OTH/THN UROGRAPY BI,,TC,20,,RBRVS,,3.87 ,3.87 ,,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
76120,CPT,CINERADIOGRAPY/VIDRADIOGRAPY XCPT WHERE SPEC,,,20,,RBRVS,0.38 ,2.12 ,2.12 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76120,CPT,CINERADIOGRAPY/VIDRADIOGRAPY XCPT WHERE SPEC,,PC,20,,RBRVS,0.38 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
76120,CPT,CINERADIOGRAPY/VIDRADIOGRAPY XCPT WHERE SPEC,,TC,20,,RBRVS,,1.97 ,1.97 ,,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
76125,CPT,CINERADIOGRAPY/VIDRADIOGRAPY ROUTINE EXAMINATION,,,20,,TotalUnits,,,,1.16 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76125,CPT,CINERADIOGRAPY/VIDRADIOGRAPY ROUTINE EXAMINATION,,PC,20,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
76125,CPT,CINERADIOGRAPY/VIDRADIOGRAPY ROUTINE EXAMINATION,,TC,20,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
76140,CPT,CONSLTJ X-RAY XM MADE ELSEWHERE WRTTN REPRT,,,20,,TotalUnits,,,,0.75 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76376,CPT,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,,,20,,RBRVS,0.20 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76376,CPT,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,26,,20,,RBRVS,0.20 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76376,CPT,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,TC,,20,,RBRVS,,0.35 ,0.35 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76377,CPT,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,,,20,,RBRVS,0.79 ,0.96 ,0.96 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76377,CPT,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,26,,20,,RBRVS,0.79 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76377,CPT,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,TC,,20,,RBRVS,,0.67 ,0.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76380,CPT,CT LIMITED/LOCALIZED FOLLOW UP STUDY,,,20,,RBRVS,0.98 ,3.07 ,3.07 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76380,CPT,CT LIMITED/LOCALIZED FOLLOW UP STUDY,26,,20,,RBRVS,0.98 ,0.36 ,0.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76380,CPT,CT LIMITED/LOCALIZED FOLLOW UP STUDY,TC,,20,,RBRVS,,2.71 ,2.71 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76390,CPT,MRI SPECTROSCOPY,,,20,,RBRVS,1.40 ,11.03 ,11.03 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76390,CPT,MRI SPECTROSCOPY,26,,20,,RBRVS,1.40 ,0.54 ,0.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76390,CPT,MRI SPECTROSCOPY,TC,,20,,RBRVS,,10.49 ,10.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76496,CPT,UNLISTED FLUOROSCOPIC PROCEDURE,,,20,,TotalUnits,,,,1.29 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76496,CPT,UNLISTED FLUOROSCOPIC PROCEDURE,26,,20,,TotalUnits,,,,0.23 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76496,CPT,UNLISTED FLUOROSCOPIC PROCEDURE,TC,,20,,TotalUnits,,,,1.06 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76497,CPT,UNLISTED COMPUTED TOMOGRAPHY PROCEDURE,,,20,,TotalUnits,,,,4.98 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76497,CPT,UNLISTED COMPUTED TOMOGRAPHY PROCEDURE,26,,20,,TotalUnits,,,,1.40 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76497,CPT,UNLISTED COMPUTED TOMOGRAPHY PROCEDURE,TC,,20,,TotalUnits,,,,3.58 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76498,CPT,UNLISTED MAGNETIC RESONANCE PROCEDURE,,,20,,TotalUnits,,,,6.51 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76498,CPT,UNLISTED MAGNETIC RESONANCE PROCEDURE,26,,20,,TotalUnits,,,,1.41 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76498,CPT,UNLISTED MAGNETIC RESONANCE PROCEDURE,TC,,20,,TotalUnits,,,,5.10 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76499,CPT,UNLISTED DIAGNOSTIC RADIOGRAPHIC PROCEDURE,,,20,,TotalUnits,,,,3.07 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76499,CPT,UNLISTED DIAGNOSTIC RADIOGRAPHIC PROCEDURE,26,,20,,TotalUnits,,,,0.81 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76499,CPT,UNLISTED DIAGNOSTIC RADIOGRAPHIC PROCEDURE,TC,,20,,TotalUnits,,,,2.26 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76506,CPT,ECHOENCEPHALOGRAPHY REAL TIME IMAGING,,,20,,RBRVS,0.63 ,2.67 ,2.67 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76506,CPT,ECHOENCEPHALOGRAPHY REAL TIME IMAGING,26,,20,,RBRVS,0.63 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76506,CPT,ECHOENCEPHALOGRAPHY REAL TIME IMAGING,TC,,20,,RBRVS,,2.43 ,2.43 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76510,CPT,OPH US DX B-SCAN&QUAN A-SCAN SM PT ENCTR,,,20,,RBRVS,1.55 ,3.23 ,3.23 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76510,CPT,OPH US DX B-SCAN&QUAN A-SCAN SM PT ENCTR,26,,20,,RBRVS,1.55 ,0.95 ,0.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76510,CPT,OPH US DX B-SCAN&QUAN A-SCAN SM PT ENCTR,TC,,20,,RBRVS,,2.28 ,2.28 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76511,CPT,OPHTHALMIC ULTRASOUND DX QUAN A-SCAN ONLY,,,20,,RBRVS,0.94 ,1.94 ,1.94 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76511,CPT,OPHTHALMIC ULTRASOUND DX QUAN A-SCAN ONLY,26,,20,,RBRVS,0.94 ,0.56 ,0.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76511,CPT,OPHTHALMIC ULTRASOUND DX QUAN A-SCAN ONLY,TC,,20,,RBRVS,,1.38 ,1.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76512,CPT,OPHTHALMIC ULTRASOUND DX B-SCAN W/WO A-SCAN,,,20,,RBRVS,0.94 ,1.66 ,1.66 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76512,CPT,OPHTHALMIC ULTRASOUND DX B-SCAN W/WO A-SCAN,26,,20,,RBRVS,0.94 ,0.55 ,0.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76512,CPT,OPHTHALMIC ULTRASOUND DX B-SCAN W/WO A-SCAN,TC,,20,,RBRVS,,1.11 ,1.11 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76513,CPT,OPH US DX ANT SGM US IMMERSION B-SCAN/HR BIOM,,,20,,RBRVS,0.66 ,2.03 ,2.03 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76513,CPT,OPH US DX ANT SGM US IMMERSION B-SCAN/HR BIOM,26,,20,,RBRVS,0.66 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76513,CPT,OPH US DX ANT SGM US IMMERSION B-SCAN/HR BIOM,TC,,20,,RBRVS,,1.68 ,1.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76514,CPT,OPHTHALMIC US DX CORNEAL PACHYMETRY UNI/BI,,,20,,RBRVS,0.17 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76514,CPT,OPHTHALMIC US DX CORNEAL PACHYMETRY UNI/BI,26,,20,,RBRVS,0.17 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76514,CPT,OPHTHALMIC US DX CORNEAL PACHYMETRY UNI/BI,TC,,20,,RBRVS,,0.14 ,0.14 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76516,CPT,OPHTHALMIC BIOMETRY US ECHOGRAPY A-SCAN,,,20,,RBRVS,0.54 ,1.66 ,1.66 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76516,CPT,OPHTHALMIC BIOMETRY US ECHOGRAPY A-SCAN,26,,20,,RBRVS,0.54 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76516,CPT,OPHTHALMIC BIOMETRY US ECHOGRAPY A-SCAN,TC,,20,,RBRVS,,1.33 ,1.33 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76519,CPT,OPH BMTRY US ECHOGRAPY A-SCAN IO LENS PWR CAL,,,20,,RBRVS,0.54 ,1.82 ,1.82 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76519,CPT,OPH BMTRY US ECHOGRAPY A-SCAN IO LENS PWR CAL,26,,20,,RBRVS,0.54 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76519,CPT,OPH BMTRY US ECHOGRAPY A-SCAN IO LENS PWR CAL,TC,,20,,RBRVS,,1.49 ,1.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76529,CPT,OPHTHALMIC ULTRASONIC FOREIGN BODY LOCALIZATION,,,20,,RBRVS,0.57 ,1.66 ,1.66 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76529,CPT,OPHTHALMIC ULTRASONIC FOREIGN BODY LOCALIZATION,26,,20,,RBRVS,0.57 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76529,CPT,OPHTHALMIC ULTRASONIC FOREIGN BODY LOCALIZATION,TC,,20,,RBRVS,,1.32 ,1.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76536,CPT,US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM,,,20,,RBRVS,0.56 ,2.69 ,2.69 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76536,CPT,US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM,26,,20,,RBRVS,0.56 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76536,CPT,US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM,TC,,20,,RBRVS,,2.48 ,2.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76604,CPT,US CHEST REAL TIME W/IMAGE DOCUMENTATION,,,20,,RBRVS,0.55 ,1.90 ,1.90 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76604,CPT,US CHEST REAL TIME W/IMAGE DOCUMENTATION,26,,20,,RBRVS,0.55 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76604,CPT,US CHEST REAL TIME W/IMAGE DOCUMENTATION,TC,,20,,RBRVS,,1.70 ,1.70 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76641,CPT,US BREAST UNI REAL TIME WITH IMAGE COMPLETE,,,20,,RBRVS,0.73 ,2.27 ,2.27 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76641,CPT,US BREAST UNI REAL TIME WITH IMAGE COMPLETE,26,,20,,RBRVS,0.73 ,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76641,CPT,US BREAST UNI REAL TIME WITH IMAGE COMPLETE,TC,,20,,RBRVS,,2.00 ,2.00 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76642,CPT,US BREAST UNI REAL TIME WITH IMAGE LIMITED,,,20,,RBRVS,0.68 ,1.78 ,1.78 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76642,CPT,US BREAST UNI REAL TIME WITH IMAGE LIMITED,26,,20,,RBRVS,0.68 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76642,CPT,US BREAST UNI REAL TIME WITH IMAGE LIMITED,TC,,20,,RBRVS,,1.53 ,1.53 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76700,CPT,US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION,,,20,,RBRVS,0.81 ,2.61 ,2.61 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76700,CPT,US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION,26,,20,,RBRVS,0.81 ,0.30 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76700,CPT,US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION,TC,,20,,RBRVS,,2.31 ,2.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76705,CPT,US ABDOMINAL REAL TIME W/IMAGE LIMITED,,,20,,RBRVS,0.59 ,1.96 ,1.96 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76705,CPT,US ABDOMINAL REAL TIME W/IMAGE LIMITED,26,,20,,RBRVS,0.59 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76705,CPT,US ABDOMINAL REAL TIME W/IMAGE LIMITED,TC,,20,,RBRVS,,1.74 ,1.74 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76770,CPT,US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE,,,20,,RBRVS,0.74 ,2.41 ,2.41 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76770,CPT,US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE,26,,20,,RBRVS,0.74 ,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76770,CPT,US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE,TC,,20,,RBRVS,,2.14 ,2.14 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76775,CPT,US RETROPERITONEAL REAL TIME W/IMAGE LIMITED,,,20,,RBRVS,0.58 ,1.01 ,1.01 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76775,CPT,US RETROPERITONEAL REAL TIME W/IMAGE LIMITED,26,,20,,RBRVS,0.58 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76775,CPT,US RETROPERITONEAL REAL TIME W/IMAGE LIMITED,TC,,20,,RBRVS,,0.80 ,0.80 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76776,CPT,US TRNSPLNT KIDNEY REAL TIME W/IMAGE DOCMTN,,,20,,RBRVS,0.76 ,3.61 ,3.61 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76776,CPT,US TRNSPLNT KIDNEY REAL TIME W/IMAGE DOCMTN,26,,20,,RBRVS,0.76 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76776,CPT,US TRNSPLNT KIDNEY REAL TIME W/IMAGE DOCMTN,TC,,20,,RBRVS,,3.33 ,3.33 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76800,CPT,ULTRASOUND SPINAL CANAL & CONTENTS,,,20,,RBRVS,1.13 ,2.71 ,2.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76800,CPT,ULTRASOUND SPINAL CANAL & CONTENTS,26,,20,,RBRVS,1.13 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76800,CPT,ULTRASOUND SPINAL CANAL & CONTENTS,TC,,20,,RBRVS,,2.27 ,2.27 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76801,CPT,US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT,,,20,,RBRVS,0.99 ,2.43 ,2.43 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76801,CPT,US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT,26,,20,,RBRVS,0.99 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76801,CPT,US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT,TC,,20,,RBRVS,,2.05 ,2.05 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76802,CPT,US PREG UTERUS 14 WK TRANSABDL EACH GESTATION,,,20,,RBRVS,0.83 ,0.95 ,0.95 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76802,CPT,US PREG UTERUS 14 WK TRANSABDL EACH GESTATION,26,,20,,RBRVS,0.83 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76802,CPT,US PREG UTERUS 14 WK TRANSABDL EACH GESTATION,TC,,20,,RBRVS,,0.63 ,0.63 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76805,CPT,US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION,,,20,,RBRVS,0.99 ,2.95 ,2.95 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76805,CPT,US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION,26,,20,,RBRVS,0.99 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76805,CPT,US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION,TC,,20,,RBRVS,,2.57 ,2.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76810,CPT,US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO,,,20,,RBRVS,0.98 ,1.61 ,1.61 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76810,CPT,US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO,26,,20,,RBRVS,0.98 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76810,CPT,US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO,TC,,20,,RBRVS,,1.23 ,1.23 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76811,CPT,US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION,,,20,,RBRVS,1.90 ,3.07 ,3.07 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76811,CPT,US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION,26,,20,,RBRVS,1.90 ,0.74 ,0.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76811,CPT,US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION,TC,,20,,RBRVS,,2.33 ,2.33 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76812,CPT,US PREG UTERUS DETAIL FETAL ANAT EXAM EA GESTAT,,,20,,RBRVS,1.78 ,3.89 ,3.89 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76812,CPT,US PREG UTERUS DETAIL FETAL ANAT EXAM EA GESTAT,26,,20,,RBRVS,1.78 ,0.70 ,0.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76812,CPT,US PREG UTERUS DETAIL FETAL ANAT EXAM EA GESTAT,TC,,20,,RBRVS,,3.19 ,3.19 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76813,CPT,US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION,,,20,,RBRVS,1.18 ,2.15 ,2.15 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76813,CPT,US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION,26,,20,,RBRVS,1.18 ,0.46 ,0.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76813,CPT,US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION,TC,,20,,RBRVS,,1.69 ,1.69 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76814,CPT,US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION,,,20,,RBRVS,0.99 ,1.23 ,1.23 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76814,CPT,US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION,26,,20,,RBRVS,0.99 ,0.39 ,0.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76814,CPT,US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION,TC,,20,,RBRVS,,0.84 ,0.84 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76815,CPT,US PREGNANT UTERUS LIMITED 1/> FETUSES,,,20,,RBRVS,0.65 ,1.69 ,1.69 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76815,CPT,US PREGNANT UTERUS LIMITED 1/> FETUSES,26,,20,,RBRVS,0.65 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76815,CPT,US PREGNANT UTERUS LIMITED 1/> FETUSES,TC,,20,,RBRVS,,1.44 ,1.44 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76816,CPT,US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS,,,20,,RBRVS,0.85 ,2.33 ,2.33 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76816,CPT,US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS,26,,20,,RBRVS,0.85 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76816,CPT,US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS,TC,,20,,RBRVS,,2.00 ,2.00 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76817,CPT,US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG,,,20,,RBRVS,0.75 ,1.94 ,1.94 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76817,CPT,US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG,26,,20,,RBRVS,0.75 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76817,CPT,US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG,TC,,20,,RBRVS,,1.65 ,1.65 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76818,CPT,FETAL BIOPHYSICAL PROFILE NON-STRESS TESTING,,,20,,RBRVS,1.05 ,2.29 ,2.29 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76818,CPT,FETAL BIOPHYSICAL PROFILE NON-STRESS TESTING,26,,20,,RBRVS,1.05 ,0.41 ,0.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76818,CPT,FETAL BIOPHYSICAL PROFILE NON-STRESS TESTING,TC,,20,,RBRVS,,1.88 ,1.88 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76819,CPT,FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING,,,20,,RBRVS,0.77 ,1.68 ,1.68 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76819,CPT,FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING,26,,20,,RBRVS,0.77 ,0.30 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76819,CPT,FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING,TC,,20,,RBRVS,,1.38 ,1.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76820,CPT,DOPPLER VELOCIMETRY FETAL UMBILICAL ARTERY,,,20,,RBRVS,0.50 ,0.79 ,0.79 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76820,CPT,DOPPLER VELOCIMETRY FETAL UMBILICAL ARTERY,26,,20,,RBRVS,0.50 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76820,CPT,DOPPLER VELOCIMETRY FETAL UMBILICAL ARTERY,TC,,20,,RBRVS,,0.60 ,0.60 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76821,CPT,DOPPLER VELOCIMETRY FETAL MIDDLE CEREBRAL ART,,,20,,RBRVS,0.70 ,1.86 ,1.86 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76821,CPT,DOPPLER VELOCIMETRY FETAL MIDDLE CEREBRAL ART,26,,20,,RBRVS,0.70 ,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76821,CPT,DOPPLER VELOCIMETRY FETAL MIDDLE CEREBRAL ART,TC,,20,,RBRVS,,1.59 ,1.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76825,CPT,ECHO FETAL CARDIOVASC W/WO M-MODE RECORDING,,,20,,RBRVS,1.67 ,6.02 ,6.02 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76825,CPT,ECHO FETAL CARDIOVASC W/WO M-MODE RECORDING,26,,20,,RBRVS,1.67 ,0.62 ,0.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76825,CPT,ECHO FETAL CARDIOVASC W/WO M-MODE RECORDING,TC,,20,,RBRVS,,5.40 ,5.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76826,CPT,ECHO FETAL CARDIOVASC W/WO M-MODE REPEAT STD,,,20,,RBRVS,0.83 ,3.75 ,3.75 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76826,CPT,ECHO FETAL CARDIOVASC W/WO M-MODE REPEAT STD,26,,20,,RBRVS,0.83 ,0.31 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76826,CPT,ECHO FETAL CARDIOVASC W/WO M-MODE REPEAT STD,TC,,20,,RBRVS,,3.44 ,3.44 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76827,CPT,DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE,,,20,,RBRVS,0.58 ,1.53 ,1.53 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76827,CPT,DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE,26,,20,,RBRVS,0.58 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76827,CPT,DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE,TC,,20,,RBRVS,,1.32 ,1.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76828,CPT,DOPPLER ECHO FETAL PULS SPECTRAL F/U/REPEAT,,,20,,RBRVS,0.56 ,0.91 ,0.91 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76828,CPT,DOPPLER ECHO FETAL PULS SPECTRAL F/U/REPEAT,26,,20,,RBRVS,0.56 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76828,CPT,DOPPLER ECHO FETAL PULS SPECTRAL F/U/REPEAT,TC,,20,,RBRVS,,0.70 ,0.70 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76830,CPT,US TRANSVAGINAL,,,20,,RBRVS,0.69 ,2.71 ,2.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76830,CPT,US TRANSVAGINAL,26,,20,,RBRVS,0.69 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76830,CPT,US TRANSVAGINAL,TC,,20,,RBRVS,,2.45 ,2.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76831,CPT,SALINE INFUS SONOHYSTEROGRAPHY W/COLOR DOPPLER,,,20,,RBRVS,0.72 ,2.57 ,2.57 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76831,CPT,SALINE INFUS SONOHYSTEROGRAPHY W/COLOR DOPPLER,26,,20,,RBRVS,0.72 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76831,CPT,SALINE INFUS SONOHYSTEROGRAPHY W/COLOR DOPPLER,TC,,20,,RBRVS,,2.29 ,2.29 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76856,CPT,US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE,,,20,,RBRVS,0.69 ,2.37 ,2.37 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76856,CPT,US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE,26,,20,,RBRVS,0.69 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76856,CPT,US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE,TC,,20,,RBRVS,,2.12 ,2.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76857,CPT,US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U,,,20,,RBRVS,0.50 ,0.81 ,0.81 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76857,CPT,US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U,26,,20,,RBRVS,0.50 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76857,CPT,US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U,TC,,20,,RBRVS,,0.63 ,0.63 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76870,CPT,US SCROTUM & CONTENTS,,,20,,RBRVS,0.64 ,1.21 ,1.21 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76870,CPT,US SCROTUM & CONTENTS,26,,20,,RBRVS,0.64 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76870,CPT,US SCROTUM & CONTENTS,TC,,20,,RBRVS,,0.98 ,0.98 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76872,CPT,US TRANSRECTAL,,,20,,RBRVS,0.69 ,1.92 ,1.92 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76872,CPT,US TRANSRECTAL,26,,20,,RBRVS,0.69 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76872,CPT,US TRANSRECTAL,TC,,20,,RBRVS,,1.68 ,1.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76873,CPT,US TRANSRCT PRSTATE VOL BRACHYTX PLNNING SPX,,,20,,RBRVS,1.55 ,3.08 ,3.08 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76873,CPT,US TRANSRCT PRSTATE VOL BRACHYTX PLNNING SPX,26,,20,,RBRVS,1.55 ,0.59 ,0.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76873,CPT,US TRANSRCT PRSTATE VOL BRACHYTX PLNNING SPX,TC,,20,,RBRVS,,2.49 ,2.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76881,CPT,US EXTREMITY NON-VASC REAL-TIME IMG COMPL,,,20,,RBRVS,0.63 ,2.62 ,2.62 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76881,CPT,US EXTREMITY NON-VASC REAL-TIME IMG COMPL,26,,20,,RBRVS,0.63 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76881,CPT,US EXTREMITY NON-VASC REAL-TIME IMG COMPL,TC,,20,,RBRVS,,2.38 ,2.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76882,CPT,US EXTREMITY NON-VASC REAL-TIME IMG LMTD,,,20,,RBRVS,0.49 ,0.49 ,0.49 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76882,CPT,US EXTREMITY NON-VASC REAL-TIME IMG LMTD,26,,20,,RBRVS,0.49 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76882,CPT,US EXTREMITY NON-VASC REAL-TIME IMG LMTD,TC,,20,,RBRVS,,0.31 ,0.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76885,CPT,US INFT HIPS R-T IMG DYNAMIC REQ PHYS/QHP MANJ,,,20,,RBRVS,0.74 ,3.32 ,3.32 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76885,CPT,US INFT HIPS R-T IMG DYNAMIC REQ PHYS/QHP MANJ,26,,20,,RBRVS,0.74 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76885,CPT,US INFT HIPS R-T IMG DYNAMIC REQ PHYS/QHP MANJ,TC,,20,,RBRVS,,3.04 ,3.04 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76886,CPT,US INFT HIPS R-T IMG LMTD STATIC PHYS/QHP MANJ,,,20,,RBRVS,0.62 ,2.34 ,2.34 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76886,CPT,US INFT HIPS R-T IMG LMTD STATIC PHYS/QHP MANJ,26,,20,,RBRVS,0.62 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76886,CPT,US INFT HIPS R-T IMG LMTD STATIC PHYS/QHP MANJ,TC,,20,,RBRVS,,2.11 ,2.11 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76930,CPT,US GUIDANCE PERICARDIOCENTESIS RS&I,,,20,,TotalUnits,,,,2.34 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76930,CPT,US GUIDANCE PERICARDIOCENTESIS RS&I,26,,20,,TotalUnits,,,,0.90 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76930,CPT,US GUIDANCE PERICARDIOCENTESIS RS&I,TC,,20,,TotalUnits,,,,1.44 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76932,CPT,US ENDOMYOCARDIAL BIOPSY RS&I,,,20,,TotalUnits,,,,2.46 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76932,CPT,US ENDOMYOCARDIAL BIOPSY RS&I,26,,20,,TotalUnits,,,,0.90 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76932,CPT,US ENDOMYOCARDIAL BIOPSY RS&I,TC,,20,,TotalUnits,,,,1.56 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76936,CPT,US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL,,,20,,RBRVS,1.99 ,5.42 ,5.42 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76936,CPT,US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL,26,,20,,RBRVS,1.99 ,0.57 ,0.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76936,CPT,US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL,TC,,20,,RBRVS,,4.85 ,4.85 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76937,CPT,US VASC ACCESS SITS VSL PATENCY NDL ENTRY,,,20,,RBRVS,0.30 ,0.57 ,0.57 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76937,CPT,US VASC ACCESS SITS VSL PATENCY NDL ENTRY,26,,20,,RBRVS,0.30 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76937,CPT,US VASC ACCESS SITS VSL PATENCY NDL ENTRY,TC,,20,,RBRVS,,0.48 ,0.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76940,CPT,US &MNTR PARENCHYMAL TISSUE ABLATION,,,20,,TotalUnits,,,,4.31 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76940,CPT,US &MNTR PARENCHYMAL TISSUE ABLATION,26,,20,,TotalUnits,,,,2.69 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76940,CPT,US &MNTR PARENCHYMAL TISSUE ABLATION,TC,,20,,TotalUnits,,,,1.62 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76941,CPT,US INTRAUTERINE FTL TFUJ/CORDOCNTS IMG S&I,,,20,,TotalUnits,,,,2.78 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76941,CPT,US INTRAUTERINE FTL TFUJ/CORDOCNTS IMG S&I,26,,20,,TotalUnits,,,,1.79 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76941,CPT,US INTRAUTERINE FTL TFUJ/CORDOCNTS IMG S&I,TC,,20,,TotalUnits,,,,0.99 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76942,CPT,US GUIDANCE NEEDLE PLACEMENT IMG S&I,,,20,,RBRVS,0.67 ,0.98 ,0.98 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76942,CPT,US GUIDANCE NEEDLE PLACEMENT IMG S&I,26,,20,,RBRVS,0.67 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76942,CPT,US GUIDANCE NEEDLE PLACEMENT IMG S&I,TC,,20,,RBRVS,,0.75 ,0.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76945,CPT,US GUIDANCE CHORIONIC VILLUS SAMPLING IMG S&I,,,20,,TotalUnits,,,,2.62 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76945,CPT,US GUIDANCE CHORIONIC VILLUS SAMPLING IMG S&I,26,,20,,TotalUnits,,,,0.93 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76945,CPT,US GUIDANCE CHORIONIC VILLUS SAMPLING IMG S&I,TC,,20,,TotalUnits,,,,1.69 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76946,CPT,US GUIDANCE AMNIOCENTESIS IMG S&I,,,20,,RBRVS,0.38 ,0.51 ,0.51 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76946,CPT,US GUIDANCE AMNIOCENTESIS IMG S&I,26,,20,,RBRVS,0.38 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76946,CPT,US GUIDANCE AMNIOCENTESIS IMG S&I,TC,,20,,RBRVS,,0.36 ,0.36 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76948,CPT,US GUIDANCE ASPIRATION OVA IMG S&I,,,20,,RBRVS,0.67 ,1.37 ,1.37 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76948,CPT,US GUIDANCE ASPIRATION OVA IMG S&I,26,,20,,RBRVS,0.67 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76948,CPT,US GUIDANCE ASPIRATION OVA IMG S&I,TC,,20,,RBRVS,,1.11 ,1.11 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76965,CPT,US GUIDANCE INTERSTITIAL RADIOELMENT APPLICATION,,,20,,RBRVS,1.34 ,1.14 ,1.14 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76965,CPT,US GUIDANCE INTERSTITIAL RADIOELMENT APPLICATION,26,,20,,RBRVS,1.34 ,0.49 ,0.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76965,CPT,US GUIDANCE INTERSTITIAL RADIOELMENT APPLICATION,TC,,20,,RBRVS,,0.65 ,0.65 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76970,CPT,US STUDY FOLLOW UP,,,20,,RBRVS,0.40 ,2.17 ,2.17 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76970,CPT,US STUDY FOLLOW UP,26,,20,,RBRVS,0.40 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76970,CPT,US STUDY FOLLOW UP,TC,,20,,RBRVS,,2.04 ,2.04 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76975,CPT,GI ENDOSCOPIC US S&I,,,20,,TotalUnits,,,,4.35 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76975,CPT,GI ENDOSCOPIC US S&I,26,,20,,TotalUnits,,,,1.15 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76975,CPT,GI ENDOSCOPIC US S&I,TC,,20,,TotalUnits,,,,3.20 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76977,CPT,US BONE DENSITY MEAS & INTERP PERIPH ANY METHO,,,20,,RBRVS,0.05 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76977,CPT,US BONE DENSITY MEAS & INTERP PERIPH ANY METHO,26,,20,,RBRVS,0.05 ,0.02 ,0.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76977,CPT,US BONE DENSITY MEAS & INTERP PERIPH ANY METHO,TC,,20,,RBRVS,,0.11 ,0.11 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76998,CPT,ULTRASONIC GUIDANCE INTRAOPERATIVE,,,20,,TotalUnits,,,,3.01 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76998,CPT,ULTRASONIC GUIDANCE INTRAOPERATIVE,26,,20,,TotalUnits,,,,1.59 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
76998,CPT,ULTRASONIC GUIDANCE INTRAOPERATIVE,TC,,20,,TotalUnits,,,,1.42 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
76999,CPT,UNLISTED US PROCEDURE,,,20,,TotalUnits,,,,3.14 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
76999,CPT,UNLISTED US PROCEDURE,,PC,20,,TotalUnits,,,,0.81 ,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
76999,CPT,UNLISTED US PROCEDURE,,TC,20,,TotalUnits,,,,2.33 ,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
77001,CPT,FLUORO CENTRAL VENOUS ACCESS DEV PLACEMENT,,,20,,RBRVS,0.38 ,1.56 ,1.56 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77001,CPT,FLUORO CENTRAL VENOUS ACCESS DEV PLACEMENT,26,,20,,RBRVS,0.38 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77001,CPT,FLUORO CENTRAL VENOUS ACCESS DEV PLACEMENT,TC,,20,,RBRVS,,1.43 ,1.43 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77002,CPT,FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT,,,20,,RBRVS,0.54 ,2.01 ,2.01 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77002,CPT,FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT,26,,20,,RBRVS,0.54 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77002,CPT,FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT,TC,,20,,RBRVS,,1.79 ,1.79 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77003,CPT,FLUORO NEEDLE/CATH SPINE/PARASPINAL DX/THER,,,20,,RBRVS,0.60 ,1.76 ,1.76 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77003,CPT,FLUORO NEEDLE/CATH SPINE/PARASPINAL DX/THER,26,,20,,RBRVS,0.60 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77003,CPT,FLUORO NEEDLE/CATH SPINE/PARASPINAL DX/THER,TC,,20,,RBRVS,,1.53 ,1.53 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77011,CPT,CT GUIDANCE STEREOTACTIC LOCALIZATION,,,20,,RBRVS,1.21 ,4.90 ,4.90 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77011,CPT,CT GUIDANCE STEREOTACTIC LOCALIZATION,,PC,20,,RBRVS,1.21 ,0.49 ,0.49 ,,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
77011,CPT,CT GUIDANCE STEREOTACTIC LOCALIZATION,,TC,20,,RBRVS,,4.41 ,4.41 ,,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
77012,CPT,CT GUIDANCE NEEDLE PLACEMENT,,,20,,RBRVS,1.16 ,2.27 ,2.27 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77012,CPT,CT GUIDANCE NEEDLE PLACEMENT,,PC,20,,RBRVS,1.16 ,0.41 ,0.41 ,,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
77012,CPT,CT GUIDANCE NEEDLE PLACEMENT,,TC,20,,RBRVS,,1.86 ,1.86 ,,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
77013,CPT,CT GUIDANCE &MONITORING VISC TISS ABLATION,,,20,,TotalUnits,,,,23.20 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77013,CPT,CT GUIDANCE &MONITORING VISC TISS ABLATION,,PC,20,,TotalUnits,,,,5.34 ,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
77013,CPT,CT GUIDANCE &MONITORING VISC TISS ABLATION,,TC,20,,TotalUnits,,,,17.86 ,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
77014,CPT,CT GUIDANCE RADIATION THERAPY FLDS PLACEMENT,,,20,,RBRVS,0.85 ,2.38 ,2.38 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77014,CPT,CT GUIDANCE RADIATION THERAPY FLDS PLACEMENT,,PC,20,,RBRVS,0.85 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
77014,CPT,CT GUIDANCE RADIATION THERAPY FLDS PLACEMENT,,TC,20,,RBRVS,,2.04 ,2.04 ,,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
77021,CPT,MR GUIDANCE NEEDLE PLACEMENT,,,20,,RBRVS,1.50 ,9.95 ,9.95 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77021,CPT,MR GUIDANCE NEEDLE PLACEMENT,26,,20,,RBRVS,1.50 ,0.56 ,0.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77021,CPT,MR GUIDANCE NEEDLE PLACEMENT,TC,,20,,RBRVS,,9.39 ,9.39 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77022,CPT,MR GUIDANCE &MONITORING TISSUE ABLATION,,,20,,TotalUnits,,,,28.82 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77022,CPT,MR GUIDANCE &MONITORING TISSUE ABLATION,26,,20,,TotalUnits,,,,5.80 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77022,CPT,MR GUIDANCE &MONITORING TISSUE ABLATION,TC,,20,,TotalUnits,,,,23.02 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77051,CPT,COMPUTER-AIDED DETECTION DX MAMMOGRAPHY,,,20,,RBRVS,0.06 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77051,CPT,COMPUTER-AIDED DETECTION DX MAMMOGRAPHY,26,,20,,RBRVS,0.06 ,0.02 ,0.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77051,CPT,COMPUTER-AIDED DETECTION DX MAMMOGRAPHY,TC,,20,,RBRVS,,0.15 ,0.15 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77052,CPT,COMPUTER-AIDED DETECTION SCREENING MAMMOGRAPHY,,,20,,RBRVS,0.06 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77052,CPT,COMPUTER-AIDED DETECTION SCREENING MAMMOGRAPHY,26,,20,,RBRVS,0.06 ,0.02 ,0.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77052,CPT,COMPUTER-AIDED DETECTION SCREENING MAMMOGRAPHY,TC,,20,,RBRVS,,0.15 ,0.15 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77053,CPT,MAMMARY DUCTOGRAM OR GALACTOGRAM SINGLE,,,20,,RBRVS,0.36 ,1.24 ,1.24 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77053,CPT,MAMMARY DUCTOGRAM OR GALACTOGRAM SINGLE,26,,20,,RBRVS,0.36 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77053,CPT,MAMMARY DUCTOGRAM OR GALACTOGRAM SINGLE,TC,,20,,RBRVS,,1.11 ,1.11 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77054,CPT,MAMMARY DUCTOGRAM OR GALACTOGRAM MULTIPLE,,,20,,RBRVS,0.45 ,1.65 ,1.65 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77054,CPT,MAMMARY DUCTOGRAM OR GALACTOGRAM MULTIPLE,26,,20,,RBRVS,0.45 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77054,CPT,MAMMARY DUCTOGRAM OR GALACTOGRAM MULTIPLE,TC,,20,,RBRVS,,1.48 ,1.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77055,CPT,MAMMOGRAPHY UNILATERAL,,,20,,RBRVS,0.70 ,1.77 ,1.77 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77055,CPT,MAMMOGRAPHY UNILATERAL,26,,20,,RBRVS,0.70 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77055,CPT,MAMMOGRAPHY UNILATERAL,TC,,20,,RBRVS,,1.51 ,1.51 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77056,CPT,MAMMOGRAPHY BILATERAL,,,20,,RBRVS,0.87 ,2.31 ,2.31 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77056,CPT,MAMMOGRAPHY BILATERAL,26,,20,,RBRVS,0.87 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77056,CPT,MAMMOGRAPHY BILATERAL,TC,,20,,RBRVS,,1.99 ,1.99 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77057,CPT,SCREENING MAMMOGRAPHY BILATERAL,,,20,,RBRVS,0.70 ,1.56 ,1.56 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77057,CPT,SCREENING MAMMOGRAPHY BILATERAL,26,,20,,RBRVS,0.70 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77057,CPT,SCREENING MAMMOGRAPHY BILATERAL,TC,,20,,RBRVS,,1.30 ,1.30 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77058,CPT,MRI BREAST UNILATERAL,,,20,,RBRVS,1.63 ,13.43 ,13.43 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77058,CPT,MRI BREAST UNILATERAL,26,,20,,RBRVS,1.63 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77058,CPT,MRI BREAST UNILATERAL,TC,,20,,RBRVS,,12.83 ,12.83 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77059,CPT,MRI BREAST BILATERAL,,,20,,RBRVS,1.63 ,13.27 ,13.27 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77059,CPT,MRI BREAST BILATERAL,26,,20,,RBRVS,1.63 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77059,CPT,MRI BREAST BILATERAL,TC,,20,,RBRVS,,12.67 ,12.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77061,CPT,DIGITAL BREAST TOMOSYNTHESIS UNILATERAL,,,20,,RBRVS,0.87 ,3.66 ,3.66 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77061,CPT,DIGITAL BREAST TOMOSYNTHESIS UNILATERAL,26,,20,,RBRVS,0.87 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77061,CPT,DIGITAL BREAST TOMOSYNTHESIS UNILATERAL,TC,,20,,RBRVS,,3.34 ,3.34 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77062,CPT,DIGITAL BREAST TOMOSYNTHESIS BILATERAL,,,20,,RBRVS,0.70 ,2.87 ,2.87 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77062,CPT,DIGITAL BREAST TOMOSYNTHESIS BILATERAL,26,,20,,RBRVS,0.70 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77062,CPT,DIGITAL BREAST TOMOSYNTHESIS BILATERAL,TC,,20,,RBRVS,,2.62 ,2.62 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77063,CPT,SCREENING DIGITAL BREAST TOMOSYNTHESIS BI,,,20,,RBRVS,0.60 ,0.93 ,0.93 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77063,CPT,SCREENING DIGITAL BREAST TOMOSYNTHESIS BI,26,,20,,RBRVS,0.60 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77063,CPT,SCREENING DIGITAL BREAST TOMOSYNTHESIS BI,TC,,20,,RBRVS,,0.71 ,0.71 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77071,CPT,MANUAL APPL STRESS PFRMD PHYS/QHP JOINT FILMS,,PC,20,,RBRVS,0.41 ,0.88 ,0.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77072,CPT,BONE AGE STUDIES,,,20,,RBRVS,0.19 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77072,CPT,BONE AGE STUDIES,26,,20,,RBRVS,0.19 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77072,CPT,BONE AGE STUDIES,TC,,20,,RBRVS,,0.37 ,0.37 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77073,CPT,BONE LENGTH STUDIES,,,20,,RBRVS,0.27 ,0.71 ,0.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77073,CPT,BONE LENGTH STUDIES,26,,20,,RBRVS,0.27 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77073,CPT,BONE LENGTH STUDIES,TC,,20,,RBRVS,,0.59 ,0.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77074,CPT,RADIOLOGIC EXAMINATION OSSEOUS SURVEY LIMITED,,,20,,RBRVS,0.45 ,1.31 ,1.31 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77074,CPT,RADIOLOGIC EXAMINATION OSSEOUS SURVEY LIMITED,26,,20,,RBRVS,0.45 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77074,CPT,RADIOLOGIC EXAMINATION OSSEOUS SURVEY LIMITED,TC,,20,,RBRVS,,1.14 ,1.14 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77075,CPT,RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPL,,,20,,RBRVS,0.54 ,1.86 ,1.86 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77075,CPT,RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPL,26,,20,,RBRVS,0.54 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77075,CPT,RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPL,TC,,20,,RBRVS,,1.66 ,1.66 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77076,CPT,RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT,,,20,,RBRVS,0.70 ,1.92 ,1.92 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77076,CPT,RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT,26,,20,,RBRVS,0.70 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77076,CPT,RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT,TC,,20,,RBRVS,,1.66 ,1.66 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77077,CPT,JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS,,,20,,RBRVS,0.31 ,0.70 ,0.70 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77077,CPT,JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS,26,,20,,RBRVS,0.31 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77077,CPT,JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS,TC,,20,,RBRVS,,0.57 ,0.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77078,CPT,CT BONE MINERL DENSITY STUDY 1/> SITS AXIAL SKE,,,20,,RBRVS,0.25 ,2.92 ,2.92 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77078,CPT,CT BONE MINERL DENSITY STUDY 1/> SITS AXIAL SKE,26,,20,,RBRVS,0.25 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77078,CPT,CT BONE MINERL DENSITY STUDY 1/> SITS AXIAL SKE,TC,,20,,RBRVS,,2.83 ,2.83 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77080,CPT,DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL,,,20,,RBRVS,0.20 ,0.94 ,0.94 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77080,CPT,DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL,26,,20,,RBRVS,0.20 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77080,CPT,DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL,TC,,20,,RBRVS,,0.86 ,0.86 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77081,CPT,DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL,,,20,,RBRVS,0.22 ,0.55 ,0.55 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77081,CPT,DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL,26,,20,,RBRVS,0.22 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77081,CPT,DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL,TC,,20,,RBRVS,,0.47 ,0.47 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77084,CPT,BONE MARROW BLOOD SUPPLY,,,20,,RBRVS,1.60 ,9.24 ,9.24 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77084,CPT,BONE MARROW BLOOD SUPPLY,26,,20,,RBRVS,1.60 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77084,CPT,BONE MARROW BLOOD SUPPLY,TC,,20,,RBRVS,,8.64 ,8.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77085,CPT,DXA BONE DENSITY STUDY AXIAL SKELETON,,,20,,RBRVS,0.30 ,1.26 ,1.26 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77085,CPT,DXA BONE DENSITY STUDY AXIAL SKELETON,26,,20,,RBRVS,0.30 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77085,CPT,DXA BONE DENSITY STUDY AXIAL SKELETON,TC,,20,,RBRVS,,1.14 ,1.14 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77086,CPT,VERTEBRAL FRACTURE ASSESSMENT VIA DXA,,,20,,RBRVS,0.17 ,0.81 ,0.81 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77086,CPT,VERTEBRAL FRACTURE ASSESSMENT VIA DXA,26,,20,,RBRVS,0.17 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77086,CPT,VERTEBRAL FRACTURE ASSESSMENT VIA DXA,TC,,20,,RBRVS,,0.74 ,0.74 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77261,CPT,THERAPEUTIC RADIOLOGY TX PLANNING SIMPLE,,PC,20,,RBRVS,1.39 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77262,CPT,THERAPEUTIC RADIOLOGY TX PLANNING INTERMEDIATE,,PC,20,,RBRVS,2.11 ,0.91 ,0.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77263,CPT,THERAPEUTIC RADIOLOGY TX PLANNING COMPLEX,,PC,20,,RBRVS,3.14 ,1.26 ,1.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77280,CPT,THER RAD SIMULAJ-AIDED FIELD SETTING SIMPLE,,,20,,RBRVS,0.70 ,6.85 ,6.85 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77280,CPT,THER RAD SIMULAJ-AIDED FIELD SETTING SIMPLE,26,,20,,RBRVS,0.70 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77280,CPT,THER RAD SIMULAJ-AIDED FIELD SETTING SIMPLE,TC,,20,,RBRVS,,6.57 ,6.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77285,CPT,THER RAD SIMULAJ-AIDED FIELD SETTING INTERMED,,,20,,RBRVS,1.05 ,10.86 ,10.86 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77285,CPT,THER RAD SIMULAJ-AIDED FIELD SETTING INTERMED,26,,20,,RBRVS,1.05 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77285,CPT,THER RAD SIMULAJ-AIDED FIELD SETTING INTERMED,TC,,20,,RBRVS,,10.43 ,10.43 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77290,CPT,THER RAD SIMULAJ-AIDED FIELD SETTING COMPLEX,,,20,,RBRVS,1.56 ,12.66 ,12.66 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77290,CPT,THER RAD SIMULAJ-AIDED FIELD SETTING COMPLEX,26,,20,,RBRVS,1.56 ,0.63 ,0.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77290,CPT,THER RAD SIMULAJ-AIDED FIELD SETTING COMPLEX,TC,,20,,RBRVS,,12.03 ,12.03 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77293,CPT,RESPIRATORY MOTION MANAGEMENT SIMULATION,,,20,,RBRVS,2.00 ,10.87 ,10.87 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77293,CPT,RESPIRATORY MOTION MANAGEMENT SIMULATION,26,,20,,RBRVS,2.00 ,0.80 ,0.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77293,CPT,RESPIRATORY MOTION MANAGEMENT SIMULATION,TC,,20,,RBRVS,,10.07 ,10.07 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77295,CPT,3-D RADIOTHERAPY PLAN DOSE-VOLUME HISTOGRAMS,,,20,,RBRVS,4.29 ,9.13 ,9.13 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77295,CPT,3-D RADIOTHERAPY PLAN DOSE-VOLUME HISTOGRAMS,26,,20,,RBRVS,4.29 ,1.72 ,1.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77295,CPT,3-D RADIOTHERAPY PLAN DOSE-VOLUME HISTOGRAMS,TC,,20,,RBRVS,,7.41 ,7.41 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77299,CPT,UNLIS PX THER RADIOL CLINICAL TX PLANNING,,,20,,TotalUnits,,,,13.42 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77299,CPT,UNLIS PX THER RADIOL CLINICAL TX PLANNING,26,,20,,TotalUnits,,,,3.42 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77299,CPT,UNLIS PX THER RADIOL CLINICAL TX PLANNING,TC,,20,,TotalUnits,,,,10.00 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77300,CPT,BASIC RADIATION DOSIMETRY CALCULATION,,,20,,RBRVS,0.62 ,1.11 ,1.11 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77300,CPT,BASIC RADIATION DOSIMETRY CALCULATION,26,,20,,RBRVS,0.62 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77300,CPT,BASIC RADIATION DOSIMETRY CALCULATION,TC,,20,,RBRVS,,0.86 ,0.86 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77301,CPT,NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS,,,20,,RBRVS,7.99 ,45.65 ,45.66 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77301,CPT,NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS,26,,20,,RBRVS,7.99 ,3.19 ,3.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77301,CPT,NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS,TC,,20,,RBRVS,,42.46 ,42.46 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77306,CPT,TELETHX ISODOSE PLN SMPL W/DOSIMETRY CALCULATION,,,20,,RBRVS,1.40 ,2.60 ,2.60 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77306,CPT,TELETHX ISODOSE PLN SMPL W/DOSIMETRY CALCULATION,26,,20,,RBRVS,1.40 ,0.56 ,0.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77306,CPT,TELETHX ISODOSE PLN SMPL W/DOSIMETRY CALCULATION,TC,,20,,RBRVS,,2.04 ,2.04 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77307,CPT,TELETHX ISODOSE PLN CPLX W/BASIC DOSIMETRY,,,20,,RBRVS,2.90 ,4.90 ,4.90 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77307,CPT,TELETHX ISODOSE PLN CPLX W/BASIC DOSIMETRY,26,,20,,RBRVS,2.90 ,1.17 ,1.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77307,CPT,TELETHX ISODOSE PLN CPLX W/BASIC DOSIMETRY,TC,,20,,RBRVS,,3.73 ,3.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77316,CPT,BRACHYTX ISODOSE PLN SMPL W/DOSIMETRY CAL,,,20,,RBRVS,1.40 ,3.73 ,3.73 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77316,CPT,BRACHYTX ISODOSE PLN SMPL W/DOSIMETRY CAL,26,,20,,RBRVS,1.40 ,0.56 ,0.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77316,CPT,BRACHYTX ISODOSE PLN SMPL W/DOSIMETRY CAL,TC,,20,,RBRVS,,3.17 ,3.17 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77317,CPT,BRACHYTX ISODOSE PLN INTERMED W/DOSIMETRY CAL,,,20,,RBRVS,1.83 ,4.87 ,4.87 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77317,CPT,BRACHYTX ISODOSE PLN INTERMED W/DOSIMETRY CAL,26,,20,,RBRVS,1.83 ,0.74 ,0.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77317,CPT,BRACHYTX ISODOSE PLN INTERMED W/DOSIMETRY CAL,TC,,20,,RBRVS,,4.13 ,4.13 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77318,CPT,BRACHYTX ISODOSE PLN CPLX W/DOSIMETRY CAL,,,20,,RBRVS,2.90 ,6.78 ,6.78 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77318,CPT,BRACHYTX ISODOSE PLN CPLX W/DOSIMETRY CAL,26,,20,,RBRVS,2.90 ,1.17 ,1.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77318,CPT,BRACHYTX ISODOSE PLN CPLX W/DOSIMETRY CAL,TC,,20,,RBRVS,,5.61 ,5.61 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77321,CPT,SPEC TELETHX PORT PLN PARTS HEMIBDY TOT BDY,,,20,,RBRVS,0.95 ,1.58 ,1.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77321,CPT,SPEC TELETHX PORT PLN PARTS HEMIBDY TOT BDY,26,,20,,RBRVS,0.95 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77321,CPT,SPEC TELETHX PORT PLN PARTS HEMIBDY TOT BDY,TC,,20,,RBRVS,,1.20 ,1.20 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77331,CPT,SPEC DOSIM ONLY PRESCRIBED TREATING PHYS,,,20,,RBRVS,0.87 ,0.87 ,0.87 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77331,CPT,SPEC DOSIM ONLY PRESCRIBED TREATING PHYS,26,,20,,RBRVS,0.87 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77331,CPT,SPEC DOSIM ONLY PRESCRIBED TREATING PHYS,TC,,20,,RBRVS,,0.52 ,0.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77332,CPT,TX DEVICES DESIGN & CONSTRUCTION SIMPLE,,,20,,RBRVS,0.54 ,1.74 ,1.74 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77332,CPT,TX DEVICES DESIGN & CONSTRUCTION SIMPLE,26,,20,,RBRVS,0.54 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77332,CPT,TX DEVICES DESIGN & CONSTRUCTION SIMPLE,TC,,20,,RBRVS,,1.51 ,1.51 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77333,CPT,TX DEVICES DESIGN & CONSTRUCTION INTERMEDIATE,,,20,,RBRVS,0.84 ,0.59 ,0.59 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77333,CPT,TX DEVICES DESIGN & CONSTRUCTION INTERMEDIATE,26,,20,,RBRVS,0.84 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77333,CPT,TX DEVICES DESIGN & CONSTRUCTION INTERMEDIATE,TC,,20,,RBRVS,,0.25 ,0.25 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77334,CPT,TX DEVICES DESIGN & CONSTRUCTION COMPLEX,,,20,,RBRVS,1.24 ,2.96 ,2.96 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77334,CPT,TX DEVICES DESIGN & CONSTRUCTION COMPLEX,26,,20,,RBRVS,1.24 ,0.50 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77334,CPT,TX DEVICES DESIGN & CONSTRUCTION COMPLEX,TC,,20,,RBRVS,,2.46 ,2.46 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77336,CPT,CONTINUING MEDICAL PHYSICS CONSLTJ PR WK,,TC,20,,RBRVS,,2.13 ,2.13 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77338,CPT,MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN,,,20,,RBRVS,4.29 ,9.60 ,9.60 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77338,CPT,MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN,,PC,20,,RBRVS,4.29 ,1.72 ,1.72 ,,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
77338,CPT,MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN,,TC,20,,RBRVS,,7.88 ,7.88 ,,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
77370,CPT,SPEC MEDICAL RADJ PHYSICS CONSLTJ,,TC,20,,RBRVS,,3.23 ,3.23 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77371,CPT,RADIATION DELIVERY STEREOTACTIC CRANIAL COBALT,,TC,20,,RBRVS,6.66 ,26.28 ,26.28 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77372,CPT,RADIATION DELIVERY STEREOTACTIC CRANIAL LINEAR,,TC,20,,RBRVS,,29.67 ,29.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77373,CPT,STEREOTACTIC BODY RADIATION DELIVERY,,TC,20,,RBRVS,,37.68 ,37.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77385,CPT,INTENSITY MODULATED RADIATION TX DLVR SIMPLE,,TC,20,,RBRVS,,11.15 ,11.15 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77386,CPT,INTENSITY MODULATED RADIATION TX DLVR COMPLEX,,TC,20,,RBRVS,,11.15 ,11.15 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77387,CPT,GUIDANCE FOR LOC OF TARGET VOL RADIAJ TX DLVR,,,20,,RBRVS,0.49 ,1.25 ,1.25 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77387,CPT,GUIDANCE FOR LOC OF TARGET VOL RADIAJ TX DLVR,26,,20,,RBRVS,0.49 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77387,CPT,GUIDANCE FOR LOC OF TARGET VOL RADIAJ TX DLVR,TC,,20,,RBRVS,,1.05 ,1.05 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77399,CPT,UNLIS MEDICAL RADJ DOSIM TX DEV SPEC SVCS,,,20,,TotalUnits,,,,2.13 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77399,CPT,UNLIS MEDICAL RADJ DOSIM TX DEV SPEC SVCS,,PC,20,,TotalUnits,,,,0.85 ,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
77399,CPT,UNLIS MEDICAL RADJ DOSIM TX DEV SPEC SVCS,,TC,20,,TotalUnits,,,,1.28 ,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
77401,CPT,RADIATION TX DELIVERY SUPERFICIAL&/ORTHO VOLTA,,TC,20,,RBRVS,,0.57 ,0.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77402,CPT,RADIATION TREATMENT DELIVERY 1 MEV >= SIMPLE,,TC,20,,TotalUnits,,,,1.51 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77407,CPT,RADIATION TX DELIVERY 1 MEV >= INTERMEDIATE,,TC,20,,TotalUnits,,,,1.99 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77412,CPT,RADIATION TREATMENT DELIVERY 1 MEV >= COMPLEX,,TC,20,,TotalUnits,,,,2.30 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77417,CPT,THERAPEUTIC RADIOLOGY PORT IMAGES(S),,TC,20,,RBRVS,,0.29 ,0.29 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77422,CPT,HIGH ENERGY NEUTRON RADJ TX DLVR 1 TX AREA,,TC,20,,RBRVS,,0.93 ,0.93 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77423,CPT,HIGH ENERGY NEUTRON RADJ TX DLVR 1/> ISOCENTER,,TC,20,,RBRVS,,1.81 ,1.81 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77427,CPT,RADIATION TREATMENT MANAGEMENT 5 TREATMENTS,,PC,20,,RBRVS,3.37 ,1.58 ,1.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77431,CPT,RADIATION THERAPY MGMT 1/2 FRACTIONS ONLY,,PC,20,,RBRVS,1.81 ,0.91 ,0.91 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77432,CPT,STERETCTC RADIATION TX MANAGEMENT CRANIAL LESION,,PC,20,,RBRVS,7.92 ,3.16 ,3.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77435,CPT,STEREOTACTIC BODY RADIATION MANAGEMENT,,PC,20,,RBRVS,11.87 ,4.86 ,4.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77469,CPT,INTRAOPERATIVE RADIATION TREATMENT MANAGEMENT,,,20,,RBRVS,5.75 ,2.86 ,2.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77470,CPT,SPECIAL TREATMENT PROCEDURE,,,20,,RBRVS,2.09 ,2.15 ,2.15 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77470,CPT,SPECIAL TREATMENT PROCEDURE,26,,20,,RBRVS,2.09 ,0.84 ,0.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77470,CPT,SPECIAL TREATMENT PROCEDURE,TC,,20,,RBRVS,,1.31 ,1.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77499,CPT,UNLISTED PROCEDURE THERAPEUTIC RADIOLOGY TX MGMT,,,20,,TotalUnits,,,,4.95 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77499,CPT,UNLISTED PROCEDURE THERAPEUTIC RADIOLOGY TX MGMT,,PC,20,,TotalUnits,,,,0.84 ,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
77499,CPT,UNLISTED PROCEDURE THERAPEUTIC RADIOLOGY TX MGMT,,TC,20,,TotalUnits,,,,4.11 ,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
77520,CPT,PROTON TX DELIVERY SIMPLE W/O COMPENSATION,,TC,20,,TotalUnits,,,,17.30 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77522,CPT,PROTON TX DELIVERY SIMPLE W/COMPENSATION,,TC,20,,TotalUnits,,,,24.24 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77523,CPT,PROTON TX DELIVERY INTERMEDIATE,,TC,20,,TotalUnits,,,,24.75 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77525,CPT,PROTON TX DELIVERY COMPLEX,,TC,20,,TotalUnits,,,,25.94 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77600,CPT,HYPERTHERMIA EXTERNAL GENERATED SUPERFICIAL,,,20,,RBRVS,1.56 ,9.63 ,9.63 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77600,CPT,HYPERTHERMIA EXTERNAL GENERATED SUPERFICIAL,26,,20,,RBRVS,1.56 ,0.63 ,0.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77600,CPT,HYPERTHERMIA EXTERNAL GENERATED SUPERFICIAL,TC,,20,,RBRVS,,9.00 ,9.00 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77605,CPT,HYPERTHERMIA EXTERNAL GENERATED DEEP,,,20,,RBRVS,2.09 ,19.16 ,19.16 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77605,CPT,HYPERTHERMIA EXTERNAL GENERATED DEEP,26,,20,,RBRVS,2.09 ,0.82 ,0.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77605,CPT,HYPERTHERMIA EXTERNAL GENERATED DEEP,TC,,20,,RBRVS,,18.34 ,18.34 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77610,CPT,HYPERTHERMIA INTERSTITIAL PROBE 5/< APPLICATORS,,,20,,RBRVS,1.56 ,27.18 ,27.18 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77610,CPT,HYPERTHERMIA INTERSTITIAL PROBE 5/< APPLICATORS,26,,20,,RBRVS,1.56 ,0.56 ,0.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77610,CPT,HYPERTHERMIA INTERSTITIAL PROBE 5/< APPLICATORS,TC,,20,,RBRVS,,26.62 ,26.62 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77615,CPT,HYPERTHERMIA INTERSTIAL PROBE 5/> APPLICATORS,,,20,,RBRVS,2.09 ,26.07 ,26.07 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77615,CPT,HYPERTHERMIA INTERSTIAL PROBE 5/> APPLICATORS,26,,20,,RBRVS,2.09 ,0.84 ,0.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77615,CPT,HYPERTHERMIA INTERSTIAL PROBE 5/> APPLICATORS,TC,,20,,RBRVS,,25.23 ,25.23 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77620,CPT,HYPERTHERMIA INTRACAVITARY PROBES,,,20,,RBRVS,1.56 ,11.11 ,11.11 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77620,CPT,HYPERTHERMIA INTRACAVITARY PROBES,26,,20,,RBRVS,1.56 ,0.58 ,0.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77620,CPT,HYPERTHERMIA INTRACAVITARY PROBES,TC,,20,,RBRVS,,10.53 ,10.53 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77750,CPT,NFS/INSTLJ RADIOELMNT SLN 3 MO FOLLOW-UP CARE,,,20,,RBRVS,5.00 ,5.11 ,5.11 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77750,CPT,NFS/INSTLJ RADIOELMNT SLN 3 MO FOLLOW-UP CARE,26,,20,,RBRVS,5.00 ,2.01 ,2.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77750,CPT,NFS/INSTLJ RADIOELMNT SLN 3 MO FOLLOW-UP CARE,TC,,20,,RBRVS,,3.10 ,3.10 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77761,CPT,INTRACAVITARY RADIATION SOURCE APPLIC SIMPLE,,,20,,RBRVS,3.85 ,6.79 ,6.79 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77761,CPT,INTRACAVITARY RADIATION SOURCE APPLIC SIMPLE,26,,20,,RBRVS,3.85 ,1.49 ,1.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77761,CPT,INTRACAVITARY RADIATION SOURCE APPLIC SIMPLE,TC,,20,,RBRVS,,5.30 ,5.30 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77762,CPT,INTRACAVITARY RADIATION SOURCE APPLIC INTERMED,,,20,,RBRVS,5.76 ,8.34 ,8.34 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77762,CPT,INTRACAVITARY RADIATION SOURCE APPLIC INTERMED,26,,20,,RBRVS,5.76 ,2.24 ,2.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77762,CPT,INTRACAVITARY RADIATION SOURCE APPLIC INTERMED,TC,,20,,RBRVS,,6.10 ,6.10 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77763,CPT,INTRACAVITARY RADIATION SOURCE APPLIC COMPLEX,,,20,,RBRVS,8.66 ,11.32 ,11.33 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77763,CPT,INTRACAVITARY RADIATION SOURCE APPLIC COMPLEX,26,,20,,RBRVS,8.66 ,3.45 ,3.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77763,CPT,INTRACAVITARY RADIATION SOURCE APPLIC COMPLEX,TC,,20,,RBRVS,,7.87 ,7.87 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77767,CPT,HDR RDNCL SKN SURF BRACHYTX LES </2CM/1 CHAN,,,20,,RBRVS,1.05 ,5.21 ,5.21 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77767,CPT,HDR RDNCL SKN SURF BRACHYTX LES </2CM/1 CHAN,26,,20,,RBRVS,1.05 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77767,CPT,HDR RDNCL SKN SURF BRACHYTX LES </2CM/1 CHAN,TC,,20,,RBRVS,,4.77 ,4.77 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77768,CPT,HDR RDNCL SK SRF BRCHYTX LES >2CM&2CHAN/MLT LES,,,20,,RBRVS,1.40 ,8.42 ,8.42 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77768,CPT,HDR RDNCL SK SRF BRCHYTX LES >2CM&2CHAN/MLT LES,26,,20,,RBRVS,1.40 ,0.58 ,0.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77768,CPT,HDR RDNCL SK SRF BRCHYTX LES >2CM&2CHAN/MLT LES,TC,,20,,RBRVS,,7.84 ,7.84 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77770,CPT,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 1 CHANNEL,,,20,,RBRVS,1.95 ,6.98 ,6.98 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77770,CPT,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 1 CHANNEL,26,,20,,RBRVS,1.95 ,0.81 ,0.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77770,CPT,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 1 CHANNEL,TC,,20,,RBRVS,,6.17 ,6.17 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77771,CPT,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 2-12 CHANNEL,,,20,,RBRVS,3.80 ,12.83 ,12.83 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77771,CPT,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 2-12 CHANNEL,26,,20,,RBRVS,3.80 ,1.59 ,1.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77771,CPT,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 2-12 CHANNEL,TC,,20,,RBRVS,,11.24 ,11.24 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77772,CPT,HDR RDNCL NTRSTL/INTRCAV BRACHYTX >12 CHANNELS,,,20,,RBRVS,5.40 ,19.97 ,19.97 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77772,CPT,HDR RDNCL NTRSTL/INTRCAV BRACHYTX >12 CHANNELS,26,,20,,RBRVS,5.40 ,2.24 ,2.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77772,CPT,HDR RDNCL NTRSTL/INTRCAV BRACHYTX >12 CHANNELS,TC,,20,,RBRVS,,17.73 ,17.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77778,CPT,INTERSTITIAL RADIATION SOURCE APPLIC COMPLEX,,,20,,RBRVS,11.32 ,12.48 ,12.49 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77778,CPT,INTERSTITIAL RADIATION SOURCE APPLIC COMPLEX,26,,20,,RBRVS,11.32 ,4.48 ,4.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77778,CPT,INTERSTITIAL RADIATION SOURCE APPLIC COMPLEX,TC,,20,,RBRVS,,8.00 ,8.00 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77789,CPT,SURFACE APPLIC LOW DOSE RATE RADIONUCLIDE SOURCE,,,20,,RBRVS,1.14 ,2.14 ,2.14 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77789,CPT,SURFACE APPLIC LOW DOSE RATE RADIONUCLIDE SOURCE,26,,20,,RBRVS,1.14 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77789,CPT,SURFACE APPLIC LOW DOSE RATE RADIONUCLIDE SOURCE,TC,,20,,RBRVS,,1.67 ,1.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77790,CPT,SUPERVISION HANDLING LOADING RADIATION SOURCE,,TC,20,,RBRVS,1.05 ,1.60 ,1.60 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77790,CPT,SUPERVISION HANDLING LOADING RADIATION SOURCE,26,,20,,RBRVS,1.05 ,0.41 ,0.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77790,CPT,SUPERVISION HANDLING LOADING RADIATION SOURCE,TC,,20,,RBRVS,,1.19 ,1.19 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
77799,CPT,UNLISTED PROCEDURE CLINICAL BRACHYTHERAPY,,,20,,TotalUnits,,,,23.81 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
77799,CPT,UNLISTED PROCEDURE CLINICAL BRACHYTHERAPY,26,,20,,TotalUnits,,,,10.78 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
77799,CPT,UNLISTED PROCEDURE CLINICAL BRACHYTHERAPY,TC,,20,,TotalUnits,,,,13.02 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78012,CPT,THYROID UPTAKE SINGLE/MULTIPLE QUANT MEASUREMENT,,,20,,RBRVS,0.19 ,2.09 ,2.09 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78012,CPT,THYROID UPTAKE SINGLE/MULTIPLE QUANT MEASUREMENT,26,,20,,RBRVS,0.19 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78012,CPT,THYROID UPTAKE SINGLE/MULTIPLE QUANT MEASUREMENT,TC,,20,,RBRVS,,2.02 ,2.02 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78013,CPT,THYROID IMAGING WITH VASCULAR FLOW,,,20,,RBRVS,0.37 ,5.11 ,5.11 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78013,CPT,THYROID IMAGING WITH VASCULAR FLOW,26,,20,,RBRVS,0.37 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78013,CPT,THYROID IMAGING WITH VASCULAR FLOW,TC,,20,,RBRVS,,4.98 ,4.98 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78014,CPT,THYROID UPTAKE W/BLOOD FLOW SNGLE/MULT QUAN MEAS,,,20,,RBRVS,0.50 ,6.44 ,6.44 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78014,CPT,THYROID UPTAKE W/BLOOD FLOW SNGLE/MULT QUAN MEAS,26,,20,,RBRVS,0.50 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78014,CPT,THYROID UPTAKE W/BLOOD FLOW SNGLE/MULT QUAN MEAS,TC,,20,,RBRVS,,6.27 ,6.27 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78015,CPT,THYROID CARCINOMA METASTASES IMG LMTD AREA,,,20,,RBRVS,0.67 ,5.67 ,5.67 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78015,CPT,THYROID CARCINOMA METASTASES IMG LMTD AREA,26,,20,,RBRVS,0.67 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78015,CPT,THYROID CARCINOMA METASTASES IMG LMTD AREA,TC,,20,,RBRVS,,5.44 ,5.44 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78016,CPT,THYROID CARCINOMA METASTASES IMG ADDL STUDY,,,20,,RBRVS,0.82 ,7.34 ,7.34 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78016,CPT,THYROID CARCINOMA METASTASES IMG ADDL STUDY,26,,20,,RBRVS,0.82 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78016,CPT,THYROID CARCINOMA METASTASES IMG ADDL STUDY,TC,,20,,RBRVS,,7.19 ,7.19 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78018,CPT,THYROID CARCINOMA METASTASES IMG WHOLE BODY,,,20,,RBRVS,0.86 ,8.12 ,8.12 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78018,CPT,THYROID CARCINOMA METASTASES IMG WHOLE BODY,26,,20,,RBRVS,0.86 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78018,CPT,THYROID CARCINOMA METASTASES IMG WHOLE BODY,TC,,20,,RBRVS,,7.84 ,7.84 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78020,CPT,THYROID CARCINOMA METASTASES UPTAKE,,,20,,RBRVS,0.60 ,1.78 ,1.78 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78020,CPT,THYROID CARCINOMA METASTASES UPTAKE,26,,20,,RBRVS,0.60 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78020,CPT,THYROID CARCINOMA METASTASES UPTAKE,TC,,20,,RBRVS,,1.61 ,1.61 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78070,CPT,PARATHYROID PLANAR IMAGING,,,20,,RBRVS,0.80 ,7.85 ,7.85 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78070,CPT,PARATHYROID PLANAR IMAGING,26,,20,,RBRVS,0.80 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78070,CPT,PARATHYROID PLANAR IMAGING,TC,,20,,RBRVS,,7.57 ,7.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78071,CPT,PARATHYROID PLANAR IMAGING W/WO SUBTRACTION,,,20,,RBRVS,1.20 ,9.10 ,9.10 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78071,CPT,PARATHYROID PLANAR IMAGING W/WO SUBTRACTION,26,,20,,RBRVS,1.20 ,0.41 ,0.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78071,CPT,PARATHYROID PLANAR IMAGING W/WO SUBTRACTION,TC,,20,,RBRVS,,8.69 ,8.69 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78072,CPT,PARATHYROID IMAGING W/TOMOGRAPHIC SPECT & CT,,,20,,RBRVS,1.60 ,10.18 ,10.18 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78072,CPT,PARATHYROID IMAGING W/TOMOGRAPHIC SPECT & CT,26,,20,,RBRVS,1.60 ,0.50 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78072,CPT,PARATHYROID IMAGING W/TOMOGRAPHIC SPECT & CT,TC,,20,,RBRVS,,9.68 ,9.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78075,CPT,ADRENAL IMAGING CORTEX &/MEDULLA,,,20,,RBRVS,0.74 ,12.30 ,12.30 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78075,CPT,ADRENAL IMAGING CORTEX &/MEDULLA,26,,20,,RBRVS,0.74 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78075,CPT,ADRENAL IMAGING CORTEX &/MEDULLA,TC,,20,,RBRVS,,12.02 ,12.02 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78099,CPT,UNLISTED ENDOCRINE PX DX NUCLEAR MEDICINE,,,20,,TotalUnits,,,,6.94 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78099,CPT,UNLISTED ENDOCRINE PX DX NUCLEAR MEDICINE,26,,20,,TotalUnits,,,,0.67 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78099,CPT,UNLISTED ENDOCRINE PX DX NUCLEAR MEDICINE,TC,,20,,TotalUnits,,,,6.27 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78102,CPT,BONE MARROW IMAGING LIMITED AREA,,,20,,RBRVS,0.55 ,4.32 ,4.32 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78102,CPT,BONE MARROW IMAGING LIMITED AREA,26,,20,,RBRVS,0.55 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78102,CPT,BONE MARROW IMAGING LIMITED AREA,TC,,20,,RBRVS,,4.14 ,4.14 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78103,CPT,BONE MARROW IMAGING MULTIPLE AREAS,,,20,,RBRVS,0.75 ,5.61 ,5.61 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78103,CPT,BONE MARROW IMAGING MULTIPLE AREAS,26,,20,,RBRVS,0.75 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78103,CPT,BONE MARROW IMAGING MULTIPLE AREAS,TC,,20,,RBRVS,,5.37 ,5.37 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78104,CPT,BONE MARROW IMAGING WHOLE BODY,,,20,,RBRVS,0.80 ,6.26 ,6.26 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78104,CPT,BONE MARROW IMAGING WHOLE BODY,26,,20,,RBRVS,0.80 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78104,CPT,BONE MARROW IMAGING WHOLE BODY,TC,,20,,RBRVS,,6.00 ,6.00 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78110,CPT,PLASMA VOL RADIOPHARM VOL DILUTION SPX 1 SAMPLE,,,20,,RBRVS,0.19 ,2.76 ,2.76 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78110,CPT,PLASMA VOL RADIOPHARM VOL DILUTION SPX 1 SAMPLE,26,,20,,RBRVS,0.19 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78110,CPT,PLASMA VOL RADIOPHARM VOL DILUTION SPX 1 SAMPLE,TC,,20,,RBRVS,,2.68 ,2.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78111,CPT,PLASMA VOL RADIOPHARM VOL DILUTE SPX MULT SMPLES,,,20,,RBRVS,0.22 ,2.54 ,2.54 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78111,CPT,PLASMA VOL RADIOPHARM VOL DILUTE SPX MULT SMPLES,26,,20,,RBRVS,0.22 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78111,CPT,PLASMA VOL RADIOPHARM VOL DILUTE SPX MULT SMPLES,TC,,20,,RBRVS,,2.46 ,2.46 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78120,CPT,RED CELL VOLUME DETERMINATION SPX 1 SAMPLING,,,20,,RBRVS,0.23 ,2.46 ,2.46 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78120,CPT,RED CELL VOLUME DETERMINATION SPX 1 SAMPLING,26,,20,,RBRVS,0.23 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78120,CPT,RED CELL VOLUME DETERMINATION SPX 1 SAMPLING,TC,,20,,RBRVS,,2.37 ,2.37 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78121,CPT,RED CELL VOLUME DETERMINATION SPX MULT SAMPLINGS,,,20,,RBRVS,0.32 ,2.70 ,2.70 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78121,CPT,RED CELL VOLUME DETERMINATION SPX MULT SAMPLINGS,26,,20,,RBRVS,0.32 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78121,CPT,RED CELL VOLUME DETERMINATION SPX MULT SAMPLINGS,TC,,20,,RBRVS,,2.58 ,2.58 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78122,CPT,WHOLE BLOOD VOLUME DETERM PLASMA&RED CELL VOLU,,,20,,RBRVS,0.45 ,2.30 ,2.30 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78122,CPT,WHOLE BLOOD VOLUME DETERM PLASMA&RED CELL VOLU,26,,20,,RBRVS,0.45 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78122,CPT,WHOLE BLOOD VOLUME DETERM PLASMA&RED CELL VOLU,TC,,20,,RBRVS,,2.17 ,2.17 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78130,CPT,RED CELL SURVIVAL STUDY,,,20,,RBRVS,0.61 ,3.90 ,3.90 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78130,CPT,RED CELL SURVIVAL STUDY,26,,20,,RBRVS,0.61 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78130,CPT,RED CELL SURVIVAL STUDY,TC,,20,,RBRVS,,3.70 ,3.70 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78135,CPT,RBC SURVIVAL STUDY DIFFERNTL ORGAN/TISS KINETICS,,,20,,RBRVS,0.64 ,9.46 ,9.46 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78135,CPT,RBC SURVIVAL STUDY DIFFERNTL ORGAN/TISS KINETICS,26,,20,,RBRVS,0.64 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78135,CPT,RBC SURVIVAL STUDY DIFFERNTL ORGAN/TISS KINETICS,TC,,20,,RBRVS,,9.22 ,9.22 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78140,CPT,LABELED RBC SEQUESTRATION DIFFERNTL ORGAN/TISSUE,,,20,,RBRVS,0.61 ,3.28 ,3.28 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78140,CPT,LABELED RBC SEQUESTRATION DIFFERNTL ORGAN/TISSUE,26,,20,,RBRVS,0.61 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78140,CPT,LABELED RBC SEQUESTRATION DIFFERNTL ORGAN/TISSUE,TC,,20,,RBRVS,,3.05 ,3.05 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78185,CPT,SPLEEN IMAGING ONLY W/WO VASCULAR FLOW,,,20,,RBRVS,0.40 ,5.70 ,5.70 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78185,CPT,SPLEEN IMAGING ONLY W/WO VASCULAR FLOW,26,,20,,RBRVS,0.40 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78185,CPT,SPLEEN IMAGING ONLY W/WO VASCULAR FLOW,TC,,20,,RBRVS,,5.55 ,5.55 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78190,CPT,KINETICS PLATELET W/WO DIFFRNTL ORGAN/TIS LOCLZJ,,,20,,RBRVS,1.09 ,10.23 ,10.23 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78190,CPT,KINETICS PLATELET W/WO DIFFRNTL ORGAN/TIS LOCLZJ,26,,20,,RBRVS,1.09 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78190,CPT,KINETICS PLATELET W/WO DIFFRNTL ORGAN/TIS LOCLZJ,TC,,20,,RBRVS,,9.81 ,9.81 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78191,CPT,PLATELET SURVIVAL STUDY,,,20,,RBRVS,0.61 ,4.14 ,4.14 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78191,CPT,PLATELET SURVIVAL STUDY,26,,20,,RBRVS,0.61 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78191,CPT,PLATELET SURVIVAL STUDY,TC,,20,,RBRVS,,3.91 ,3.91 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78195,CPT,LYMPHATICS & LYMPH NODES IMAGING,,,20,,RBRVS,1.20 ,9.03 ,9.03 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78195,CPT,LYMPHATICS & LYMPH NODES IMAGING,26,,20,,RBRVS,1.20 ,0.41 ,0.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78195,CPT,LYMPHATICS & LYMPH NODES IMAGING,TC,,20,,RBRVS,,8.62 ,8.62 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78199,CPT,UNLIS HEMATOP RET/ENDO&LYMPHATIC DX NUC MED,,,20,,TotalUnits,,,,10.23 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78199,CPT,UNLIS HEMATOP RET/ENDO&LYMPHATIC DX NUC MED,26,,20,,TotalUnits,,,,1.61 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78199,CPT,UNLIS HEMATOP RET/ENDO&LYMPHATIC DX NUC MED,TC,,20,,TotalUnits,,,,8.62 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78201,CPT,LIVER IMAGING STATIC ONLY,,,20,,RBRVS,0.44 ,4.96 ,4.96 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78201,CPT,LIVER IMAGING STATIC ONLY,26,,20,,RBRVS,0.44 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78201,CPT,LIVER IMAGING STATIC ONLY,TC,,20,,RBRVS,,4.82 ,4.82 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78202,CPT,LIVER IMAGING W/VASCULAR FLOW,,,20,,RBRVS,0.51 ,5.27 ,5.27 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78202,CPT,LIVER IMAGING W/VASCULAR FLOW,26,,20,,RBRVS,0.51 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78202,CPT,LIVER IMAGING W/VASCULAR FLOW,TC,,20,,RBRVS,,5.12 ,5.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78205,CPT,LIVER IMAGING SPECT,,,20,,RBRVS,0.71 ,5.33 ,5.33 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78205,CPT,LIVER IMAGING SPECT,26,,20,,RBRVS,0.71 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78205,CPT,LIVER IMAGING SPECT,TC,,20,,RBRVS,,5.11 ,5.11 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78206,CPT,LIVER IMAGING SPECT W/VASCULAR FLOW,,,20,,RBRVS,0.96 ,8.91 ,8.91 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78206,CPT,LIVER IMAGING SPECT W/VASCULAR FLOW,26,,20,,RBRVS,0.96 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78206,CPT,LIVER IMAGING SPECT W/VASCULAR FLOW,TC,,20,,RBRVS,,8.59 ,8.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78215,CPT,LIVER & SPLEEN IMAGING STATIC ONLY,,,20,,RBRVS,0.49 ,5.09 ,5.09 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78215,CPT,LIVER & SPLEEN IMAGING STATIC ONLY,26,,20,,RBRVS,0.49 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78215,CPT,LIVER & SPLEEN IMAGING STATIC ONLY,TC,,20,,RBRVS,,4.92 ,4.92 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78216,CPT,LIVER & SPLEEN IMAGING W/VASCULAR FLOW,,,20,,RBRVS,0.57 ,3.01 ,3.01 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78216,CPT,LIVER & SPLEEN IMAGING W/VASCULAR FLOW,26,,20,,RBRVS,0.57 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78216,CPT,LIVER & SPLEEN IMAGING W/VASCULAR FLOW,TC,,20,,RBRVS,,2.82 ,2.82 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78226,CPT,HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER,,,20,,RBRVS,0.74 ,8.81 ,8.81 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78226,CPT,HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER,26,,20,,RBRVS,0.74 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78226,CPT,HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER,TC,,20,,RBRVS,,8.55 ,8.55 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78227,CPT,HEPATOBIL SYST IMAG INC GB W/PHARMA INTERVENJ,,,20,,RBRVS,0.90 ,12.06 ,12.06 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78227,CPT,HEPATOBIL SYST IMAG INC GB W/PHARMA INTERVENJ,26,,20,,RBRVS,0.90 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78227,CPT,HEPATOBIL SYST IMAG INC GB W/PHARMA INTERVENJ,TC,,20,,RBRVS,,11.74 ,11.74 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78230,CPT,SALIVARY GLAND IMAGING,,,20,,RBRVS,0.45 ,4.53 ,4.53 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78230,CPT,SALIVARY GLAND IMAGING,26,,20,,RBRVS,0.45 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78230,CPT,SALIVARY GLAND IMAGING,TC,,20,,RBRVS,,4.36 ,4.36 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78231,CPT,SALIVARY GLAND IMAGING SERIAL IMAGES,,,20,,RBRVS,0.52 ,3.19 ,3.19 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78231,CPT,SALIVARY GLAND IMAGING SERIAL IMAGES,26,,20,,RBRVS,0.52 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78231,CPT,SALIVARY GLAND IMAGING SERIAL IMAGES,TC,,20,,RBRVS,,2.99 ,2.99 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78232,CPT,SALIVARY GLAND FUNCTION STUDY,,,20,,RBRVS,0.47 ,2.33 ,2.33 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78232,CPT,SALIVARY GLAND FUNCTION STUDY,26,,20,,RBRVS,0.47 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78232,CPT,SALIVARY GLAND FUNCTION STUDY,TC,,20,,RBRVS,,2.25 ,2.25 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78258,CPT,ESOPHAGEAL MOTILITY,,,20,,RBRVS,0.74 ,5.60 ,5.60 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78258,CPT,ESOPHAGEAL MOTILITY,26,,20,,RBRVS,0.74 ,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78258,CPT,ESOPHAGEAL MOTILITY,TC,,20,,RBRVS,,5.33 ,5.33 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78261,CPT,GASTRIC MUCOSA IMAGING,,,20,,RBRVS,0.69 ,6.58 ,6.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78261,CPT,GASTRIC MUCOSA IMAGING,26,,20,,RBRVS,0.69 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78261,CPT,GASTRIC MUCOSA IMAGING,TC,,20,,RBRVS,,6.32 ,6.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78262,CPT,GASTROESOPHAGEAL REFLUX STUDY,,,20,,RBRVS,0.68 ,6.34 ,6.34 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78262,CPT,GASTROESOPHAGEAL REFLUX STUDY,26,,20,,RBRVS,0.68 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78262,CPT,GASTROESOPHAGEAL REFLUX STUDY,TC,,20,,RBRVS,,6.10 ,6.10 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78264,CPT,GASTRIC EMPTYING IMAGING STUDY,,,20,,RBRVS,0.80 ,7.53 ,7.53 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78264,CPT,GASTRIC EMPTYING IMAGING STUDY,26,,20,,RBRVS,0.80 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78264,CPT,GASTRIC EMPTYING IMAGING STUDY,TC,,20,,RBRVS,,7.25 ,7.25 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78265,CPT,GASTRIC EMPTYNG IMAG STD W/SM BWL TRANSIT,,,20,,RBRVS,0.98 ,10.52 ,10.52 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78265,CPT,GASTRIC EMPTYNG IMAG STD W/SM BWL TRANSIT,26,,20,,RBRVS,0.98 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78265,CPT,GASTRIC EMPTYNG IMAG STD W/SM BWL TRANSIT,TC,,20,,RBRVS,,10.18 ,10.18 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78266,CPT,GSTRC EMPTNG IMAG STD W/SM BWL COL TRNST MLT DAY,,,20,,RBRVS,1.08 ,12.57 ,12.57 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78266,CPT,GSTRC EMPTNG IMAG STD W/SM BWL COL TRNST MLT DAY,26,,20,,RBRVS,1.08 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78266,CPT,GSTRC EMPTNG IMAG STD W/SM BWL COL TRNST MLT DAY,TC,,20,,RBRVS,,12.19 ,12.19 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78267,CPT,UREA BREATH TEST C-14 ISOTOPIC ACQUISJ ANALYSIS,,,17,,TotalUnits,,,,0.30 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78268,CPT,UREA BREATH TEST C-14 ISOTOPIC ANALYSIS,,,17,,TotalUnits,,,,2.56 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78270,CPT,VITAMIN B-12 ABSRPJ STUDY W/O INTRINSIC FACTOR,,,20,,RBRVS,0.20 ,2.71 ,2.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78270,CPT,VITAMIN B-12 ABSRPJ STUDY W/O INTRINSIC FACTOR,26,,20,,RBRVS,0.20 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78270,CPT,VITAMIN B-12 ABSRPJ STUDY W/O INTRINSIC FACTOR,TC,,20,,RBRVS,,2.62 ,2.62 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78271,CPT,VITAMIN B-12 ABSRPJ STUDY W/INTRINSIC FACTOR,,,20,,RBRVS,0.20 ,2.39 ,2.39 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78271,CPT,VITAMIN B-12 ABSRPJ STUDY W/INTRINSIC FACTOR,26,,20,,RBRVS,0.20 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78271,CPT,VITAMIN B-12 ABSRPJ STUDY W/INTRINSIC FACTOR,TC,,20,,RBRVS,,2.31 ,2.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78272,CPT,VITAMIN B-12 ABSRPJ STDY W/WO INTRINSIC FACT,,,20,,RBRVS,0.27 ,2.51 ,2.51 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78272,CPT,VITAMIN B-12 ABSRPJ STDY W/WO INTRINSIC FACT,26,,20,,RBRVS,0.27 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78272,CPT,VITAMIN B-12 ABSRPJ STDY W/WO INTRINSIC FACT,TC,,20,,RBRVS,,2.41 ,2.41 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78278,CPT,ACUTE GASTROINTESTINAL BLOOD LOSS IMAGING,,,20,,RBRVS,0.99 ,9.05 ,9.05 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78278,CPT,ACUTE GASTROINTESTINAL BLOOD LOSS IMAGING,26,,20,,RBRVS,0.99 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78278,CPT,ACUTE GASTROINTESTINAL BLOOD LOSS IMAGING,TC,,20,,RBRVS,,8.70 ,8.70 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78282,CPT,GASTROINTESTINAL PROTEIN LOSS,,,20,,RBRVS,0.38 ,1.71 ,1.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78282,CPT,GASTROINTESTINAL PROTEIN LOSS,26,,20,,RBRVS,0.38 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78282,CPT,GASTROINTESTINAL PROTEIN LOSS,TC,,20,,RBRVS,,1.57 ,1.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78290,CPT,INTESTINE IMAGING,,,20,,RBRVS,0.68 ,8.90 ,8.90 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78290,CPT,INTESTINE IMAGING,26,,20,,RBRVS,0.68 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78290,CPT,INTESTINE IMAGING,TC,,20,,RBRVS,,8.66 ,8.66 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78291,CPT,PERITONEAL-VENOUS SHUNT PATENCY TEST,,,20,,RBRVS,0.88 ,6.26 ,6.26 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78291,CPT,PERITONEAL-VENOUS SHUNT PATENCY TEST,26,,20,,RBRVS,0.88 ,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78291,CPT,PERITONEAL-VENOUS SHUNT PATENCY TEST,TC,,20,,RBRVS,,5.99 ,5.99 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78299,CPT,UNLISTED GASTROINTESTINAL PX DX NUCLEAR MEDICINE,,,20,,TotalUnits,,,,8.33 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78299,CPT,UNLISTED GASTROINTESTINAL PX DX NUCLEAR MEDICINE,26,,20,,TotalUnits,,,,0.90 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78299,CPT,UNLISTED GASTROINTESTINAL PX DX NUCLEAR MEDICINE,TC,,20,,TotalUnits,,,,7.43 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78300,CPT,BONE &/JOINT IMAGING LIMITED AREA,,,20,,RBRVS,0.62 ,4.55 ,4.55 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78300,CPT,BONE &/JOINT IMAGING LIMITED AREA,26,,20,,RBRVS,0.62 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78300,CPT,BONE &/JOINT IMAGING LIMITED AREA,TC,,20,,RBRVS,,4.32 ,4.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78305,CPT,BONE &/JOINT IMAGING MULTIPLE AREAS,,,20,,RBRVS,0.83 ,5.79 ,5.79 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78305,CPT,BONE &/JOINT IMAGING MULTIPLE AREAS,26,,20,,RBRVS,0.83 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78305,CPT,BONE &/JOINT IMAGING MULTIPLE AREAS,TC,,20,,RBRVS,,5.50 ,5.50 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78306,CPT,BONE &/JOINT IMAGING WHOLE BODY,,,20,,RBRVS,0.86 ,6.38 ,6.38 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78306,CPT,BONE &/JOINT IMAGING WHOLE BODY,26,,20,,RBRVS,0.86 ,0.30 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78306,CPT,BONE &/JOINT IMAGING WHOLE BODY,TC,,20,,RBRVS,,6.08 ,6.08 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78315,CPT,BONE &/JOINT IMAGING 3 PHASE STUDY,,,20,,RBRVS,1.02 ,8.97 ,8.97 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78315,CPT,BONE &/JOINT IMAGING 3 PHASE STUDY,26,,20,,RBRVS,1.02 ,0.36 ,0.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78315,CPT,BONE &/JOINT IMAGING 3 PHASE STUDY,TC,,20,,RBRVS,,8.61 ,8.61 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78320,CPT,BONE &/JOINT IMAGING TOMOGRAPHIC SPECT,,,20,,RBRVS,1.04 ,5.49 ,5.49 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78320,CPT,BONE &/JOINT IMAGING TOMOGRAPHIC SPECT,26,,20,,RBRVS,1.04 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78320,CPT,BONE &/JOINT IMAGING TOMOGRAPHIC SPECT,TC,,20,,RBRVS,,5.15 ,5.15 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78350,CPT,BONE DENSITY 1/> SITES 1 PHOTON ABSORPTIOMETRY,,,20,,RBRVS,0.22 ,0.69 ,0.69 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78350,CPT,BONE DENSITY 1/> SITES 1 PHOTON ABSORPTIOMETRY,26,,20,,RBRVS,0.22 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78350,CPT,BONE DENSITY 1/> SITES 1 PHOTON ABSORPTIOMETRY,TC,,20,,RBRVS,,0.61 ,0.61 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78351,CPT,BONE DENSTY 1/> SITES DUAL PHOTON ABSORPTIOMETR,,,20,,RBRVS,0.30 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78399,CPT,UNLISTED MUSCULOSKELETAL PX DX NUCLEAR MEDICINE,,,20,,TotalUnits,,,,7.24 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78399,CPT,UNLISTED MUSCULOSKELETAL PX DX NUCLEAR MEDICINE,,PC,20,,TotalUnits,,,,1.16 ,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
78399,CPT,UNLISTED MUSCULOSKELETAL PX DX NUCLEAR MEDICINE,,TC,20,,TotalUnits,,,,6.08 ,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
78414,CPT,CARD-VASC HEMODYNAM W/WO PHARM/EXER 1/MLT DETERM,,,20,,RBRVS,0.45 ,1.58 ,1.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78414,CPT,CARD-VASC HEMODYNAM W/WO PHARM/EXER 1/MLT DETERM,26,,20,,RBRVS,0.45 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78414,CPT,CARD-VASC HEMODYNAM W/WO PHARM/EXER 1/MLT DETERM,TC,,20,,RBRVS,,1.42 ,1.42 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78428,CPT,CARDIAC SHUNT DETECTION,,,20,,RBRVS,0.78 ,4.40 ,4.40 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78428,CPT,CARDIAC SHUNT DETECTION,26,,20,,RBRVS,0.78 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78428,CPT,CARDIAC SHUNT DETECTION,TC,,20,,RBRVS,,4.14 ,4.14 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78445,CPT,NONCARDIAC VASCULAR FLOW IMAGING,,,20,,RBRVS,0.49 ,4.67 ,4.67 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78445,CPT,NONCARDIAC VASCULAR FLOW IMAGING,26,,20,,RBRVS,0.49 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78445,CPT,NONCARDIAC VASCULAR FLOW IMAGING,TC,,20,,RBRVS,,4.51 ,4.51 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78451,CPT,MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS,,,20,,RBRVS,1.38 ,8.43 ,8.43 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78451,CPT,MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS,26,,20,,RBRVS,1.38 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78451,CPT,MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS,TC,,20,,RBRVS,,7.96 ,7.96 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78452,CPT,MYOCARDIAL SPECT MULTIPLE STUDIES,,,20,,RBRVS,1.62 ,11.98 ,11.98 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78452,CPT,MYOCARDIAL SPECT MULTIPLE STUDIES,26,,20,,RBRVS,1.62 ,0.56 ,0.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78452,CPT,MYOCARDIAL SPECT MULTIPLE STUDIES,TC,,20,,RBRVS,,11.42 ,11.42 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78453,CPT,MYOCARDIAL PERFUSION PLANAR 1 STUDY REST/STRESS,,,20,,RBRVS,1.00 ,7.77 ,7.77 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78453,CPT,MYOCARDIAL PERFUSION PLANAR 1 STUDY REST/STRESS,26,,20,,RBRVS,1.00 ,0.36 ,0.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78453,CPT,MYOCARDIAL PERFUSION PLANAR 1 STUDY REST/STRESS,TC,,20,,RBRVS,,7.41 ,7.41 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78454,CPT,MYOCARDIAL PERFUSION PLANAR MULTIPLE STUDIES,,,20,,RBRVS,1.34 ,11.21 ,11.21 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78454,CPT,MYOCARDIAL PERFUSION PLANAR MULTIPLE STUDIES,26,,20,,RBRVS,1.34 ,0.49 ,0.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78454,CPT,MYOCARDIAL PERFUSION PLANAR MULTIPLE STUDIES,TC,,20,,RBRVS,,10.72 ,10.72 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78456,CPT,ACUTE VENOUS THROMBOSIS IMAGING PEPTIDE,,,20,,RBRVS,1.00 ,8.23 ,8.23 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78456,CPT,ACUTE VENOUS THROMBOSIS IMAGING PEPTIDE,26,,20,,RBRVS,1.00 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78456,CPT,ACUTE VENOUS THROMBOSIS IMAGING PEPTIDE,TC,,20,,RBRVS,,7.88 ,7.88 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78457,CPT,VENOUS THROMBOSIS IMAGING VENOGRAM UNILATERAL,,,20,,RBRVS,0.77 ,4.25 ,4.25 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78457,CPT,VENOUS THROMBOSIS IMAGING VENOGRAM UNILATERAL,26,,20,,RBRVS,0.77 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78457,CPT,VENOUS THROMBOSIS IMAGING VENOGRAM UNILATERAL,TC,,20,,RBRVS,,3.99 ,3.99 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78458,CPT,VENOUS THROMBOSIS IMAGING VENOGRAM BILATERAL,,,20,,RBRVS,0.90 ,4.99 ,4.99 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78458,CPT,VENOUS THROMBOSIS IMAGING VENOGRAM BILATERAL,26,,20,,RBRVS,0.90 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78458,CPT,VENOUS THROMBOSIS IMAGING VENOGRAM BILATERAL,TC,,20,,RBRVS,,4.65 ,4.65 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78459,CPT,MYOCARDIAL IMAGING PET METABOLIC EVALUATION,,,20,,TotalUnits,,,,9.56 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78459,CPT,MYOCARDIAL IMAGING PET METABOLIC EVALUATION,26,,20,,TotalUnits,,,,1.95 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78459,CPT,MYOCARDIAL IMAGING PET METABOLIC EVALUATION,TC,,20,,TotalUnits,,,,7.61 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78466,CPT,MYOCARDIAL IMAGING INFARCT AVID PLANAR QUAL/QUAN,,,20,,RBRVS,0.69 ,4.91 ,4.91 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78466,CPT,MYOCARDIAL IMAGING INFARCT AVID PLANAR QUAL/QUAN,26,,20,,RBRVS,0.69 ,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78466,CPT,MYOCARDIAL IMAGING INFARCT AVID PLANAR QUAL/QUAN,TC,,20,,RBRVS,,4.64 ,4.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78468,CPT,MYOCRD IMG INFARCT AVID PLNR EJEC FXJ 1ST PS TQ,,,20,,RBRVS,0.80 ,4.74 ,4.74 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78468,CPT,MYOCRD IMG INFARCT AVID PLNR EJEC FXJ 1ST PS TQ,26,,20,,RBRVS,0.80 ,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78468,CPT,MYOCRD IMG INFARCT AVID PLNR EJEC FXJ 1ST PS TQ,TC,,20,,RBRVS,,4.47 ,4.47 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78469,CPT,MYOCRD INFARCT AVID PLNR TOMOG SPECT W/WO QUANTJ,,,20,,RBRVS,0.92 ,5.62 ,5.62 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78469,CPT,MYOCRD INFARCT AVID PLNR TOMOG SPECT W/WO QUANTJ,26,,20,,RBRVS,0.92 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78469,CPT,MYOCRD INFARCT AVID PLNR TOMOG SPECT W/WO QUANTJ,TC,,20,,RBRVS,,5.28 ,5.28 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78472,CPT,CARD BLOOD POOL GATED PLANAR 1 STUDY REST/STRESS,,,20,,RBRVS,0.98 ,5.62 ,5.62 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78472,CPT,CARD BLOOD POOL GATED PLANAR 1 STUDY REST/STRESS,26,,20,,RBRVS,0.98 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78472,CPT,CARD BLOOD POOL GATED PLANAR 1 STUDY REST/STRESS,TC,,20,,RBRVS,,5.28 ,5.28 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78473,CPT,CARD BL POOL GATED MLT STDY WAL MOTN EJECT FRACT,,,20,,RBRVS,1.47 ,6.82 ,6.82 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78473,CPT,CARD BL POOL GATED MLT STDY WAL MOTN EJECT FRACT,26,,20,,RBRVS,1.47 ,0.49 ,0.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78473,CPT,CARD BL POOL GATED MLT STDY WAL MOTN EJECT FRACT,TC,,20,,RBRVS,,6.33 ,6.33 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78481,CPT,CARD BL POOL PLANAR 1 STDY WAL MOTN EJECT FRACT,,,20,,RBRVS,0.98 ,4.03 ,4.03 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78481,CPT,CARD BL POOL PLANAR 1 STDY WAL MOTN EJECT FRACT,26,,20,,RBRVS,0.98 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78481,CPT,CARD BL POOL PLANAR 1 STDY WAL MOTN EJECT FRACT,TC,,20,,RBRVS,,3.69 ,3.69 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78483,CPT,CARD BL POOL PLNR MLT STDY WAL MOTN EJECT FRACT,,,20,,RBRVS,1.47 ,5.35 ,5.35 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78483,CPT,CARD BL POOL PLNR MLT STDY WAL MOTN EJECT FRACT,26,,20,,RBRVS,1.47 ,0.50 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78483,CPT,CARD BL POOL PLNR MLT STDY WAL MOTN EJECT FRACT,TC,,20,,RBRVS,,4.85 ,4.85 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78491,CPT,MYOCRD IMAGE PET PERFUS SINGLE STUDY REST/STRESS,,,20,,TotalUnits,,,,9.88 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78491,CPT,MYOCRD IMAGE PET PERFUS SINGLE STUDY REST/STRESS,26,,20,,TotalUnits,,,,1.96 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78491,CPT,MYOCRD IMAGE PET PERFUS SINGLE STUDY REST/STRESS,TC,,20,,TotalUnits,,,,7.92 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78492,CPT,MYOCRD IMAGE PET PERFUS MULTPL STUDY REST/STRESS,,,20,,TotalUnits,,,,12.51 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78492,CPT,MYOCRD IMAGE PET PERFUS MULTPL STUDY REST/STRESS,26,,20,,TotalUnits,,,,2.48 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78492,CPT,MYOCRD IMAGE PET PERFUS MULTPL STUDY REST/STRESS,TC,,20,,TotalUnits,,,,10.03 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78494,CPT,CARD BL POOL GATED SPECT REST WAL MOTN EJCT FRCT,,,20,,RBRVS,1.19 ,5.23 ,5.23 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78494,CPT,CARD BL POOL GATED SPECT REST WAL MOTN EJCT FRCT,26,,20,,RBRVS,1.19 ,0.41 ,0.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78494,CPT,CARD BL POOL GATED SPECT REST WAL MOTN EJCT FRCT,TC,,20,,RBRVS,,4.82 ,4.82 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78496,CPT,CARD BL POOL GATED 1 STDY REST RT VENT EJCT FRCT,,,20,,RBRVS,0.50 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78496,CPT,CARD BL POOL GATED 1 STDY REST RT VENT EJCT FRCT,26,,20,,RBRVS,0.50 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78496,CPT,CARD BL POOL GATED 1 STDY REST RT VENT EJCT FRCT,TC,,20,,RBRVS,,0.58 ,0.58 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78499,CPT,UNLISTED CARDIOVASCULAR PX DX NUCLEAR MEDICINE,,,20,,TotalUnits,,,,13.60 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78499,CPT,UNLISTED CARDIOVASCULAR PX DX NUCLEAR MEDICINE,26,,20,,TotalUnits,,,,2.18 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78499,CPT,UNLISTED CARDIOVASCULAR PX DX NUCLEAR MEDICINE,TC,,20,,TotalUnits,,,,11.42 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78579,CPT,PULMONARY VENTILATION IMAGING,,,20,,RBRVS,0.49 ,4.83 ,4.83 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78579,CPT,PULMONARY VENTILATION IMAGING,26,,20,,RBRVS,0.49 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78579,CPT,PULMONARY VENTILATION IMAGING,TC,,20,,RBRVS,,4.67 ,4.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78580,CPT,PULMONARY PERFUSION IMAGING PARTICULATE,,,20,,RBRVS,0.74 ,6.13 ,6.13 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78580,CPT,PULMONARY PERFUSION IMAGING PARTICULATE,26,,20,,RBRVS,0.74 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78580,CPT,PULMONARY PERFUSION IMAGING PARTICULATE,TC,,20,,RBRVS,,5.87 ,5.87 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78582,CPT,PULMONARY VENTILATION & PERFUSION IMAGING,,,20,,RBRVS,1.07 ,8.57 ,8.57 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78582,CPT,PULMONARY VENTILATION & PERFUSION IMAGING,26,,20,,RBRVS,1.07 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78582,CPT,PULMONARY VENTILATION & PERFUSION IMAGING,TC,,20,,RBRVS,,8.19 ,8.19 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78597,CPT,QUANT DIFFERENTIAL PULM PERFUSION W/WO IMAGING,,,20,,RBRVS,0.75 ,5.05 ,5.05 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78597,CPT,QUANT DIFFERENTIAL PULM PERFUSION W/WO IMAGING,26,,20,,RBRVS,0.75 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78597,CPT,QUANT DIFFERENTIAL PULM PERFUSION W/WO IMAGING,TC,,20,,RBRVS,,4.82 ,4.82 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78598,CPT,QUANT DIFF PULM PRFUSION & VENTLAJ W/WO IMAGIN,,,20,,RBRVS,0.85 ,7.97 ,7.97 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78598,CPT,QUANT DIFF PULM PRFUSION & VENTLAJ W/WO IMAGIN,26,,20,,RBRVS,0.85 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78598,CPT,QUANT DIFF PULM PRFUSION & VENTLAJ W/WO IMAGIN,TC,,20,,RBRVS,,7.68 ,7.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78599,CPT,UNLISTED RESPIRATORY PX DX NUCLEAR MEDICINE,,,20,,TotalUnits,,,,9.64 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78599,CPT,UNLISTED RESPIRATORY PX DX NUCLEAR MEDICINE,26,,20,,TotalUnits,,,,1.45 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78599,CPT,UNLISTED RESPIRATORY PX DX NUCLEAR MEDICINE,TC,,20,,TotalUnits,,,,8.19 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78600,CPT,BRAIN IMAGING <4 STATIC VIEWS,,,20,,RBRVS,0.44 ,4.86 ,4.86 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78600,CPT,BRAIN IMAGING <4 STATIC VIEWS,26,,20,,RBRVS,0.44 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78600,CPT,BRAIN IMAGING <4 STATIC VIEWS,TC,,20,,RBRVS,,4.69 ,4.69 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78601,CPT,BRAIN IMAGING <4 STATIC VIEWS W/VASCULAR FLOW,,,20,,RBRVS,0.51 ,5.66 ,5.66 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78601,CPT,BRAIN IMAGING <4 STATIC VIEWS W/VASCULAR FLOW,26,,20,,RBRVS,0.51 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78601,CPT,BRAIN IMAGING <4 STATIC VIEWS W/VASCULAR FLOW,TC,,20,,RBRVS,,5.49 ,5.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78605,CPT,BRAIN IMAGING MINIMUM 4 STATIC VIEWS,,,20,,RBRVS,0.53 ,5.18 ,5.18 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78605,CPT,BRAIN IMAGING MINIMUM 4 STATIC VIEWS,26,,20,,RBRVS,0.53 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78605,CPT,BRAIN IMAGING MINIMUM 4 STATIC VIEWS,TC,,20,,RBRVS,,4.98 ,4.98 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78606,CPT,BRAIN IMAGING MIN 4 STATIC VIEWS W VASCULAR FLOW,,,20,,RBRVS,0.64 ,8.96 ,8.96 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78606,CPT,BRAIN IMAGING MIN 4 STATIC VIEWS W VASCULAR FLOW,26,,20,,RBRVS,0.64 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78606,CPT,BRAIN IMAGING MIN 4 STATIC VIEWS W VASCULAR FLOW,TC,,20,,RBRVS,,8.73 ,8.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78607,CPT,BRAIN IMAGING TOMOGRAPHIC SPECT,,,20,,RBRVS,1.23 ,8.91 ,8.91 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78607,CPT,BRAIN IMAGING TOMOGRAPHIC SPECT,26,,20,,RBRVS,1.23 ,0.40 ,0.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78607,CPT,BRAIN IMAGING TOMOGRAPHIC SPECT,TC,,20,,RBRVS,,8.51 ,8.51 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78608,CPT,BRAIN IMAGING PET METABOLIC EVALUATION,,,20,,TotalUnits,,,,12.48 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78608,CPT,BRAIN IMAGING PET METABOLIC EVALUATION,,PC,20,,TotalUnits,,,,1.97 ,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
78608,CPT,BRAIN IMAGING PET METABOLIC EVALUATION,,TC,20,,TotalUnits,,,,10.51 ,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
78609,CPT,BRAIN IMAGING PET PERFUSION EVALUATION,,,20,,TotalUnits,,,,8.28 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78609,CPT,BRAIN IMAGING PET PERFUSION EVALUATION,,PC,20,,TotalUnits,,,,2.07 ,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
78609,CPT,BRAIN IMAGING PET PERFUSION EVALUATION,,TC,20,,TotalUnits,,,,6.21 ,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
78610,CPT,BRAIN IMAGING VASCULAR FLOW ONLY,,,20,,RBRVS,0.30 ,4.71 ,4.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78610,CPT,BRAIN IMAGING VASCULAR FLOW ONLY,26,,20,,RBRVS,0.30 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78610,CPT,BRAIN IMAGING VASCULAR FLOW ONLY,TC,,20,,RBRVS,,4.60 ,4.60 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78630,CPT,CEREBROSPINAL FLUID FLOW W/O MATL CISTERNOGRAPHY,,,20,,RBRVS,0.68 ,9.10 ,9.10 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78630,CPT,CEREBROSPINAL FLUID FLOW W/O MATL CISTERNOGRAPHY,26,,20,,RBRVS,0.68 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78630,CPT,CEREBROSPINAL FLUID FLOW W/O MATL CISTERNOGRAPHY,TC,,20,,RBRVS,,8.86 ,8.86 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78635,CPT,CEREBROSPINAL FLUID FLOW W/O MATL VENTRICLGRAPHY,,,20,,RBRVS,0.61 ,9.20 ,9.20 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78635,CPT,CEREBROSPINAL FLUID FLOW W/O MATL VENTRICLGRAPHY,26,,20,,RBRVS,0.61 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78635,CPT,CEREBROSPINAL FLUID FLOW W/O MATL VENTRICLGRAPHY,TC,,20,,RBRVS,,8.97 ,8.97 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78645,CPT,CEREBROSPINAL FLUID FLOW W/O MATL SHUNT EVALTJ,,,20,,RBRVS,0.57 ,8.76 ,8.76 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78645,CPT,CEREBROSPINAL FLUID FLOW W/O MATL SHUNT EVALTJ,26,,20,,RBRVS,0.57 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78645,CPT,CEREBROSPINAL FLUID FLOW W/O MATL SHUNT EVALTJ,TC,,20,,RBRVS,,8.57 ,8.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78647,CPT,CEREBROSPINAL FLUID FLOW W/O MATL TOMOG SPECT,,,20,,RBRVS,0.90 ,9.24 ,9.24 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78647,CPT,CEREBROSPINAL FLUID FLOW W/O MATL TOMOG SPECT,26,,20,,RBRVS,0.90 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78647,CPT,CEREBROSPINAL FLUID FLOW W/O MATL TOMOG SPECT,TC,,20,,RBRVS,,8.90 ,8.90 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78650,CPT,CEREBROSPINAL FLUID LEAK DETECTION&LOCALIZATIO,,,20,,RBRVS,0.61 ,9.01 ,9.01 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78650,CPT,CEREBROSPINAL FLUID LEAK DETECTION&LOCALIZATIO,26,,20,,RBRVS,0.61 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78650,CPT,CEREBROSPINAL FLUID LEAK DETECTION&LOCALIZATIO,TC,,20,,RBRVS,,8.80 ,8.80 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78660,CPT,RADIOPHARMACEUTICAL DACRYOCYSTOGRAPHY,,,20,,RBRVS,0.53 ,4.55 ,4.55 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78660,CPT,RADIOPHARMACEUTICAL DACRYOCYSTOGRAPHY,26,,20,,RBRVS,0.53 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78660,CPT,RADIOPHARMACEUTICAL DACRYOCYSTOGRAPHY,TC,,20,,RBRVS,,4.36 ,4.36 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78699,CPT,UNLISTED NERVOUS SYSTEM PX DX NUCLEAR MEDICINE,,,20,,TotalUnits,,,,12.48 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78699,CPT,UNLISTED NERVOUS SYSTEM PX DX NUCLEAR MEDICINE,26,,20,,TotalUnits,,,,1.97 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78699,CPT,UNLISTED NERVOUS SYSTEM PX DX NUCLEAR MEDICINE,TC,,20,,TotalUnits,,,,10.51 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78700,CPT,KIDNEY IMAGING MORPHOLOGY,,,20,,RBRVS,0.45 ,4.49 ,4.49 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78700,CPT,KIDNEY IMAGING MORPHOLOGY,26,,20,,RBRVS,0.45 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78700,CPT,KIDNEY IMAGING MORPHOLOGY,TC,,20,,RBRVS,,4.33 ,4.33 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78701,CPT,KIDNEY IMAGING MORPHOOGY W/VASCULAR FLOW,,,20,,RBRVS,0.49 ,5.56 ,5.56 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78701,CPT,KIDNEY IMAGING MORPHOOGY W/VASCULAR FLOW,26,,20,,RBRVS,0.49 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78701,CPT,KIDNEY IMAGING MORPHOOGY W/VASCULAR FLOW,TC,,20,,RBRVS,,5.40 ,5.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78707,CPT,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/O RX,,,20,,RBRVS,0.96 ,5.70 ,5.70 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78707,CPT,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/O RX,26,,20,,RBRVS,0.96 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78707,CPT,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/O RX,TC,,20,,RBRVS,,5.38 ,5.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78708,CPT,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/RX,,,20,,RBRVS,1.21 ,3.73 ,3.73 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78708,CPT,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/RX,26,,20,,RBRVS,1.21 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78708,CPT,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/RX,TC,,20,,RBRVS,,3.31 ,3.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78709,CPT,KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE,,,20,,RBRVS,1.41 ,8.98 ,8.98 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78709,CPT,KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE,26,,20,,RBRVS,1.41 ,0.46 ,0.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78709,CPT,KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE,TC,,20,,RBRVS,,8.52 ,8.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78710,CPT,KIDNEY IMAGING MORPHOLOGY TOMOGRAPHIC,,,20,,RBRVS,0.66 ,5.03 ,5.03 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78710,CPT,KIDNEY IMAGING MORPHOLOGY TOMOGRAPHIC,26,,20,,RBRVS,0.66 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78710,CPT,KIDNEY IMAGING MORPHOLOGY TOMOGRAPHIC,TC,,20,,RBRVS,,4.86 ,4.86 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78725,CPT,KIDNEY FUNCJ STUDY NON-IMG RADIOISOTOPIC STUDY,,,20,,RBRVS,0.38 ,2.71 ,2.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78725,CPT,KIDNEY FUNCJ STUDY NON-IMG RADIOISOTOPIC STUDY,26,,20,,RBRVS,0.38 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78725,CPT,KIDNEY FUNCJ STUDY NON-IMG RADIOISOTOPIC STUDY,TC,,20,,RBRVS,,2.59 ,2.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78730,CPT,URINARY BLADDER RESIDUAL STUDY,,,20,,RBRVS,0.15 ,2.05 ,2.05 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78730,CPT,URINARY BLADDER RESIDUAL STUDY,26,,20,,RBRVS,0.15 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78730,CPT,URINARY BLADDER RESIDUAL STUDY,TC,,20,,RBRVS,,1.99 ,1.99 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78740,CPT,URETERAL REFLUX STUDY RP VOIDING CYSTOGRAM,,,20,,RBRVS,0.57 ,5.72 ,5.72 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78740,CPT,URETERAL REFLUX STUDY RP VOIDING CYSTOGRAM,26,,20,,RBRVS,0.57 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78740,CPT,URETERAL REFLUX STUDY RP VOIDING CYSTOGRAM,TC,,20,,RBRVS,,5.52 ,5.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78761,CPT,TESTICULAR IMAGING WITH VASCULAR FLOW,,,20,,RBRVS,0.71 ,5.33 ,5.33 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78761,CPT,TESTICULAR IMAGING WITH VASCULAR FLOW,26,,20,,RBRVS,0.71 ,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78761,CPT,TESTICULAR IMAGING WITH VASCULAR FLOW,TC,,20,,RBRVS,,5.06 ,5.06 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78799,CPT,UNLISTED GENITOURINARY PX DX NUCLEAR MEDICINE,,,20,,TotalUnits,,,,4.94 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78799,CPT,UNLISTED GENITOURINARY PX DX NUCLEAR MEDICINE,26,,20,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78799,CPT,UNLISTED GENITOURINARY PX DX NUCLEAR MEDICINE,TC,,20,,TotalUnits,,,,3.61 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78800,CPT,RP LOCLZJ TUMOR/DSTRBJ AGENT LIMITED AREA,,,20,,RBRVS,0.66 ,4.80 ,4.80 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78800,CPT,RP LOCLZJ TUMOR/DSTRBJ AGENT LIMITED AREA,26,,20,,RBRVS,0.66 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78800,CPT,RP LOCLZJ TUMOR/DSTRBJ AGENT LIMITED AREA,TC,,20,,RBRVS,,4.56 ,4.56 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78801,CPT,RP LOCLZJ TUMOR/DSTRBJ AGENT MULTIPLE AREAS,,,20,,RBRVS,0.79 ,6.68 ,6.68 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78801,CPT,RP LOCLZJ TUMOR/DSTRBJ AGENT MULTIPLE AREAS,26,,20,,RBRVS,0.79 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78801,CPT,RP LOCLZJ TUMOR/DSTRBJ AGENT MULTIPLE AREAS,TC,,20,,RBRVS,,6.39 ,6.39 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78802,CPT,RP LOCLZJ TUMOR/DSTRBJ AGENT WHOLE BDY 1 DAY,,,20,,RBRVS,0.86 ,8.47 ,8.47 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78802,CPT,RP LOCLZJ TUMOR/DSTRBJ AGENT WHOLE BDY 1 DAY,26,,20,,RBRVS,0.86 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78802,CPT,RP LOCLZJ TUMOR/DSTRBJ AGENT WHOLE BDY 1 DAY,TC,,20,,RBRVS,,8.18 ,8.18 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78803,CPT,RP LOCLZJ TUMOR/DSTRBJ AGENT TOMOG SPECT,,,20,,RBRVS,1.09 ,8.71 ,8.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78803,CPT,RP LOCLZJ TUMOR/DSTRBJ AGENT TOMOG SPECT,26,,20,,RBRVS,1.09 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78803,CPT,RP LOCLZJ TUMOR/DSTRBJ AGENT TOMOG SPECT,TC,,20,,RBRVS,,8.37 ,8.37 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78804,CPT,RP LOCLZJ TUMOR/DSTRBJ AGT WHOL BDY REQ 2/> DAY,,,20,,RBRVS,1.07 ,15.37 ,15.37 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78804,CPT,RP LOCLZJ TUMOR/DSTRBJ AGT WHOL BDY REQ 2/> DAY,26,,20,,RBRVS,1.07 ,0.36 ,0.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78804,CPT,RP LOCLZJ TUMOR/DSTRBJ AGT WHOL BDY REQ 2/> DAY,TC,,20,,RBRVS,,15.01 ,15.01 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78805,CPT,RP LOCLZJ INFLAMMATORY PROCESS LIMITED AREA,,,20,,RBRVS,0.73 ,4.48 ,4.48 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78805,CPT,RP LOCLZJ INFLAMMATORY PROCESS LIMITED AREA,26,,20,,RBRVS,0.73 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78805,CPT,RP LOCLZJ INFLAMMATORY PROCESS LIMITED AREA,TC,,20,,RBRVS,,4.23 ,4.23 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78806,CPT,RP LOCLZJ INFLAMMATORY PROCESS WHOLE BODY,,,20,,RBRVS,0.86 ,8.74 ,8.74 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78806,CPT,RP LOCLZJ INFLAMMATORY PROCESS WHOLE BODY,26,,20,,RBRVS,0.86 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78806,CPT,RP LOCLZJ INFLAMMATORY PROCESS WHOLE BODY,TC,,20,,RBRVS,,8.45 ,8.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78807,CPT,RP LOCLZJ INFLAMMATORY PROCESS TOMOG SPECT,,,20,,RBRVS,1.09 ,8.74 ,8.74 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78807,CPT,RP LOCLZJ INFLAMMATORY PROCESS TOMOG SPECT,26,,20,,RBRVS,1.09 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78807,CPT,RP LOCLZJ INFLAMMATORY PROCESS TOMOG SPECT,TC,,20,,RBRVS,,8.40 ,8.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78808,CPT,NJX RP LOCLZJ NON-IMG PROBE STUDY INTRAVENOUS,,,20,,RBRVS,0.18 ,1.06 ,1.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78811,CPT,PET IMAGING LIMITED AREA CHEST HEAD/NECK,,,20,,TotalUnits,,,,16.87 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78811,CPT,PET IMAGING LIMITED AREA CHEST HEAD/NECK,26,,20,,TotalUnits,,,,2.10 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78811,CPT,PET IMAGING LIMITED AREA CHEST HEAD/NECK,TC,,20,,TotalUnits,,,,14.77 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78812,CPT,PET IMAGING SKULL BASE TO MID-THIGH,,,20,,TotalUnits,,,,20.55 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78812,CPT,PET IMAGING SKULL BASE TO MID-THIGH,26,,20,,TotalUnits,,,,2.58 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78812,CPT,PET IMAGING SKULL BASE TO MID-THIGH,TC,,20,,TotalUnits,,,,17.97 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78813,CPT,PET IMAGING WHOLE BODY,,,20,,TotalUnits,,,,21.34 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78813,CPT,PET IMAGING WHOLE BODY,26,,20,,TotalUnits,,,,2.69 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78813,CPT,PET IMAGING WHOLE BODY,TC,,20,,TotalUnits,,,,18.65 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78814,CPT,PET IMAGING CT FOR ATTENUATION LIMITED AREA,,,20,,TotalUnits,,,,23.73 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78814,CPT,PET IMAGING CT FOR ATTENUATION LIMITED AREA,26,,20,,TotalUnits,,,,2.98 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78814,CPT,PET IMAGING CT FOR ATTENUATION LIMITED AREA,TC,,20,,TotalUnits,,,,20.75 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78815,CPT,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,,,20,,TotalUnits,,,,25.82 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78815,CPT,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,26,,20,,TotalUnits,,,,3.28 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78815,CPT,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,TC,,20,,TotalUnits,,,,22.54 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78816,CPT,PET IMAGING FOR CT ATTENUATION WHOLE BODY,,,20,,TotalUnits,,,,26.30 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78816,CPT,PET IMAGING FOR CT ATTENUATION WHOLE BODY,26,,20,,TotalUnits,,,,3.31 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78816,CPT,PET IMAGING FOR CT ATTENUATION WHOLE BODY,TC,,20,,TotalUnits,,,,22.99 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
78999,CPT,UNLISTED MISCELLANEOUS PX DX NUCLEAR MEDICINE,,,20,,TotalUnits,,,,25.82 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
78999,CPT,UNLISTED MISCELLANEOUS PX DX NUCLEAR MEDICINE,26,,20,,TotalUnits,,,,3.40 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
78999,CPT,UNLISTED MISCELLANEOUS PX DX NUCLEAR MEDICINE,TC,,20,,TotalUnits,,,,22.42 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
79005,CPT,RP THERAPY ORAL ADMINISTRATION,,,20,,RBRVS,1.80 ,1.98 ,1.98 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
79005,CPT,RP THERAPY ORAL ADMINISTRATION,26,,20,,RBRVS,1.80 ,0.61 ,0.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
79005,CPT,RP THERAPY ORAL ADMINISTRATION,TC,,20,,RBRVS,,1.37 ,1.37 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
79101,CPT,RP THERAPY INTRAVENOUS ADMINISTRATION,,,20,,RBRVS,1.96 ,1.99 ,1.99 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
79101,CPT,RP THERAPY INTRAVENOUS ADMINISTRATION,26,,20,,RBRVS,1.96 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
79101,CPT,RP THERAPY INTRAVENOUS ADMINISTRATION,TC,,20,,RBRVS,,1.34 ,1.34 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
79200,CPT,RP THERAPY INRACAVITARY ADMINISTRATION,,,20,,RBRVS,1.99 ,1.80 ,1.80 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
79200,CPT,RP THERAPY INRACAVITARY ADMINISTRATION,26,,20,,RBRVS,1.99 ,0.36 ,0.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
79200,CPT,RP THERAPY INRACAVITARY ADMINISTRATION,TC,,20,,RBRVS,,1.44 ,1.44 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
79300,CPT,RP THERAPY INTERSTITIAL RADIOACTIVE COLLOID ADMN,,,20,,RBRVS,1.60 ,1.68 ,1.68 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
79300,CPT,RP THERAPY INTERSTITIAL RADIOACTIVE COLLOID ADMN,26,,20,,RBRVS,1.60 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
79300,CPT,RP THERAPY INTERSTITIAL RADIOACTIVE COLLOID ADMN,TC,,20,,RBRVS,,1.30 ,1.30 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
79403,CPT,RP THER RADIOLBLD MONOCLONAL ANTIBODY IV INFUS,,,20,,RBRVS,2.25 ,3.00 ,3.00 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
79403,CPT,RP THER RADIOLBLD MONOCLONAL ANTIBODY IV INFUS,26,,20,,RBRVS,2.25 ,0.76 ,0.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
79403,CPT,RP THER RADIOLBLD MONOCLONAL ANTIBODY IV INFUS,TC,,20,,RBRVS,,2.24 ,2.24 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
79440,CPT,RP THERAPY INTRA-ARTICULAR ADMINISTRATION,,,20,,RBRVS,1.99 ,1.55 ,1.55 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
79440,CPT,RP THERAPY INTRA-ARTICULAR ADMINISTRATION,26,,20,,RBRVS,1.99 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
79440,CPT,RP THERAPY INTRA-ARTICULAR ADMINISTRATION,TC,,20,,RBRVS,,1.12 ,1.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
79445,CPT,RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN,,,20,,TotalUnits,,,,9.55 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
79445,CPT,RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN,26,,20,,TotalUnits,,,,3.16 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
79445,CPT,RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN,TC,,20,,TotalUnits,,,,6.39 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
79999,CPT,RP THERAPY UNLISTED PROCEDURE,,,20,,TotalUnits,,,,3.78 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
79999,CPT,RP THERAPY UNLISTED PROCEDURE,,PC,20,,TotalUnits,,,,2.41 ,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
79999,CPT,RP THERAPY UNLISTED PROCEDURE,,TC,20,,TotalUnits,,,,1.37 ,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
80047,CPT,BASIC METABOLIC PANEL CALCIUM IONIZED,,,17,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80048,CPT,BASIC METABOLIC PANEL CALCIUM TOTAL,,,17,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80050,CPT,GENERAL HEALTH PANEL,,,17,,TotalUnits,,,,0.88 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80051,CPT,ELECTROLYTE PANEL,,,17,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80053,CPT,COMPREHENSIVE METABOLIC PANEL,,,17,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80055,CPT,OBSTETRIC PANEL,,,17,,TotalUnits,,,,1.27 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80061,CPT,LIPID PANEL,,,17,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80069,CPT,RENAL FUNCTION PANEL,,,17,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80074,CPT,ACUTE HEPATITIS PANEL,,,17,,TotalUnits,,,,1.81 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80076,CPT,HEPATIC FUNCTION PANEL,,,17,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80081,CPT,OBSTETRIC PANEL,,,17,,TotalUnits,,,,3.00 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80150,CPT,DRUG SCREEN QUANTITATIVE AMIKACIN,,,17,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80155,CPT,DRUG ASSAY CAFFEINE,,,17,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80156,CPT,DRUG ASSAY CARBAMAZEPINE TOTAL,,,17,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80157,CPT,DRUG ASSAY CARBAMAZEPINE FREE,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80158,CPT,DRUG ASSAY CYCLOSPORINE,,,17,,TotalUnits,,,,0.69 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80159,CPT,DRUG ASSAY CLOZAPINE,,,17,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80162,CPT,DRUG SCREEN QUANTITATIVE DIGOXIN TOTAL,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80163,CPT,DRUG SCREEN QUANTITATIVE DIGOXIN FREE,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80164,CPT,DRUG ASSAY VALPROIC DIPROPYLACETIC ACID TOTAL,,,17,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80165,CPT,DRUG SCREEN QUANT DIPROPYLACETIC ACID FREE,,,17,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80168,CPT,DRUG SCREEN QUANTITATIVE ETHOSUXIMIDE,,,17,,TotalUnits,,,,0.62 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80169,CPT,DRUG ASSAY EVEROLIMUS,,,17,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80170,CPT,DRUG SCREEN QUANTITATIVE GENTAMICIN,,,17,,TotalUnits,,,,0.62 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80171,CPT,DRUG SCREEN QUANTITATIVE GABAPENTIN,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80173,CPT,DRUG SCREEN QUANTITATIVE HALOPRIDOL,,,17,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80175,CPT,DRUG SCREEN QUANTITATIVE LAMOTRIGINE,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80176,CPT,DRUG SCREEN QUANTITATIVE LIDOCAINE,,,17,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80177,CPT,DRUG SCREEN QUANTITATIVE LEVETIRACETAM,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80178,CPT,DRUG SCREEN QUANTITATIVE LITHIUM,,,17,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80180,CPT,DRUG SCREEN QUANTITATIVE MYCOPHENOLATE,,,17,,TotalUnits,,,,0.69 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80183,CPT,DRUG SCREEN QUANTITATIVE OXCARBAZEPINE,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80184,CPT,DRUG SCREEN QUANTITATIVE PHENOBARBITAL,,,17,,TotalUnits,,,,0.43 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80185,CPT,DRUG SCREEN QUANTITATIVE PHENYTOIN TOTAL,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80186,CPT,DRUG SCREEN QUANTITATIVE PHENYTOIN FREE,,,17,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80188,CPT,DRUG SCREEN QUANTITATIVE PRIMIDONE,,,17,,TotalUnits,,,,0.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80190,CPT,DRUG SCREEN QUANTITATIVE PROCAINAMIDE,,,17,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80192,CPT,DRUG SCREEN QUANTITATIVE PROCAINAMIDE METABOLITE,,,17,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80194,CPT,DRUG SCREEN QUANTITATIVE QUINIDINE,,,17,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80195,CPT,DRUG SCREEN QUANTITATIVE SIROLIMUS,,,17,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80197,CPT,DRUG SCREEN QUANTITATIVE TACROLIMUS,,,17,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80198,CPT,DRUG SCREEN QUANTITATIVE THEOPHYLLINE,,,17,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80199,CPT,DRUG SCREEN QUANTITATIVE TIAGABINE,,,17,,TotalUnits,,,,0.69 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80200,CPT,DRUG SCREEN QUANTITATIVE TOBRAMYCIN,,,17,,TotalUnits,,,,0.61 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80201,CPT,DRUG SCREEN QUANTITATIVE TOPIRAMATE,,,17,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80202,CPT,DRUG SCREEN QUANTITATIVE VANCOMYCIN,,,17,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80203,CPT,DRUG SCREEN QUANTITATIVE ZONISAMIDE,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80299,CPT,QUANTITATION DRUG NOT ELSEWHERE SPECIFIED,,,17,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80400,CPT,ACTH STIMULATION PANEL ADRENAL INSUFFICIENCY,,,17,,TotalUnits,,,,1.24 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80402,CPT,ACTH STIMULATION PANEL 21 HYDROXYLASE DEFICIENCY,,,17,,TotalUnits,,,,3.30 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80406,CPT,ACTH STIMJ PANEL 3 BETA-HYDROXYDEHYD DEFNCY,,,17,,TotalUnits,,,,2.97 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80408,CPT,ALDOSTERONE SUPPRESSION EVALUATION PANEL,,,17,,TotalUnits,,,,4.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80410,CPT,CALCITONIN STIMULATION PANEL,,,17,,TotalUnits,,,,3.05 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80412,CPT,CORTICOTROPIC RELEASING HORM STIMJ PANEL,,,17,,TotalUnits,,,,12.51 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80414,CPT,CHORNC GONAD STIMJ PANEL TSTOSTERONE RESPONSE,,,17,,TotalUnits,,,,1.96 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80415,CPT,CHORNC GONAD STIMJ PANEL ESTRADIOL RESPONSE,,,17,,TotalUnits,,,,2.12 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80416,CPT,RENAL VEIN RENIN STIMULATION PANEL,,,17,,TotalUnits,,,,5.01 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80417,CPT,PERIPHERAL VEIN RENIN STIMULATION PANEL,,,17,,TotalUnits,,,,1.67 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80418,CPT,COMBINED RAPID ANT PITUITARY EVALUATION PANEL,,,17,,TotalUnits,,,,22.00 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80420,CPT,DEXMETHASONE SUPPRESSION PANEL 48 HR,,,17,,TotalUnits,,,,2.74 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80422,CPT,GLUCOSE TOLERANCE PANEL INSULINOMA,,,17,,TotalUnits,,,,1.75 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80424,CPT,GLUCOSE TOLERANCE PANEL PHEOCHROMOCYTOMA,,,17,,TotalUnits,,,,1.92 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80426,CPT,GONADOTROPIN RELEASING HORMONE STIMJ PANEL,,,17,,TotalUnits,,,,5.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80428,CPT,GROWTH HORMONE STIMULATION PANEL,,,17,,TotalUnits,,,,2.53 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80430,CPT,GROWTH HORMONE SUPRJ PANEL GLUCOSE ADMN,,,17,,TotalUnits,,,,2.98 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80432,CPT,INSULIN-INDUCED C-PEPTIDE SUPRESSION PANEL,,,17,,TotalUnits,,,,5.13 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80434,CPT,INSULIN TOLERANCE PANEL ACTH INSUFFICIENCY,,,17,,TotalUnits,,,,3.84 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80435,CPT,INSULIN TOLERANCE PANEL GROWTH HORM DEFNCY,,,17,,TotalUnits,,,,3.91 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80436,CPT,METYRAPONE PANEL,,,17,,TotalUnits,,,,3.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80438,CPT,THYROTROPIN RELEASING HORMONE STMLJ PANEL 1 HR,,,17,,TotalUnits,,,,1.91 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80439,CPT,THYROTROPIN RELEASING HORMONE STMLJ PANEL 2 HR,,,17,,TotalUnits,,,,2.55 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
80500,CPT,CLINICAL PATHOLOGY CONSULTATION LIMITED,,,17,,RBRVS,0.37 ,0.17 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
80502,CPT,CLINICAL PATHOLOGY CONSULTATION COMPREHENSIVE,,,17,,RBRVS,1.33 ,0.57 ,0.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
81000,CPT,URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY,,,17,,TotalUnits,,,,0.12 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81001,CPT,URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY,,,17,,TotalUnits,,,,0.12 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81002,CPT,URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP,,,17,,TotalUnits,,,,0.10 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81003,CPT,URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY,,,17,,TotalUnits,,,,0.09 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81005,CPT,URINALYSIS QUAL/SEMIQUANT EXCEPT IMMUNOASSAYS,,,17,,TotalUnits,,,,0.08 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81007,CPT,URINALYSIS BACTERIURIA SCR XCPT CULTURE/DIPSTICK,,,17,,TotalUnits,,,,0.10 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81015,CPT,URINALYSIS MICROSCOPIC ONLY,,,17,,TotalUnits,,,,0.12 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81020,CPT,URINALYSIS 2/3 GLASS TEST,,,17,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81025,CPT,URINE PREGNANCY TEST VISUAL COLOR CMPRSN METHS,,,17,,TotalUnits,,,,0.24 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81050,CPT,VOLUME MEASUREMENT TIMED COLLECTION EACH,,,17,,TotalUnits,,,,0.11 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81099,CPT,UNLISTED URINALYSIS PROCEDURE,,,17,,TotalUnits,,,,0.09 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81161,CPT,DMD DUPLICATION/DELETION ANALYSIS,,,17,,TotalUnits,,,,3.91 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81162,CPT,BRCA1&BRCA2 FULL SEQ ANALYS/FULL DUP/DEL ANALYS,,,17,,TotalUnits,,,,69.28 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81170,CPT,ABL1 GENE ANALYSIS KINASE DOMAIN VARIANTS,,,17,,TotalUnits,,,,9.18 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81201,CPT,APC GENE ANALYSIS FULL GENE SEQUENCE,,,17,,TotalUnits,,,,0.94 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81202,CPT,APC GENE ANALYSIS KNOWN FAMILIAL VARIANTS,,,17,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81203,CPT,APC GENE ANALYSIS DUPLICATION/DELETION VARIANTS,,,17,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81206,CPT,BCR/ABL1 MAJOR BREAKPNT QUALITATIVE/QUANTITATIVE,,,17,,TotalUnits,,,,6.23 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81207,CPT,BCR/ABL1 MINOR BREAKPNT QUALITATIVE/QUANTITATIVE,,,17,,TotalUnits,,,,5.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81208,CPT,BCR/ABL1 OTHER BREAKPNT QUALITATIVE/QUANTITATIVE,,,17,,TotalUnits,,,,6.11 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81210,CPT,BRAF GENE ANALYSIS V600 VARIANT(S),,,17,,TotalUnits,,,,4.99 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81211,CPT,BRCA1&BRCA2 FULL SEQ ANALYS/COMM DUP/DEL BRCA,,,17,,TotalUnits,,,,60.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81212,CPT,BRCA1&BRCA2 ANAL 185DELAG5385INSC/6174DELT,,,17,,TotalUnits,,,,4.92 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81213,CPT,BRCA1&BRCA2 ANAL UNCOMMON DUP/DEL VARIANTS,,,17,,TotalUnits,,,,16.22 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81214,CPT,BRCA1 FULL SEQ ANAL&COMMON DUP/DEL VARIANTS,,,17,,TotalUnits,,,,40.02 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81215,CPT,BRCA1 GENE ANALYSIS KNOWN FAMILIAL VARIANT,,,17,,TotalUnits,,,,2.59 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81217,CPT,BRCA2 GENE ANALYSIS KNOWN FAMILIAL VARIANT,,,17,,TotalUnits,,,,2.59 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81218,CPT,CEBPA GENE ANALYSIS FULL GENE SEQUENCE,,,17,,TotalUnits,,,,9.18 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81219,CPT,CALR GENE ANALYSIS COMMON VARIANTS IN EXON 9,,,17,,TotalUnits,,,,4.62 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81220,CPT,CFTR GENE ANALYSIS COMMON VARIANTS,,,17,,TotalUnits,,,,6.95 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81225,CPT,CYP2C19 GENE ANALYSIS COMMON VARIANTS,,,17,,TotalUnits,,,,8.12 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81226,CPT,CYP2D6 GENE ANALYSIS COMMON VARIANTS,,,17,,TotalUnits,,,,12.57 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81227,CPT,CYP2C9 GENE ANALYSIS COMMON VARIANTS,,,17,,TotalUnits,,,,4.87 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81228,CPT,CYTOGENOM CONST MICROARRAY COPY NUMBER VARIANTS,,,17,,TotalUnits,,,,11.59 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81235,CPT,EGFR GENE ANALYSIS COMMON VARIANTS,,,17,,TotalUnits,,,,9.18 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81240,CPT,F2 GENE ANALYSIS 20210G >A VARIANT,,,17,,TotalUnits,,,,1.87 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81241,CPT,F5 COAGULATION FACTOR V ANAL LEIDEN VARIANT,,,17,,TotalUnits,,,,2.32 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81243,CPT,FMR1 ANALYSIS EVAL TO DETECT ABNORMAL ALLELES,,,17,,TotalUnits,,,,2.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81245,CPT,FLT3 GENE ANALYSIS INTERNAL TANDEM DUP VARIANTS,,,17,,TotalUnits,,,,4.62 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81246,CPT,FLT3 GENE ANLYS TYROSINE KINASE DOMAIN VARIANTS,,,17,,TotalUnits,,,,2.32 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81252,CPT,GJB2 GENE ANALYSIS FULL GENE SEQUENCE,,,17,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81253,CPT,GJB2 GENE ANALYSIS KNOWN FAMILIAL VARIANTS,,,17,,TotalUnits,,,,0.35 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81254,CPT,GJB6 GENE ANALYSIS COMMON VARIANTS,,,17,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81256,CPT,HFE HEMOCHROMATOSIS GENE ANAL COMMON VARIANTS,,,17,,TotalUnits,,,,2.48 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81257,CPT,HBA1/HBA2 ANALYSIS FOR COMMON DELETIONS/VARIANT,,,17,,TotalUnits,,,,3.38 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81261,CPT,IGH@ REARRANGE ABNORMAL CLONAL POP AMPLIFIED,,,17,,TotalUnits,,,,7.52 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81262,CPT,IGH@ REARRANGE ABNORMAL CLONAL POP DIRECT PROBE,,,17,,TotalUnits,,,,1.66 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81263,CPT,IGH@ VARIABLE REGION SOMATIC MUTATION ANALYSIS,,,17,,TotalUnits,,,,11.18 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81264,CPT,IGK@ GENE REARRANGE DETECT ABNORMAL CLONAL POP,,,17,,TotalUnits,,,,5.67 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81265,CPT,COMPARATIVE ANAL STR MARKERS PATIENT&COMP SPEC,,,17,,TotalUnits,,,,8.16 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81266,CPT,COMPARATIVE ANAL STR MARKERS EA ADDL SPECIMEN,,,17,,TotalUnits,,,,10.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81267,CPT,CHIMERISM W/COMP TO BASELINE W/O CELL SELECTION,,,17,,TotalUnits,,,,7.88 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81268,CPT,CHIMERISM W/COMP TO BASELINE W/CELL SELECTION EA,,,17,,TotalUnits,,,,9.90 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81270,CPT,JAK2 GENE ANALYSIS P.VAL617PHE VARIANT,,,17,,TotalUnits,,,,3.48 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81272,CPT,KIT GENE ANALYSIS TARGETED SEQUENCE ANALYSIS,,,17,,TotalUnits,,,,9.18 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81273,CPT,KIT GENE ANALYSIS D816 VARIANT(S),,,17,,TotalUnits,,,,3.48 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81275,CPT,KRAS GENE ANALYSIS VARIANTS IN EXON 2,,,17,,TotalUnits,,,,5.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81276,CPT,KRAS GENE ANALYSIS ADDITIONAL VARIANT(S),,,17,,TotalUnits,,,,5.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81287,CPT,MGMT METHYLATION ANALYSIS,,,17,,TotalUnits,,,,2.32 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81288,CPT,MLH1 GENE ANALYSIS PROMOTER METHYLATION ANALYSIS,,,17,,TotalUnits,,,,4.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81291,CPT,MTHFR GENE ANALYSIS COMMON VARIANTS,,,17,,TotalUnits,,,,1.66 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81292,CPT,MLH1 GENE ANALYSIS FULL SEQUENCE ANALYSIS,,,17,,TotalUnits,,,,17.98 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81293,CPT,MLH1 GENE ANALYSIS KNOWN FAMILIAL VARIANTS,,,17,,TotalUnits,,,,7.21 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81294,CPT,MLH1 GENE ANALYSIS DUPLICATION/DELETION VARIANTS,,,17,,TotalUnits,,,,5.31 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81295,CPT,MSH2 GENE ANALYSIS FULL SEQUENCE ANALYSIS,,,17,,TotalUnits,,,,4.22 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81296,CPT,MSH2 GENE ANALYSIS KNOWN FAMILIAL VARIANTS,,,17,,TotalUnits,,,,3.60 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81297,CPT,MSH2 GENE ANALYSIS DUPLICATION/DELETION VARIANTS,,,17,,TotalUnits,,,,4.22 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81298,CPT,MSH6 GENE ANALYSIS FULL SEQUENCE ANALYSIS,,,17,,TotalUnits,,,,8.01 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81299,CPT,MSH6 GENE ANALYSIS KNOWN FAMILIAL VARIANTS,,,17,,TotalUnits,,,,4.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81300,CPT,MSH6 GENE ANALYSIS DUPLICATION/DELETION VARIA,,,17,,TotalUnits,,,,4.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81301,CPT,MICROSATELLITE INSTAB ANAL MISMATCH REPAIR DEF,,,17,,TotalUnits,,,,10.99 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81310,CPT,NPM1 NUCLEOPHOSMIN GENE ANAL EXON 12 VARIANTS,,,17,,TotalUnits,,,,6.88 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81311,CPT,NRAS GENE ANALYSIS VARIANTS IN EXON 2&3,,,17,,TotalUnits,,,,8.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81313,CPT,PCA3/KLK3 PROSTATE SPECIFIC ANTIGEN RATIO,,,17,,TotalUnits,,,,7.26 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81314,CPT,PDGFRA GENE ANALYS TARGETED SEQUENCE ANALYS,,,17,,TotalUnits,,,,9.18 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81315,CPT,PML/RARALPHA COMMON BREAKPOINTS QUAL/QUANT,,,17,,TotalUnits,,,,7.87 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81316,CPT,PML/RARALPHA SINGLE BREAKPOINT QUAL/QUAN,,,17,,TotalUnits,,,,12.01 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81317,CPT,PMS2 GENE ANALYSIS FULL SEQUENCE,,,17,,TotalUnits,,,,21.74 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81318,CPT,PMS2 GENE ANALYSIS KNOWN FAMILIAL VARIANTS,,,17,,TotalUnits,,,,5.14 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81319,CPT,PMS2 GENE ANALYSIS DUPLICATION/DELETION VARIANTS,,,17,,TotalUnits,,,,6.17 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81321,CPT,PTEN GENE ANALYSIS FULL SEQUENCE ANALYSIS,,,17,,TotalUnits,,,,16.72 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81322,CPT,PTEN GENE ANALYSIS KNOWN FAMILIAL VARIANT,,,17,,TotalUnits,,,,1.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81323,CPT,PTEN GENE ANALYSIS DUPLICATION/DELETION VARIANT,,,17,,TotalUnits,,,,2.44 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81332,CPT,SERPINA1 GENE ANALYSIS COMMON VARIANTS,,,17,,TotalUnits,,,,1.66 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81340,CPT,TRB@ REARRANGEMENT ANAL AMPLIFICATION METHOD,,,17,,TotalUnits,,,,7.93 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81341,CPT,TRB@ REARRANGEMENT ANAL DIRECT PROBE METHODOLOGY,,,17,,TotalUnits,,,,1.88 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81342,CPT,TRG@ GENE REARRANGEMENT ANALYSIS,,,17,,TotalUnits,,,,7.65 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81350,CPT,UGT1A1 GENE ANALYSIS COMMON VARIANTS,,,17,,TotalUnits,,,,0.96 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81355,CPT,VKORC1 GENE ANALYSIS COMMON VARIANT(S),,,17,,TotalUnits,,,,1.45 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81370,CPT,HLA CLASS I&II LOW HLA-A -B -C -DRB1/3/4/5&DQB,,,17,,TotalUnits,,,,15.27 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81371,CPT,HLA I&LI LOW RESOLUTION HLA-A -B&-DRB1,,,17,,TotalUnits,,,,9.14 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81372,CPT,HLA CLASS I TYPING LOW RESOLUTION COMPLETE,,,17,,TotalUnits,,,,8.39 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81373,CPT,HLA CLASS I TYPING LOW RESOLUTION ONE LOCUS EACH,,,17,,TotalUnits,,,,4.23 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81374,CPT,HLA I LOW RESOLUTION ONE ANTIGEN EQUIVALENT EACH,,,17,,TotalUnits,,,,2.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81375,CPT,HLA II LOW RESOLUTION HLA-DRB1/3/4/5 AND -DQB1,,,17,,TotalUnits,,,,8.38 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81376,CPT,HLA CLASS II TYPING LOW RESOLUTION ONE LOCUS EA,,,17,,TotalUnits,,,,4.64 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81377,CPT,HLA II LOW RESOLUTION ONE ANTIGEN EQUIVALENT EA,,,17,,TotalUnits,,,,3.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81378,CPT,HLA I&II HIGH RESOLUTION HLA-A -B -C AND -DRB1,,,17,,TotalUnits,,,,13.12 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81379,CPT,HLA CLASS I TYPING HIGH RESOLUTION COMPLETE,,,17,,TotalUnits,,,,12.73 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81380,CPT,HLA CLASS I TYPING HIGH RESOLUTION ONE LOCUS EA,,,17,,TotalUnits,,,,6.73 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81381,CPT,HLA I TYPING HIGH RESOLUTION 1 ALLELE/ALLELE GRP,,,17,,TotalUnits,,,,3.59 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81382,CPT,HLA CLASS II TYPING HIGH RESOLUTION ONE LOCUS EA,,,17,,TotalUnits,,,,4.70 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81383,CPT,HLA II HIGH RESOLUTION 1 ALLELE/ALLELE GROUP,,,17,,TotalUnits,,,,4.14 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81400,CPT,MOLECULAR PATHOLOGY PROCEDURE LEVEL 1,,,17,,TotalUnits,,,,1.64 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81401,CPT,MOLECULAR PATHOLOGY PROCEDURE LEVEL 2,,,17,,TotalUnits,,,,2.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81402,CPT,MOLECULAR PATHOLOGY PROCEDURE LEVEL 3,,,17,,TotalUnits,,,,3.93 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81403,CPT,MOLECULAR PATHOLOGY PROCEDURE LEVEL 4,,,17,,TotalUnits,,,,5.94 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81404,CPT,MOLECULAR PATHOLOGY PROCEDURE LEVEL 5,,,17,,TotalUnits,,,,8.52 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81405,CPT,MOLECULAR PATHOLOGY PROCEDURE LEVEL 6,,,17,,TotalUnits,,,,11.68 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81406,CPT,MOLECULAR PATHOLOGY PROCEDURE LEVEL 7,,,17,,TotalUnits,,,,15.41 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81407,CPT,MOLECULAR PATHOLOGY PROCEDURE LEVEL 8,,,17,,TotalUnits,,,,43.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81408,CPT,MOLECULAR PATHOLOGY PROCEDURE LEVEL 9,,,17,,TotalUnits,,,,96.04 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81420,CPT,FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS,,,17,,TotalUnits,,,,2.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81435,CPT,HEREDITARY COLON CA DSRDRS GEN SEQ ANALYS 10 GEN,,,17,,TotalUnits,,,,22.24 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81436,CPT,HEREDITARY COLON CA DSRDRS DUP/DEL ANALYS 5 GEN,,,17,,TotalUnits,,,,22.24 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81445,CPT,GEN SEQ ANALYS SOLID ORGAN NEOPLASM 5-50 GENE,,,17,,TotalUnits,,,,16.69 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81450,CPT,GEN SEQ ANALYS HEMATOLYMPHOID NEO 5-50 GENE,,,17,,TotalUnits,,,,18.10 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81479,CPT,UNLISTED MOLELCULAR PATHOLOGY PROCEDURE,,,17,,TotalUnits,,,,2.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81490,CPT,AUTOIMMUNE RHEUMATOID ARTHRTS ANALYS 12 BIOMRKRS,,,17,,TotalUnits,,,,5.88 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81493,CPT,COR ART DISEASE MRNA GENE EXPRESSION 23 GENES,,,17,,TotalUnits,,,,17.98 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81519,CPT,ONCOLOGY BREAST MRNA GENE EXPRESSION 21 GENES,,,17,,TotalUnits,,,,95.44 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81525,CPT,ONCOLOGY COLON MRNA GENE EXPRESSION 12 GENES,,,17,,TotalUnits,,,,17.98 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81528,CPT,ONCOLOGY COLORECTAL SCREENING QUAN 10 DNA MARKRS,,,17,,TotalUnits,,,,13.97 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81535,CPT,ONCOLOGY GYNE LIVE TUM CELL CLTR&CHEMO RESP 1ST,,,17,,TotalUnits,,,,18.55 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81536,CPT,ONCOLOGY GYNE LIVE TUM CELL CLTR&CHEMO RESP ADD,,,17,,TotalUnits,,,,4.96 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81538,CPT,ONCOLOGY LUNG MS 8-PROTEIN SIGNATURE,,,17,,TotalUnits,,,,5.52 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81540,CPT,ONCOLOGY TUM UNKNOWN ORIGIN MRNA 92 GENES,,,17,,TotalUnits,,,,40.02 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81545,CPT,ONCOLOGY THYROID GENE EXPRESSION 142 GENES,,,17,,TotalUnits,,,,60.03 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
81595,CPT,CARDIOLOGY HRT TRNSPL MRNA GENE EXPRESS 20 GENES,,,17,,TotalUnits,,,,17.98 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82009,CPT,KETONE BODIES SERUM QUALITATIVE,,,17,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82010,CPT,KETONE BODIES SERUM QUANTITATIVE,,,17,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82013,CPT,ASSAY OF ACETYLCHOLINESTERASE,,,17,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82016,CPT,ACYLCARNITINES QUALITATIVE EACH SPECIMEN,,,17,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82017,CPT,ACYLCARNITINES QUANTIATIVE EACH SPECIMEN,,,17,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82024,CPT,ADRENOCORTICOTROPIC HORMONE ACTH,,,17,,TotalUnits,,,,1.47 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82030,CPT,ADENOSINE 5-MONOPHOSPHATE CYCLIC,,,17,,TotalUnits,,,,0.98 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82040,CPT,ALBUMIN SERUM PLASMA/WHOLE BLOOD,,,17,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82042,CPT,ALBUMIN URINE/OTHER SOURCE QUAN EACH SPECIMEN,,,17,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82043,CPT,ALBUMIN URINE MICROALBUMIN QUANTIATIVE,,,17,,TotalUnits,,,,0.22 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82044,CPT,ALBUMIN URINE MICROALBUMIN SEMIQUANTITATIVE,,,17,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82045,CPT,ALBUMIN ISCHEMIA MODIFIED,,,17,,TotalUnits,,,,1.29 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82075,CPT,ASSAY OF ALCOHOL BREATH,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82085,CPT,ASSAY OF ALDOLASE,,,17,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82088,CPT,ASSAY OF ALDOSTERONE,,,17,,TotalUnits,,,,1.55 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82103,CPT,ALPHA-1-ANTITRYPSIN TOTAL,,,17,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82104,CPT,ALPHA-1-ANTITRYPSIN PHENOTYPE,,,17,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82105,CPT,ALPHA-FETOPROTEIN SERUM,,,17,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82106,CPT,ALPHA-FETOPROTEIN AMNIOTIC FLUID,,,17,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82107,CPT,AFP-L3 FRACTION ISOFORM & TOTAL AFP W/RATIO,,,17,,TotalUnits,,,,2.45 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82108,CPT,ASSAY OF ALUMINUM,,,17,,TotalUnits,,,,0.97 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82120,CPT,AMINES VAGINAL FLUID QUALITATIVE,,,17,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82127,CPT,AMINO ACIDS 1 QUALITATIVE EACH SPECIMEN,,,17,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82128,CPT,AMINO ACIDS MULTIPLE QUALITATIVE EACH SPECIMEN,,,17,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82131,CPT,AMINO ACIDS 1 QUANTITATIVE EACH SPECIMEN,,,17,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82135,CPT,AMINOLEVULINIC ACID DELTA,,,17,,TotalUnits,,,,0.62 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82136,CPT,AMINO ACIDS 2-5 AMINO ACIDS QUANTITATIVE EA SPEC,,,17,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82139,CPT,AMINO ACIDS 6/> AMINO ACIDS QUANTITATIVE EA SPE,,,17,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82140,CPT,ASSAY OF AMMONIA,,,17,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82143,CPT,AMNIOTIC FLU SCAN,,,17,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82150,CPT,ASSAY OF AMYLASE,,,17,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82154,CPT,ANDROSTANEDIOL GLUCURONIDE,,,17,,TotalUnits,,,,1.09 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82157,CPT,ANDROSTENEDIONE,,,17,,TotalUnits,,,,1.11 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82160,CPT,ANDROSTERONE,,,17,,TotalUnits,,,,0.95 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82163,CPT,ANGIOTENSIN II,,,17,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82164,CPT,ANGIOTENSIN I-CONVERTING ENZYME,,,17,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82172,CPT,APOLIPOPROTEIN EACH,,,17,,TotalUnits,,,,0.59 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82175,CPT,ASSAY OF ARSENIC,,,17,,TotalUnits,,,,0.72 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82180,CPT,ASSAY OF ASCORBIC ACID BLOOD,,,17,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82190,CPT,ATOMIC ABSRPJ SPECTROSCOPY EA ANALYTE,,,17,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82232,CPT,BETA-2 MICROGLOBULIN,,,17,,TotalUnits,,,,0.61 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82239,CPT,BILE ACIDS TOTAL,,,17,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82240,CPT,BILE ACIDS CHOLYLGLYCINE,,,17,,TotalUnits,,,,1.01 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82247,CPT,BILIRUBIN TOTAL,,,17,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82248,CPT,BILIRUBIN DIRECT,,,17,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82252,CPT,BILIRUBIN FECES QUALITATIVE,,,17,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82261,CPT,BIOTINIDASE EACH SPECIMEN,,,17,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82270,CPT,BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER,,,17,,TotalUnits,,,,0.12 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82271,CPT,BLOOD OCCULT PEROXIDASE ACTV QUAL OTHER SOURCES,,,17,,TotalUnits,,,,0.12 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82272,CPT,BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1-3 SPEC,,,17,,TotalUnits,,,,0.12 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82274,CPT,BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3,,,17,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82286,CPT,BRADYKININ,,,17,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82300,CPT,CADMIUM,,,17,,TotalUnits,,,,0.88 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82306,CPT,25 HYDROXY INCLUDES FRACTIONS IF PERFORMED,,,17,,TotalUnits,,,,1.12 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82308,CPT,CALCITONIN,,,17,,TotalUnits,,,,1.02 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82310,CPT,CALCIUM TOTAL,,,17,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82330,CPT,CALCIUM IONIZED,,,17,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82331,CPT,CALCIUM AFTER CALCIUM INFUSION TEST,,,17,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82340,CPT,CALCIUM URINE QUANTITATIVE TIMED SPECIMEN,,,17,,TotalUnits,,,,0.23 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82355,CPT,CALCULUS QUALITATIVE ANALYSIS,,,17,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82360,CPT,CALCULUS QUANTITATIVE CHEMICAL,,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82365,CPT,CALCULUS INFRARED SPECTROSCOPY,,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82370,CPT,CALCULUS XRAY DIFFRACTION,,,17,,TotalUnits,,,,0.48 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82373,CPT,CARBOHYDRATE DEFICIENT TRANSFERRIN,,,17,,TotalUnits,,,,0.69 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82374,CPT,CARBON DIOXIDE BICARBONATE,,,17,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82375,CPT,CARBOXYHEMOGLOBIN QUANTITATIVE,,,17,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82376,CPT,CARBOXYHEMOGLOBIN QUALITATIVE,,,17,,TotalUnits,,,,0.23 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82378,CPT,CARCINOEMBRYONIC ANTIGEN CEA,,,17,,TotalUnits,,,,0.72 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82379,CPT,CARNITINE QUANTITATIVE EACH SPECIMEN,,,17,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82380,CPT,CAROTENE,,,17,,TotalUnits,,,,0.35 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82382,CPT,CATECHOLAMINES TOTAL URINE,,,17,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82383,CPT,CATECHOLAMINES BLOOD,,,17,,TotalUnits,,,,0.95 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82384,CPT,CATECHOLAMINES FRACTIONATED,,,17,,TotalUnits,,,,0.96 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82387,CPT,CATHEPSIN-D,,,17,,TotalUnits,,,,0.79 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82390,CPT,CERULOPLASMIN,,,17,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82397,CPT,CHEMILUMINESCENT ASSAY,,,17,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82415,CPT,CHLORAMPHENICOL,,,17,,TotalUnits,,,,0.48 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82435,CPT,CHLORIDE BLD,,,17,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82436,CPT,CHLORIDE URINE,,,17,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82438,CPT,CHLORIDE OTHER SOURCE,,,17,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82441,CPT,CHLORINATED HYDROCARBONS SCREEN,,,17,,TotalUnits,,,,0.23 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82465,CPT,CHOLESTEROL SERUM/WHOLE BLOOD TOTAL,,,17,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82480,CPT,CHOLINESTERASE SERUM,,,17,,TotalUnits,,,,0.30 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82482,CPT,CHOLINESTERASE RBC,,,17,,TotalUnits,,,,0.29 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82485,CPT,CHONDROITIN B SULFATE QUANTITATIVE,,,17,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82495,CPT,ASSAY OF CHROMIUM,,,17,,TotalUnits,,,,0.77 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82507,CPT,ASSAY OF CITRATE,,,17,,TotalUnits,,,,1.06 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82523,CPT,COLLAGEN CROSS LINKS ANY METHOD,,,17,,TotalUnits,,,,0.71 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82525,CPT,ASSAY OF COPPER,,,17,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82528,CPT,CORTICOSTERONE,,,17,,TotalUnits,,,,0.85 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82530,CPT,CORTISOL FREE,,,17,,TotalUnits,,,,0.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82533,CPT,CORTISOL TOTAL,,,17,,TotalUnits,,,,0.62 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82540,CPT,ASSAY OF CREATINE,,,17,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82542,CPT,COL-CHR/MS NONDRUG ANALYTE NES QUAL/QUAN EA SPEC,,,17,,TotalUnits,,,,0.69 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82550,CPT,CREATINE KINASE TOTAL,,,17,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82552,CPT,CREATINE KINASE ISOENZYMES,,,17,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82553,CPT,CREATINE KINASE MB FRACTION ONLY,,,17,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82554,CPT,CREATINE KINASE ISOFORMS,,,17,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82565,CPT,CREATININE BLOOD,,,17,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82570,CPT,CREATININE OTHER SOURCE,,,17,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82575,CPT,CREATININE CLEARANCE,,,17,,TotalUnits,,,,0.36 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82585,CPT,ASSAY OF CRYOFIBRN,,,17,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82595,CPT,CRYOGLOBULIN QUALITATIVE/SEMI-QUANTITATIVE,,,17,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82600,CPT,ASSAY OF CYANIDE,,,17,,TotalUnits,,,,0.74 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82607,CPT,CYANOCOBALAMIN VITAMIN B-12,,,17,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82608,CPT,CYANOCOBALAMIN VIT B-12 UNSAT BINDING CAPACITY,,,17,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82610,CPT,CYSTATIN C,,,17,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82615,CPT,CSTINE&HOMOCSTINE URINE QUALITATIVE,,,17,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82626,CPT,DEHYDROEPIANDROSTERONE,,,17,,TotalUnits,,,,0.96 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82627,CPT,DEHYDROEPIANDROSTERONE-SULFATE,,,17,,TotalUnits,,,,0.84 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82633,CPT,DESOXYCORTICOSTERONE 11-,,,17,,TotalUnits,,,,1.18 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82634,CPT,DEOXYCORTISOL 11-,,,17,,TotalUnits,,,,1.11 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82638,CPT,ASSAY OF DIBUCAINE NUMBER,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82652,CPT,1 25 DIHYDROXY INCLUDES FRACTIONS IF PERFORMED,,,17,,TotalUnits,,,,1.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82656,CPT,ELASTASE PANCREATIC FECAL QUAL/SEMI-QUAN,,,17,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82657,CPT,NZYM ACTIV BLD CELLS/TISS NONRADACT SUBSTRATE EA,,,17,,TotalUnits,,,,0.69 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82658,CPT,NZYM ACTV BLOOD CELLS/TISS RADACT SUBSTRATE EA,,,17,,TotalUnits,,,,0.69 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82664,CPT,ELCTROPHORETIC TECHNIQUE NOT ELSEWHERE SPECIFIED,,,17,,TotalUnits,,,,1.30 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82668,CPT,ASSAY OF ERYTHROPOIETIN,,,17,,TotalUnits,,,,0.71 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82670,CPT,ASSAY OF ESTRADIOL,,,17,,TotalUnits,,,,1.06 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82671,CPT,ASSAY OF ESTROGENS FRACTIONATED,,,17,,TotalUnits,,,,1.23 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82672,CPT,ASSAY OF ESTROGENS TOTAL,,,17,,TotalUnits,,,,0.82 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82677,CPT,ASSAY OF ESTRIOL,,,17,,TotalUnits,,,,0.92 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82679,CPT,ASSAY OF ESTRONE,,,17,,TotalUnits,,,,0.95 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82693,CPT,ASSAY OF ETHYLENE GLYCOL,,,17,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82696,CPT,ASSAY OF ETIOCHOLANOLONE,,,17,,TotalUnits,,,,0.90 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82705,CPT,FAT/LIPIDS FECES QUALITATIVE,,,17,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82710,CPT,FAT/LIPIDS FECES QUANTITATIVE,,,17,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82715,CPT,FAT DIFFIAL FECES QUANTITATIVE,,,17,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82725,CPT,FATTY ACIDS NONESTERIFIED,,,17,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82726,CPT,VERY LONG CHAIN FATTY ACIDS,,,17,,TotalUnits,,,,0.69 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82728,CPT,ASSAY OF FERRITIN,,,17,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82731,CPT,FTL FIBRONECTIN CERVICOVAG SECRETIONS SEMI-QUAN,,,17,,TotalUnits,,,,2.45 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82735,CPT,ASSAY OF FLUORIDE,,,17,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82746,CPT,ASSAY OF FOLIC ACID SERUM,,,17,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82747,CPT,ASSAY OF FOLIC ACID RBC,,,17,,TotalUnits,,,,0.66 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82757,CPT,ASSAY OF FRUCTOSE SEMEN,,,17,,TotalUnits,,,,0.66 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82759,CPT,ASSAY OF GALACTOKINASE RBC,,,17,,TotalUnits,,,,0.82 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82760,CPT,ASSAY OF GALACTOSE,,,17,,TotalUnits,,,,0.43 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82775,CPT,GALACTOSE-1-PHOSPHATE URIDYL TRANSFERASE QUAN,,,17,,TotalUnits,,,,0.80 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82776,CPT,GALACTOSE-1-PHOSPHATE URIDYL TRANSFERASE SCREEN,,,17,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82777,CPT,GALECTIN-3,,,17,,TotalUnits,,,,0.84 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82784,CPT,ASSAY OF GAMMAGLOBULIN IGA IGD IGG IGM EACH,,,17,,TotalUnits,,,,0.35 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82785,CPT,ASSAY OF GAMMAGLOBULIN IGE,,,17,,TotalUnits,,,,0.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82787,CPT,GAMMAGLOBULIN IMMUNOGLOBULIN SUBCLASSES,,,17,,TotalUnits,,,,0.30 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82800,CPT,GASES BLOOD PH ONLY,,,17,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82803,CPT,BLOOD GASES ANY COMBINATION PH PCO2 PO2 CO2 HCO3,,,17,,TotalUnits,,,,0.73 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82805,CPT,GASES BLOOD PH DIRECT MEAS XCPT PULSE OXIMITRY,,,17,,TotalUnits,,,,1.08 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82810,CPT,GASES BLOOD O2 SATURATION ONLY DIRECT MEAS,,,17,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82820,CPT,HGB-O2 AFFINITY PO2 50% SATURATION OXYGEN,,,17,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82930,CPT,GASTRIC ACID ANALYIS W/PH EACH SPECIMEN,,,17,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82938,CPT,GASTRIN AFTER SECRETIN STIMULATION,,,17,,TotalUnits,,,,0.67 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82941,CPT,ASSAY OF GASTRIN,,,17,,TotalUnits,,,,0.67 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82943,CPT,ASSAY OF GLUCAGON,,,17,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82945,CPT,GLUCOSE BODY FLUID OTHER THAN BLOOD,,,17,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82946,CPT,GLUCOSE TOLERANCE TEST,,,17,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82947,CPT,GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP,,,17,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82948,CPT,GLUCOSE BLOOD REAGENT STRIP,,,17,,TotalUnits,,,,0.12 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82950,CPT,GLUCOSE POST GLUCOSE DOSE,,,17,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82951,CPT,GLUCOSE TOLERANCE TEST GTT 3 SPECIMENS,,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82952,CPT,GLUCOSE TOLERANCE EA ADDL BEYOND 3 SPECIMENS,,,17,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82955,CPT,GLUC-6-PHOSPHATE DEHYDROGENASE QUANTITATIVE,,,17,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82960,CPT,GLUC-6-PHOSPHATE DEHYDROGENASE SCREEN,,,17,,TotalUnits,,,,0.23 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82962,CPT,GLUC BLD GLUC MNTR DEV CLEARED FDA SPEC HOME USE,,,17,,TotalUnits,,,,0.09 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82963,CPT,ASSAY OF GLUCOSIDASE BETA,,,17,,TotalUnits,,,,0.82 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82965,CPT,ASSAY OF GLUTAMATE DEHYDROGENASE,,,17,,TotalUnits,,,,0.29 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82977,CPT,ASSAY OF GLUTAMYLTRASE GAMMA,,,17,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82978,CPT,ASSAY OF GLUTATHIONE,,,17,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82979,CPT,ASSAY OF GLUTATHIONE REDUCTASE RBC,,,17,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
82985,CPT,ASSAY OF GLYCATED PROTEIN,,,17,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83001,CPT,GONADOTROPIN FOLLICLE STIMULATING HORMONE,,,17,,TotalUnits,,,,0.71 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83002,CPT,GONADOTROPIN LUTEINIZING HORMONE,,,17,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83003,CPT,ASSAY OF GROWTH HORMONE HUMAN,,,17,,TotalUnits,,,,0.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83006,CPT,GROWTH STIMULATION EXPRESSED GENE 2,,,17,,TotalUnits,,,,0.84 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83009,CPT,HPYLORI BLOOD ANAL UREASE ACT NON-RADACT ISOTOPE,,,17,,TotalUnits,,,,2.56 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83010,CPT,ASSAY OF HAPTOGLOBIN QUANTITATIVE,,,17,,TotalUnits,,,,0.48 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83012,CPT,ASSAY OF HAPTOGLOBIN PHENOTYPES,,,17,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83013,CPT,HPYLORI BREATH ANAL UREASE ACT NON-RADACT ISTOPE,,,17,,TotalUnits,,,,2.56 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83014,CPT,HPYLORI DRUG ADMINISTRATION,,,17,,TotalUnits,,,,0.30 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83015,CPT,HEAVY METAL SCREEN,,,17,,TotalUnits,,,,0.72 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83018,CPT,HEAVY METAL QUANTIATIVE EACH,,,17,,TotalUnits,,,,0.83 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83020,CPT,HEMOGLOBIN FRACTJ/QUANTJ ELECTROPHORESIS,,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
83020,CPT,HEMOGLOBIN FRACTJ/QUANTJ ELECTROPHORESIS,26,,17,,RBRVS,0.37 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
83021,CPT,HEMOGLOBIN FRACTJ/QUANTJ CHROMOTOGRAPHY,,,17,,TotalUnits,,,,0.69 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83026,CPT,HEMOGLOBIN COPPER SULFATE METHOD NON-AUTOMATED,,,17,,TotalUnits,,,,0.09 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83030,CPT,HEMOGLOBIN F FETAL CHEMICAL,,,17,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83033,CPT,HEMOGLOBIN F FETAL QUALITATIVE,,,17,,TotalUnits,,,,0.23 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83036,CPT,HEMOGLOBIN GLYCOSYLATED A1C,,,17,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83037,CPT,HGB GLYCOSYLATED DEVICE CLEARED FDA HOME USE,,,17,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83045,CPT,HEMOGLOBIN METHEMOGLOBIN QUALITATIVE,,,17,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83050,CPT,HEMOGLOBIN METHEMOGLOBIN QUANTITATIVE,,,17,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83051,CPT,ASSAY OF HEMOGLOBIN PLASMA,,,17,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83060,CPT,HEMOGLOBIN SULFHEMOGLOBIN QUANTITATIVE,,,17,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83065,CPT,HEMOGLOBIN THERMOLABILE,,,17,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83068,CPT,HEMOGLOBIN UNSTABLE SCREEN,,,17,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83069,CPT,ASSAY OF HEMOGLOBIN URINE,,,17,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83070,CPT,ASSAY OF HEMOSIDERIN QUALITATIVE,,,17,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83080,CPT,ASSAY OF B-HEXOSAMINIDASE EACH ASSAY,,,17,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83088,CPT,ASSAY OF HISTAMINE,,,17,,TotalUnits,,,,1.12 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83090,CPT,ASSAY OF HOMOCYSTEINE,,,17,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83150,CPT,ASSAY OF HOMOVANILLIC ACID,,,17,,TotalUnits,,,,0.73 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83491,CPT,HYDROXYCORTICOSTEROIDS 17,,,17,,TotalUnits,,,,0.67 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83497,CPT,ASSAY OF HYDROXYINDOLACETIC ACID 5-HIAA,,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83498,CPT,ASSAY OF HYDROXYPROGESTERONE 17-D,,,17,,TotalUnits,,,,1.03 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83499,CPT,ASSAY OF HYDROXYPROGESTERONE 20-,,,17,,TotalUnits,,,,0.96 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83500,CPT,ASSAY OF HYDROXYPROLINE FREE,,,17,,TotalUnits,,,,0.86 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83505,CPT,ASSAY OF HYDROXYPROLINE TOTAL,,,17,,TotalUnits,,,,0.92 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83516,CPT,IMMUNOASSAY ANALYTE QUAL/SEMIQUAL MULTIPLE STEP,,,17,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83518,CPT,IMMUNOASSAY ANALYTE QUAL/SEMIQUAL SINGLE STEP,,,17,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83519,CPT,IMMUNOASSAY ANALYTE QUANT RADIOIMMUNOASSAY,,,17,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83520,CPT,IMMUNOASSAY ANALYTE QUANTITATIVE NOS,,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83525,CPT,ASSAY OF INSULIN TOTAL,,,17,,TotalUnits,,,,0.43 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83527,CPT,ASSAY OF INSULIN FREE,,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83528,CPT,ASSAY OF INTRINSIC FACTOR,,,17,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83540,CPT,ASSAY OF IRON,,,17,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83550,CPT,IRON BINDING CAPACITY,,,17,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83570,CPT,ISOCITRIC DEHYDROGENASE,,,17,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83582,CPT,ASSAY OF KETOGENIC STEROIDS FRACTIONATION,,,17,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83586,CPT,ASSAY OF KETOSTEROIDS 17- TOTAL,,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83593,CPT,KETOSTEROIDS 17- FRACTIONATION,,,17,,TotalUnits,,,,1.00 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83605,CPT,ASSAY OF LACTATE,,,17,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83615,CPT,LACTATE DEHYDROGENASE LDH,,,17,,TotalUnits,,,,0.23 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83625,CPT,LACTATE DEHYDROGENASE ISOENZYMES SEP&QUAN,,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83630,CPT,LACTOFERRIN FECAL QUALITATIVE,,,17,,TotalUnits,,,,0.75 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83631,CPT,LACTOFERRIN FECAL QUANTITATIVE,,,17,,TotalUnits,,,,0.75 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83632,CPT,LACTOGEN HPL HUMAN CHORIONIC SOMATOMAMMOTROPIN,,,17,,TotalUnits,,,,0.77 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83633,CPT,LACTOSE URINE QUALITATIVE,,,17,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83655,CPT,ASSAY OF LEAD,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83661,CPT,FETAL LUNG MATURITY LECITHIN SPHINGOMYELIN RATIO,,,17,,TotalUnits,,,,0.83 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83662,CPT,FETAL LUNG MATURITY FOAM STABILITY TEST,,,17,,TotalUnits,,,,0.72 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83663,CPT,FETAL LUNG MATURITY FLUORESCENCE POLARIZATION,,,17,,TotalUnits,,,,0.72 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83664,CPT,FETAL LUNG MATURITY LAMELLAR BODY DENSITY,,,17,,TotalUnits,,,,0.72 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83670,CPT,LEUCINE AMINOPEPTIDASE LAP,,,17,,TotalUnits,,,,0.35 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83690,CPT,ASSAY OF LIPASE,,,17,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83695,CPT,LIPOPROTEIN (A),,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83698,CPT,LIPOPROTEIN-ASSOCIATED PHOSPHOLIPASE A2,,,17,,TotalUnits,,,,1.29 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83700,CPT,LIPOPROTEIN BLOOD ELECTROPHORECTIC SEP&QUAN,,,17,,TotalUnits,,,,0.43 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83701,CPT,LIPOPROTEIN BLOOD HIGH RESOLTJ&QUANTJ SUBCLASS,,,17,,TotalUnits,,,,0.94 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83704,CPT,LIPOPROTEIN BLOOD QUAN NUMBERS&SUBCLASSES,,,17,,TotalUnits,,,,1.20 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83718,CPT,LIPOPROTEIN DIR MEAS HIGH DENSITY CHOLESTEROL,,,17,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83719,CPT,LIPOPROTEIN DIRECT MEASUREMENT VLDL CHOLESTEROL,,,17,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83721,CPT,LIPOPROTEIN DIRECT MEASUREMENT LDL CHOLESTEROL,,,17,,TotalUnits,,,,0.36 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83727,CPT,LUTEINIZING RELEASING FACTOR,,,17,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83735,CPT,ASSAY OF MAGNESIUM,,,17,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83775,CPT,ASSAY OF MALATE DEHYDROGENASE,,,17,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83785,CPT,ASSAY OF MANGANESE,,,17,,TotalUnits,,,,0.93 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83789,CPT,MASS SPECT&TANDEM MASS SPECT NONDRG ANAL NES EA,,,17,,TotalUnits,,,,0.69 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83825,CPT,ASSAY OF MERCURY QUANTITATIVE,,,17,,TotalUnits,,,,0.62 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83835,CPT,METANEPHRINES,,,17,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83857,CPT,METHEMALBUMIN,,,17,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83861,CPT,MICROFLUIDIC ANALYSIS TEAR OSMOLARITY,,,17,,TotalUnits,,,,0.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83864,CPT,MUCOPOLYSACCHARIDES ACID QUANTITATIVE,,,17,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83872,CPT,MUCIN SYNOVIAL FLUID ROPES TEST,,,17,,TotalUnits,,,,0.22 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83873,CPT,MYELIN BASIC PROTEIN CEREBROSPINAL FLUID,,,17,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83874,CPT,MYOGLOBIN,,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83876,CPT,MYELOPEROXIDASE MPO,,,17,,TotalUnits,,,,1.29 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83880,CPT,NATRIURETIC PEPTIDE,,,17,,TotalUnits,,,,1.29 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83883,CPT,ASSAY OF NEPHELOMETRY EACH ANALYTE NES,,,17,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83885,CPT,ASSAY OF NICKEL,,,17,,TotalUnits,,,,0.93 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83915,CPT,ASSAY OF NUCLEOTIDASE 5'-,,,17,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83916,CPT,OLIGOCLONAL IMMUNE,,,17,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83918,CPT,ORGANIC ACIDS TOTAL QUANTITATIVE EACH SPECIMEN,,,17,,TotalUnits,,,,0.62 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83919,CPT,ORGANIC ACIDS QUALITATIVE EACH SPECIMEN,,,17,,TotalUnits,,,,0.62 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83921,CPT,ORGANIC ACID 1 QUANTITATIVE,,,17,,TotalUnits,,,,0.62 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83930,CPT,ASSAY OF OSMOLALITY BLOOD,,,17,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83935,CPT,ASSAY OF OSMOLALITY URINE,,,17,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83937,CPT,ASSAY OF OSTEOCALCIN,,,17,,TotalUnits,,,,1.13 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83945,CPT,ASSAY OF OXALATE,,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83950,CPT,ONCOPROTEIN HER-2/NEU,,,17,,TotalUnits,,,,2.45 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83951,CPT,ONCOPROTEIN DES-GAMMA-CARBOXY-PROTHROMBIN DCP,,,17,,TotalUnits,,,,2.45 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83970,CPT,ASSAY OF PARATHORMONE,,,17,,TotalUnits,,,,1.57 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83986,CPT,PH BODY FLUID NOT ELSEWHERE SPECIFIED,,,17,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83987,CPT,PH EXHALED BREATH CONDENSATE,,,17,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83992,CPT,ASSAY OF PHENCYCLIDINE,,,17,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
83993,CPT,ASSAY OF CALPROTECTIN FECAL,,,17,,TotalUnits,,,,0.75 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84030,CPT,ASSAY OF PHENYLALANINE BLOOD,,,17,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84035,CPT,ASSAY OF PHENYLKETONES QUALITATIVE,,,17,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84060,CPT,ASSAY OF PHOSPHATASE ACID TOTAL,,,17,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84061,CPT,PHOSPHATASE ACID FORENSIC EXAMINATION,,,17,,TotalUnits,,,,0.30 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84066,CPT,ASSAY OF PHOSPHATASE ACID PROSTATIC,,,17,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84075,CPT,ASSAY OF PHOSPHATASE ALKALINE,,,17,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84078,CPT,ASSAY OF PHOSPHATASE ALKALINE HEAT STABLE,,,17,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84080,CPT,ASSAY OF PHOSPHATASE ALKALINE ISOENZYMES,,,17,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84081,CPT,PHOSPHATIDYLGLYCEROL,,,17,,TotalUnits,,,,0.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84085,CPT,PHOSPHOGLUCONATE 6-DEHYD RBC,,,17,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84087,CPT,ASSAY OF PHOSPHOHEXOSE ISOMERASE,,,17,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84100,CPT,ASSAY OF PHOSPHORUS INORGANIC,,,17,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84105,CPT,ASSAY OF PHOSPHORUS INORGANIC URINE,,,17,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84106,CPT,PORPHOBILINOGEN URINE QUALITATIVE,,,17,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84110,CPT,ASSAY OF PORPHOBILINOGEN URINE QUANTITATIVE,,,17,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84112,CPT,EVAL C/V AMNIOTIC FLUID PROTEIN QUAL EA SPECIMEN,,,17,,TotalUnits,,,,2.45 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84119,CPT,PORPHYRINS URINE QUALITATAIVE,,,17,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84120,CPT,PORPHYRINS URINE QUANTITATION & FRACTIONATION,,,17,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84126,CPT,PORPHYRINS FECES QUANTITATIVE,,,17,,TotalUnits,,,,0.97 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84132,CPT,POTASSIUM SERUM PLASMA/WHOLE BLOOD,,,17,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84133,CPT,POTASSIUM URINE,,,17,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84134,CPT,PREALBUMIN,,,17,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84135,CPT,PREGNANEDIOL,,,17,,TotalUnits,,,,0.73 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84138,CPT,PREGNANETRIOL,,,17,,TotalUnits,,,,0.72 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84140,CPT,PREGNENOLONE,,,17,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84143,CPT,17-HYDROXYPREGNENOLONE,,,17,,TotalUnits,,,,0.87 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84144,CPT,ASSAY OF PROGESTERONE,,,17,,TotalUnits,,,,0.79 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84145,CPT,PROCALCITONIN (PCT),,,17,,TotalUnits,,,,1.02 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84146,CPT,ASSAY OF PROLACTIN,,,17,,TotalUnits,,,,0.74 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84150,CPT,ASSAY OF PROSTAGLNDIN EACH,,,17,,TotalUnits,,,,0.95 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84152,CPT,ASSAY OF PROSTATE SPECIFIC ANTIGEN COMPLEXED,,,17,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84153,CPT,ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL,,,17,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84154,CPT,ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE,,,17,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84155,CPT,PROTEIN XCPT REFRACTOMETRY SERUM PLASMA/WHL BLD,,,17,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84156,CPT,PROTEIN TOTAL XCPT REFRACTOMETRY URINE,,,17,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84157,CPT,PROTEIN TOTAL XCPT REFRACTOMETRY OTH SRC,,,17,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84160,CPT,PROTEIN TOTAL REFRACTOMETRY ANY SRC,,,17,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84163,CPT,PREGNANCY-ASSOCIATED PLASMA PROTEIN-A,,,17,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84165,CPT,PROTEIN ELECTROPHORETIC FRACTJ&QUANTJ SERUM,,,17,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
84165,CPT,PROTEIN ELECTROPHORETIC FRACTJ&QUANTJ SERUM,26,,17,,RBRVS,0.37 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
84166,CPT,PROTEIN ELECTROP FXJ&QUAN OTH FLUS CONCENTRATI,,,17,,TotalUnits,,,,0.68 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
84166,CPT,PROTEIN ELECTROP FXJ&QUAN OTH FLUS CONCENTRATI,26,,17,,RBRVS,0.37 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
84181,CPT,PROTEIN WESTRN BLOT I&R BLOOD/OTHER FLUID,,,17,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
84181,CPT,PROTEIN WESTRN BLOT I&R BLOOD/OTHER FLUID,26,,17,,RBRVS,0.37 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
84182,CPT,PROTEIN WESTRN BLOT BLOOD/OTH FLU IMMUNOLOGICAL,,,17,,TotalUnits,,,,0.68 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
84182,CPT,PROTEIN WESTRN BLOT BLOOD/OTH FLU IMMUNOLOGICAL,26,,17,,RBRVS,0.37 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
84202,CPT,PROTOPORPHYRIN RBC QUANTITATIVE,,,17,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84203,CPT,PROTOPORPHYRIN RBC SCREEN,,,17,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84206,CPT,ASSAY OF PROINSULIN,,,17,,TotalUnits,,,,0.68 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84207,CPT,ASSAY OF PYRIDOXAL PHOSPHATE,,,17,,TotalUnits,,,,1.07 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84210,CPT,ASSAY OF PYRUVATE,,,17,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84220,CPT,ASSAY OF PYRUVATE KINASE,,,17,,TotalUnits,,,,0.36 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84228,CPT,ASSAY OF QUININE,,,17,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84233,CPT,ASSAY OF RECEPTOR ASSAY ESTROGEN,,,17,,TotalUnits,,,,2.45 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84234,CPT,ASSAY OF RECEPTOR ASSAY PROGESTERONE,,,17,,TotalUnits,,,,2.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84235,CPT,RECEPTOR ASSAY ENDOCRINE OTH/THN ESTRGN/PROGST,,,17,,TotalUnits,,,,1.99 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84238,CPT,RECEPTOR ASSAY NON-ENDOCRINE SPECIFY RECEPTOR,,,17,,TotalUnits,,,,1.39 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84244,CPT,ASSAY OF RENIN,,,17,,TotalUnits,,,,0.84 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84252,CPT,ASSAY OF RIBOFLAVIN-VITAMIN B-2,,,17,,TotalUnits,,,,0.77 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84255,CPT,ASSAY OF SELENIUM,,,17,,TotalUnits,,,,0.97 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84260,CPT,ASSAY OF SEROTONIN,,,17,,TotalUnits,,,,1.18 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84270,CPT,ASSAY OF SEX HORMONE BINDING GLOBULIN,,,17,,TotalUnits,,,,0.83 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84275,CPT,ASSAY OF SIALIC ACID,,,17,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84285,CPT,ASSAY OF SILICA,,,17,,TotalUnits,,,,0.89 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84295,CPT,SODIUM SERUM PLASMA OR WHOLE BLOOD,,,17,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84300,CPT,ASSAY OF URINE SODIUM,,,17,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84302,CPT,ASSAY OF SODIUM OTHER SOURCE,,,17,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84305,CPT,ASSAY OF SOMATOMEDIN,,,17,,TotalUnits,,,,0.81 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84307,CPT,ASSAY OF SOMATOSTATIN,,,17,,TotalUnits,,,,0.69 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84311,CPT,SPECTROPHOTOMETRY ANALYT NOT ELSEWHERE SPECIFIED,,,17,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84315,CPT,SPECIFIC GRAVITY EXCEPT URINE,,,17,,TotalUnits,,,,0.10 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84375,CPT,SUGARS CHROMATOGRAPHIC TLC/PAPER CHROMATOGRAPHY,,,17,,TotalUnits,,,,0.74 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84376,CPT,SUGARS MONO DI&OLIGOS 1 QUALITATAIVE EACH SPEC,,,17,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84377,CPT,SUGARS MONO DI&OLIGOS MLT QUALITATIVE EACH SPE,,,17,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84378,CPT,SUGARS MONO DI&OLIGOS 1 QUANTITATIVE EACH SPEC,,,17,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84379,CPT,SUGARS MONO DI&OLIGOS MLT QUANTITATIVE EA SPEC,,,17,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84392,CPT,ASSAY OF SULFATE URINE,,,17,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84402,CPT,ASSAY OF TESTOSTERONE FREE,,,17,,TotalUnits,,,,0.97 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84403,CPT,ASSAY OF TESTOSTERONE TOTAL,,,17,,TotalUnits,,,,0.98 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84425,CPT,ASSAY OF THIAMINE-VITAMIN B-1,,,17,,TotalUnits,,,,0.81 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84430,CPT,ASSAY OF THIOCYANATE,,,17,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84431,CPT,THROMBOXANE METABOLITE W/WO THROMBOXANE URINE,,,17,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84432,CPT,ASSAY OF THYROGLOBULIN,,,17,,TotalUnits,,,,0.61 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84436,CPT,ASSAY OF THYROXINE TOTAL,,,17,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84437,CPT,ASSAY OF THYROXINE REQUIRING ELUTION,,,17,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84439,CPT,ASSAY OF FREE THYROXINE,,,17,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84442,CPT,ASSAY OF THYROXINE BINDING GLOBULIN,,,17,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84443,CPT,ASSAY OF THYROID STIMULATING HORMONE TSH,,,17,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84445,CPT,THYROID STIMULATING IMMUNE GLOBULINS TSI,,,17,,TotalUnits,,,,1.93 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84446,CPT,ASSAY OF TOCOPHEROL ALPHA VITAMIN E,,,17,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84449,CPT,ASSAY OF TRANSCORTIN CORTISOL BINDING GLOBULIN,,,17,,TotalUnits,,,,0.68 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84450,CPT,TRANSFERASE ASPARTATE AMINO AST SGOT,,,17,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84460,CPT,TRANSFERASE ALANINE AMINO ALT SGPT,,,17,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84466,CPT,ASSAY OF L7383TRANSFERRIN,,,17,,TotalUnits,,,,0.48 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84478,CPT,ASSAY OF TRIGLYCERIDES,,,17,,TotalUnits,,,,0.22 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84479,CPT,THYROID HORM UPTK/THYROID HORMONE BINDING RATIO,,,17,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84480,CPT,ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3,,,17,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84481,CPT,ASSAY OF TRIIODOTHYRONINE T3 FREE,,,17,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84482,CPT,TRIIODOTHYRONINE T3 REVERSE,,,17,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84484,CPT,ASSAY OF TROPONIN QUANTITATIVE,,,17,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84485,CPT,ASSAY OF TRYPSIN DUODENAL FLUID,,,17,,TotalUnits,,,,0.29 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84488,CPT,ASSAY OF TRYPSIN FECES QUALITATIVE,,,17,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84490,CPT,TRYPSIN FECES QUANTITATIVE 24-HR COLLECTION,,,17,,TotalUnits,,,,0.29 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84510,CPT,ASSAY OF TYROSINE,,,17,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84512,CPT,ASSAY OF TROPONIN QUALITATIVE,,,17,,TotalUnits,,,,0.29 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84520,CPT,ASSAY OF UREA NITROGEN QUANTITATIVE,,,17,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84525,CPT,ASSAY OF UREA NITROGEN SEMIQUANTITATIVE,,,17,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84540,CPT,ASSAY OF UREA NITROGEN URINE,,,17,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84545,CPT,UREA NITROGEN CLEARANCE,,,17,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84550,CPT,ASSAY OF BLOOD/URIC ACID,,,17,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84560,CPT,ASSAY OF URIC ACID OTHER SOURCE,,,17,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84577,CPT,ASSAY OF UROBILINOGEN FECES QUANTITATIVE,,,17,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84578,CPT,ASSAY OF UROBILINOGEN URINE QUALITATIVE,,,17,,TotalUnits,,,,0.12 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84580,CPT,UROBILINOGEN URINE QUANTITATIVE TIMED SPECIMEN,,,17,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84583,CPT,ASSAY OF UROBILINOGEN URINE SEMIQUANTITATIVE,,,17,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84585,CPT,ASSAY OF VANILLYLMANDELIC ACID URINE,,,17,,TotalUnits,,,,0.59 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84586,CPT,ASSAY OF VASOACTIVE INTESTINAL PEPTIDE,,,17,,TotalUnits,,,,1.34 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84588,CPT,ASSAY OF VASOPRESSIN ANTI-DIURETIC HORMONE,,,17,,TotalUnits,,,,1.29 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84590,CPT,ASSAY OF VITAMIN A,,,17,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84591,CPT,ASSAY OF VITAMIN NOT OTHERWISE SPECIFIED,,,17,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84597,CPT,ASSAY OF VITAMIN K,,,17,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84600,CPT,ASSAY OF VOLATILES,,,17,,TotalUnits,,,,0.61 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84620,CPT,XYLOSE ABSORPTION TEST BLOOD &/URINE,,,17,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84630,CPT,ASSAY OF ZINC,,,17,,TotalUnits,,,,0.43 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84681,CPT,ASSAY OF C-PEPTIDE,,,17,,TotalUnits,,,,0.79 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84702,CPT,GONADOTROPIN CHORIONIC QUANTITATIVE,,,17,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84703,CPT,GONADOTROPIN CHORIONIC QUALITATIVE,,,17,,TotalUnits,,,,0.29 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84704,CPT,GONADOTROPIN CHORIONIC HCG FREE BETA CHAIN,,,17,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84830,CPT,OVULATION TEST VISUAL COLOR COMPARISON HLH,,,17,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
84999,CPT,UNLISTED CHEMISTRY PROCEDURE,,,17,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85002,CPT,BLEEDING TIME TEST,,,17,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85004,CPT,BLOOD COUNT AUTOMATED DIFFERENTIAL WBC COUNT,,,17,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85007,CPT,BLOOD COUNT SMEAR MCRSCP W/MNL DIFRNTL WBC COUNT,,,17,,TotalUnits,,,,0.13 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85008,CPT,BLD COUNT SMEAR MCRSCP W/O MNL DIFRNTL WBC COUNT,,,17,,TotalUnits,,,,0.13 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85009,CPT,BLOOD COUNT MANUAL DIFRNTL WBC COUNT BUFFY COAT,,,17,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85013,CPT,BLOOD COUNT SPUN MICROHEMATOCRIT,,,17,,TotalUnits,,,,0.09 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85014,CPT,BLOOD COUNT HEMATOCRIT,,,17,,TotalUnits,,,,0.09 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85018,CPT,BLOOD COUNT HEMOGLOBIN,,,17,,TotalUnits,,,,0.09 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85025,CPT,BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC,,,17,,TotalUnits,,,,0.30 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85027,CPT,BLOOD COUNT COMPLETE AUTOMATED,,,17,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85032,CPT,BLOOD COUNT MANUAL CELL COUNT EACH,,,17,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85041,CPT,BLOOD COUNT RED BLOOD CELL AUTOMATED,,,17,,TotalUnits,,,,0.11 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85044,CPT,BLOOD COUNT RETICULOCYTE AUTOMATED,,,17,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85045,CPT,BLOOD COUNT RETICULOCYTE AUTOMATED,,,17,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85046,CPT,BLOOD COUNT RETICULOCYTES AUTO 1/> CELL MEAS,,,17,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85048,CPT,BLOOD COUNT LEUKOCYTE WBC AUTOMATED,,,17,,TotalUnits,,,,0.10 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85049,CPT,BLOOD COUNT PLATELET AUTOMATED,,,17,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85055,CPT,RETICULATED PLATELET ASSAY,,,17,,TotalUnits,,,,1.02 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85060,CPT,BLOOD SMEAR PERIPHERAL INTERP PHYS W/WRIT REPORT,,,17,,RBRVS,0.45 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
85097,CPT,BONE MARROW SMEAR INTERPRETATION,,,17,,RBRVS,0.94 ,0.41 ,1.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
85130,CPT,CHROMOGENIC SUBSTRATE ASSAY,,,17,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85170,CPT,BLOOD CLOT RETRACTION,,,17,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85175,CPT,CLOT LYSIS TIME WHOLE BLOOD DILUTION,,,17,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85210,CPT,CLOTTING FACTOR II PROTHROMBIN SPECIFIC,,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85220,CPT,CLOTTING FACTOR V ACG/PROACCELERIN LABILE FACTOR,,,17,,TotalUnits,,,,0.67 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85230,CPT,CLOTTING FACTOR VII PROCONVERTIN STABLE FACTOR,,,17,,TotalUnits,,,,0.68 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85240,CPT,CLOTTING FACTOR VIII AHG 1 STAGE,,,17,,TotalUnits,,,,0.68 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85244,CPT,CLOTTING FACTOR VIII RELATED ANTIGEN,,,17,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85245,CPT,CLOTTING FACTOR VIII VW FACTOR RISTOCETIN COFACT,,,17,,TotalUnits,,,,0.87 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85246,CPT,CLOTTING FACTOR VIII VW FACTOR ANTIGEN,,,17,,TotalUnits,,,,0.87 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85247,CPT,CLOTTING FACTOR VIII MULTIMETRIC ANALYSIS,,,17,,TotalUnits,,,,0.87 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85250,CPT,CLOTTING FACTOR IX PTC/CHRISTMAS,,,17,,TotalUnits,,,,0.72 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85260,CPT,CLOTTING FACTOR X STUART-PROWER,,,17,,TotalUnits,,,,0.68 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85270,CPT,CLOTTING FACTOR XI PTA,,,17,,TotalUnits,,,,0.68 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85280,CPT,CLOTTING FACTOR XII HAGEMAN,,,17,,TotalUnits,,,,0.73 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85290,CPT,CLOTTING FACTOR XIII FIBRIN STABILIZING,,,17,,TotalUnits,,,,0.62 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85291,CPT,CLOTTING FACTOR XIII FIBRN STABILIZ SCREEN SOLUB,,,17,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85292,CPT,CLOTTING PREKALLIKREIN ASSAY FLETCHER FACT ASSAY,,,17,,TotalUnits,,,,0.72 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85293,CPT,CLOTTING HI MOLEC WEIGHT KININOGEN ASSAY,,,17,,TotalUnits,,,,0.72 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85300,CPT,CLOTTING INHIBITORS ANTITHROMBIN III ACTIVITY,,,17,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85301,CPT,CLOTTING INHIBITRS ANTITHROMBN III ANTIGEN ASSAY,,,17,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85302,CPT,CLOTTING INHIBITORS PROTEIN C ANTIGEN,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85303,CPT,CLOTTING INHIBITORS PROTEIN C ACTIVITY,,,17,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85305,CPT,CLOTTING INHIBITORS PROTEIN S TOTAL,,,17,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85306,CPT,CLOTTING INHIBITORS PROTEIN S FREE,,,17,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85307,CPT,ACTIVATED PROTEIN C APC RESISTANCE ASSAY,,,17,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85335,CPT,FACTOR INHIBITOR TEST,,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85337,CPT,THROMBOMODULIN,,,17,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85345,CPT,COAGULATION TIME LEE AND WHITE,,,17,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85347,CPT,COAGULATION TIME ACTIVATED,,,17,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85348,CPT,COAGULATION TIME OTHER METHODS,,,17,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85360,CPT,EUGLOBULIN LYSIS,,,17,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85362,CPT,FIBRIN DGRADJ SPLT PRODUXS AGGLUJ SLIDE SEMIQUAN,,,17,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85366,CPT,FIBRIN DGRADJ SPLT PRODUXS PARACOAGJ,,,17,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85370,CPT,FIBRIN DGRADJ SPLT PRODUCTS QUANTITATIVE,,,17,,TotalUnits,,,,0.43 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85378,CPT,FIBRIN DGRADJ PRODUCTS D-DIMER QUAL/SEMIQUAN,,,17,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85379,CPT,FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE,,,17,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85380,CPT,FIBRIN DGRADJ PRODUCTS D-DIMER ULTRASENSITIVE,,,17,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85384,CPT,FIBRINOGEN ACTIVITY,,,17,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85385,CPT,FIBRINOGEN ANTIGEN,,,17,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85390,CPT,FIBRINOLYSINS/COAGULOPATHY SCREEN INTERP&REPOR,,,17,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
85390,CPT,FIBRINOLYSINS/COAGULOPATHY SCREEN INTERP&REPOR,26,,17,,RBRVS,0.37 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
85396,CPT,COAGJ/FBRNLYS ASSAY WHOLE BLOOD ADDITIVE PER DAY,,,17,,RBRVS,0.37 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
85397,CPT,COAGJ&FIBRINOLYSIS FUNCTIONAL ACTV NOS EA ANAL,,,17,,TotalUnits,,,,0.87 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85400,CPT,FIBRINOLYTIC FACTORS & INHIBITORS PLASMIN,,,17,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85410,CPT,FBRNLYC FACTORS&INHIBITORS ALPHA-2 ANTIPLASMIN,,,17,,TotalUnits,,,,0.29 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85415,CPT,FBRNLYC FACTORS&INHIBITORS PLSMNG ACTIVATOR,,,17,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85420,CPT,FBRNLYC FACTORS&INHIBITRS PLSMNG XCPT AGIC ASS,,,17,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85421,CPT,FBRNLYC FACTORS&INHIBITORS PLSMNG AGIC ASSAY,,,17,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85441,CPT,HEINZ BODIES DIRECT,,,17,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85445,CPT,HEINZ BODIES INDUCED ACETYL PHENYLHYDRAZINE,,,17,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85460,CPT,HGB/RBCS FETAL FETOMATERNAL HEMRRG DIFRNTL LYSIS,,,17,,TotalUnits,,,,0.29 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85461,CPT,HGB/RBCS FETAL FETOMATERNAL HEMRRG ROSETTE,,,17,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85475,CPT,HEMOLYSIN ACID,,,17,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85520,CPT,HEPARIN ASSAY,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85525,CPT,HEPARIN NEUTRALIZATION,,,17,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85530,CPT,HEPARIN-PROTAMINE TOLERANCE TST,,,17,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85536,CPT,IRON STAIN PERIPHERAL BLOOD,,,17,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85540,CPT,WBC ALKALINE PHOSPHATASE COUNT,,,17,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85547,CPT,MECHANICAL FRAGILITY RBC,,,17,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85549,CPT,MURAMIDASE,,,17,,TotalUnits,,,,0.71 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85555,CPT,OSMOTIC FRAGILITY RBC UNINCUBATED,,,17,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85557,CPT,OSMOTIC FRAGILITY RBC INCUBATED,,,17,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85576,CPT,PLATELET AGGREGATION IN VITRO EACH AGENT,,,17,,TotalUnits,,,,0.82 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
85576,CPT,PLATELET AGGREGATION IN VITRO EACH AGENT,26,,17,,RBRVS,0.37 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
85597,CPT,PHOSPHOLIPID NEUTRALIZATION PLATELET,,,17,,TotalUnits,,,,0.68 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85598,CPT,PHOSPHOLIPID NEUTRALIZATION HEXAGONAL,,,17,,TotalUnits,,,,0.68 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85610,CPT,PROTHROMBIN TIME,,,17,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85611,CPT,PROTHROMBIN TIME SUBSTITUTION PLASMA FRCTJ EACH,,,17,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85612,CPT,RUSSELL VIPER VENON TIME UNDILUTED,,,17,,TotalUnits,,,,0.36 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85613,CPT,RUSSELL VIPER VENOM TIME DILUTED,,,17,,TotalUnits,,,,0.36 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85635,CPT,REPTILASE TEST,,,17,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85651,CPT,SEDIMENTATION RATE RBC NON-AUTOMATED,,,17,,TotalUnits,,,,0.13 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85652,CPT,SEDIMENTATION RATE RBC AUTOMATED,,,17,,TotalUnits,,,,0.10 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85660,CPT,SICKLING RBC REDUCTION,,,17,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85670,CPT,THROMBIN TIME PLASMA,,,17,,TotalUnits,,,,0.22 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85675,CPT,THROMBIN TIME TITER,,,17,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85705,CPT,THROMBOPLASTIN INHIBITION TISSUE,,,17,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85730,CPT,THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD,,,17,,TotalUnits,,,,0.23 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85732,CPT,THROMBOPLASTIN TIME PRTL SUBSTIT PLASMA FRCTJ EA,,,17,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85810,CPT,VISCOSITY,,,17,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
85999,CPT,UNLISTED HEMATOLOGY & COAGULATION PROCEDURE,,,17,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86000,CPT,AGGLUTININS FEBRILE EACH ANTIGEN,,,17,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86001,CPT,ALLERGEN SPECIFIC IGG QUAN/SEMIQUAN EA ALLERGEN,,,17,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86003,CPT,ALLERGEN SPECIFIC IGE QUAN/SEMIQUAN EA ALLERGEN,,,17,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86005,CPT,ALLERGEN SPECIFIC IGE QUAL MULTIALLERGEN SCREEN,,,17,,TotalUnits,,,,0.30 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86021,CPT,ANTIBODY IDENTIFICATION LEUKOCYTE ANTIBODIES,,,17,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86022,CPT,ANTIBODY IDENTIFICATION PLATELET ANTIBODIES,,,17,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86023,CPT,ANTIBODY IDENTIFICATION PLATELET IMMUNOGL ASSAY,,,17,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86038,CPT,ANTINUCLEAR ANTIBODIES ANA,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86039,CPT,ANTINUCLEAR ANTIBODIES ANA TITER,,,17,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86060,CPT,ANTISTREPTOLYSIN O TITER,,,17,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86063,CPT,ANTISTREPTOLYSIN O SCREEN,,,17,,TotalUnits,,,,0.22 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86077,CPT,BLD BANK PHYS SVCS DIFFC CROSS MATCH&/EVAL REP,,,17,,RBRVS,0.94 ,0.48 ,0.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86078,CPT,BLD BANK PHYS SVCS INVSTGJ TFUJ RXN REPRT,,,17,,RBRVS,0.94 ,0.47 ,0.58 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86079,CPT,BLD BANK PHYS SVCS AUTHJ DEVIJ STANDARD REPRT,,,17,,RBRVS,0.94 ,0.45 ,0.55 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86140,CPT,C-REACTIVE PROTEIN,,,17,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86141,CPT,C-REACTIVE PROTEIN HIGH SENSITIVITY,,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86146,CPT,BETA 2 GLYCOPROTEIN I ANTIBODY EACH,,,17,,TotalUnits,,,,0.97 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86147,CPT,CARDIOLIPIN ANTIBODY EACH IG CLASS,,,17,,TotalUnits,,,,0.97 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86148,CPT,ANTI-PHOSPHATIDYLSERINE ANTIBODY,,,17,,TotalUnits,,,,0.61 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86152,CPT,CELL ENUMERATION IMMUNE SELECTJ & ID FLUID SPEC,,,17,,TotalUnits,,,,9.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86153,CPT,CELL ENUMERATION IMMUNE SELECTJ & ID PHYS INTERP,,,17,,TotalUnits,,,,1.07 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86153,CPT,CELL ENUMERATION IMMUNE SELECTJ & ID PHYS INTERP,26,,17,,RBRVS,0.69 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
86155,CPT,CHEMOTAXIS ASSAY SPECIFY METHOD,,,17,,TotalUnits,,,,0.61 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86156,CPT,COLD AGGLUTININ SCREEN,,,17,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86157,CPT,COLD AGGLUTININ TITER,,,17,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86160,CPT,COMPLEMENT ANTIGEN EACH COMPONENT,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86161,CPT,COMPLEMENT FUNCTIONAL ACTIVITY EACH COMPONENT,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86162,CPT,COMPLEMENT TOTAL HEMOLYTIC,,,17,,TotalUnits,,,,0.77 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86171,CPT,COMPLEMENT FIXATION TESTS EACH ANTIGEN,,,17,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86185,CPT,CNTERIMMUNOELECTROPHORESIS EACH ANTIGEN,,,17,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86200,CPT,CYCLIC CITRULLINATED PEPTIDE ANTIBODY,,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86215,CPT,DEOXYRIBONUCLEASE ANTIBODY,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86225,CPT,DNA ANTIBODY NATIVE/DOUBLE STRANDED,,,17,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86226,CPT,DNA ANTIBODY SINGLE STRANDED,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86235,CPT,EXTRACTABLE NUCLEAR ANTIGEN ANTIBODY ANY METHOD,,,17,,TotalUnits,,,,0.68 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86243,CPT,FC RECEPTOR,,,17,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86255,CPT,FLUORESCENT NONNFCT AGT ANTB SCREEN EA ANTIBODY,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
86255,CPT,FLUORESCENT NONNFCT AGT ANTB SCREEN EA ANTIBODY,26,,17,,RBRVS,0.37 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
86256,CPT,FLUORESCENT NONNFCT AGT ANTB TITER EA ANTIBODY,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
86256,CPT,FLUORESCENT NONNFCT AGT ANTB TITER EA ANTIBODY,26,,17,,RBRVS,0.37 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
86277,CPT,GROWTH HORMONE HUMAN ANTIBODY,,,17,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86280,CPT,HEMAGGLUTINATION INHIBITION TEST HAI,,,17,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86294,CPT,IMMUNOASSAY TUMOR ANTIGEN QUAL/SEMIQUANTITATIVE,,,17,,TotalUnits,,,,0.74 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86300,CPT,IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 15-3,,,17,,TotalUnits,,,,0.79 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86301,CPT,IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 19-9,,,17,,TotalUnits,,,,0.79 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86304,CPT,IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125,,,17,,TotalUnits,,,,0.79 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86305,CPT,HUMAN EPIDIDYMIS PROTEIN 4 (HE4),,,17,,TotalUnits,,,,0.79 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86308,CPT,HETEROPHILE ANTIBODIES SCREEN,,,17,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86309,CPT,HETEROPHILE ANTIBODIES TITER,,,17,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86310,CPT,HETEROPHILE ANTIBODIES TITER AFTER ABSORPTION,,,17,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86316,CPT,IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE,,,17,,TotalUnits,,,,0.79 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86317,CPT,IMMUNOASSAY INFECTIOUS AGENT ANTIBODY QUAN NOS,,,17,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86318,CPT,IMMUNOASSAY NFCT AGT ANTB QUAL/SEMIQUAN 1 STEP,,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86320,CPT,IMMUNOELECTROPHORESIS SERUM,,,17,,TotalUnits,,,,0.85 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
86320,CPT,IMMUNOELECTROPHORESIS SERUM,26,,17,,RBRVS,0.37 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
86325,CPT,IMMUNOELECTROPHORESIS OTHER FLUIDS CONCENTRATION,,,17,,TotalUnits,,,,0.85 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
86325,CPT,IMMUNOELECTROPHORESIS OTHER FLUIDS CONCENTRATION,26,,17,,RBRVS,0.37 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
86327,CPT,IMMUNOELECTROPHORESIS CROSSED,,,17,,TotalUnits,,,,0.86 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
86327,CPT,IMMUNOELECTROPHORESIS CROSSED,26,,17,,RBRVS,0.42 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
86329,CPT,IMMUNODIFFUSION NOT ELSEWHERE SPECIFIED,,,17,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86331,CPT,IMMUNODIFFUSION GEL DIFFUSION QUAL EA AG/ANTBDY,,,17,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86332,CPT,IMMUNE COMPLEX ASSAY,,,17,,TotalUnits,,,,0.93 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86334,CPT,IMMUNOFIXJ ELECTROPHORESIS SERUM,,,17,,TotalUnits,,,,0.85 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
86334,CPT,IMMUNOFIXJ ELECTROPHORESIS SERUM,26,,17,,RBRVS,0.37 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
86335,CPT,IMMUNOFIXJ ELECTROPHORESIS OTHER FLUIDS,,,17,,TotalUnits,,,,1.11 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
86335,CPT,IMMUNOFIXJ ELECTROPHORESIS OTHER FLUIDS,26,,17,,RBRVS,0.37 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
86336,CPT,INHIBIN A,,,17,,TotalUnits,,,,0.59 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86337,CPT,INSULIN ANTIBODIES,,,17,,TotalUnits,,,,0.81 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86340,CPT,INTRINSIC FACTOR ANTIBODIES,,,17,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86341,CPT,ISLET CELL ANTIBODY,,,17,,TotalUnits,,,,0.75 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86343,CPT,LEUKOCYTE HISTAMINE RELEASE TEST LHR,,,17,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86344,CPT,LEUKOCYTE PHAGOCYTOSIS,,,17,,TotalUnits,,,,0.30 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86352,CPT,CELLULAR FUNCTION ASSAY STIMUL&DETECT BIOMARKE,,,17,,TotalUnits,,,,5.16 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86353,CPT,LYMPHOCYTE TR MITOGEN/AG INDUCED BLASTOGENESIS,,,17,,TotalUnits,,,,1.86 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86355,CPT,B CELLS TOTAL COUNT,,,17,,TotalUnits,,,,1.43 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86356,CPT,MONONUCLEAR CELL ANTIGEN QUANTITATIVE NOS EA,,,17,,TotalUnits,,,,1.02 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86357,CPT,NATURAL KILLER CELLS TOTAL COUNT,,,17,,TotalUnits,,,,1.43 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86359,CPT,T CELLS TOTAL COUNT,,,17,,TotalUnits,,,,1.43 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86360,CPT,T CELLS ABSOLUTE CD4&CD8 COUNT RATIO,,,17,,TotalUnits,,,,1.78 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86361,CPT,T CELLS ABSOLUTE CD4 COUNT,,,17,,TotalUnits,,,,1.02 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86367,CPT,STEM CELLS TOTAL COUNT,,,17,,TotalUnits,,,,1.43 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86376,CPT,MICROSOMAL ANTIBODIES EACH,,,17,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86378,CPT,MIGRATION INHIBITORY FACTOR TEST MIF,,,17,,TotalUnits,,,,0.75 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86382,CPT,NEUTRALIZATION TEST VIRAL,,,17,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86384,CPT,NITROBLUE TETRAZOLIUM DYE TEST NTD,,,17,,TotalUnits,,,,0.43 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86386,CPT,NUCLEAR MATRIX PROTEIN 22 NMP22 QUALITATIVE,,,17,,TotalUnits,,,,0.61 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86403,CPT,PARTICLE AGGLUTINATION SCREEN EACH ANTIBODY,,,17,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86406,CPT,PARTICLE AGGLUTINATION TITER EACH ANTIBODY,,,17,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86430,CPT,RHEUMATOID FACTOR QUALITATIVE,,,17,,TotalUnits,,,,0.22 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86431,CPT,RHEUMATOID FACTOR QUANTITATIVE,,,17,,TotalUnits,,,,0.22 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86480,CPT,TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON,,,17,,TotalUnits,,,,2.35 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86481,CPT,TB ANTIGEN RESPONSE GAMMA INTERFERON T-CELL SUSP,,,17,,TotalUnits,,,,2.84 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86485,CPT,SKIN TEST CANDIDA,,TC,17,,TotalUnits,,,,0.24 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86486,CPT,SKIN TEST UNLISTED ANTIGEN EACH,,TC,17,,RBRVS,,0.13 ,0.13 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86490,CPT,SKIN TEST COCCIDIOIDOMYCOSIS,,TC,17,,RBRVS,,1.96 ,1.96 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86510,CPT,SKIN TEST HISTOPLASMOSIS,,TC,17,,RBRVS,,0.16 ,0.16 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86580,CPT,SKIN TEST TUBERCULOSIS INTRADERMAL,,TC,17,,RBRVS,,0.21 ,0.21 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86590,CPT,STREPTOKINASE ANTIBODY,,,17,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86592,CPT,SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL,,,17,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86593,CPT,SYPHILIS TEST QUANTITATIVE,,,17,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86602,CPT,ANTIBODY ACTINOMYCES,,,17,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86603,CPT,ANTIBODY ADENOVIRUS,,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86606,CPT,ANTIBODY ASPERGILLUS,,,17,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86609,CPT,ANTIBODY BACTERIUM NOT ELSEWHERE SPECIFIED,,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86611,CPT,ANTIBODY BARTONELLA,,,17,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86612,CPT,ANTIBODY BLASTOMYCES,,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86615,CPT,ANTIBODY BORDETELLA,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86617,CPT,ANTIBODY BORRELIA BURGDORFERI CONFIRMATORY TST,,,17,,TotalUnits,,,,0.59 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86618,CPT,ANTIBODY BORRELIA BURGDORFERI LYME DISEASE,,,17,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86619,CPT,ANTIBODY BORRELIA RELAPSING FEVER,,,17,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86622,CPT,ANTIBODY BRUCELLA,,,17,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86625,CPT,ANTIBODY CAMPYLOBACTER,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86628,CPT,ANTIBODY CANDIDA,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86631,CPT,ANTIBODY CHLAMYDIA,,,17,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86632,CPT,ANTIBODY CHLAMYDIA IGM,,,17,,TotalUnits,,,,0.48 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86635,CPT,ANTIBODY COCCIDIOIDES,,,17,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86638,CPT,ANTIBODY COXIELLA BURNETII Q FEVER,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86641,CPT,ANTIBODY CRYPTOCOCCUS,,,17,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86644,CPT,ANTIBODY CYTOMEGALOVIRUS CMV,,,17,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86645,CPT,ANTIBODY CYTOMEGALOVIRUS CMV IGM,,,17,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86648,CPT,ANTIBODY DIPHTHERIA,,,17,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86651,CPT,ANTIBODY ENCEPHALITIS CALIFORNIA LA CROSSE,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86652,CPT,ANTIBODY ENCEPHALITIS EASTERN EQUINE,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86653,CPT,ANTIBODY ENCEPHALITIS ST. LOUIS,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86654,CPT,ANTIBODY ENCEPHALITIS WESTRN EQUINE,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86658,CPT,ANTIBODY ENTEROVIRUS,,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86663,CPT,ANTIBODY EPSTEIN-BARR EB VIRUS EARLY ANTIGEN EA,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86664,CPT,ANTIBODY EPSTEIN-BARR EB VIRUS NUCLEAR AG EBNA,,,17,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86665,CPT,ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA,,,17,,TotalUnits,,,,0.69 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86666,CPT,ANTIBODY EHRLICHIA,,,17,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86668,CPT,ANTIBODY FRANCISELLA TULARENSIS,,,17,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86671,CPT,ANTIBODY FUNGUS NOT ELSEWHERE SPECIFIED,,,17,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86674,CPT,ANTIBODY GIARDIA LAMBLIA,,,17,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86677,CPT,ANTIBODY HELICOBACTER PYLORI,,,17,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86682,CPT,ANTIBODY HELMINTH NOT ELSEWHERE SPECIFIED,,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86684,CPT,ANTIBODY HAEMOPHILUS INFLUENZA,,,17,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86687,CPT,ANTIBODY HTLV-I,,,17,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86688,CPT,ANTIBODY HTLV-II,,,17,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86689,CPT,ANTIBODY HTLV/HIV ANTIBODY CONFIRMATORY TEST,,,17,,TotalUnits,,,,0.73 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86692,CPT,ANTIBODY HEP DELTA AGENT,,,17,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86694,CPT,ANTIBODY HERPES SMPLX NON-SPECIFIC TYPE TEST,,,17,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86695,CPT,ANTIBODY HERPES SMPLX TYPE 1,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86696,CPT,ANTIBODY HERPES SMPLX TYPE 2,,,17,,TotalUnits,,,,0.73 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86698,CPT,ANTIBODY HISTOPLASMA,,,17,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86701,CPT,ANTIBODY HIV-1,,,17,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86702,CPT,ANTIBODY HIV-2,,,17,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86703,CPT,ANTIBODY HIV-1&HIV-2 SINGLE RESULT,,,17,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86704,CPT,HEPATITIS B CORE ANTIBODY HBCAB TOTAL,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86705,CPT,HEPATITIS B CORE ANTIBODY HBCAB IGM ANTIBODY,,,17,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86706,CPT,HEPATITIS B SURF ANTIBODY HBSAB,,,17,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86707,CPT,HEPATITIS BE ANTIBODY HBEAB,,,17,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86708,CPT,HEPATITIS A ANTIBODY HAAB,,,17,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86709,CPT,HEPATITIS ANTIBODY HAAB IGM ANTIBODY,,,17,,TotalUnits,,,,0.43 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86710,CPT,ANTIBODY INFLUENZA VIRUS,,,17,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86711,CPT,ANTIBODY JOHN CUNNINGHAM VIRUS,,,17,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86713,CPT,ANTIBODY LEGIONELLA,,,17,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86717,CPT,ANTIBODY LEISHMANIA,,,17,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86720,CPT,ANTIBODY LEPTOSPIRA,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86723,CPT,ANTIBODY LISTERIA MONOCYTOGENES,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86727,CPT,ANTIBODY LYMPHOCYTIC CHORIOMENINGITIS,,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86729,CPT,ANTIBODY LYMPHOGRANULOMA VENEREUM,,,17,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86732,CPT,ANTIBODY MUCORMYCOSIS,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86735,CPT,ANTIBODY MUMPS,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86738,CPT,ANTIBODY MYCOPLSM,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86741,CPT,ANTIBODY NEISSERIA MENINGITIDIS,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86744,CPT,ANTIBODY NOCARDIA,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86747,CPT,ANTIBODY PARVOVIRUS,,,17,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86750,CPT,ANTIBODY PLASMODIUM MALARIA,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86753,CPT,ANTIBODY PROTOZOA NES,,,17,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86756,CPT,ANTIBODY RESPIRATORY SYNCTIAL VIRUS,,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86757,CPT,ANTIBODY RICKETTSIA,,,17,,TotalUnits,,,,0.73 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86759,CPT,ANTIBODY ROTAVIRUS,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86762,CPT,ANTIBODY RUBELLA,,,17,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86765,CPT,ANTIBODY RUBEOLA,,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86768,CPT,ANTIBODY SALMONELLA,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86771,CPT,ANTIBODY SHIGELLA,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86774,CPT,ANTIBODY TETANUS,,,17,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86777,CPT,ANTIBODY TOXOPLASMA,,,17,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86778,CPT,ANTIBODY TOXOPLASMA IGM,,,17,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86780,CPT,ANTIBODY TREPONEMA PALLIDUM,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86784,CPT,ANTIBODY TRICHINELLA,,,17,,TotalUnits,,,,0.48 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86787,CPT,ANTIBODY VARICELLA-ZOSTER,,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86788,CPT,ANTIBODY WEST NILE VIRUS IGM,,,17,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86789,CPT,ANTIBODY WEST NILE VIRUS,,,17,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86790,CPT,ANTIBODY VIRUS NOT ELSEWHERE SPECIFIFED,,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86793,CPT,ANTIBODY YERSINIA,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86800,CPT,THYROGLOBULIN ANTIBODY,,,17,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86803,CPT,HEPATITIS C ANTIBODY,,,17,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86804,CPT,HEPATITIS C ANTIBODY CONFIRMATORY TEST,,,17,,TotalUnits,,,,0.59 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86805,CPT,LYMPHOCYTOTOXICITY ASSAY VIS CROSSMATCH TITRATJ,,,17,,TotalUnits,,,,1.99 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86806,CPT,LMPHOCYTOTOXICITY ASSAY VIS CROSSMTCH W/O TITRAT,,,17,,TotalUnits,,,,1.81 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86807,CPT,SERUM SCREENING % REACTIVE ANTIBODY STANDRD METH,,,17,,TotalUnits,,,,1.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86808,CPT,SERUM SCREENING % REACTIVE ANTIBODY QUICK METH,,,17,,TotalUnits,,,,1.13 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86812,CPT,HLA TYPING A/B/C SINGLE ANTIGEN,,,17,,TotalUnits,,,,0.98 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86813,CPT,HLA TYPING A/B/C MULTIPLE ANTIGENS,,,17,,TotalUnits,,,,2.20 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86816,CPT,HLA TYPING DR/DQ SINGLE ANTIGEN,,,17,,TotalUnits,,,,1.06 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86817,CPT,HLA TYPING DR/DQ MULTIPLE ANTIGENS,,,17,,TotalUnits,,,,2.44 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86821,CPT,HLA TYPING LYMPHOCYTE CULTURE MIXED,,,17,,TotalUnits,,,,2.14 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86822,CPT,HLA TYPING LYMPHOCYTE CULTURE PRIMED,,,17,,TotalUnits,,,,1.39 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86825,CPT,HLA CROSSMATCH NONCYTOTOXIC 1ST SERUM/DILUTION,,,17,,TotalUnits,,,,3.05 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86826,CPT,HLA CROSSMATCH NONCYTOTOXIC ADDL SERUM/DILUTION,,,17,,TotalUnits,,,,1.02 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86828,CPT,ANTIBODY HLA CLASS I & CLASS II ANTIGENS QUAL,,,17,,TotalUnits,,,,1.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86829,CPT,ANTIBODY HLA CLASS I OR CLASS II ANTIGENS QUAL,,,17,,TotalUnits,,,,1.13 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86830,CPT,ANTIBODY HLA CLASS I PHENOTYPE PANEL QUALITATIVE,,,17,,TotalUnits,,,,3.07 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86831,CPT,ANTIBODY HLA CLASS II PHENOTYPE PANEL QUAL,,,17,,TotalUnits,,,,2.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86832,CPT,ANTIBODY HLA CLASS I HIGH DEFINITION PANEL QUAL,,,17,,TotalUnits,,,,4.82 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86833,CPT,ANTIBODY HLA CLASS II HIGH DEFINITION PANEL QUAL,,,17,,TotalUnits,,,,4.38 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86834,CPT,ANTIBODY HLA CLASS I SEMIQUANTITATIVE PANEL,,,17,,TotalUnits,,,,13.58 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86835,CPT,ANTIBODY HLA CLASS II SEMIQUANTITATIVE PANEL,,,17,,TotalUnits,,,,12.26 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86849,CPT,UNLISTED IMMUNOLOGY,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86850,CPT,ANTIBODY SCREEN RBC EACH SERUM TECHNIQUE,,,17,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86860,CPT,ANTIBODY ELUTION RBC EACH ELUTION,,,17,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86870,CPT,ANTIBODY ID RBC ANTIBODIES EA PANEL EA SERUM TQ,,,17,,TotalUnits,,,,0.83 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86880,CPT,ANTIHUMAN GLOBULIN DIRECT EACH ANTISERUM,,,17,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86885,CPT,ANTIHUMAN GLOBULIN INDIR QUAL EA REAGENT CELL,,,17,,TotalUnits,,,,0.22 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86886,CPT,ANTIHUMAN GLOBULIN INDIRECT EACH ANTIBODY TITER,,,17,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86890,CPT,AUTOL BLD/COMPONENT COLLJ STORAGE PREDEPOSITED,,,17,,TotalUnits,,,,1.90 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86891,CPT,AUTOL BLD/COMPONENT COLLJ STORAGE SALVAGE,,,17,,TotalUnits,,,,2.68 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86900,CPT,BLOOD TYPING SEROLOGIC ABO,,,17,,TotalUnits,,,,0.11 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86901,CPT,BLOOD TYPING SEROLOGIC RH (D),,,17,,TotalUnits,,,,0.11 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86902,CPT,BLOOD TYPE ANTIGEN DONOR REAGENT SERUM EACH,,,17,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86904,CPT,BLOOD TYPING ANTIGEN SCREEN PATIENT SERUM/UNIT,,,17,,TotalUnits,,,,0.36 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86905,CPT,BLOOD TYPING RBC ANTIGENS OTH/THN ABO/RH D EACH,,,17,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86906,CPT,BLOOD TYPING SEROLOGIC RH PHENOTYPING COMPLETE,,,17,,TotalUnits,,,,0.29 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86910,CPT,BLOOD TYPING PATERNITY PR INDIV ABO RH&MN,,,17,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86911,CPT,BLOOD TYPING PATERNITY INDIV ADDL ANTIGEN SYS,,,17,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86920,CPT,COMPATIBILITY EACH UNIT IMMEDIATE SPIN TECHNIQUE,,,17,,TotalUnits,,,,0.67 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86921,CPT,COMPATIBILITY EACH UNIT INCUBATION,,,17,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86922,CPT,COMPATIBILITY EACH UNIT ANTIGLOBULIN,,,17,,TotalUnits,,,,0.72 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86923,CPT,COMPATIBILITY EACH UNIT ELECTRONIC,,,17,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86927,CPT,FRESH FROZEN PLASMA THAWING EACH UNIT,,,17,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86930,CPT,FROZEN BLOOD EACH UNIT FREEZING,,,17,,TotalUnits,,,,2.35 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86931,CPT,FROZEN BLOOD EACH UNIT THAWING,,,17,,TotalUnits,,,,1.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86932,CPT,FROZEN BLOOD EACH UNIT FREEZING & THAWING,,,17,,TotalUnits,,,,2.00 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86940,CPT,HEMOLYSINS&AGGLUTININS AUTO SCREEN EACH,,,17,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86941,CPT,HEMOLYSINS&AGGLUTININS INCUBATED,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86945,CPT,IRRADIATION BLOOD PRODUCT EACH UNIT,,,17,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86950,CPT,LEUKOCYTE TRANSFUSION,,,17,,TotalUnits,,,,1.53 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86960,CPT,VOLUME REDUCTION BLOOD/BLOOD PRODUCT EACH UNIT,,,17,,TotalUnits,,,,0.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86965,CPT,POOLING PLATELETS/OTHER BLOOD PRODUCTS,,,17,,TotalUnits,,,,0.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86970,CPT,PRETX RBC ANTIBODY INCUBAT W/CHEM AGNTS/DRUGS EA,,,17,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86971,CPT,PRETX RBC ANTIBODY INCUBAT W/ENZYMES EACH,,,17,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86972,CPT,PRETX RBC ANTIBODY INCUBAT W/DENSITY GRAD SEP,,,17,,TotalUnits,,,,0.82 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86975,CPT,PRETX SERUM RBC ANTIBODY INCUBATION DRUGS EACH,,,17,,TotalUnits,,,,0.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86976,CPT,PRETX SERUM RBC ANTIBODY IDENTIFICATION DILUTION,,,17,,TotalUnits,,,,0.71 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86977,CPT,PRETX SERUM RBC ANTB ID INCUBATION INHIBITORS EA,,,17,,TotalUnits,,,,0.71 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86978,CPT,PRETX SERUM RBC ANTIBODY ID DIFFIAL EACH ABSRPJ,,,17,,TotalUnits,,,,0.67 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86985,CPT,SPLITTING BLOOD/BLOOD PRODUCTS EACH UNIT,,,17,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
86999,CPT,UNLISTED TRANSFUSION MEDICINE PROCEDURE,,,17,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87003,CPT,ANIMAL INOCULATION SMALL ANIMAL W/OBS&DSJ,,,17,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87015,CPT,CONCENTRATION INFECTIOUS AGENTS,,,17,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87040,CPT,CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES,,,17,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87045,CPT,CUL BACT STOOL AEROBIC ISOL SALMONELLA&SHIGELL,,,17,,TotalUnits,,,,0.36 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87046,CPT,CUL BACT STOOL AEROBIC ADDL PATHOGENS&ID EA,,,17,,TotalUnits,,,,0.36 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87070,CPT,CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL,,,17,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87071,CPT,CUL BACT QUAN AEROBIC ISOL XCPT UR BLOOD/STOOL,,,17,,TotalUnits,,,,0.36 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87073,CPT,CUL BACT QUAN ANAERC ISOL XCPT UR BLOOD/STOOL,,,17,,TotalUnits,,,,0.36 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87075,CPT,CULTURE BACTERIAL ANY SOURCE ANAEROBIC ISO&ID,,,17,,TotalUnits,,,,0.36 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87076,CPT,CUL BACT ANAEROBIC ADDL METHS DEFINITIVE EA ISOL,,,17,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87077,CPT,CUL BACT AEROBIC ADDL METHS DEFINITIVE EA ISOL,,,17,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87081,CPT,CUL PRSMPTV PTHGNC ORGANISM SCRN W/COLONY ESTIMJ,,,17,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87084,CPT,CUL PRSMPTV PTHGNC ORGANISMS SCR DNS CHART,,,17,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87086,CPT,CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE,,,17,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87088,CPT,CULTURE BCT ISOL&PRSMPTV ID ISOLATE EA URINE,,,17,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87101,CPT,CUL FNGI MOLD/YEAST PRSMPTV ID SKN HAIR/NAIL,,,17,,TotalUnits,,,,0.29 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87102,CPT,CULTURE FNGI MOLD/YEAST PRSMPTV OTH XCPT BLOOD,,,17,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87103,CPT,CULTURE FNGI MOLD/YEAST ISOL PRSMPTV ISOL BLOOD,,,17,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87106,CPT,CULTURE FUNGI DEFINITIVE ID EACH ORGANISM YEAST,,,17,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87107,CPT,CULTURE FUNGI DEFINITIVE ID EACH ORGANISM MOLD,,,17,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87109,CPT,CULTURE MYCOPLASMA ANY SOURCE,,,17,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87110,CPT,CULTURE CHLAMYDIA ANY SOURCE,,,17,,TotalUnits,,,,0.74 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87116,CPT,CULTURE TUBERCLE/OTH ACID-FAST BACILLI ANY ISOL,,,17,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87118,CPT,CULTURE MYCOBACTERIAL DEFINITIVE ID EA ISOL,,,17,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87140,CPT,CULTURE TYPING IMMUNOFLUORESCENT EACH ANTISERUM,,,17,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87143,CPT,CULTURE TYPING GAS/HIGH PRES LIQ CHROMATOGRAPHY,,,17,,TotalUnits,,,,0.48 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87147,CPT,CULTURE TYPING IMMUNOLOGIC OTH/THN IMMUNOFLUORES,,,17,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87149,CPT,CULTURE TYPING NUCLEIC ACID PROBE DIR EA ORGANSM,,,17,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87150,CPT,CULTYP NUC ACID AMP PRB CULT/ISOLATE EA ORGNISM,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87152,CPT,CULTURE TYPING IDENTIFJ PULSE FIELD GEL TYPING,,,17,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87153,CPT,CULTYP NUCLEIC ACID SEQUENCING METH EA ISOLATE,,,17,,TotalUnits,,,,4.38 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87158,CPT,CULTURE TYPING OTHER METHODS,,,17,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87164,CPT,DARK FIELD EXAM ANY SOURCE W/SPECIMEN COLLECTION,,,17,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
87164,CPT,DARK FIELD EXAM ANY SOURCE W/SPECIMEN COLLECTION,26,,17,,RBRVS,0.37 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
87166,CPT,DARK FIELD EXAM ANY SOURCE W/O SPECIMEN COLLECT,,,17,,TotalUnits,,,,0.43 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87168,CPT,MACROSCOPIC EXAMINATION ARTHROPOD,,,17,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87169,CPT,MACROSCOPIC EXAMINATION PARASITE,,,17,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87172,CPT,PINWORM EXAMINATION,,,17,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87176,CPT,HOMOGENIZATION TISSUE CULTURE,,,17,,TotalUnits,,,,0.22 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87177,CPT,OVA&PARASITES DIRECT SMEARS CONCENTRATION & ID,,,17,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87181,CPT,SUSCEPTBILTY STDY ANTIMICRBIAL AGNT AGAR DILUTJ,,,17,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87184,CPT,SUSCEPTIBILITY STUDY ANTIMICROBIAL DISK METHOD,,,17,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87185,CPT,SUSCEPTIBILITY STUDY ANTIMICROBIAL ENZYME DETCJ,,,17,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87186,CPT,SUSCEPTIBLTY STDY ANTIMICRBIAL MICRO/AGAR DILUTJ,,,17,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87187,CPT,SUSCEPTIBLTY STDY ANTMCRB MICRO/AGAR DILUTJ EA,,,17,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87188,CPT,SC STD ANTMCRB AGT MACROBROTH DIL METH EA AGT,,,17,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87190,CPT,SUSCEPTIBLTY STDY ANTMCRB MYCOBACT PROPORJ MTHD,,,17,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87197,CPT,SERUM BACTERICIDAL TITER,,,17,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87205,CPT,SMR PRIM SRC GRAM/GIEMSA STAIN BCT FUNGI/CELL,,,17,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87206,CPT,SMR PRIM SRC FLUORESCENT&/AFS BCT FNGI PARASIT,,,17,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87207,CPT,SMR PRIM SRC SPEC STAIN BODIES/PARASITS,,,17,,TotalUnits,,,,0.23 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
87207,CPT,SMR PRIM SRC SPEC STAIN BODIES/PARASITS,26,,17,,RBRVS,0.37 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
87209,CPT,SMR PRIM SRC CPLX SPEC STAIN OVA&PARASITS,,,17,,TotalUnits,,,,0.68 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87210,CPT,SMR PRIM SRC WET MOUNT NFCT AGT,,,17,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87220,CPT,TISS KOH SLIDE SAMPS SKN/HR/NLS FNGI/ECTOPARASIT,,,17,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87230,CPT,TOXIN/ANTITOXIN ASSAY TISSUE CULTURE,,,17,,TotalUnits,,,,0.75 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87250,CPT,VIRUS INOCULATION EGGS/SM ANIMAL OBS&DSJ,,,17,,TotalUnits,,,,0.74 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87252,CPT,VIRUS TISS CUL INOCULATION CYTOPATHIC EFFECT,,,17,,TotalUnits,,,,0.99 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87253,CPT,VIRUS TISSUE CULTURE ADDL STDY/ID EACH ISOLATE,,,17,,TotalUnits,,,,0.77 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87254,CPT,VIRUS CENTRIFUGE ENHNCD ID IMFLUOR STAIN EA,,,17,,TotalUnits,,,,0.74 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87255,CPT,VIRUS ID NON-IMMUNOLOGIC OTH/THN CYTOPATHIC,,,17,,TotalUnits,,,,1.29 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87260,CPT,IAADI ADENOVIRUS,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87265,CPT,IAADI BORDETELLA PRTUSSIS/PARAPRTUSSIS,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87267,CPT,IAADI ENTEROVIRUS DIRECT FLUORESCENT ANTIBODY,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87269,CPT,IAADI GIARDIA,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87270,CPT,IAADI CHLAMYDIA TRACHOMATIS,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87271,CPT,IAADI CYTOMEGALOVIRUS DIR FLUORESCENT ANTIBODY,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87272,CPT,IAADI CRYPTOSPORIDIUM,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87273,CPT,IAADI HERPES SMPLX VIRUS TYPE 2,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87274,CPT,IAADI HERPES SMPLX VIRUS TYPE 1,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87275,CPT,IAADI INFLUENZA B VIRUS,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87276,CPT,IAADI INFFLUENZA A VIRUS,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87277,CPT,IAADI LEGIONELLA MICDADEI,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87278,CPT,IAADI LEGIONELLA PNEUMOPHILA,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87279,CPT,IAADI PARAINFLUENZA VIRUS EACH TYPE,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87280,CPT,IAADI RESPIRATORY SYNCTIAL VIRUS,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87281,CPT,IAADI PNEUMOCUSTIS CARINII,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87283,CPT,IAADI RUBEOLA,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87285,CPT,IAADI TREPONEMA PALLIDUM,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87290,CPT,IAADI VARICELLA ZOSTER VIRUS,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87299,CPT,IAADI NOT OTHERWISE SPECIFIED EACH ORGANISM,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87300,CPT,IAADI POLYV MLT ORGANISMS EA POLYV ANTISERUM,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87301,CPT,IAAD IA ADENOVIRUS ENTERIC TYP 40/41,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87305,CPT,IAAD IA QUAL/SEMIQUAN MULTIPLE STEP ASPERGILLUS,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87320,CPT,IAAD IA CHLAMYDIA TRACHOMATIS,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87324,CPT,IAAD IA CLOSTRIDIUM DIFFICILE TOXIN,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87327,CPT,IAAD IA CRYPTOCOCCUS NEOFORMANS,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87328,CPT,IAAD IA CRYPTOSPORIDIUM,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87329,CPT,IAAD IA GIARDIA,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87332,CPT,IAAD IA CYTOMEGALOVIRUS,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87335,CPT,IAAD IA ESCHERICHIA COLI 0157,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87336,CPT,IAAD IA ENTAMOEBA HISTOLYTICA DISPAR GRP,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87337,CPT,IAAD IA ENTAMOEBA HISTOLYTICA GRP,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87338,CPT,IAAD IA HPYLORI STOOL,,,17,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87339,CPT,IAAD IA HPYLORI,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87340,CPT,IAAD IA HEPATITIS B SURFACE ANTIGEN,,,17,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87341,CPT,IAAD IA HEPATITIS B SURFACE AG NEUTRALIZATION,,,17,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87350,CPT,IAAD IA HEPATITIS BE ANTIGEN,,,17,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87380,CPT,IAAD IA HEPATITIS DELTA ANTIGEN,,,17,,TotalUnits,,,,0.62 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87385,CPT,IAAD IA HISTOPLASM CAPSULATUM,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87389,CPT,IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE,,,17,,TotalUnits,,,,0.91 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87390,CPT,IAAD IA HIV-1,,,17,,TotalUnits,,,,0.67 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87391,CPT,IAAD IA HIV-2,,,17,,TotalUnits,,,,0.67 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87400,CPT,IAAD IA INFLUENZA A/B EACH,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87420,CPT,IAAD IA RESPIRATORY SYNCTIAL VIRUS,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87425,CPT,IAAD IA ROTAVIRUS,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87427,CPT,IAAD IA SHIGA-LIKE TOXIN,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87430,CPT,IAAD IA STREPTOCOCCUS GROUP A,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87449,CPT,IAAD IA MULT STEP METHOD NOS EACH ORGANISM,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87450,CPT,IAAD IA SINGLE STEP METHOD NOS EA ORGANISM,,,17,,TotalUnits,,,,0.36 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87451,CPT,IAAD IA POLYV MLT ORGANISMS EA POLYV ANTISERUM,,,17,,TotalUnits,,,,0.36 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87470,CPT,IADNA BARTONELLA DIRECT PROBE TECHNIQUE,,,17,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87471,CPT,IADNA BARTONELLA AMPLIFIED PROBE TECHNIQUE,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87472,CPT,IADNA BARTONELLA HENSELAE&QUINTANA QUANTJ,,,17,,TotalUnits,,,,1.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87475,CPT,IADNA BORRELIA BURGDORFERI DIRECT PROBE TQ,,,17,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87476,CPT,IADNA BORRELIA BURGDORFERI AMPLIFIED PROBE TQ,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87477,CPT,IADNA BORRELIA BURGDORFERI QUANTIFICATION,,,17,,TotalUnits,,,,1.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87480,CPT,IADNA CANDIDA SPECIES DIRECT PROBE TQ,,,17,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87481,CPT,IADNA CANDIDA SPECIES AMPLIFIED PROBE TQ,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87482,CPT,IADNA CANDIDA SPECIES QUANTIFICATION,,,17,,TotalUnits,,,,1.59 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87485,CPT,IADNA CHLAMYDIA PNEUMONIAE DIRECT PROBE TQ,,,17,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87486,CPT,IADNA CHLAMYDIA PNEUMONIAE AMPLIFIED PROBE TQ,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87487,CPT,IADNA CHLAMYDIA PNEUMONIAE QUANTIFICATION,,,17,,TotalUnits,,,,1.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87490,CPT,IADNA CHLAMYDIA TRACHOMATIS DIRECT PROBE TQ,,,17,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87491,CPT,IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87492,CPT,IADNA CHLAMYDIA TRACHOMATIS QUANTIFICATION,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87493,CPT,INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87495,CPT,IADNA CYTOMEGALOVIRUS DIRECT PROBE TQ,,,17,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87496,CPT,IADNA CYTOMEGALOVIRUS AMPLIFIED PROBE TQ,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87497,CPT,IADNA CYTOMEGALOVIRUS QUANTIFICATION,,,17,,TotalUnits,,,,1.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87498,CPT,IADNA ENTEROVIRUS AMPLIF PROBE & REVRSE TRNSCRIP,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87500,CPT,INFECTIOUS AGENT DNA/RNA VANCOMYCIN RESISTANCE,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87501,CPT,INFECTIOUS AGENT DNA/RNA INFLUENZA EA TYPE,,,17,,TotalUnits,,,,1.95 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87502,CPT,INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES,,,17,,TotalUnits,,,,3.23 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87503,CPT,NFCT AGENT DNA/RNA INFLUENZA >2 TYPES EA ADDL,,,17,,TotalUnits,,,,0.79 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87505,CPT,NFCT AGENT DNA/RNA GASTROINTESTINAL PATHOGEN,,,17,,TotalUnits,,,,4.87 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87506,CPT,IADNA-DNA/RNA GI PTHGN MULTIPLEX PROBE TQ 6-11,,,17,,TotalUnits,,,,8.10 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87507,CPT,IADNA-DNA/RNA GI PTHGN MULTIPLEX PROBE TQ 12-25,,,17,,TotalUnits,,,,15.82 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87510,CPT,IADNA GARDNERELLA VAGINALIS DIRECT PROBE TQ,,,17,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87511,CPT,IADNA GARDNERELLA VAGINALIS AMPLIFIED PROBE TQ,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87512,CPT,IADNA GARDNERELLA VAGINALIS QUANTIFICATION,,,17,,TotalUnits,,,,1.59 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87515,CPT,IADNA HEPATITIS B VIRUS DIRECT PROBE TECHNIQUE,,,17,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87516,CPT,IADNA HEPATITIS B VIRUS AMPLIFIED PROBE TQ,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87517,CPT,IADNA HEPATITIS B VIRUS QUANTIFICATION,,,17,,TotalUnits,,,,1.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87520,CPT,IADNA HEPATITIS C DIRECT PROBE TECHNIQUE,,,17,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87521,CPT,IADNA HEPATITIS C AMPLIFIED PROBE&REVRSE TRANSCR,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87522,CPT,IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION,,,17,,TotalUnits,,,,1.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87525,CPT,IADNA HEPATITIS G DIRECT PROBE TECHNIQUE,,,17,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87526,CPT,IADNA HEPATITIS G AMPLIFIED PROBE TECHNIQUE,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87527,CPT,IADNA HEPATITIS G QUANTIFICATION,,,17,,TotalUnits,,,,1.59 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87528,CPT,IADNA HERPES SIMPLX VIRUS DIRECT PROBE TQ,,,17,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87529,CPT,IADNA HERPES SOMPLX VIRUS AMPLIFIED PROBE TQ,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87530,CPT,IADNA HERPES SOMPLX VIRUS QUANTIFICATION,,,17,,TotalUnits,,,,1.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87531,CPT,IADNA HERPES VIRUS-6 DIRECT PROBE TQ,,,17,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87532,CPT,IADNA HERPES VIRUS-6 AMPLIFIED PROBE TQ,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87533,CPT,IADNA HERPES VIRUS-6 QUANTIFICATION,,,17,,TotalUnits,,,,1.59 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87534,CPT,IADNA HIV-1 DIRECT PROBE TECHNIQUE,,,17,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87535,CPT,IADNA HIV-1 AMPLIFIED PROBE & REVERSE TRANSCRPJ,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87536,CPT,IADNA HIV-1 QUANT & REVERSE TRANSCRIPTION,,,17,,TotalUnits,,,,3.23 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87537,CPT,IADNA HIV-2 DIRECT PROBE TECHNIQUE,,,17,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87538,CPT,IADNA HIV-2 AMPLIFIED PROBE & REVERSE TRANSCRIPJ,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87539,CPT,IADNA HIV-2 QUANT & REVERSE TRANSCRIPTION,,,17,,TotalUnits,,,,1.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87540,CPT,IADNA LEGIONELLA PNEUMOPHILA DIRECT PROBE TQ,,,17,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87541,CPT,IADNA LEGIONELLA PNEUMOPHILA AMPLIFIED PROBE TQ,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87542,CPT,IADNA LEGIONELLA PNEUMOPHILA QUANTIFICATION,,,17,,TotalUnits,,,,1.59 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87550,CPT,IADNA MYCOBACTERIA SPECIES DIRECT PROBE TQ,,,17,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87551,CPT,IADNA MYCOBACTERIA SPECIES AMPLIFIED PROBE TQ,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87552,CPT,IADNA MYCOBACTERIA SPECIES QUANTIFICATION,,,17,,TotalUnits,,,,1.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87555,CPT,IADNA MYCOBACTERIA TUBERCULOSIS DIR PRB,,,17,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87556,CPT,IADNA MYCOBACTERIA TUBERCULOSIS AMP PRB,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87557,CPT,IADNA MYCOBACTERIA TUBERCULOSIS QUANTIFICATION,,,17,,TotalUnits,,,,1.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87560,CPT,IADNA MYCOBACTERIA AVIUM-INTRACLRE DIR PRB,,,17,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87561,CPT,IADNA MYCOBACTERIA AVIUM-INTRACLRE AMP PRB,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87562,CPT,IADNA MYCOBACTERIA AVIUM-INTRACELLULARE QUANT,,,17,,TotalUnits,,,,1.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87580,CPT,IADNA MYCOPLSM PNEUMONIAE DIRECT PROBE TQ,,,17,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87581,CPT,IADNA MYCOPLSM PNEUMONIAE AMPLIFIED PROBE TQ,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87582,CPT,IADNA MYCOPLSM PNEUMONIAE QUANTIFICATION,,,17,,TotalUnits,,,,1.59 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87590,CPT,IADNA NEISSERIA GONORRHOEAE DIRECT PROBE TQ,,,17,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87591,CPT,IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87592,CPT,IADNA NEISSERIA GONORRHOEAE QUANTIFICATION,,,17,,TotalUnits,,,,1.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87623,CPT,IADNA HUMAN PAPILLOMAVIRUS LOW-RISK TYPES,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87624,CPT,IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87625,CPT,IADNA HUMAN PAPILLOMAVIRUS TYPES 16 & 18 ONLY,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87631,CPT,IADNA RESPIRATRY PROBE & REV TRNSCR 3-5 TARGETS,,,17,,TotalUnits,,,,4.87 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87632,CPT,IADNA RESPIRATRY PROBE & REV TRNSCR 6-11 TARGETS,,,17,,TotalUnits,,,,8.10 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87633,CPT,IADNA RESPIRATRY PROBE & REV TRNSCR 12-25 TARGET,,,17,,TotalUnits,,,,15.82 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87640,CPT,IADNA S AUREUS AMPLIFIED PROBE TQ,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87641,CPT,IADNA S AUREUS METHICILLIN RESIST AMP PROBE TQ,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87650,CPT,IADNA STREPTOCOCCUS GROUP A DIRECT PROBE TQ,,,17,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87651,CPT,IADNA STREPTOCOCCUS GROUP A AMPLIFIED PROBE TQ,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87652,CPT,IADNA STREPTOCOCCUS GROUP A QUANTIFICATION,,,17,,TotalUnits,,,,1.59 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87653,CPT,IADNA STREPTOCOCCUS GROUP B AMPLIFIED PROBE TQ,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87660,CPT,IADNA TRICHOMONAS VAGINALIS DIRECT PROBE TQ,,,17,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87661,CPT,IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87797,CPT,IADNA NOS DIRECT PROBE TQ EACH ORGANISM,,,17,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87798,CPT,IADNA NOS AMPLIFIED PROBE TQ EACH ORGANISM,,,17,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87799,CPT,IADNA NOS QUANTIFICATION EACH ORGANISM,,,17,,TotalUnits,,,,1.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87800,CPT,IADNA MULTIPLE ORGANISMS DIRECT PROBE TQ,,,17,,TotalUnits,,,,1.52 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87801,CPT,IADNA MULTIPLE ORGANISMS AMPLIFIED PROBE TQ,,,17,,TotalUnits,,,,2.66 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87802,CPT,IAADIADOO STREPTOCOCCUS GROUP B,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87803,CPT,IAADIADOO CLOSTRIDIUM DIFFICILE TOXIN,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87804,CPT,IAADIADOO INFLUENZA,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87806,CPT,IAADIADOO HIV1 ANTIGEN W/HIV1 & HIV2 ANTIBODIES,,,17,,TotalUnits,,,,0.91 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87807,CPT,IAADIADOO RESPIRATORY SYNCTIAL VIRUS,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87808,CPT,IAADIADOO TRICHOMONAS VAGINALIS,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87809,CPT,INFECTIOUS AGENT IMMUNOASSAY OPTICAL ADENOVIRUS,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87810,CPT,CHLAMYDIA TRACHOMATIS,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87850,CPT,IAADIADOO NEISSERIA GONORRHOEAE,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87880,CPT,IAADIADOO STREPTOCOCCUS GROUP A,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87899,CPT,IAADIADOO NOT OTHERWISE SPECIFIED,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87900,CPT,NFCT AGT DRUG SUSCEPT PHENOTYPE PREDICTION,,,17,,TotalUnits,,,,4.95 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87901,CPT,NFCT GEXYP NUCLEIC ACID HIV REV TRNSCR&PROTEAS,,,17,,TotalUnits,,,,9.77 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87902,CPT,NFCT AGNT GENOTYP NUCLEIC ACID HEPATITIS C VIRUS,,,17,,TotalUnits,,,,9.77 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87903,CPT,NFCT PHEXYP RESIST TISS CUL HIV FIRST 1-10 DRUGS,,,17,,TotalUnits,,,,18.55 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87904,CPT,NFCT PHEXYP RESIST TISS CUL HIV EA ADDL DRUG,,,17,,TotalUnits,,,,0.99 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87905,CPT,INFECTIOUS AGENT ENZYMATIC ACTV OTH/THN VIRUS,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87906,CPT,NFCT GEXYP DNA/RNA HIV 1 OTHER REGION,,,17,,TotalUnits,,,,4.89 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87910,CPT,NFCT AGT GENOTYPE NUCLEIC ACID CYTOMEGALOVIRUS,,,17,,TotalUnits,,,,9.77 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87912,CPT,NFCT AGENT GENOTYPE HEPATITIS B VIRUS,,,17,,TotalUnits,,,,9.77 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
87999,CPT,UNLISTED MICROBIOLOGY,,,17,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88000,CPT,NECROPSY GROSS EXAMINATION ONLY W/O CNS,,,17,,TotalUnits,,,,6.48 ,,$0.00,$0.00,1,0,1,0,1,1,20161001,,,,
88005,CPT,NECROPSY GROSS EXAMINATION W/BRAIN,,,17,,TotalUnits,,,,7.56 ,,$0.00,$0.00,1,0,1,0,1,1,20161001,,,,
88007,CPT,NECROPSY GROSS EXAMINATION W/BRAIN&SPINAL CORD,,,17,,TotalUnits,,,,7.92 ,,$0.00,$0.00,1,0,1,0,1,1,20161001,,,,
88012,CPT,NECROPSY GROSS EXAMINATION INFANT W/BRAIN,,,17,,TotalUnits,,,,6.48 ,,$0.00,$0.00,1,0,1,0,1,1,20161001,,,,
88014,CPT,NECROPSY GROSS EXAM STILLBORN/NEWBORN W/BRAIN,,,17,,TotalUnits,,,,5.94 ,,$0.00,$0.00,1,0,1,0,1,1,20161001,,,,
88016,CPT,NECROPSY GROSS EXAM MACERATED STILLBORN,,,17,,TotalUnits,,,,8.28 ,,$0.00,$0.00,1,0,1,0,1,1,20161001,,,,
88020,CPT,NECROPSY GROSS & MICROSCOPIC W/O CNS,,,17,,TotalUnits,,,,11.16 ,,$0.00,$0.00,1,0,1,0,1,1,20161001,,,,
88025,CPT,NECROPSY GROSS & MICROSCOPIC W/BRAIN,,,17,,TotalUnits,,,,10.80 ,,$0.00,$0.00,1,0,1,0,1,1,20161001,,,,
88027,CPT,NECROPSY GROSS&MCRSCP BRAIN & SPINAL CORD,,,17,,TotalUnits,,,,11.52 ,,$0.00,$0.00,1,0,1,0,1,1,20161001,,,,
88028,CPT,NECROPSY GROSS & MICROSCOPIC INFANT W/BRAIN,,,17,,TotalUnits,,,,6.48 ,,$0.00,$0.00,1,0,1,0,1,1,20161001,,,,
88029,CPT,NECROPSY GROSS&MCRSCP STILLBORN/NEWBORN BRAIN,,,17,,TotalUnits,,,,6.48 ,,$0.00,$0.00,1,0,1,0,1,1,20161001,,,,
88036,CPT,NECROPSY LIMITED GROSS&/MCRSCP REGIONAL,,,17,,TotalUnits,,,,3.24 ,,$0.00,$0.00,1,0,1,0,1,1,20161001,,,,
88037,CPT,NECROPSY LIMITD GROSS&/MCRSCP SINGLE ORGAN,,,17,,TotalUnits,,,,2.88 ,,$0.00,$0.00,1,0,1,0,1,1,20161001,,,,
88040,CPT,NECROPSY FORENSIC EXAMINATION,,,17,,TotalUnits,,,,18.00 ,,$0.00,$0.00,1,0,1,0,1,1,20161001,,,,
88045,CPT,NECROPSY CORONER CALL,,,17,,TotalUnits,,,,1.80 ,,$0.00,$0.00,1,0,1,0,1,1,20161001,,,,
88099,CPT,UNLISTED NECROPSY PROCEDURE,,,17,,TotalUnits,,,,10.80 ,,$0.00,$0.00,1,0,1,0,1,1,20161001,,,,
88104,CPT,CYTP FLU WASHGS/BRUSHINGS XCPT C/V SMRS INTERPJ,,,17,,RBRVS,0.56 ,1.52 ,1.52 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88104,CPT,CYTP FLU WASHGS/BRUSHINGS XCPT C/V SMRS INTERPJ,26,,17,,RBRVS,0.56 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88104,CPT,CYTP FLU WASHGS/BRUSHINGS XCPT C/V SMRS INTERPJ,TC,,17,,RBRVS,,1.26 ,1.26 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88106,CPT,CYTP FLU BR/WA XCPT C/V FILTER METH ONLY INTERPJ,,,17,,RBRVS,0.37 ,2.07 ,2.07 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88106,CPT,CYTP FLU BR/WA XCPT C/V FILTER METH ONLY INTERPJ,26,,17,,RBRVS,0.37 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88106,CPT,CYTP FLU BR/WA XCPT C/V FILTER METH ONLY INTERPJ,TC,,17,,RBRVS,,1.89 ,1.89 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88108,CPT,CYTP CONCENTRATION SMEARS & INTERPRETATION,,,17,,RBRVS,0.44 ,1.91 ,1.91 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88108,CPT,CYTP CONCENTRATION SMEARS & INTERPRETATION,26,,17,,RBRVS,0.44 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88108,CPT,CYTP CONCENTRATION SMEARS & INTERPRETATION,TC,,17,,RBRVS,,1.70 ,1.70 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88112,CPT,CYTP SLCTV CELL ENHANCEMENT INTERPJ XCPT C/V,,,17,,RBRVS,0.56 ,1.23 ,1.23 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88112,CPT,CYTP SLCTV CELL ENHANCEMENT INTERPJ XCPT C/V,26,,17,,RBRVS,0.56 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88112,CPT,CYTP SLCTV CELL ENHANCEMENT INTERPJ XCPT C/V,TC,,17,,RBRVS,,1.00 ,1.00 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88120,CPT,CYTP INSITU HYBRID URINE SPEC 3-5 PROBES EA MNL,,,17,,RBRVS,1.20 ,16.19 ,16.19 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88120,CPT,CYTP INSITU HYBRID URINE SPEC 3-5 PROBES EA MNL,26,,17,,RBRVS,1.20 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88120,CPT,CYTP INSITU HYBRID URINE SPEC 3-5 PROBES EA MNL,TC,,17,,RBRVS,,15.76 ,15.76 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88121,CPT,CYTP INSITU HYBRID URNE SPEC 3-5 PROBES CPTR EA,,,17,,RBRVS,1.00 ,14.47 ,14.47 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88121,CPT,CYTP INSITU HYBRID URNE SPEC 3-5 PROBES CPTR EA,26,,17,,RBRVS,1.00 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88121,CPT,CYTP INSITU HYBRID URNE SPEC 3-5 PROBES CPTR EA,TC,,17,,RBRVS,,14.05 ,14.05 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88125,CPT,CYTOPATHOLOGY FORENSIC,,,17,,RBRVS,0.26 ,0.45 ,0.45 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88125,CPT,CYTOPATHOLOGY FORENSIC,26,,17,,RBRVS,0.26 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88125,CPT,CYTOPATHOLOGY FORENSIC,TC,,17,,RBRVS,,0.32 ,0.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88130,CPT,SEX CHROMATIN IDENTIFICATION BARR BODIES,,,17,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88140,CPT,SEX CHROMATIN IDENTJ PERIPHERAL BLOOD SMEAR,,,17,,TotalUnits,,,,0.30 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88141,CPT,CYTP CERVICAL/VAGINAL REQ INTERP PHYSICIAN,,PC,17,,RBRVS,0.42 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88142,CPT,CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN,,,17,,TotalUnits,,,,0.77 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88143,CPT,CYTP C/V FLU AUTO THIN MNL SCR&RESCR PHYS,,,17,,TotalUnits,,,,0.77 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88147,CPT,CYTP SMRS C/V SCR AUTOMATED SYSTEM PHYS SUPV,,,17,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88148,CPT,CYTP SMRS C/V SCR AUTO SYS MNL RESCR PHYS,,,17,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88150,CPT,CYTP SLIDES C/V MNL SCR UNDER PHYS,,,17,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88152,CPT,CYTP SLIDES C/V MNL SCR&CPTR RESCR PHYS,,,17,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88153,CPT,CYTP SLIDES C/V MNL SCR&RESCR PHYS,,,17,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88154,CPT,CYTP SLIDES C/V MNL SCR&CPTR-RESCR CELL S&I,,,17,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88155,CPT,CYTP SLIDES C/V DEFINITIVE HORMONAL EVAL,,,17,,TotalUnits,,,,0.23 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88160,CPT,CYTP SMRS ANY OTH SRC SCR&INTERPJ,,,17,,RBRVS,0.50 ,1.36 ,1.36 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88160,CPT,CYTP SMRS ANY OTH SRC SCR&INTERPJ,26,,17,,RBRVS,0.50 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88160,CPT,CYTP SMRS ANY OTH SRC SCR&INTERPJ,TC,,17,,RBRVS,,1.12 ,1.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88161,CPT,CYTP SMRS ANY OTH SRC PREPJ SCR&INTERPJ,,,17,,RBRVS,0.50 ,1.18 ,1.18 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88161,CPT,CYTP SMRS ANY OTH SRC PREPJ SCR&INTERPJ,26,,17,,RBRVS,0.50 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88161,CPT,CYTP SMRS ANY OTH SRC PREPJ SCR&INTERPJ,TC,,17,,RBRVS,,0.97 ,0.97 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88162,CPT,CYTP SMRS ANY OTH SRC EXTND STD > 5 SLIDES,,,17,,RBRVS,0.76 ,2.01 ,2.01 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88162,CPT,CYTP SMRS ANY OTH SRC EXTND STD > 5 SLIDES,26,,17,,RBRVS,0.76 ,0.37 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88162,CPT,CYTP SMRS ANY OTH SRC EXTND STD > 5 SLIDES,TC,,17,,RBRVS,,1.64 ,1.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88164,CPT,CYTP SLIDES CERV/VAG MNL SCRN PHYSICIAN SUPV,,,17,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88165,CPT,CYTP SLIDES C/V MNL SCR&RESCR PHYS SUPV,,,17,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88166,CPT,CYTP SLIDES C/V MNL SCR&CPTR RESCR PHYS SUPV,,,17,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88167,CPT,CYTP SLIDES C/V MNL SCR&CPTR RESCR CELL S&I,,,17,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88172,CPT,CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD DX 1ST,,,17,,RBRVS,0.69 ,0.88 ,0.88 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88172,CPT,CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD DX 1ST,26,,17,,RBRVS,0.69 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88172,CPT,CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD DX 1ST,TC,,17,,RBRVS,,0.54 ,0.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88173,CPT,CYTP EVAL FINE NEEDLE ASPIRATE INTERP & REPORT,,,17,,RBRVS,1.39 ,2.82 ,2.82 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88173,CPT,CYTP EVAL FINE NEEDLE ASPIRATE INTERP & REPORT,26,,17,,RBRVS,1.39 ,0.62 ,0.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88173,CPT,CYTP EVAL FINE NEEDLE ASPIRATE INTERP & REPORT,TC,,17,,RBRVS,,2.20 ,2.20 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88174,CPT,CYTP C/V AUTO THIN LYR PREPJ SCR SYS PHYS,,,17,,TotalUnits,,,,0.81 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88175,CPT,CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS,,,17,,TotalUnits,,,,1.01 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88177,CPT,CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD EA EVAL,,,17,,RBRVS,0.42 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88177,CPT,CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD EA EVAL,26,,17,,RBRVS,0.42 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88177,CPT,CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD EA EVAL,TC,,17,,RBRVS,,0.21 ,0.21 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88182,CPT,FLOW CYTOMETRY CELL CYCLE/DNA ANALYSIS,,,17,,RBRVS,0.77 ,2.23 ,2.23 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88182,CPT,FLOW CYTOMETRY CELL CYCLE/DNA ANALYSIS,26,,17,,RBRVS,0.77 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88182,CPT,FLOW CYTOMETRY CELL CYCLE/DNA ANALYSIS,TC,,17,,RBRVS,,2.00 ,2.00 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88184,CPT,FLOW CYTOMETRY CELL SURF MARKER TECHL ONLY 1ST,,TC,17,,RBRVS,,2.62 ,2.62 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88185,CPT,FLOW CYTOMETRY CELL SURF MARKER TECHL ONLY EA,,TC,17,,RBRVS,,1.59 ,1.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88187,CPT,FLOW CYTOMETRY INTERPJ 2-8 MARKERS,,PC,17,,RBRVS,1.36 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88188,CPT,FLOW CYTOMETRY INTERPJ 9-15 MARKERS,,PC,17,,RBRVS,1.69 ,0.79 ,0.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88189,CPT,FLOW CYTOMETRY INTERPRETATION 16/> MARKERS,,PC,17,,RBRVS,2.23 ,0.84 ,0.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88199,CPT,UNLISTED CYTOPATHOLOGY PROCEDURE,,,17,,TotalUnits,,,,1.79 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88199,CPT,UNLISTED CYTOPATHOLOGY PROCEDURE,,PC,17,,TotalUnits,,,,0.79 ,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
88199,CPT,UNLISTED CYTOPATHOLOGY PROCEDURE,,TC,17,,TotalUnits,,,,1.00 ,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
88230,CPT,TISS CUL NON-NEO DISORDERS LYMPHOCYTE,,,17,,TotalUnits,,,,4.42 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88233,CPT,TISS CUL NON-NEO DISORDERS SKN/OTH SOLID TISS BX,,,17,,TotalUnits,,,,5.34 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88235,CPT,TISS CUL NON-NEO DISORDERS AMNIOTIC/CHORNC CELLS,,,17,,TotalUnits,,,,5.59 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88237,CPT,TISS CUL NEO DISORDERS BONE MARROW BLOOD CELLS,,,17,,TotalUnits,,,,4.80 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88239,CPT,TISS CUL NEO DISORDERS SOLID TUMOR,,,17,,TotalUnits,,,,5.60 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88240,CPT,CRYOPRSRV FRZING&STORAGE CELLS EA CELL LINE,,,17,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88241,CPT,THAWING&EXPANSION FROZEN CELLS EACH ALIQUOT,,,17,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88245,CPT,CHRMSM BREAKAGE BASELINE SISTER 20-25 CLL,,,17,,TotalUnits,,,,5.65 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88248,CPT,CHRMSM BREAKAGE BASELINE BREAKAGE 50-100 CLL,,,17,,TotalUnits,,,,6.57 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88249,CPT,CHRMSM BREAKAGE SYNDS SCORE 100 CLL,,,17,,TotalUnits,,,,6.57 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88261,CPT,CHRMSM COUNT 5 CELL 1KARYOTYPE BANDING,,,17,,TotalUnits,,,,6.71 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88262,CPT,CHRMSM COUNT 15-20 CLL 2KARYOTYP BANDING,,,17,,TotalUnits,,,,4.73 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88263,CPT,CHRMSM COUNT 45 CELL MOSAICISM 2KARYOTYPE,,,17,,TotalUnits,,,,5.71 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88264,CPT,CHRMSM ANALYZE 20-25 CELLS,,,17,,TotalUnits,,,,4.73 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88267,CPT,CHRMSM ALYS AMNIOTIC/VILLUS 15 CELL 1KARYOTYPE,,,17,,TotalUnits,,,,6.83 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88269,CPT,CHRMSM SITU AMNIOTIC CLL 6-12 COLONIES 1KARYOTYP,,,17,,TotalUnits,,,,6.31 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88271,CPT,MOLECULAR CYTOGENETICS DNA PROBE EACH,,,17,,TotalUnits,,,,0.81 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88272,CPT,MOLECULAR CYTOGENETICS CHRMOML ISH 3-5 CELLS,,,17,,TotalUnits,,,,1.02 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88273,CPT,MOLECULAR CYTOGENETICS CHRMOML ISH 10-30 CLL,,,17,,TotalUnits,,,,1.22 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88274,CPT,MOLECULAR CYTOGENETICS INTERPHASE ISH 25-99 CLL,,,17,,TotalUnits,,,,1.32 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88275,CPT,MOLEC CYTG INTERPHASE ISH ANALYZE 100-300 CLL,,,17,,TotalUnits,,,,1.52 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88280,CPT,CHRMSM ANALYSIS ADDL KARYOTYP EACH STUDY,,,17,,TotalUnits,,,,0.95 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88283,CPT,CHRMSM ANALYSIS ADDL SPECIALIZED BANDING,,,17,,TotalUnits,,,,2.60 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88285,CPT,CHRMSM ANALYSIS ADDL CELLS COUNTED EACH STUDY,,,17,,TotalUnits,,,,0.72 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88289,CPT,CHRMSM ANALYSIS ADDL HIGH RESOLUTION STUDY,,,17,,TotalUnits,,,,1.31 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88291,CPT,CYTOGENETICS&MOLEC CYTOGENETICS INTERP&REP,,PC,17,,RBRVS,0.52 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88299,CPT,UNLISTED CYTOGENETIC STUDY,,,17,,TotalUnits,,,,1.32 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88300,CPT,LEVEL I SURG PATHOLOGY GROSS EXAMINATION ONLY,,,17,,RBRVS,0.08 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88300,CPT,LEVEL I SURG PATHOLOGY GROSS EXAMINATION ONLY,26,,17,,RBRVS,0.08 ,0.04 ,0.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88300,CPT,LEVEL I SURG PATHOLOGY GROSS EXAMINATION ONLY,TC,,17,,RBRVS,,0.29 ,0.29 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88302,CPT,LEVEL II SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,,,17,,RBRVS,0.13 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88302,CPT,LEVEL II SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,26,,17,,RBRVS,0.13 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88302,CPT,LEVEL II SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,TC,,17,,RBRVS,,0.69 ,0.69 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88304,CPT,LEVEL III SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,,,17,,RBRVS,0.22 ,1.04 ,1.04 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88304,CPT,LEVEL III SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,26,,17,,RBRVS,0.22 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88304,CPT,LEVEL III SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,TC,,17,,RBRVS,,0.94 ,0.94 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88305,CPT,LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,,,17,,RBRVS,0.75 ,1.27 ,1.27 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88305,CPT,LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,26,,17,,RBRVS,0.75 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88305,CPT,LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,TC,,17,,RBRVS,,0.94 ,0.94 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88307,CPT,LEVEL V SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,,,17,,RBRVS,1.59 ,6.93 ,6.93 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88307,CPT,LEVEL V SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,26,,17,,RBRVS,1.59 ,0.79 ,0.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88307,CPT,LEVEL V SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,TC,,17,,RBRVS,,6.14 ,6.14 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88309,CPT,LEVEL VI SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,,,17,,RBRVS,2.80 ,10.12 ,10.12 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88309,CPT,LEVEL VI SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,26,,17,,RBRVS,2.80 ,1.39 ,1.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88309,CPT,LEVEL VI SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,TC,,17,,RBRVS,,8.73 ,8.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88311,CPT,DECALCIFICATION PROCEDURE,,,17,,RBRVS,0.24 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88311,CPT,DECALCIFICATION PROCEDURE,26,,17,,RBRVS,0.24 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88311,CPT,DECALCIFICATION PROCEDURE,TC,,17,,RBRVS,,0.22 ,0.22 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88312,CPT,SPECIAL STAIN GROUP 1 MICROORGANISMS I&R,,,17,,RBRVS,0.54 ,2.17 ,2.17 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88312,CPT,SPECIAL STAIN GROUP 1 MICROORGANISMS I&R,26,,17,,RBRVS,0.54 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88312,CPT,SPECIAL STAIN GROUP 1 MICROORGANISMS I&R,TC,,17,,RBRVS,,1.94 ,1.94 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88313,CPT,SPCL STN 2 I&R EXCPT MICROORG/ENZYME/IMCYT,,,17,,RBRVS,0.24 ,1.64 ,1.64 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88313,CPT,SPCL STN 2 I&R EXCPT MICROORG/ENZYME/IMCYT,26,,17,,RBRVS,0.24 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88313,CPT,SPCL STN 2 I&R EXCPT MICROORG/ENZYME/IMCYT,TC,,17,,RBRVS,,1.54 ,1.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88314,CPT,SPECIAL STAIN I&R HISTOCHEMICAL W/FROZEN TISSU,,,17,,RBRVS,0.45 ,1.62 ,1.62 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88314,CPT,SPECIAL STAIN I&R HISTOCHEMICAL W/FROZEN TISSU,26,,17,,RBRVS,0.45 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88314,CPT,SPECIAL STAIN I&R HISTOCHEMICAL W/FROZEN TISSU,TC,,17,,RBRVS,,1.44 ,1.44 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88319,CPT,SPECIAL STAIN I&R GROUP III ENZYME CONSITUENTS,,,17,,RBRVS,0.53 ,1.92 ,1.92 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88319,CPT,SPECIAL STAIN I&R GROUP III ENZYME CONSITUENTS,26,,17,,RBRVS,0.53 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88319,CPT,SPECIAL STAIN I&R GROUP III ENZYME CONSITUENTS,TC,,17,,RBRVS,,1.68 ,1.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88321,CPT,CONSLTJ&REPRT SLIDES PREPARED ELSEWHERE,,,17,,RBRVS,1.63 ,0.72 ,1.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88323,CPT,CONSLTJ&REPRT MATERIAL REQUIRING PREPJ SLIDES,,,17,,RBRVS,1.83 ,2.40 ,2.40 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88323,CPT,CONSLTJ&REPRT MATERIAL REQUIRING PREPJ SLIDES,26,,17,,RBRVS,1.83 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88323,CPT,CONSLTJ&REPRT MATERIAL REQUIRING PREPJ SLIDES,TC,,17,,RBRVS,,1.75 ,1.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88325,CPT,CONSLTJ COMPRE REVIEW REPRT REFERRED MATRL,,,17,,RBRVS,2.50 ,1.20 ,3.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88329,CPT,PATHOLOGY CONSULTATION DURING SURGERY,,,17,,RBRVS,0.67 ,0.33 ,0.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88331,CPT,PATH CONSLTJ SURG 1ST BLK FROZEN SCTJ 1 SPEC,,,17,,RBRVS,1.19 ,1.68 ,1.68 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88331,CPT,PATH CONSLTJ SURG 1ST BLK FROZEN SCTJ 1 SPEC,26,,17,,RBRVS,1.19 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88331,CPT,PATH CONSLTJ SURG 1ST BLK FROZEN SCTJ 1 SPEC,TC,,17,,RBRVS,,1.08 ,1.08 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88332,CPT,PATH CONSLTJ SURG EA ADDL BLK FROZEN SECTION,,,17,,RBRVS,0.59 ,0.66 ,0.66 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88332,CPT,PATH CONSLTJ SURG EA ADDL BLK FROZEN SECTION,26,,17,,RBRVS,0.59 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88332,CPT,PATH CONSLTJ SURG EA ADDL BLK FROZEN SECTION,TC,,17,,RBRVS,,0.37 ,0.37 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88333,CPT,PATH CONSLTJ SURG CYTOLOGIC EXAM INITIAL SITE,,,17,,RBRVS,1.20 ,1.82 ,1.82 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88333,CPT,PATH CONSLTJ SURG CYTOLOGIC EXAM INITIAL SITE,26,,17,,RBRVS,1.20 ,0.59 ,0.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88333,CPT,PATH CONSLTJ SURG CYTOLOGIC EXAM INITIAL SITE,TC,,17,,RBRVS,,1.23 ,1.23 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88334,CPT,PATH CONSLTJ SURG CYTOLOGIC EXAM ADDL SITE,,,17,,RBRVS,0.73 ,1.11 ,1.11 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88334,CPT,PATH CONSLTJ SURG CYTOLOGIC EXAM ADDL SITE,26,,17,,RBRVS,0.73 ,0.36 ,0.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88334,CPT,PATH CONSLTJ SURG CYTOLOGIC EXAM ADDL SITE,TC,,17,,RBRVS,,0.75 ,0.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88341,CPT,IMHISTOCHEM/CYTCHM EA ADDL ANTIBODY SLIDE,,,17,,RBRVS,0.42 ,1.45 ,1.45 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88341,CPT,IMHISTOCHEM/CYTCHM EA ADDL ANTIBODY SLIDE,26,,17,,RBRVS,0.42 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88341,CPT,IMHISTOCHEM/CYTCHM EA ADDL ANTIBODY SLIDE,TC,,17,,RBRVS,,1.27 ,1.27 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88342,CPT,IMHISTOCHEM/CYTCHM 1ST ANTIBODY STAIN PROCEDURE,,,17,,RBRVS,0.70 ,1.81 ,1.81 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88342,CPT,IMHISTOCHEM/CYTCHM 1ST ANTIBODY STAIN PROCEDURE,26,,17,,RBRVS,0.70 ,0.31 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88342,CPT,IMHISTOCHEM/CYTCHM 1ST ANTIBODY STAIN PROCEDURE,TC,,17,,RBRVS,,1.50 ,1.50 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88344,CPT,IMHISTOCHEM/CYTCHM EA MULTIPLEX ANTIBODY SLIDE,,,17,,RBRVS,0.77 ,2.48 ,2.48 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88344,CPT,IMHISTOCHEM/CYTCHM EA MULTIPLEX ANTIBODY SLIDE,26,,17,,RBRVS,0.77 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88344,CPT,IMHISTOCHEM/CYTCHM EA MULTIPLEX ANTIBODY SLIDE,TC,,17,,RBRVS,,2.14 ,2.14 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88346,CPT,IMMUNOFLUORESCENCE PER SPEC 1ST SINGL ANTB STAIN,,,17,,RBRVS,0.86 ,2.21 ,2.21 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88346,CPT,IMMUNOFLUORESCENCE PER SPEC 1ST SINGL ANTB STAIN,26,,17,,RBRVS,0.86 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88346,CPT,IMMUNOFLUORESCENCE PER SPEC 1ST SINGL ANTB STAIN,TC,,17,,RBRVS,,1.86 ,1.86 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88348,CPT,ELECTRON MICROSCOPY DIAGNOSTIC,,,17,,RBRVS,1.51 ,8.14 ,8.14 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88348,CPT,ELECTRON MICROSCOPY DIAGNOSTIC,26,,17,,RBRVS,1.51 ,0.66 ,0.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88348,CPT,ELECTRON MICROSCOPY DIAGNOSTIC,TC,,17,,RBRVS,,7.48 ,7.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88350,CPT,IMMUNOFLUORESCENCE PER SPEC ADD SINGL ANTB STAIN,,,17,,RBRVS,0.56 ,1.45 ,1.45 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88350,CPT,IMMUNOFLUORESCENCE PER SPEC ADD SINGL ANTB STAIN,26,,17,,RBRVS,0.56 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88350,CPT,IMMUNOFLUORESCENCE PER SPEC ADD SINGL ANTB STAIN,TC,,17,,RBRVS,,1.22 ,1.22 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88355,CPT,MORPHOMETRIC ANALYSIS SKELETAL MUSCLE,,,17,,RBRVS,1.85 ,3.01 ,3.01 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88355,CPT,MORPHOMETRIC ANALYSIS SKELETAL MUSCLE,26,,17,,RBRVS,1.85 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88355,CPT,MORPHOMETRIC ANALYSIS SKELETAL MUSCLE,TC,,17,,RBRVS,,2.54 ,2.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88356,CPT,MORPHOMETRIC ANALYSIS NERVE,,,17,,RBRVS,2.80 ,2.91 ,2.91 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88356,CPT,MORPHOMETRIC ANALYSIS NERVE,26,,17,,RBRVS,2.80 ,0.61 ,0.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88356,CPT,MORPHOMETRIC ANALYSIS NERVE,TC,,17,,RBRVS,,2.30 ,2.30 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88358,CPT,MORPHOMETRIC ANALYSIS TUMOR,,,17,,RBRVS,0.95 ,1.39 ,1.39 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88358,CPT,MORPHOMETRIC ANALYSIS TUMOR,26,,17,,RBRVS,0.95 ,0.31 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88358,CPT,MORPHOMETRIC ANALYSIS TUMOR,TC,,17,,RBRVS,,1.08 ,1.08 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88360,CPT,M/PHMTRC ALYS TUMOR IMHCHEM EA ANTIBODY MANUAL,,,17,,RBRVS,1.10 ,2.68 ,2.68 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88360,CPT,M/PHMTRC ALYS TUMOR IMHCHEM EA ANTIBODY MANUAL,26,,17,,RBRVS,1.10 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88360,CPT,M/PHMTRC ALYS TUMOR IMHCHEM EA ANTIBODY MANUAL,TC,,17,,RBRVS,,2.24 ,2.24 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88361,CPT,M/PHMTRC ALYS TUMOR IMHCHEM EA ANTBDY CMPTR ASST,,,17,,RBRVS,1.18 ,3.54 ,3.54 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88361,CPT,M/PHMTRC ALYS TUMOR IMHCHEM EA ANTBDY CMPTR ASST,26,,17,,RBRVS,1.18 ,0.49 ,0.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88361,CPT,M/PHMTRC ALYS TUMOR IMHCHEM EA ANTBDY CMPTR ASST,TC,,17,,RBRVS,,3.05 ,3.05 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88362,CPT,NERVE TEASING PREPARATIONS,,,17,,RBRVS,2.17 ,5.95 ,5.95 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88362,CPT,NERVE TEASING PREPARATIONS,26,,17,,RBRVS,2.17 ,0.87 ,0.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88362,CPT,NERVE TEASING PREPARATIONS,TC,,17,,RBRVS,,5.08 ,5.08 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88363,CPT,EXAM & SELECT ARCHIVE TISSUE MOLECULAR ANALYSI,,,17,,RBRVS,0.37 ,0.16 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88364,CPT,IN SITU HYBRIDIZATION EA ADDL PROBE STAIN,,,17,,RBRVS,0.53 ,2.17 ,2.17 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88364,CPT,IN SITU HYBRIDIZATION EA ADDL PROBE STAIN,26,,17,,RBRVS,0.53 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88364,CPT,IN SITU HYBRIDIZATION EA ADDL PROBE STAIN,TC,,17,,RBRVS,,1.95 ,1.95 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88365,CPT,IN SITU HYBRIDIZATION 1ST PROBE STAIN,,,17,,RBRVS,0.88 ,3.48 ,3.48 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88365,CPT,IN SITU HYBRIDIZATION 1ST PROBE STAIN,26,,17,,RBRVS,0.88 ,0.36 ,0.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88365,CPT,IN SITU HYBRIDIZATION 1ST PROBE STAIN,TC,,17,,RBRVS,,3.12 ,3.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88366,CPT,IN SITU HYBRIDIZATION EA MULTIPLEX PROBE STAIN,,,17,,RBRVS,1.24 ,6.05 ,6.05 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88366,CPT,IN SITU HYBRIDIZATION EA MULTIPLEX PROBE STAIN,26,,17,,RBRVS,1.24 ,0.53 ,0.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88366,CPT,IN SITU HYBRIDIZATION EA MULTIPLEX PROBE STAIN,TC,,17,,RBRVS,,5.52 ,5.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88367,CPT,M/PHMTRC ALYS ISH CPTR-ASST TECH 1ST PROBE STAIN,,,17,,RBRVS,0.73 ,2.25 ,2.25 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88367,CPT,M/PHMTRC ALYS ISH CPTR-ASST TECH 1ST PROBE STAIN,26,,17,,RBRVS,0.73 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88367,CPT,M/PHMTRC ALYS ISH CPTR-ASST TECH 1ST PROBE STAIN,TC,,17,,RBRVS,,2.00 ,2.00 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88368,CPT,M/PHMTRC ALYS IN SITU HYBRIDIZATION EA PROBE MNL,,,17,,RBRVS,0.88 ,2.14 ,2.14 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88368,CPT,M/PHMTRC ALYS IN SITU HYBRIDIZATION EA PROBE MNL,26,,17,,RBRVS,0.88 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88368,CPT,M/PHMTRC ALYS IN SITU HYBRIDIZATION EA PROBE MNL,TC,,17,,RBRVS,,1.88 ,1.88 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88369,CPT,M/PHMTRC ALYS ISH QUANT/SEMIQ MNL PER SPEC EACH,,,17,,RBRVS,0.53 ,1.51 ,1.51 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88369,CPT,M/PHMTRC ALYS ISH QUANT/SEMIQ MNL PER SPEC EACH,26,,17,,RBRVS,0.53 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88369,CPT,M/PHMTRC ALYS ISH QUANT/SEMIQ MNL PER SPEC EACH,TC,,17,,RBRVS,,1.35 ,1.35 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88371,CPT,PROTEIN ANAL TISSUE WESTERN BLOT W/INTERP&REPO,,,17,,TotalUnits,,,,0.84 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
88371,CPT,PROTEIN ANAL TISSUE WESTERN BLOT W/INTERP&REPO,26,,17,,RBRVS,0.37 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88372,CPT,PROTEIN ALYS WSTRN BLOT I&R IMMUNOLOGICAL EA,,,17,,TotalUnits,,,,0.86 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
88372,CPT,PROTEIN ALYS WSTRN BLOT I&R IMMUNOLOGICAL EA,26,,17,,RBRVS,0.37 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88373,CPT,M/PHMTRC ALYS ISH QUANT/SEMIQ CPTR PER SPEC EACH,,,17,,RBRVS,0.43 ,1.24 ,1.24 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88373,CPT,M/PHMTRC ALYS ISH QUANT/SEMIQ CPTR PER SPEC EACH,26,,17,,RBRVS,0.43 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88373,CPT,M/PHMTRC ALYS ISH QUANT/SEMIQ CPTR PER SPEC EACH,TC,,17,,RBRVS,,1.09 ,1.09 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88374,CPT,M/PHMTRC ALYS ISH QUANT/SEMIQ CPTR EACH MULTIPRB,,,17,,RBRVS,0.93 ,8.70 ,8.70 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88374,CPT,M/PHMTRC ALYS ISH QUANT/SEMIQ CPTR EACH MULTIPRB,26,,17,,RBRVS,0.93 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88374,CPT,M/PHMTRC ALYS ISH QUANT/SEMIQ CPTR EACH MULTIPRB,TC,,17,,RBRVS,,8.36 ,8.36 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88375,CPT,OPTICAL ENDOMICROSCOPIC IMAGE INTERP & REPORT,,,17,,TotalUnits,,,,1.29 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
88377,CPT,M/PHMTRC ALYS ISH QUANT/SEMIQ MNL EACH MULTIPRB,,,17,,RBRVS,1.40 ,10.06 ,10.06 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88377,CPT,M/PHMTRC ALYS ISH QUANT/SEMIQ MNL EACH MULTIPRB,26,,17,,RBRVS,1.40 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88377,CPT,M/PHMTRC ALYS ISH QUANT/SEMIQ MNL EACH MULTIPRB,TC,,17,,RBRVS,,9.63 ,9.63 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88380,CPT,MICRODISSECTION PREP IDENTIFIED TARGET LASER,,,17,,RBRVS,1.14 ,2.55 ,2.55 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88380,CPT,MICRODISSECTION PREP IDENTIFIED TARGET LASER,26,,17,,RBRVS,1.14 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88380,CPT,MICRODISSECTION PREP IDENTIFIED TARGET LASER,TC,,17,,RBRVS,,2.12 ,2.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88381,CPT,MICRODISSECTION PREP IDENTIFIED TARGET MANUAL,,,17,,RBRVS,0.53 ,2.92 ,2.92 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88381,CPT,MICRODISSECTION PREP IDENTIFIED TARGET MANUAL,26,,17,,RBRVS,0.53 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
88381,CPT,MICRODISSECTION PREP IDENTIFIED TARGET MANUAL,TC,,17,,RBRVS,,2.73 ,2.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88387,CPT,MACRO EXAM DISSECT&PREP TISS NONMICRO STD EA,,,17,,RBRVS,0.62 ,0.56 ,0.56 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88387,CPT,MACRO EXAM DISSECT&PREP TISS NONMICRO STD EA,,PC,17,,RBRVS,0.62 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
88387,CPT,MACRO EXAM DISSECT&PREP TISS NONMICRO STD EA,,TC,17,,RBRVS,,0.27 ,0.27 ,,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
88388,CPT,MACR EXM DISS&PRP NONMICR IMPRNT/CONSLT/FRZ SE,,,17,,RBRVS,0.45 ,0.49 ,0.49 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88388,CPT,MACR EXM DISS&PRP NONMICR IMPRNT/CONSLT/FRZ SE,,PC,17,,RBRVS,0.45 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
88388,CPT,MACR EXM DISS&PRP NONMICR IMPRNT/CONSLT/FRZ SE,,TC,17,,RBRVS,,0.26 ,0.26 ,,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
88399,CPT,UNLISTED SURGICAL PATHOLOGY PROCEDURE,,,17,,TotalUnits,,,,2.02 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
88399,CPT,UNLISTED SURGICAL PATHOLOGY PROCEDURE,,PC,17,,TotalUnits,,,,1.08 ,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
88399,CPT,UNLISTED SURGICAL PATHOLOGY PROCEDURE,,TC,17,,TotalUnits,,,,0.94 ,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
88720,CPT,BILIRUBIN TOTAL TRANSCUTANEOUS,,,17,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88738,CPT,HGB QUANTITATIVE TRANSCUTANEOUS,,,17,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88740,CPT,HEMOGLOBIN QUAN TC PER DAY CARBOXYHEMOGLOBIN,,,17,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88741,CPT,HEMOGLOBIN QUANTITATIVE TC PER DAY METHEMOGLOBIN,,,17,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
88749,CPT,UNLISTED IN VIVO LABORTORY SERVICE,,,17,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89049,CPT,CAFFEINE HALOTHANE CONTRACTURE TEST,,,17,,RBRVS,1.40 ,0.24 ,5.24 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89050,CPT,CELL COUNT MISCELLANEOUS BODY FLUIDS,,,17,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89051,CPT,CELL COUNT MISC BODY FLUIDS W/DIFFERENTIAL COUNT,,,17,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89055,CPT,LEUKOCYTE ASSMT FECAL QUAL/SEMIQUANTITATIVE,,,17,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89060,CPT,CRYSTAL ID LIGHT MICROSCOPY ALYS TISS/ANY FLUID,,,17,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
89060,CPT,CRYSTAL ID LIGHT MICROSCOPY ALYS TISS/ANY FLUID,26,,17,,RBRVS,0.37 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
89125,CPT,FAT STAIN FECES URINE/RESPIR SECRETIONS,,,17,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89160,CPT,MEAT FIBERS FECES,,,17,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89190,CPT,NASAL SMEAR EOSINOPHILS,,,17,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89220,CPT,SPUTUM OBTAINING SPEC AEROSOL INDUCED TX SPX,,TC,17,,RBRVS,,0.43 ,0.43 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89230,CPT,SWEAT COLLECTION IONTOPHORESIS,,TC,17,,RBRVS,,0.14 ,0.14 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89240,CPT,UNLIS MISC PATH,,,17,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89250,CPT,CUL OOCYTE/EMBRYO <4 DAYS,,,17,,TotalUnits,,,,11.48 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89251,CPT,CUL OOCYTE/EMBRYO < 4 D CO-CULT OCYTE/EMBRY,,,17,,TotalUnits,,,,11.94 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89253,CPT,ASSTD EMBRYO HATCHING MICROTQS ANY METH,,,17,,TotalUnits,,,,5.58 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89254,CPT,OOCYTE ID FROM FOLLICULAR FLU,,,17,,TotalUnits,,,,6.11 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89255,CPT,PREPJ EMBRYO TR,,,17,,TotalUnits,,,,4.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89257,CPT,SPRM ID FROM ASPIR OTH/THN SEMINAL,,,17,,TotalUnits,,,,5.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89258,CPT,CRYOPRSRV EMBRYO,,,17,,TotalUnits,,,,5.78 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89259,CPT,CRYOPRSRV SPRM,,,17,,TotalUnits,,,,1.82 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89260,CPT,SPRM ISOL SMPL PREP INSEMINATION/DX SEMEN ALYS,,,17,,TotalUnits,,,,1.34 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89261,CPT,SPRM ISOL CPLX PREP INSEMINATION/DX SEMEN ALYS,,,17,,TotalUnits,,,,2.02 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89264,CPT,SPRM ID FROM TSTIS TISS FRSH/CRYOPRSRVD,,,17,,TotalUnits,,,,5.04 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89268,CPT,INSEMINATION OOCYTES,,,17,,TotalUnits,,,,4.98 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89272,CPT,EXTND CUL OOCYTE/EMBRYO 4-7 DAYS,,,17,,TotalUnits,,,,8.36 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89280,CPT,ASSTD FERTILIZATION MICROTQ </EQUAL 10 OOCYTES,,,17,,TotalUnits,,,,12.96 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89281,CPT,ASSTD FERTILIZATION MICROTQ > 10 OOCYTES,,,17,,TotalUnits,,,,14.91 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89290,CPT,BX OOCYTE MICROTQ </= 5 EMBRY,,,17,,TotalUnits,,,,22.24 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89291,CPT,BX OOCYTE MICROTQ >5 EMBRY,,,17,,TotalUnits,,,,14.66 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89300,CPT,SEMEN ALYS PRESENCE&/MOTILITY SPRM HUHNER,,,17,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89310,CPT,SEMEN ALYS MOTILITY&CNT X W/HUHNER TST,,,17,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89320,CPT,SEMEN ANALYSIS VOLUME COUNT MOTILITY DIFFERENT,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89321,CPT,SEMEN ANALYSIS SPERM PRESENCE&/MOTILITY SPRM,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89322,CPT,SEMEN ANALYSIS STRICT MORPHOLOGIC CRITERIA,,,17,,TotalUnits,,,,0.59 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89325,CPT,SPERM ANTIBODIES,,,17,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89329,CPT,SPERM EVALUATION HAMSTER PENETRATION TEST,,,17,,TotalUnits,,,,0.80 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89330,CPT,SPERM EVALUATION CERVICAL MUCOUS PENETRATION,,,17,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89331,CPT,SPERM EVALUATION RETROGRADE EJACULATION URINE,,,17,,TotalUnits,,,,0.74 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89337,CPT,CRYOPRESERVATION MATURE OOCYTE(S),,,17,,TotalUnits,,,,5.78 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89342,CPT,STORAGE PER YEAR EMBRYO,,,17,,TotalUnits,,,,2.67 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89343,CPT,STORAGE PER YEAR SPERM/SEMEN,,,17,,TotalUnits,,,,1.16 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89352,CPT,THAWING CRYOPRESERVED EMBRYO,,,17,,TotalUnits,,,,5.12 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89353,CPT,THAWING CRYOPRESERVED SPERM/SEMEN EACH ALIQUOT,,,17,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
89398,CPT,UNLISTED REPRODUCTIVE MEDICINE LAB PROCEDURE,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90281,CPT,IMMUNE GLOBULIN IG HUMAN IM USE,,,22,,TotalUnits,,,,0.35 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90283,CPT,IMMUNE GLOBULIN IGIV HUMAN IV USE,,,22,,TotalUnits,,,,0.95 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90284,CPT,IMMUNE GLOBULIN HUMAN SUBQ INFUSION 100 MG EA,,,22,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90287,CPT,BOTULINUM ANTITOXIN EQUINE ANY ROUTE,,,22,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90296,CPT,DIPHTHERIA ANTITOXIN EQUINE ANY ROUTE,,,22,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90371,CPT,HEPATITIS B IMMUNE GLOBULIN HBIG HUMAN IM,,,22,,TotalUnits,,,,2.81 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90375,CPT,RABIES IMMUNE GLOBULIN RIG HUMAN IM/SUBQ,,,22,,TotalUnits,,,,3.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90376,CPT,RABIES IG HEAT-TREATED HUMAN IM/SUBQ,,,22,,TotalUnits,,,,3.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90378,CPT,RESPIRATORY SYNCYTIAL VIRUS IG IM 50 MG E,,,22,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90384,CPT,RHO(D) IMMUNE GLOBULIN HUMAN FULL-DOSE IM,,,22,,TotalUnits,,,,2.07 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90385,CPT,RHO(D) IMMUNE GLOBULIN HUMAN MINI-DOSE IM,,,22,,TotalUnits,,,,0.95 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90386,CPT,RHO(D) IMMUNE GLOBULIN HUMAN IV,,,22,,RBRVS,,3.59 ,3.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90389,CPT,TETANUS IMMUNE GLOBULIN TIG HUMAN IM,,,22,,TotalUnits,,,,1.92 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90396,CPT,VARICELLA-ZOSTER IMMUNE GLOBULIN HUMAN IM,,,22,,TotalUnits,,,,2.13 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90399,CPT,UNLISTED IMMUNE GLOBULIN,,,22,,TotalUnits,,,,0.95 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90460,CPT,IM ADM THRU 18YR ANY RTE 1ST/ONLY COMPT VAC/TOX,,,9,,RBRVS,0.17 ,0.53 ,0.53 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90461,CPT,IM ADM THRU 18YR ANY RTE ADDL VAC/TOX COMPT,,,9,,RBRVS,0.15 ,0.20 ,0.20 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90471,CPT,IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE,,,9,,RBRVS,0.17 ,0.53 ,0.53 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90472,CPT,IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE,,,9,,RBRVS,0.15 ,0.20 ,0.20 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90473,CPT,IM ADM INTRANSL/ORAL 1 VACCINE,,,9,,RBRVS,0.17 ,0.53 ,0.53 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90474,CPT,IM ADM INTRANSL/ORAL EA VACCINE,,,9,,RBRVS,0.15 ,0.20 ,0.20 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90476,CPT,ADENOVIRUS VACCINE TYPE 4 LIVE ORAL,,,9,,TotalUnits,,,,0.35 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90477,CPT,ADENOVIRUS VACCINE TYPE 7 LIVE FOR ORAL,,,9,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90581,CPT,ANTHRAX VACCINE SUBCUTANEOUS/IM USE,,,9,,RBRVS,,3.99 ,3.99 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90585,CPT,BACILLUS CALMETTE-GUERIN VACC FOR TB LIVE PERQ,,,9,,TotalUnits,,,,4.24 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90586,CPT,BACILLUS CALMETTE-GUERIN VACCINE INTRAVESICAL,,,9,,TotalUnits,,,,6.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90620,CPT,MENB RECOMBINANT PROT W/OUT MEMBR VESIC VACC IM,,,9,,TotalUnits,,,,5.70 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90621,CPT,MENB RECOMBINANT LIPOPROTEIN VACCINE IM,,,9,,TotalUnits,,,,5.70 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90630,CPT,INFLUENZA VACC IIV4 SPLIT VIRUS PRSRV FREE ID,,,9,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90632,CPT,HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE,,,9,,TotalUnits,,,,2.32 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90633,CPT,HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE,,,9,,TotalUnits,,,,1.13 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90634,CPT,HEPA VACCINE 3 DOSE SCHEDULE PED/ADOLESC IM USE,,,9,,TotalUnits,,,,1.19 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90636,CPT,HEPATITIS A & B VACCINE HEPA-HEPB ADULT IM,,,9,,TotalUnits,,,,3.11 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90644,CPT,HIB-MENCY VACC 4 DOSE SCHEDULE 2-18 MONTHS IM,,,9,,TotalUnits,,,,0.90 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90647,CPT,HIB PRP-OMP VACCINE 3 DOSE SCHEDULE IM USE,,,9,,TotalUnits,,,,0.96 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90648,CPT,HIB PRP-T VACCINE 4 DOSE SCHEDULE IM USE,,,9,,TotalUnits,,,,0.90 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90649,CPT,4VHPV VACCINE 3 DOSE SCHEDULE FOR IM USE,,,9,,TotalUnits,,,,4.29 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90650,CPT,2VHPV VACCINE 3 DOSE SCHEDULE FOR IM USE,,,9,,TotalUnits,,,,2.14 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90651,CPT,9VHPV VACCINE 3 DOSE SCHEDULE FOR IM USE,,,9,,TotalUnits,,,,4.29 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90653,CPT,IIV ADJUVANTED VACCINE FOR INTRAMUSCULAR USE,,,9,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90654,CPT,INFLUENZA VACC IIV3 SPLIT VIRUS PRSRV FREE ID,,,9,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90655,CPT,IIV3 VACC PRESRV FREE CHILD 6-35 MONTHS IM USE,,,9,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90656,CPT,IIV3 VACC PRESERVATIVE FREE 3 YRS & OLDER IM USE,,,9,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90657,CPT,IIV3 VACCINE TO CHILD 6-35 MONTHS FOR IM USE,,,9,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90658,CPT,IIV3 VACCINE 3 YRS & OLDER FOR IM USE,,,9,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90660,CPT,LAIV3 VACCINE LIVE FOR INTRANASAL USE,,,9,,TotalUnits,,,,0.68 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90661,CPT,CCIIV3 VACCINE PRESERVATIVE FREE FOR IM USE,,,9,,TotalUnits,,,,0.29 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90662,CPT,IIV VACCINE PRESERV FREE INCREASED AG COUNT IM,,,9,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90664,CPT,LAIV VACCINE PANDEMIC FORMULA FOR INTRANASAL USE,,,9,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90666,CPT,INFLUENZA VACCINE PANDEMIC SPLT PRSRV FREE IM,,,9,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90667,CPT,IIV VACCINE PANDEMIC ADJUVANT FOR IM USE,,,9,,TotalUnits,,,,0.45 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90668,CPT,IIV VACCINE PANDEMIC FOR INTRAMUSCULAR USE,,,9,,TotalUnits,,,,0.59 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90670,CPT,PCV13 VACCINE FOR INTRAMUSCULAR USE,,,9,,TotalUnits,,,,3.11 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90672,CPT,LAIV4 VACCINE FOR INTRANASAL USE,,,9,,TotalUnits,,,,1.55 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90673,CPT,RIV3 VACCINE PRESERVATIVE FREE FOR IM USE,,,9,,RBRVS,,1.00 ,1.00 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90675,CPT,RABIES VACCINE INTRAMUSCULAR,,,9,,TotalUnits,,,,6.44 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90676,CPT,RABIES VACCINE INTRADERMAL,,,9,,TotalUnits,,,,2.94 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90680,CPT,RV5 VACCINE 3 DOSE SCHEDULE LIVE FOR ORAL USE,,,9,,TotalUnits,,,,2.54 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90681,CPT,RV1 VACCINE 2 DOSE SCHEDULE LIVE FOR ORAL USE,,,9,,TotalUnits,,,,2.54 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90685,CPT,IIV4 PRESRV FREE VACC CHILD 6-35 MO FOR IM USE,,,9,,RBRVS,,0.67 ,0.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90686,CPT,IIV4 VACC PRESRV FREE 3 YRS & OLDER IM USE,,,9,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90687,CPT,IIV4 VACCINE CHILD 6-35 MO FOR IM USE,,,9,,RBRVS,,0.26 ,0.26 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90688,CPT,IIV4 VACCINE 3 YRS & OLDER FOR IM USE,,,9,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90690,CPT,TYPHOID VACCINE LIVE ORAL,,,9,,TotalUnits,,,,1.30 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90691,CPT,TYPHOID VACCINE VI CAPSULAR POLYSACCHARIDE IM,,,9,,TotalUnits,,,,1.85 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90696,CPT,DTAP-IPV VACCINE CHILD 4-6 YRS FOR IM USE,,,9,,TotalUnits,,,,1.39 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90697,CPT,DTAP-IPV-HIB-HEPB VACCINE INTRAMUSCULAR,,,9,,TotalUnits,,,,3.04 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90698,CPT,DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE,,,9,,TotalUnits,,,,2.54 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90700,CPT,DIPHTH TETANUS TOX ACELL PERTUSSIS VACC<7 YR IM,,,9,,TotalUnits,,,,0.85 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90702,CPT,DT VACCINE YOUNGER THAN 7 YRS FOR IM USE,,,9,,TotalUnits,,,,0.69 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90707,CPT,MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ,,,9,,TotalUnits,,,,1.69 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90710,CPT,MEASLES MUMPS RUBELLA VARICELLA VACC LIVE SUBQ,,,9,,TotalUnits,,,,4.52 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90713,CPT,POLIOVIRUS VACCINE INACTIVATED SUBQ/IM,,,9,,TotalUnits,,,,0.96 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90714,CPT,TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE,,,9,,TotalUnits,,,,0.71 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90715,CPT,TDAP VACCINE 7 YRS/> IM,,,9,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90716,CPT,VAR VACCINE LIVE FOR SUBCUTANEOUS USE,,,9,,TotalUnits,,,,2.48 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90717,CPT,YELLOW FEVER VACCINE LIVE SUBQ,,,9,,TotalUnits,,,,2.88 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90723,CPT,DTAP-HEPB-IPV VACCINE INTRAMUSCULAR,,,9,,TotalUnits,,,,2.48 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90732,CPT,PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE,,,9,,TotalUnits,,,,1.10 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90733,CPT,MPSV4 VACCINE GROUPS ACYW-135 SUBQ USE,,,9,,TotalUnits,,,,3.39 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90734,CPT,MENACWY CONJUGATE VACCINE GROUPS ACYW-135 IM USE,,,9,,TotalUnits,,,,3.22 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90736,CPT,ZOSTER VACCINE HZV LIVE FOR SUBCUTANEOUS USE,,,9,,TotalUnits,,,,5.42 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90738,CPT,JAPANESE ENCEPHALITIS VACCINE INACTIVATED IM,,,9,,TotalUnits,,,,2.24 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90739,CPT,HEPB VACCINE ADULT 2 DOSE SCHEDULE FOR IM USE,,,9,,TotalUnits,,,,3.88 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90740,CPT,HEPB VACCINE DIALYSIS/IMMUNSUP PAT 3 DOSE IM,,,9,,TotalUnits,,,,6.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90743,CPT,HEPB VACCINE ADOLESCENT 2 DOSE SCHEDULE IM,,,9,,TotalUnits,,,,1.69 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90744,CPT,HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM,,,9,,TotalUnits,,,,1.17 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90746,CPT,HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE,,,9,,TotalUnits,,,,2.29 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90747,CPT,HEPB VACCINE DIALYSIS/IMMUNSUP PAT 4 DOSE IM,,,9,,TotalUnits,,,,7.31 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90748,CPT,HIB-HEPB VACCINE FOR INTRAMUSCULAR USE,,,9,,TotalUnits,,,,1.89 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90749,CPT,UNLISTED VACCINE/TOXOID,,,9,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
90785,CPT,PSYCHOTHERAPY COMPLEX INTERACTIVE,,,16,,RBRVS,0.33 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90791,CPT,PSYCHIATRIC DIAGNOSTIC EVALUATION,,,16,,RBRVS,3.00 ,0.46 ,0.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90792,CPT,PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES,,,16,,RBRVS,3.25 ,0.61 ,0.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90832,CPT,PSYCHOTHERAPY PATIENT &/ FAMILY 30 MINUTES,,,16,,RBRVS,1.50 ,0.22 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90833,CPT,PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 30 MIN,,,16,,RBRVS,1.50 ,0.27 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90834,CPT,PSYCHOTHERAPY PATIENT &/ FAMILY 45 MINUTES,,,16,,RBRVS,2.00 ,0.29 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90836,CPT,PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 45 MIN,,,16,,RBRVS,1.90 ,0.35 ,0.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90837,CPT,PSYCHOTHERAPY PATIENT &/ FAMILY 60 MINUTES,,,16,,RBRVS,3.00 ,0.44 ,0.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90838,CPT,PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 60 MIN,,,16,,RBRVS,2.50 ,0.46 ,0.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90839,CPT,PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES,,,16,,RBRVS,3.13 ,0.46 ,0.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90840,CPT,PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MINUTES,,,16,,RBRVS,1.50 ,0.22 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90845,CPT,PSYCHOANALYSIS,,,16,,RBRVS,2.10 ,0.37 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90846,CPT,FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT,,,16,,RBRVS,2.40 ,0.38 ,0.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90847,CPT,FAMILY PSYCHOTHERAPY W/PATIENT PRESENT,,,16,,RBRVS,2.50 ,0.38 ,0.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90849,CPT,MULTIPLE FAMILY GROUP PSYCHOTHERAPY,,,16,,RBRVS,0.59 ,0.27 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90853,CPT,GROUP PSYCHOTHERAPY,,,16,,RBRVS,0.59 ,0.10 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90863,CPT,PHARMACOLOGIC MANAGEMENT W/PSYCHOTHERAPY,,,16,,TotalUnits,,,,1.55 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90865,CPT,NARCOSYNTHESIS PSYC DX&THER PURPOSES,,,16,,RBRVS,2.84 ,0.65 ,1.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90867,CPT,REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL&M,,,16,,TotalUnits,,,,9.15 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90868,CPT,THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG,,,16,,TotalUnits,,,,5.03 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90869,CPT,REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV & MN,,,16,,TotalUnits,,,,9.82 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90870,CPT,ELECTROCONVULSIVE THERAPY,,,16,,RBRVS,2.50 ,0.52 ,2.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90875,CPT,INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 30 MIN,,,16,,RBRVS,1.20 ,0.46 ,0.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90876,CPT,INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 45 MIN,,,16,,RBRVS,1.90 ,0.73 ,1.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90880,CPT,HYPNOTHERAPY,,,16,,RBRVS,2.19 ,0.38 ,0.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90882,CPT,ENVIRONMENTAL IVNTJ MGMT PURPOSES PSYC PT,,,16,,TotalUnits,,,,2.11 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90885,CPT,PSYCHIATRIC EVAL HOSPITAL RECORDS DX PURPOSES,,,16,,RBRVS,0.97 ,0.37 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90887,CPT,INTERPJ/EXPLNAJ RESULTS PSYCHIATRIC EXAM FAMILY,,,16,,RBRVS,1.48 ,0.57 ,0.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90889,CPT,PREP REPORT PT PSYCH STATUS AGENCY/PAYER,,,16,,TotalUnits,,,,1.79 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90899,CPT,UNLISTED PSYCHIATRIC SERVICE/PROCEDURE,,,16,,TotalUnits,,,,1.74 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90901,CPT,BIOFEEDBACK TRAINING ANY MODALITY,,,14,,RBRVS,0.41 ,0.14 ,0.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90911,CPT,BIOFDBK TRNG PERINL MUSC ANORECT/URO SPHX W/EMG,,,14,,RBRVS,0.89 ,0.31 ,1.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90935,CPT,HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION,,,14,,RBRVS,1.48 ,0.48 ,0.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90937,CPT,HEMODIALYSIS PX REPEAT EVAL W/WO REVJ DIALYS RX,,,14,,RBRVS,2.11 ,0.71 ,0.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90940,CPT,HEMODIALYSIS ACCESS FLOW STUDY,,,14,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90945,CPT,DIALYSIS OTHER/THAN HEMODIALYSIS 1 PHYS/QHP EVAL,,,14,,RBRVS,1.56 ,0.77 ,0.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90947,CPT,DIALYSIS OTH/THN HEMODIALY REPEAT PHYS/QHP EVALS,,,14,,RBRVS,2.52 ,0.83 ,0.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90951,CPT,ESRD RELATED SVC MONTHLY & <2 YR OLD 4/> VISITS,,,14,,RBRVS,18.46 ,6.94 ,6.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90952,CPT,ESRD RELATED SVC MONTHLY <2 YR OLD 2/3 VISITS,,,14,,RBRVS,6.42 ,13.39 ,13.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90953,CPT,ESRD RELATED SVC MONTHLY <2 YR OLD 1 VISIT,,,14,,RBRVS,4.28 ,8.93 ,8.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90954,CPT,ESRD RELATED SVC MONTHLY 2-11 YR OLD 4/> VISITS,,,14,,RBRVS,15.98 ,6.11 ,6.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90955,CPT,ESRD RELATED SVC MONTHLY 2-11 YR OLD 2/3 VISITS,,,14,,RBRVS,8.79 ,3.60 ,3.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90956,CPT,ESRD RELATED SVC MONTHLY 2-11 YR OLD 1 VISIT,,,14,,RBRVS,5.95 ,2.74 ,2.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90957,CPT,ESRD RELATED SVC MONTHLY 12-19 YR OLD 4/> VISITS,,,14,,RBRVS,12.52 ,4.91 ,4.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90958,CPT,ESRD RELATED SVC MONTHLY 12-19 YR OLD 2/3 VISITS,,,14,,RBRVS,8.34 ,3.45 ,3.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90959,CPT,ESRD RELATED SVC MONTHLY 12-19 YR OLD 1 VISIT,,,14,,RBRVS,5.50 ,2.53 ,2.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90960,CPT,ESRD RELATED SVC MONTHLY 20&/> YR OLD 4/> VISITS,,,14,,RBRVS,5.18 ,2.53 ,2.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90961,CPT,ESRD RELATED SVC MONTHLY 20/>YR OLD 2/3 VISITS,,,14,,RBRVS,4.26 ,2.22 ,2.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90962,CPT,ESRD RELATED SVC MONTHLY 20&/>YR OLD 1 VISIT,,,14,,RBRVS,3.15 ,1.86 ,1.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90963,CPT,ESRD SVC HOME DIALYSIS FULL MONTH <2YR OLD,,,14,,RBRVS,10.56 ,4.19 ,4.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90964,CPT,ESRD SVC HOME DIALYSIS FULL MONTH 2-11 YR OLD,,,14,,RBRVS,9.14 ,3.72 ,3.73 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90965,CPT,ESRD SVC HOME DIALYSIS FULL MONTH 12-19 YR OLD,,,14,,RBRVS,8.69 ,3.58 ,3.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90966,CPT,ESRD SVC HOME DIALYSIS FULL MONTH 20 YR OLD,,,14,,RBRVS,4.26 ,2.21 ,2.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90967,CPT,ESRD RELATED SVC <FULL MONTH <2 YR OLD,,,14,,RBRVS,0.35 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90968,CPT,ESRD RELATED SVC <FULL MONTH 2-11 YR OLD,,,14,,RBRVS,0.30 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90969,CPT,ESRD RELATED SVC <FULL MONTH 12-19 YR OLD,,,14,,RBRVS,0.29 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90970,CPT,ESRD RELATED SVC <FULL MONTH 20/>YR OLD,,,14,,RBRVS,0.14 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90989,CPT,DIALYSIS TRAINING PATIENT COMPLETED COURSE,,,14,,TotalUnits,,,,8.29 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90993,CPT,DIALYSIS TRAINING PATIENT PER TRAINING SESSION,,,14,,TotalUnits,,,,1.80 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90997,CPT,HEMOPERFUSION,,,14,,RBRVS,1.84 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
90999,CPT,UNLISTED DIALYSIS PROCEDURE INPATIENT/OUTPATIENT,,,14,,TotalUnits,,,,1.96 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
91010,CPT,ESOPHAGEAL MOTILITY STUDY W/INTERP&RPT,,,14,,RBRVS,1.28 ,3.65 ,3.65 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
91010,CPT,ESOPHAGEAL MOTILITY STUDY W/INTERP&RPT,26,,14,,RBRVS,1.28 ,0.57 ,0.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
91010,CPT,ESOPHAGEAL MOTILITY STUDY W/INTERP&RPT,TC,,14,,RBRVS,,3.08 ,3.08 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
91013,CPT,ESOPHAGEAL MOTILITY STD W/I&R STIM/PERFUSION,,,14,,RBRVS,0.18 ,0.48 ,0.48 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
91013,CPT,ESOPHAGEAL MOTILITY STD W/I&R STIM/PERFUSION,26,,14,,RBRVS,0.18 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
91013,CPT,ESOPHAGEAL MOTILITY STD W/I&R STIM/PERFUSION,TC,,14,,RBRVS,,0.40 ,0.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
91020,CPT,GASTRIC MOTILITY MANOMETRIC STUDIES,,,14,,RBRVS,1.44 ,5.12 ,5.12 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
91020,CPT,GASTRIC MOTILITY MANOMETRIC STUDIES,26,,14,,RBRVS,1.44 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
91020,CPT,GASTRIC MOTILITY MANOMETRIC STUDIES,TC,,14,,RBRVS,,4.47 ,4.47 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
91022,CPT,DUODENAL MOTILITY MANOMETRIC STUDY,,,14,,RBRVS,1.44 ,3.32 ,3.32 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
91022,CPT,DUODENAL MOTILITY MANOMETRIC STUDY,26,,14,,RBRVS,1.44 ,0.66 ,0.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
91022,CPT,DUODENAL MOTILITY MANOMETRIC STUDY,TC,,14,,RBRVS,,2.66 ,2.66 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
91030,CPT,ESOPHAGUS ACID PERFUSION TEST ESOPHAGITIS,,,14,,RBRVS,0.91 ,2.95 ,2.95 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
91030,CPT,ESOPHAGUS ACID PERFUSION TEST ESOPHAGITIS,26,,14,,RBRVS,0.91 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
91030,CPT,ESOPHAGUS ACID PERFUSION TEST ESOPHAGITIS,TC,,14,,RBRVS,,2.53 ,2.53 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
91034,CPT,GASTROESOPHAG REFLX TEST W/CATH PH ELTRD PLCMT,,,14,,RBRVS,0.97 ,4.30 ,4.30 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
91034,CPT,GASTROESOPHAG REFLX TEST W/CATH PH ELTRD PLCMT,26,,14,,RBRVS,0.97 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
91034,CPT,GASTROESOPHAG REFLX TEST W/CATH PH ELTRD PLCMT,TC,,14,,RBRVS,,3.88 ,3.88 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
91035,CPT,GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,,,14,,RBRVS,1.59 ,12.01 ,12.01 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
91035,CPT,GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,26,,14,,RBRVS,1.59 ,0.70 ,0.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
91035,CPT,GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,TC,,14,,RBRVS,,11.31 ,11.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
91037,CPT,GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,,,14,,RBRVS,0.97 ,3.54 ,3.54 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
91037,CPT,GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,26,,14,,RBRVS,0.97 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
91037,CPT,GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,TC,,14,,RBRVS,,3.11 ,3.11 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
91038,CPT,ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG,,,14,,RBRVS,1.10 ,11.69 ,11.69 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
91038,CPT,ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG,26,,14,,RBRVS,1.10 ,0.49 ,0.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
91038,CPT,ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG,TC,,14,,RBRVS,,11.20 ,11.20 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
91040,CPT,ESOPHGL BALO DISTENSION DX STD W/PROVOCATION,,,14,,RBRVS,0.97 ,11.44 ,11.44 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
91040,CPT,ESOPHGL BALO DISTENSION DX STD W/PROVOCATION,26,,14,,RBRVS,0.97 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
91040,CPT,ESOPHGL BALO DISTENSION DX STD W/PROVOCATION,TC,,14,,RBRVS,,11.00 ,11.00 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
91065,CPT,BREATH HYDROGEN/METHANE TEST,,,14,,RBRVS,0.20 ,2.08 ,2.08 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
91065,CPT,BREATH HYDROGEN/METHANE TEST,26,,14,,RBRVS,0.20 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
91065,CPT,BREATH HYDROGEN/METHANE TEST,TC,,14,,RBRVS,,1.99 ,1.99 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
91110,CPT,GI IMAG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,,,14,,RBRVS,3.64 ,21.50 ,21.50 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
91110,CPT,GI IMAG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,26,,14,,RBRVS,3.64 ,1.66 ,1.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
91110,CPT,GI IMAG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,TC,,14,,RBRVS,,19.84 ,19.84 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
91111,CPT,GASTROINTESTINAL TRACT IMAGING ESOPHAGUS W/I&R,,,14,,RBRVS,1.00 ,19.71 ,19.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
91111,CPT,GASTROINTESTINAL TRACT IMAGING ESOPHAGUS W/I&R,26,,14,,RBRVS,1.00 ,0.45 ,0.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
91111,CPT,GASTROINTESTINAL TRACT IMAGING ESOPHAGUS W/I&R,TC,,14,,RBRVS,,19.26 ,19.26 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
91112,CPT,GI TRANSIT & PRES MEAS WIRELESS CAPSULE W/INTERP,,,14,,RBRVS,2.10 ,28.58 ,28.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
91112,CPT,GI TRANSIT & PRES MEAS WIRELESS CAPSULE W/INTERP,26,,14,,RBRVS,2.10 ,0.95 ,0.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
91112,CPT,GI TRANSIT & PRES MEAS WIRELESS CAPSULE W/INTERP,TC,,14,,RBRVS,,27.63 ,27.63 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
91117,CPT,COLON MOTILITY STDY MIN 6 HR CONT RECORD W/I&R,,,14,,RBRVS,2.45 ,1.40 ,1.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
91120,CPT,RECTAL SESATION TONE & COMPLIANCE TEST,,,14,,RBRVS,0.97 ,11.13 ,11.13 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
91120,CPT,RECTAL SESATION TONE & COMPLIANCE TEST,26,,14,,RBRVS,0.97 ,0.40 ,0.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
91120,CPT,RECTAL SESATION TONE & COMPLIANCE TEST,TC,,14,,RBRVS,,10.73 ,10.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
91122,CPT,ANORECTAL MANOMETRY,,,14,,RBRVS,1.77 ,4.49 ,4.49 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
91122,CPT,ANORECTAL MANOMETRY,26,,14,,RBRVS,1.77 ,0.68 ,0.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
91122,CPT,ANORECTAL MANOMETRY,TC,,14,,RBRVS,,3.81 ,3.81 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
91132,CPT,ELECTROGASTROGRAPHY DX TRANSCUTANEOUS,,,14,,RBRVS,0.52 ,3.67 ,3.67 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
91132,CPT,ELECTROGASTROGRAPHY DX TRANSCUTANEOUS,26,,14,,RBRVS,0.52 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
91132,CPT,ELECTROGASTROGRAPHY DX TRANSCUTANEOUS,TC,,14,,RBRVS,,3.43 ,3.43 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
91133,CPT,ELECTROGASTROGRAPHY DX TRANSCUT W/PROVOCTVE TSTG,,,14,,RBRVS,0.66 ,4.20 ,4.20 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
91133,CPT,ELECTROGASTROGRAPHY DX TRANSCUT W/PROVOCTVE TSTG,26,,14,,RBRVS,0.66 ,0.30 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
91133,CPT,ELECTROGASTROGRAPHY DX TRANSCUT W/PROVOCTVE TSTG,TC,,14,,RBRVS,,3.90 ,3.90 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
91200,CPT,LIVER ELASTOGRAPHY W/O IMAG W/I&R,,,20,,RBRVS,0.30 ,0.69 ,0.69 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
91200,CPT,LIVER ELASTOGRAPHY W/O IMAG W/I&R,26,,20,,RBRVS,0.30 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
91200,CPT,LIVER ELASTOGRAPHY W/O IMAG W/I&R,TC,,20,,RBRVS,,0.59 ,0.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
91299,CPT,UNLISTED DIAGNOSTIC GASTROENTEROLOGY PROCEDURE,,,14,,TotalUnits,,,,9.58 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
91299,CPT,UNLISTED DIAGNOSTIC GASTROENTEROLOGY PROCEDURE,,PC,14,,TotalUnits,,,,3.05 ,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
91299,CPT,UNLISTED DIAGNOSTIC GASTROENTEROLOGY PROCEDURE,,TC,14,,TotalUnits,,,,6.53 ,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
92002,CPT,OPHTH MEDICAL XM&EVAL INTERMEDIATE NEW PT,,,23,,RBRVS,0.88 ,0.44 ,1.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92004,CPT,OPHTH MEDICAL XM&EVAL COMPRE NEW PT 1/> VST,,,23,,RBRVS,1.82 ,0.93 ,2.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92012,CPT,OPHTH MEDICAL XM&EVAL INTERMEDIATE ESTAB PT,,,23,,RBRVS,0.92 ,0.53 ,1.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92014,CPT,OPHTH MEDICAL XM&EVAL COMPRHNSV ESTAB PT 1/>,,,23,,RBRVS,1.42 ,0.78 ,2.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92015,CPT,DETERMINATION REFRACTIVE STATE,,,23,,RBRVS,0.38 ,0.15 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92018,CPT,OPHTH XM&EVAL ANES W/WO MANJ GLOBE COMPL,,,14,,RBRVS,2.50 ,1.50 ,1.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92019,CPT,OPHTH XM&EVAL ANES W/WO MANJ GLOBE LMTD,,,14,,RBRVS,1.31 ,0.67 ,0.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92020,CPT,GONIOSCOPY SEPARATE PROCEDURE,,,14,,RBRVS,0.37 ,0.21 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92025,CPT,COMPUTERIZED CORNEAL TOPOGRAPHY UNI/BI,,,14,,RBRVS,0.35 ,0.70 ,0.70 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92025,CPT,COMPUTERIZED CORNEAL TOPOGRAPHY UNI/BI,26,,14,,RBRVS,0.35 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92025,CPT,COMPUTERIZED CORNEAL TOPOGRAPHY UNI/BI,TC,,14,,RBRVS,,0.49 ,0.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92060,CPT,SENSORMOTOR XM W/MLT MEAS OCULAR DEVIJ W/I&R SPX,,,14,,RBRVS,0.69 ,1.12 ,1.12 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92060,CPT,SENSORMOTOR XM W/MLT MEAS OCULAR DEVIJ W/I&R SPX,26,,14,,RBRVS,0.69 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92060,CPT,SENSORMOTOR XM W/MLT MEAS OCULAR DEVIJ W/I&R SPX,TC,,14,,RBRVS,,0.74 ,0.74 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92065,CPT,ORTHOPTIC &/PLEOPTIC TRAINING W/MEDICAL DIRECTJ,,,14,,RBRVS,0.37 ,1.12 ,1.12 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92065,CPT,ORTHOPTIC &/PLEOPTIC TRAINING W/MEDICAL DIRECTJ,26,,14,,RBRVS,0.37 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92065,CPT,ORTHOPTIC &/PLEOPTIC TRAINING W/MEDICAL DIRECTJ,TC,,14,,RBRVS,,0.99 ,0.99 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92071,CPT,FIT CONTACT LENS TX OCULAR SURFACE DISEASE,,,14,,RBRVS,0.61 ,0.32 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92072,CPT,FITTING CONTACT LENS FOR MNGT OF KERATOCONUS,,,14,,RBRVS,1.97 ,0.87 ,1.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92081,CPT,VISUAL FIELD XM UNI/BI W/INTERPRETJ LIMITED EXAM,,,14,,RBRVS,0.30 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92081,CPT,VISUAL FIELD XM UNI/BI W/INTERPRETJ LIMITED EXAM,26,,14,,RBRVS,0.30 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92081,CPT,VISUAL FIELD XM UNI/BI W/INTERPRETJ LIMITED EXAM,TC,,14,,RBRVS,,0.49 ,0.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92082,CPT,VISUAL FIELD XM UNI/BI W/INTERP INTERMED EXAM,,,14,,RBRVS,0.40 ,0.93 ,0.93 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92082,CPT,VISUAL FIELD XM UNI/BI W/INTERP INTERMED EXAM,26,,14,,RBRVS,0.40 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92082,CPT,VISUAL FIELD XM UNI/BI W/INTERP INTERMED EXAM,TC,,14,,RBRVS,,0.73 ,0.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92083,CPT,VISUAL FIELD XM UNI/BI W/INTERP EXTENDED EXAM,,,14,,RBRVS,0.50 ,1.29 ,1.29 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92083,CPT,VISUAL FIELD XM UNI/BI W/INTERP EXTENDED EXAM,26,,14,,RBRVS,0.50 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92083,CPT,VISUAL FIELD XM UNI/BI W/INTERP EXTENDED EXAM,TC,,14,,RBRVS,,1.01 ,1.01 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92100,CPT,SERIAL TONOMETRY SPX W/MLT MEAS INTRAOCULAR PRES,,,14,,RBRVS,0.61 ,0.33 ,1.63 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92132,CPT,CMPTR OPHTHALMIC DX IMG ANT SEGMT W/I&R UNI/BI,,,14,,RBRVS,0.35 ,0.61 ,0.61 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92132,CPT,CMPTR OPHTHALMIC DX IMG ANT SEGMT W/I&R UNI/BI,26,,14,,RBRVS,0.35 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92132,CPT,CMPTR OPHTHALMIC DX IMG ANT SEGMT W/I&R UNI/BI,TC,,14,,RBRVS,,0.43 ,0.43 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92133,CPT,COMPUTERIZED OPHTHALMIC IMAGING OPTIC NERVE,,,14,,RBRVS,0.50 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92133,CPT,COMPUTERIZED OPHTHALMIC IMAGING OPTIC NERVE,26,,14,,RBRVS,0.50 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92133,CPT,COMPUTERIZED OPHTHALMIC IMAGING OPTIC NERVE,TC,,14,,RBRVS,,0.44 ,0.44 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92134,CPT,COMPUTERIZED OPHTHALMIC IMAGING RETINA,,,14,,RBRVS,0.50 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92134,CPT,COMPUTERIZED OPHTHALMIC IMAGING RETINA,26,,14,,RBRVS,0.50 ,0.30 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92134,CPT,COMPUTERIZED OPHTHALMIC IMAGING RETINA,TC,,14,,RBRVS,,0.45 ,0.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92136,CPT,OPH BMTRY PRTL COHER INTRFRMTRY IO LENS PWR CAL,,,14,,RBRVS,0.54 ,1.98 ,1.98 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92136,CPT,OPH BMTRY PRTL COHER INTRFRMTRY IO LENS PWR CAL,26,,14,,RBRVS,0.54 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92136,CPT,OPH BMTRY PRTL COHER INTRFRMTRY IO LENS PWR CAL,TC,,14,,RBRVS,,1.65 ,1.65 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92140,CPT,PROVOCATIVE TESTS GLAUCOMA I&R W/O TONOGRAPHY,,,14,,RBRVS,0.50 ,0.23 ,1.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92145,CPT,CORNEA HYSTERESIS DETERMIN IMPULSE STIMJ UNI/BI,,,14,,RBRVS,0.17 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92145,CPT,CORNEA HYSTERESIS DETERMIN IMPULSE STIMJ UNI/BI,26,,14,,RBRVS,0.17 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92145,CPT,CORNEA HYSTERESIS DETERMIN IMPULSE STIMJ UNI/BI,TC,,14,,RBRVS,,0.18 ,0.18 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92225,CPT,OPHTHALMOSCPY EXTENDED RETINAL DRAWING I&R 1ST,,,14,,RBRVS,0.38 ,0.21 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92226,CPT,OPHTHALMOSCPY EXTENDED RETINAL DRAWING I&R SBS,,,14,,RBRVS,0.33 ,0.20 ,0.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92227,CPT,REMOTE IMG DX RETINL DIS W/ALYS & REPORT UNI/B,,TC,14,,RBRVS,,0.40 ,0.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92228,CPT,REMOTE IMAGING MGT RETINAL DISEASE W/I&R UNI/B,,,14,,RBRVS,0.37 ,0.61 ,0.61 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92228,CPT,REMOTE IMAGING MGT RETINAL DISEASE W/I&R UNI/B,26,,14,,RBRVS,0.37 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92228,CPT,REMOTE IMAGING MGT RETINAL DISEASE W/I&R UNI/B,TC,,14,,RBRVS,,0.38 ,0.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92230,CPT,FLUORESCEIN ANGIOSCOPY INTERPRETATION & REPORT,,,14,,RBRVS,0.60 ,0.31 ,1.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92235,CPT,FLUORESCEIN ANGIOSCOPY INTERPRETATION & REPORT,,,14,,RBRVS,0.81 ,2.26 ,2.26 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92235,CPT,FLUORESCEIN ANGIOSCOPY INTERPRETATION & REPORT,26,,14,,RBRVS,0.81 ,0.51 ,0.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92235,CPT,FLUORESCEIN ANGIOSCOPY INTERPRETATION & REPORT,TC,,14,,RBRVS,,1.75 ,1.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92240,CPT,INDOCYANINE GREEN ANGIOGRAPHY W/INTERP & REPOR,,,14,,RBRVS,1.10 ,6.05 ,6.05 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92240,CPT,INDOCYANINE GREEN ANGIOGRAPHY W/INTERP & REPOR,26,,14,,RBRVS,1.10 ,0.69 ,0.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92240,CPT,INDOCYANINE GREEN ANGIOGRAPHY W/INTERP & REPOR,TC,,14,,RBRVS,,5.36 ,5.36 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92250,CPT,FUNDUS PHOTOGRAPHY W/INTERPRETATION & REPORT,,,14,,RBRVS,0.44 ,1.76 ,1.76 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92250,CPT,FUNDUS PHOTOGRAPHY W/INTERPRETATION & REPORT,26,,14,,RBRVS,0.44 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92250,CPT,FUNDUS PHOTOGRAPHY W/INTERPRETATION & REPORT,TC,,14,,RBRVS,,1.53 ,1.53 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92260,CPT,OPHTHALMODYNAMOMETRY,,,14,,RBRVS,0.20 ,0.10 ,0.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92265,CPT,NEEDLE OCULOGRAPHY 1/ XOC MUSC 1/BOTH EYE W/I&R,,,14,,RBRVS,0.81 ,1.59 ,1.59 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92265,CPT,NEEDLE OCULOGRAPHY 1/ XOC MUSC 1/BOTH EYE W/I&R,26,,14,,RBRVS,0.81 ,0.50 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92265,CPT,NEEDLE OCULOGRAPHY 1/ XOC MUSC 1/BOTH EYE W/I&R,TC,,14,,RBRVS,,1.09 ,1.09 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92270,CPT,ELECTRO-OCULOGRAPY W/INTERPRETATION & REPORT,,,14,,RBRVS,0.81 ,1.74 ,1.74 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92270,CPT,ELECTRO-OCULOGRAPY W/INTERPRETATION & REPORT,26,,14,,RBRVS,0.81 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92270,CPT,ELECTRO-OCULOGRAPY W/INTERPRETATION & REPORT,TC,,14,,RBRVS,,1.41 ,1.41 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92275,CPT,ELECTRORETINOGRAPY W/INTERPRETATION & REPORT,,,14,,RBRVS,1.01 ,3.09 ,3.09 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92275,CPT,ELECTRORETINOGRAPY W/INTERPRETATION & REPORT,26,,14,,RBRVS,1.01 ,0.49 ,0.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92275,CPT,ELECTRORETINOGRAPY W/INTERPRETATION & REPORT,TC,,14,,RBRVS,,2.60 ,2.60 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92283,CPT,COLOR VISION XM EXTENDED ANOMALOSCOPE/EQUIV,,,14,,RBRVS,0.17 ,1.39 ,1.39 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92283,CPT,COLOR VISION XM EXTENDED ANOMALOSCOPE/EQUIV,26,,14,,RBRVS,0.17 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92283,CPT,COLOR VISION XM EXTENDED ANOMALOSCOPE/EQUIV,TC,,14,,RBRVS,,1.30 ,1.30 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92284,CPT,DARK ADAPTATION XM W/INTERPRETATION & REPORT,,,14,,RBRVS,0.24 ,1.50 ,1.50 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92284,CPT,DARK ADAPTATION XM W/INTERPRETATION & REPORT,26,,14,,RBRVS,0.24 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92284,CPT,DARK ADAPTATION XM W/INTERPRETATION & REPORT,TC,,14,,RBRVS,,1.39 ,1.39 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92285,CPT,XTRNL OCULAR PHOTOG W/I&R DOCMT MEDICAL PROGRE,,,14,,RBRVS,0.05 ,0.51 ,0.51 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92285,CPT,XTRNL OCULAR PHOTOG W/I&R DOCMT MEDICAL PROGRE,26,,14,,RBRVS,0.05 ,0.03 ,0.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92285,CPT,XTRNL OCULAR PHOTOG W/I&R DOCMT MEDICAL PROGRE,TC,,14,,RBRVS,,0.48 ,0.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92286,CPT,ANT SGM IMAGING W/MICROSCOPY ENDOTHELIAL ANALY,,,14,,RBRVS,0.40 ,0.66 ,0.66 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92286,CPT,ANT SGM IMAGING W/MICROSCOPY ENDOTHELIAL ANALY,26,,14,,RBRVS,0.40 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92286,CPT,ANT SGM IMAGING W/MICROSCOPY ENDOTHELIAL ANALY,TC,,14,,RBRVS,,0.44 ,0.44 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92287,CPT,ANT SGM IMAGING W/FLUOROSCEIN ANGIO & I&R,,,14,,RBRVS,0.81 ,3.05 ,3.05 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92287,CPT,ANT SGM IMAGING W/FLUOROSCEIN ANGIO & I&R,26,,14,,RBRVS,0.81 ,0.50 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92287,CPT,ANT SGM IMAGING W/FLUOROSCEIN ANGIO & I&R,TC,,14,,RBRVS,,2.55 ,2.55 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92310,CPT,RX&FITG C-LENS SUPVJ CRNL LENS OU XCPT APHK,,,23,,RBRVS,1.17 ,0.45 ,1.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92311,CPT,RX&FITG CONTACT CORNEAL LENS APHAKIA 1 EYE,,,14,,RBRVS,1.08 ,0.45 ,1.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92312,CPT,RX&FITG CONTACT CORNEAL LENS APHAKIA BOTH EYES,,,14,,RBRVS,1.26 ,0.52 ,2.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92313,CPT,RX&FITG CORNEOSCLERAL LENS,,,14,,RBRVS,0.92 ,0.39 ,1.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92314,CPT,RX&FTG CONTACT CORNEAL LENS EYES XCPT APHAKIA,,,23,,RBRVS,0.69 ,0.26 ,1.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92315,CPT,RX CONTACT CORNEAL LENS APHAKIA 1 EYE,,,14,,RBRVS,0.45 ,0.15 ,1.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92316,CPT,RX CONTACT CORNEAL LENS APHAKIA BOTH EYES,,,14,,RBRVS,0.68 ,0.23 ,1.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92317,CPT,RX CONTACT CORNEOSCLERAL LENS,,,14,,RBRVS,0.45 ,0.16 ,1.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92325,CPT,MODIFICAJ CONTACT LENX SPX SUPVJ ADAPTATION,,,14,,RBRVS,,1.18 ,1.18 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92326,CPT,REPLACEMENT CONTACT LENS,,,14,,RBRVS,,0.98 ,0.98 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92340,CPT,FITTING SPECTACLES XCPT APHAKIA MONOFOCAL,,,14,,RBRVS,0.37 ,0.14 ,0.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92341,CPT,FITTING SPECTACLES XCPT APHAKIA BIFOCAL,,,14,,RBRVS,0.47 ,0.18 ,0.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92342,CPT,FITTING SPECTACLES XCPT APHAKIA MULTIFOCAL,,,14,,RBRVS,0.53 ,0.20 ,0.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92352,CPT,FITTING SPECTACLE PROSTH APHAKIA MONOFOCAL,,,14,,RBRVS,0.37 ,0.14 ,0.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92353,CPT,FITTING SPECTACLE PROSTH APHAKIA MULTIFOCAL,,,14,,RBRVS,0.50 ,0.19 ,0.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92354,CPT,FITTING SPECTACLE MOUNTED LW VIS AID 1 ELMNT,,,14,,RBRVS,,0.37 ,0.37 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92355,CPT,FITTING SPECTACLE MOUNTED LW VIS AID TLSCP,,,14,,RBRVS,,0.58 ,0.58 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92358,CPT,PROSTHESIS SERVICE APHAKIA TEMPORARY,,,14,,RBRVS,,0.31 ,0.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92370,CPT,RPR&REFITG SPECTACLES EXCEPT APHAKIA,,,14,,RBRVS,0.32 ,0.12 ,0.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92371,CPT,RPR&REFITG SPECTACLE PROSTHESIS APHAKIA,,,14,,RBRVS,,0.32 ,0.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92499,CPT,UNLIVSTED OPHTHALMOLOGICAL SERVICE/PROCEDURE,,,14,,TotalUnits,,,,1.22 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92499,CPT,UNLIVSTED OPHTHALMOLOGICAL SERVICE/PROCEDURE,,PC,14,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
92499,CPT,UNLIVSTED OPHTHALMOLOGICAL SERVICE/PROCEDURE,,TC,14,,TotalUnits,,,,0.81 ,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
92502,CPT,OTOLARYNGOLOGIC EXAM UNDER GENERAL ANESTHESIA,,,14,,RBRVS,1.51 ,1.14 ,1.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92504,CPT,BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE,,,14,,RBRVS,0.18 ,0.08 ,0.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92507,CPT,TX SPEECH LANG VOICE COMMJ &/AUDITORY PROC IND,,,8,,RBRVS,1.30 ,0.89 ,0.89 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92508,CPT,TX SPEECH LANGUAGE VOICE COMMJ AUDITRY 2/>INDIV,,,8,,RBRVS,0.33 ,0.32 ,0.32 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92511,CPT,NASOPHARYNGOSCOPY W/ENDOSCOPE SPX,,,14,,RBRVS,0.61 ,0.73 ,3.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92512,CPT,NASAL FUNCTION STUDIES,,,14,,RBRVS,0.55 ,0.23 ,1.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92516,CPT,FACIAL NERVE FUNCTION STUDIES,,,14,,RBRVS,0.43 ,0.19 ,1.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92520,CPT,LARYNGEAL FUNCTION STUDIES,,,14,,RBRVS,0.75 ,0.37 ,1.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92521,CPT,EVALUATION OF SPEECH FLUENCY (STUTTER CLUTTER),,,8,,RBRVS,1.75 ,1.22 ,1.22 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92522,CPT,EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE,,,8,,RBRVS,1.50 ,1.04 ,1.04 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92523,CPT,EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION,,,8,,RBRVS,3.00 ,2.15 ,2.15 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92524,CPT,BEHAVIORAL & QUALIT ANALYSIS VOICE AND RESONANCE,,,8,,RBRVS,1.50 ,0.93 ,0.93 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92526,CPT,TX SWALLOWING DYSFUNCTION&/ORAL FUNCJ FEEDING,,,14,,RBRVS,1.34 ,1.04 ,1.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92531,CPT,SPONTANEOUS NYSTAGMUS W/GAZE,,,14,,TotalUnits,,,,0.43 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92532,CPT,POSITIONAL NYSTAGMUS TEST,,,14,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92533,CPT,CALORIC VESTIBULAR TEST EACH IRRIGATION,,,14,,TotalUnits,,,,0.72 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92534,CPT,OPTOKINETIC NYSTAGMUS TEST,,,14,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92537,CPT,CALORIC VESTIBULAR TEST W/REC BI BITHERMAL,,,14,,RBRVS,0.60 ,0.51 ,0.51 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92537,CPT,CALORIC VESTIBULAR TEST W/REC BI BITHERMAL,26,,14,,RBRVS,0.60 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92537,CPT,CALORIC VESTIBULAR TEST W/REC BI BITHERMAL,TC,,14,,RBRVS,,0.23 ,0.23 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92538,CPT,CALORIC VESTIBULAR TEST W/REC BI MONOTHERMAL,,,14,,RBRVS,0.30 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92538,CPT,CALORIC VESTIBULAR TEST W/REC BI MONOTHERMAL,26,,14,,RBRVS,0.30 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92538,CPT,CALORIC VESTIBULAR TEST W/REC BI MONOTHERMAL,TC,,14,,RBRVS,,0.12 ,0.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92540,CPT,VSTBLR FUNCJ NYSTAG FOVL&PERPH STIMJ OSCIL TRK,,,14,,RBRVS,1.50 ,1.32 ,1.32 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92540,CPT,VSTBLR FUNCJ NYSTAG FOVL&PERPH STIMJ OSCIL TRK,,PC,14,,RBRVS,1.50 ,0.70 ,0.70 ,,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
92540,CPT,VSTBLR FUNCJ NYSTAG FOVL&PERPH STIMJ OSCIL TRK,,TC,14,,RBRVS,,0.62 ,0.62 ,,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
92541,CPT,SPONTANEOUS NYSTAGMUS TEST,,,14,,RBRVS,0.40 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92541,CPT,SPONTANEOUS NYSTAGMUS TEST,26,,14,,RBRVS,0.40 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92541,CPT,SPONTANEOUS NYSTAGMUS TEST,TC,,14,,RBRVS,,0.08 ,0.08 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92542,CPT,POSITIONAL NYSTAGMUS TEST,,,14,,RBRVS,0.48 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92542,CPT,POSITIONAL NYSTAGMUS TEST,26,,14,,RBRVS,0.48 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92542,CPT,POSITIONAL NYSTAGMUS TEST,TC,,14,,RBRVS,,0.07 ,0.07 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92544,CPT,OPTKINETIC NYSTAG BIDIR/FOVEAL/PERIPH STIM W/REC,,,14,,RBRVS,0.27 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92544,CPT,OPTKINETIC NYSTAG BIDIR/FOVEAL/PERIPH STIM W/REC,26,,14,,RBRVS,0.27 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92544,CPT,OPTKINETIC NYSTAG BIDIR/FOVEAL/PERIPH STIM W/REC,TC,,14,,RBRVS,,0.06 ,0.06 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92545,CPT,OSCILLATING TRACKING TEST W/RECORDING,,,14,,RBRVS,0.25 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92545,CPT,OSCILLATING TRACKING TEST W/RECORDING,26,,14,,RBRVS,0.25 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92545,CPT,OSCILLATING TRACKING TEST W/RECORDING,TC,,14,,RBRVS,,0.03 ,0.03 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92546,CPT,SINUSOIDAL VERTICAL AXIS ROTATIONAL TESTING,,,14,,RBRVS,0.29 ,2.59 ,2.59 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92546,CPT,SINUSOIDAL VERTICAL AXIS ROTATIONAL TESTING,26,,14,,RBRVS,0.29 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92546,CPT,SINUSOIDAL VERTICAL AXIS ROTATIONAL TESTING,TC,,14,,RBRVS,,2.47 ,2.47 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92547,CPT,USE VERTICAL ELECTRODES,,TC,14,,RBRVS,,0.17 ,0.17 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92548,CPT,COMPUTERIZED DYNAMIC POSTUROGRAPY,,,14,,RBRVS,0.50 ,2.38 ,2.38 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92548,CPT,COMPUTERIZED DYNAMIC POSTUROGRAPY,26,,14,,RBRVS,0.50 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92548,CPT,COMPUTERIZED DYNAMIC POSTUROGRAPY,TC,,14,,RBRVS,,2.16 ,2.16 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92550,CPT,TYMPANOMETRY AND REFLEX THRESHOLD MEASUREMENTS,,,8,,RBRVS,0.35 ,0.23 ,0.23 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92551,CPT,SCREENING TEST PURE TONE AIR ONLY,,,8,,RBRVS,,0.33 ,0.33 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92552,CPT,PURE TONE AUDIOMETRY AIR ONLY,,TC,8,,RBRVS,,0.87 ,0.87 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92553,CPT,PURE TONE AUDIOMETRY AIR & BONE,,TC,8,,RBRVS,,1.03 ,1.03 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92555,CPT,SPEECH AUDIOMETRY THRESHOLD,,TC,8,,RBRVS,,0.64 ,0.64 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92556,CPT,SPEECH AUDIOMETRY THRESHOLD SPEECH RECOGNIJ,,TC,8,,RBRVS,,1.04 ,1.04 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92557,CPT,COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ,,,8,,RBRVS,0.60 ,0.29 ,0.43 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92558,CPT,EVOKED OTOACOUSTIC EMISSIONS SCREEN AUTO ANALYS,,,8,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92559,CPT,AUDIOMETRIC TESTING GROUPS,,,8,,TotalUnits,,,,0.80 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92560,CPT,BEKESY AUDIOMETRY SCREENING,,,8,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92561,CPT,BEKESY AUDIOMETRY DIAGNOSTIC,,TC,8,,RBRVS,,1.05 ,1.05 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92562,CPT,LOUDNESS BALANCE BINAURAL/MONAURAL,,TC,8,,RBRVS,,1.29 ,1.29 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92563,CPT,TONE DECAY TEST,,TC,8,,RBRVS,,0.86 ,0.86 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92564,CPT,SHORT INCREMENT SENSITIVITY INDEX,,TC,8,,RBRVS,,0.79 ,0.79 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92565,CPT,STENGER TEST PURE TONE,,TC,8,,RBRVS,,0.43 ,0.43 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92567,CPT,TYMPANOMETRY,,,8,,RBRVS,0.20 ,0.10 ,0.20 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92568,CPT,ACOUSTIC REFLEX THRESHOLD,,,8,,RBRVS,0.29 ,0.13 ,0.14 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92570,CPT,ACOUSTIC IMMIT TEST TYMPANOM/ACOUST REFLX/DECAY,,,8,,RBRVS,0.55 ,0.27 ,0.33 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92571,CPT,FILTERED SPEECH TEST,,TC,8,,RBRVS,,0.76 ,0.76 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92572,CPT,STAGGERED SPONDAIC WORD,,TC,8,,RBRVS,,0.87 ,0.87 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92575,CPT,SENSORINEURAL ACUITY LEVEL,,TC,8,,RBRVS,,1.99 ,1.99 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92576,CPT,SYNTHETIC SENTENCE IDENTIFICATION TEST,,TC,8,,RBRVS,,0.98 ,0.98 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92577,CPT,STENGER TEST SPEECH,,TC,8,,RBRVS,,0.44 ,0.44 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92579,CPT,VISUAL REINFORCEMENT AUDIOMETRY,,,8,,RBRVS,0.70 ,0.35 ,0.55 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92582,CPT,CONDITIONING PLAY AUDIOMETRY,,TC,8,,RBRVS,,2.00 ,2.00 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92583,CPT,SELECT PICTURE AUDIOMETRY,,TC,8,,RBRVS,,1.42 ,1.42 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92584,CPT,ELECTROCOCHLEOGRAPHY,,TC,8,,RBRVS,,2.07 ,2.07 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92585,CPT,AUDITORY EVOKED POTENTIALS COMPREHENSIVE,,,8,,RBRVS,0.50 ,3.29 ,3.29 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92585,CPT,AUDITORY EVOKED POTENTIALS COMPREHENSIVE,26,,8,,RBRVS,0.50 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92585,CPT,AUDITORY EVOKED POTENTIALS COMPREHENSIVE,TC,,8,,RBRVS,,3.05 ,3.05 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92586,CPT,AUDITORY EVOKED POTENTIALS LIMITED,,TC,8,,RBRVS,,2.34 ,2.34 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92587,CPT,DISTORT PRODUCT EVOKED OTOACOUSTIC EMISNS LIMITD,,,8,,RBRVS,0.35 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92587,CPT,DISTORT PRODUCT EVOKED OTOACOUSTIC EMISNS LIMITD,26,,8,,RBRVS,0.35 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92587,CPT,DISTORT PRODUCT EVOKED OTOACOUSTIC EMISNS LIMITD,TC,,8,,RBRVS,,0.08 ,0.08 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92588,CPT,DISTRT PROD EVOKD OTOACOUSTIC EMSNS COMP/DX EVAL,,,8,,RBRVS,0.55 ,0.36 ,0.36 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92588,CPT,DISTRT PROD EVOKD OTOACOUSTIC EMSNS COMP/DX EVAL,26,,8,,RBRVS,0.55 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92588,CPT,DISTRT PROD EVOKD OTOACOUSTIC EMSNS COMP/DX EVAL,TC,,8,,RBRVS,,0.10 ,0.10 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92590,CPT,HEARING AID EXAMINATION & SELECTION MONAURAL,,,8,,TotalUnits,,,,1.47 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92591,CPT,HEARING AID EXAMINATION & SELECTION BINAURAL,,,8,,TotalUnits,,,,1.87 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92592,CPT,HEARING AID CHECK MONAURAL,,,8,,TotalUnits,,,,0.59 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92593,CPT,HEARING AID CHECK BINAURAL,,,8,,TotalUnits,,,,0.96 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92594,CPT,ELECTROACOUS EVAL HEARING AID MONAURAL,,,8,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92595,CPT,ELECTROACOUS EVAL HEARING AID BINAURAL,,,8,,TotalUnits,,,,1.20 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92596,CPT,EAR PROTECTOR ATTENUATION MEASUREMENTS,,TC,8,,RBRVS,,1.17 ,1.17 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92597,CPT,EVAL&/FITG VOICE PROSTC DEV SUPLMNT ORAL SPEEC,,,8,,RBRVS,1.26 ,0.71 ,0.71 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92601,CPT,ANALYSIS COCHLEAR IMPLT PT <7 YR PRGRMG,,,14,,RBRVS,2.30 ,0.88 ,1.42 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92602,CPT,ANALYSIS COCHLEAR IMPLT PT <7 YR SBSQ REPRGRMG,,,14,,RBRVS,1.30 ,0.58 ,1.18 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92603,CPT,ANALYSIS COCHLEAR IMPLT 7 YR/> PRGRMG,,,14,,RBRVS,2.25 ,1.11 ,1.87 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92604,CPT,ANALYSIS COCHLEAR IMPLT 7 YR/> SBSQ REPRGRMG,,,14,,RBRVS,1.25 ,0.62 ,1.21 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92605,CPT,EVAL RX N-SP-GEN AUGMT ALT COMMUN DEV F2F 1ST HR,,,14,,RBRVS,1.75 ,0.67 ,0.78 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92606,CPT,THER SVC N-SP-GENRATJ DEV PRGRMG&MODIFICAJ,,,14,,RBRVS,1.40 ,0.54 ,0.87 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92607,CPT,RX SP-GENRATJ AUGMNT&COMUNICAJ DEV 1ST HR,,,14,,RBRVS,1.85 ,1.56 ,1.56 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92608,CPT,RX SP-GENRATJ AUGMNT&COMUNICAJ DEV EA 30 MIN,,,14,,RBRVS,0.70 ,0.78 ,0.78 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92609,CPT,THER SP-GENRATJ DEV PRGRMG&MODIFICAJ,,,14,,RBRVS,1.50 ,1.58 ,1.58 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92610,CPT,EVAL ORAL&PHARYNGEAL SWLNG FUNCJ,,,14,,RBRVS,1.30 ,0.70 ,1.04 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92611,CPT,MOTION FLUOR EVAL SWLNG FUNCJ C/V REC,,,14,,RBRVS,1.34 ,1.01 ,1.01 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92612,CPT,FLX FIBOPT NDSC EVAL SWLNG C/V REC,,,14,,RBRVS,1.27 ,0.59 ,3.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92613,CPT,FLX FIBOPT NDSC EVAL SWLNG C/V REC PHYS I&R,,,14,,RBRVS,0.71 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92614,CPT,FLX FIBOPT NDSC EVAL LARYN SENS C/V REC,,,14,,RBRVS,1.27 ,0.57 ,2.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92615,CPT,FLX FIBOPT NDSC EVAL LARYN SENS PHYS I&R,,,14,,RBRVS,0.63 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92616,CPT,FLX FIBOPT NDSC EVAL SWLNG&LARYN SENS C/V REC,,,14,,RBRVS,1.88 ,0.87 ,3.81 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92617,CPT,FLX FIBOPT NDSC EVAL SWLNG&LARYN SENS PHYS I&R,,,14,,RBRVS,0.79 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92618,CPT,EVAL RX N-SP-GEN AUGMT ALT COMMUN DEV ADD 30 MIN,,,14,,RBRVS,0.65 ,0.25 ,0.27 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
92620,CPT,EVAL CENTRAL AUDITORY FUNCJ W/REPRT 1ST 60 MIN,,,14,,RBRVS,1.50 ,0.78 ,1.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92621,CPT,EVAL CENTRAL AUDITORY FUNCJ W/REPRT EA 15 MIN,,,14,,RBRVS,0.35 ,0.18 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92625,CPT,ASSESSMENT TINNITUS,,,14,,RBRVS,1.15 ,0.57 ,0.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92626,CPT,EVALUATION AUDITORY REHAB STATUS 1ST HR,,,14,,RBRVS,1.40 ,0.70 ,1.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92627,CPT,EVALUATION AUDITORY REHAB STATUS EA 15 MIN,,,14,,RBRVS,0.33 ,0.16 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92630,CPT,AUDITORY REHABILITATION PRELINGUAL HEARING LOSS,,,14,,TotalUnits,,,,1.18 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92633,CPT,AUDITORY REHABILITATION POSTLINGUAL HEARING LOSS,,,14,,TotalUnits,,,,1.19 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92640,CPT,ANALYSIS W/PRGRMG AUD BRAINSTEM IMPLANT PR HR,,,14,,RBRVS,1.76 ,0.89 ,1.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92700,CPT,UNLISTED OTORHINOLARYNGOLOGICAL SERVICE,,,14,,TotalUnits,,,,0.73 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92920,CPT,PRQ TRLUML CORONARY ANGIOPLASTY ONE ART/BRANCH,,,21,,RBRVS,10.10 ,3.45 ,3.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92921,CPT,PRQ TRLUML CORONARY ANGIOPLASTY ADDL BRANCH,,,21,,TotalUnits,,,,3.93 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92924,CPT,PRQ TRLUML CORONARY ANGIO/ATHERECT ONE ART/BRNCH,,,21,,RBRVS,11.99 ,4.08 ,4.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92928,CPT,PRQ TRLUML CORONARY STENT W/ANGIO ONE ART/BRNCH,,,21,,RBRVS,11.21 ,3.81 ,3.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92929,CPT,PRQ TRLUML CORONARY STENT W/ANGIO ADDL ART/BRNCH,,,21,,TotalUnits,,,,4.36 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92933,CPT,PRQ TRLUML CORONRY STENT/ATH/ANGIO ONE ART/BRNCH,,,21,,RBRVS,12.54 ,4.26 ,4.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92934,CPT,PRQ TRLUML CORONARY STENT/ATH/ANGIO ADDL BRANCH,,,21,,TotalUnits,,,,5.40 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92937,CPT,PRQ TRLUML CORONARY BYP GRFT REVASC ONE VESSEL,,,21,,RBRVS,11.20 ,3.81 ,3.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92938,CPT,PRQ TRLUML CORONARY BYP GRFT REVASC ADDL VESSEL,,,21,,TotalUnits,,,,5.89 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92941,CPT,PRQ TRLUML CORONRY TOT OCCLUS REVASC MI ONE VSL,,,21,,RBRVS,12.56 ,4.27 ,4.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92943,CPT,PRQ TRLUML CORONRY CHRONIC OCCLUS REVASC ONE VSL,,,21,,RBRVS,12.56 ,4.27 ,4.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92944,CPT,PRQ TRLUML CORONRY CHRNIC OCCLUS REVASC ADDL VSL,,,21,,TotalUnits,,,,5.89 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92950,CPT,CARDIOPULMONARY RESUSCITATION,,,4,,RBRVS,4.00 ,0.97 ,4.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92953,CPT,TEMPORARY TRANSCUTANEOUS PACING,,,4,,RBRVS,0.23 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92960,CPT,CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL,,,4,,RBRVS,2.25 ,1.08 ,3.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92961,CPT,CARDIOVERSION ELECTIVE ARRHYTHMIA INTERNAL SPX,,,4,,RBRVS,4.59 ,1.98 ,1.98 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92970,CPT,CARDIOASSIST-METH CIRCULATORY ASSIST INTERNAL,,,4,,RBRVS,3.51 ,1.39 ,1.39 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
92971,CPT,CARDIOASSIST-METH CIRCULATORY ASSIST EXTERNAL,,,4,,RBRVS,1.77 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
92973,CPT,PRQ TRANSLUMINAL CORONARY MECHANICL THROMBECTOMY,,,21,,RBRVS,3.28 ,1.13 ,1.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92974,CPT,TCAT PLACEMENT RADJ DLVR DEV SBSQ C IV BRACHYTX,,,21,,RBRVS,3.00 ,1.04 ,1.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92975,CPT,THROMBOLYSIS INTRACORONARY NFS SLCTV ANGRPH,,,4,,RBRVS,7.24 ,2.49 ,2.49 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
92977,CPT,THROMBOLYSIS CORONARY INTRAVENOUS INFUSION,,,4,,RBRVS,,1.51 ,1.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92978,CPT,INTRAVASC US CORONARY INTERP&RPT INITIAL VESSE,,,4,,TotalUnits,,,,7.45 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92978,CPT,INTRAVASC US CORONARY INTERP&RPT INITIAL VESSE,26,,4,,TotalUnits,,,,2.42 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92978,CPT,INTRAVASC US CORONARY INTERP&RPT INITIAL VESSE,TC,,4,,TotalUnits,,,,5.03 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92979,CPT,INTRAVASC US CORONARY INTERP&RPT ADDL VESSEL,,,4,,TotalUnits,,,,3.99 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
92979,CPT,INTRAVASC US CORONARY INTERP&RPT ADDL VESSEL,26,,4,,TotalUnits,,,,1.94 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92979,CPT,INTRAVASC US CORONARY INTERP&RPT ADDL VESSEL,TC,,4,,TotalUnits,,,,2.05 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
92986,CPT,PRQ BALLOON VALVULOPLASTY AORTIC VALVE,,,21,,RBRVS,22.85 ,10.58 ,10.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92987,CPT,PRQ BALLOON VALVULOPLASTY MITRAL VALVE,,,21,,RBRVS,23.63 ,11.01 ,11.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92990,CPT,PRQ BALLOON VALVULOPLASTY PULMONARY VALVE,,,21,,RBRVS,18.27 ,8.99 ,8.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92992,CPT,ATRIAL SEPTECT/SEPTOST TRANSVENOUS BALLOON,,,21,,TotalUnits,,,,31.64 ,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
92993,CPT,ATRIAL SEPTECT/SEPTOSTOMY BLADE METHOD,,,21,,RBRVS,7.73 ,16.13 ,16.13 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
92997,CPT,PRQ TRLUML PULMONARY ART BALLOON ANGIOP 1 VSL,,,21,,RBRVS,11.98 ,4.45 ,4.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
92998,CPT,PRQ TRLUML PULMONARY ART BALLOON ANGIOP EA VSL,,,21,,RBRVS,5.99 ,2.04 ,2.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93000,CPT,ECG ROUTINE ECG W/LEAST 12 LDS W/I&R,,,4,,RBRVS,0.17 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93005,CPT,ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R,,TC,4,,RBRVS,,0.23 ,0.23 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93010,CPT,ECG ROUTINE ECG W/LEAST 12 LDS I&R ONLY,,PC,4,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93015,CPT,CV STRS TST XERS&/OR RX CONT ECG W/SI&R,,,4,,RBRVS,0.75 ,1.36 ,1.36 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93016,CPT,CV STRS TST XERS&/OR RX CONT ECG W/O I&R,,PC,4,,RBRVS,0.45 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93017,CPT,CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY,,TC,4,,RBRVS,,1.10 ,1.10 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93018,CPT,CV STRS TST XERS&/OR RX CONT ECG I&R ONLY,,PC,4,,RBRVS,0.30 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93024,CPT,ERGONOVINE PROVOCATION TST,,,4,,RBRVS,1.17 ,1.94 ,1.94 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93024,CPT,ERGONOVINE PROVOCATION TST,26,,4,,RBRVS,1.17 ,0.41 ,0.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93024,CPT,ERGONOVINE PROVOCATION TST,TC,,4,,RBRVS,,1.53 ,1.53 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93025,CPT,MICROVOLT T-WAVE ASSESS VENTRICULAR ARRHYTHMIAS,,,4,,RBRVS,0.75 ,3.82 ,3.82 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93025,CPT,MICROVOLT T-WAVE ASSESS VENTRICULAR ARRHYTHMIAS,26,,4,,RBRVS,0.75 ,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93025,CPT,MICROVOLT T-WAVE ASSESS VENTRICULAR ARRHYTHMIAS,TC,,4,,RBRVS,,3.55 ,3.55 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93040,CPT,RHYTHM ECG 1-3 LEADS W/INTERPRETATION & REPORT,,,4,,RBRVS,0.15 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93041,CPT,RHYTHM ECG 1-3 LEADS TRACING ONLY W/O I&R,,TC,4,,RBRVS,,0.15 ,0.15 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93042,CPT,RHYTHM ECG 1-3 LEADS INTERPRETATION & REPRT ON,,PC,4,,RBRVS,0.15 ,0.04 ,0.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93050,CPT,ART PRESS WAVEFORM ANALYS CENTRAL ART PRESSURE,,,4,,RBRVS,0.17 ,0.31 ,0.31 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93050,CPT,ART PRESS WAVEFORM ANALYS CENTRAL ART PRESSURE,26,,4,,RBRVS,0.17 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93050,CPT,ART PRESS WAVEFORM ANALYS CENTRAL ART PRESSURE,TC,,4,,RBRVS,,0.24 ,0.24 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93224,CPT,XTRNL ECG & 48 HR RECORD SCAN STOR W/R&I,,,4,,RBRVS,0.52 ,2.03 ,2.03 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93225,CPT,XTRNL ECG & 48 HR RECORDING,,TC,4,,RBRVS,,0.75 ,0.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93226,CPT,EXTERNAL ECG SCANNING ANALYSIS REPORT,,TC,4,,RBRVS,,1.06 ,1.06 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93227,CPT,XTRNL ECG CONTINUOUS RHYTHM W/I&R UP TO 48 HRS,,PC,4,,RBRVS,0.52 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93228,CPT,XTRNL MOBILE CV TELEMETRY W/I&REPORT 30 DAYS,,PC,4,,RBRVS,0.52 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93229,CPT,XTRNL MOBILE CV TELEMETRY W/TECHNICAL SUPPORT,,TC,4,,RBRVS,,18.97 ,18.97 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93260,CPT,PRGRMG DEV EVAL IMPLANTABLE SUBQ LEAD DFB SYSTEM,,,4,,RBRVS,0.85 ,1.00 ,1.00 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93260,CPT,PRGRMG DEV EVAL IMPLANTABLE SUBQ LEAD DFB SYSTEM,26,,4,,RBRVS,0.85 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93260,CPT,PRGRMG DEV EVAL IMPLANTABLE SUBQ LEAD DFB SYSTEM,TC,,4,,RBRVS,,0.62 ,0.62 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93261,CPT,INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB,,,4,,RBRVS,0.74 ,0.95 ,0.95 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93261,CPT,INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB,26,,4,,RBRVS,0.74 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93261,CPT,INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB,TC,,4,,RBRVS,,0.62 ,0.62 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93268,CPT,XTRNL PT ACTIV ECG TRANSMIS W/R&I </30 DAYS,,,4,,RBRVS,0.52 ,5.21 ,5.21 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93270,CPT,XTRNL PT ACTIVATED ECG RECORD MONITOR 30 DAYS,,TC,4,,RBRVS,,0.25 ,0.25 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93271,CPT,XTRNL PT ACTIVATED ECG REC DWNLD 30 DAYS,,TC,4,,RBRVS,,4.78 ,4.78 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93272,CPT,XTRNL PT ACTIVTD ECG DWNLD W/R&I </30 DAYS,,PC,4,,RBRVS,0.52 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93278,CPT,SIGNAL AVERAGED ELECTROCARDIOGRAPHY W/WO ECG,,,4,,RBRVS,0.25 ,0.59 ,0.59 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93278,CPT,SIGNAL AVERAGED ELECTROCARDIOGRAPHY W/WO ECG,26,,4,,RBRVS,0.25 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93278,CPT,SIGNAL AVERAGED ELECTROCARDIOGRAPHY W/WO ECG,TC,,4,,RBRVS,,0.50 ,0.50 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93279,CPT,PROGRAM EVAL IMPLANTABLE IN PRSN 1 LD PACEMAKER,,,4,,RBRVS,0.65 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93279,CPT,PROGRAM EVAL IMPLANTABLE IN PRSN 1 LD PACEMAKER,26,,4,,RBRVS,0.65 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93279,CPT,PROGRAM EVAL IMPLANTABLE IN PRSN 1 LD PACEMAKER,TC,,4,,RBRVS,,0.48 ,0.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93280,CPT,PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER,,,4,,RBRVS,0.77 ,0.84 ,0.84 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93280,CPT,PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER,26,,4,,RBRVS,0.77 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93280,CPT,PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER,TC,,4,,RBRVS,,0.55 ,0.55 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93281,CPT,PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER,,,4,,RBRVS,0.90 ,0.98 ,0.98 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93281,CPT,PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER,26,,4,,RBRVS,0.90 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93281,CPT,PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER,TC,,4,,RBRVS,,0.64 ,0.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93282,CPT,PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB,,,4,,RBRVS,0.85 ,0.90 ,0.90 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93282,CPT,PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB,26,,4,,RBRVS,0.85 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93282,CPT,PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB,TC,,4,,RBRVS,,0.57 ,0.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93283,CPT,PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB,,,4,,RBRVS,1.15 ,1.10 ,1.10 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93283,CPT,PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB,26,,4,,RBRVS,1.15 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93283,CPT,PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB,TC,,4,,RBRVS,,0.66 ,0.66 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93284,CPT,PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB,,,4,,RBRVS,1.25 ,1.23 ,1.23 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93284,CPT,PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB,26,,4,,RBRVS,1.25 ,0.48 ,0.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93284,CPT,PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB,TC,,4,,RBRVS,,0.75 ,0.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93285,CPT,PROGRAM EVAL IMPLANTABLE DEV IN PRSN ILR SYSTEM,,,4,,RBRVS,0.52 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93285,CPT,PROGRAM EVAL IMPLANTABLE DEV IN PRSN ILR SYSTEM,26,,4,,RBRVS,0.52 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93285,CPT,PROGRAM EVAL IMPLANTABLE DEV IN PRSN ILR SYSTEM,TC,,4,,RBRVS,,0.44 ,0.44 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93286,CPT,PERI-PX EVAL&PROGRAM IN PRSN PACEMAKER SYSTEM,,,4,,RBRVS,0.30 ,0.45 ,0.45 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93286,CPT,PERI-PX EVAL&PROGRAM IN PRSN PACEMAKER SYSTEM,26,,4,,RBRVS,0.30 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93286,CPT,PERI-PX EVAL&PROGRAM IN PRSN PACEMAKER SYSTEM,TC,,4,,RBRVS,,0.33 ,0.33 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93287,CPT,PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB,,,4,,RBRVS,0.45 ,0.54 ,0.54 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93287,CPT,PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB,26,,4,,RBRVS,0.45 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93287,CPT,PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB,TC,,4,,RBRVS,,0.36 ,0.36 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93288,CPT,INTERROGATION EVAL IN PERSON 1/DUAL/MLT LEAD PM,,,4,,RBRVS,0.43 ,0.60 ,0.60 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93288,CPT,INTERROGATION EVAL IN PERSON 1/DUAL/MLT LEAD PM,26,,4,,RBRVS,0.43 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93288,CPT,INTERROGATION EVAL IN PERSON 1/DUAL/MLT LEAD PM,TC,,4,,RBRVS,,0.44 ,0.44 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93289,CPT,INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB,,,4,,RBRVS,0.92 ,0.88 ,0.88 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93289,CPT,INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB,26,,4,,RBRVS,0.92 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93289,CPT,INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB,TC,,4,,RBRVS,,0.54 ,0.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93290,CPT,INTERROGATION EVAL F2F IMPLANTABLE CV MNTR SYS,,,4,,RBRVS,0.43 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93290,CPT,INTERROGATION EVAL F2F IMPLANTABLE CV MNTR SYS,26,,4,,RBRVS,0.43 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93290,CPT,INTERROGATION EVAL F2F IMPLANTABLE CV MNTR SYS,TC,,4,,RBRVS,,0.26 ,0.26 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93291,CPT,INTERROGATION EVALUATION IN PERSON ILR SYSTEM,,,4,,RBRVS,0.43 ,0.56 ,0.56 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93291,CPT,INTERROGATION EVALUATION IN PERSON ILR SYSTEM,26,,4,,RBRVS,0.43 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93291,CPT,INTERROGATION EVALUATION IN PERSON ILR SYSTEM,TC,,4,,RBRVS,,0.40 ,0.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93292,CPT,INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR,,,4,,RBRVS,0.43 ,0.46 ,0.46 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93292,CPT,INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR,26,,4,,RBRVS,0.43 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93292,CPT,INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR,TC,,4,,RBRVS,,0.30 ,0.30 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93293,CPT,TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVAL,,,4,,RBRVS,0.32 ,1.17 ,1.17 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93293,CPT,TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVAL,26,,4,,RBRVS,0.32 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93293,CPT,TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVAL,TC,,4,,RBRVS,,1.06 ,1.06 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93294,CPT,INTERROGATION EVAL REMOTE </90 D 1/2/MLT LEAD PM,,PC,4,,RBRVS,0.65 ,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93295,CPT,INTERROGATION EVAL REMOTE </90 D 1/2/MLT LD DFB,,PC,4,,RBRVS,1.29 ,0.53 ,0.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93296,CPT,INTERROGATION REMOTE </90 D TECHNICIAN REVIEW,,TC,4,,RBRVS,,0.72 ,0.72 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93297,CPT,INTERROGATION EVAL REMOTE </30 D CV MNTR SYS,,PC,4,,RBRVS,0.52 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93298,CPT,INTERROGATION EVALUATION REMOTE </30 D ILR SYS,,PC,4,,RBRVS,0.52 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93299,CPT,INTERROGATION EVAL REMOTE </30 D TECH REVIEW,,TC,4,,TotalUnits,,,,1.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93303,CPT,COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY,,,4,,RBRVS,1.30 ,5.33 ,5.33 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93303,CPT,COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY,26,,4,,RBRVS,1.30 ,0.46 ,0.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93303,CPT,COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY,TC,,4,,RBRVS,,4.87 ,4.87 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93304,CPT,F-UP/LIMITED TTHRC ECHO CONGENITAL CAR ANOMALY,,,4,,RBRVS,0.75 ,3.58 ,3.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93304,CPT,F-UP/LIMITED TTHRC ECHO CONGENITAL CAR ANOMALY,26,,4,,RBRVS,0.75 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93304,CPT,F-UP/LIMITED TTHRC ECHO CONGENITAL CAR ANOMALY,TC,,4,,RBRVS,,3.32 ,3.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93306,CPT,ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D,,,4,,RBRVS,1.30 ,5.04 ,5.04 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93306,CPT,ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D,26,,4,,RBRVS,1.30 ,0.45 ,0.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93306,CPT,ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D,TC,,4,,RBRVS,,4.59 ,4.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93307,CPT,ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP,,,4,,RBRVS,0.92 ,2.71 ,2.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93307,CPT,ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP,26,,4,,RBRVS,0.92 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93307,CPT,ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP,TC,,4,,RBRVS,,2.38 ,2.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93308,CPT,ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD,,,4,,RBRVS,0.53 ,2.95 ,2.95 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93308,CPT,ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD,26,,4,,RBRVS,0.53 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93308,CPT,ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD,TC,,4,,RBRVS,,2.77 ,2.77 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93312,CPT,ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R,,,4,,RBRVS,2.55 ,5.94 ,5.94 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93312,CPT,ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R,26,,4,,RBRVS,2.55 ,0.79 ,0.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93312,CPT,ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R,TC,,4,,RBRVS,,5.15 ,5.15 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93313,CPT,ECHO R-T 2D W/PROBE PLACEMENT ONLY,,,4,,RBRVS,0.51 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93314,CPT,ECHO TRANSESOPHAG R-T 2D IMG ACQUISJ I&R ONLY,,,4,,RBRVS,2.10 ,6.12 ,6.12 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93314,CPT,ECHO TRANSESOPHAG R-T 2D IMG ACQUISJ I&R ONLY,26,,4,,RBRVS,2.10 ,0.67 ,0.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93314,CPT,ECHO TRANSESOPHAG R-T 2D IMG ACQUISJ I&R ONLY,TC,,4,,RBRVS,,5.45 ,5.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93315,CPT,ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R,,,4,,TotalUnits,,,,6.74 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93315,CPT,ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R,26,,4,,TotalUnits,,,,3.90 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93315,CPT,ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R,TC,,4,,TotalUnits,,,,2.84 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93316,CPT,ECHO TRANSESOPHAG CONGEN PROBE PLCMT ONLY,,,4,,RBRVS,0.85 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93317,CPT,ECHO TRANSESOPHAG IMAGE ACQUISJ INTERP&REPORT,,,4,,TotalUnits,,,,4.96 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93317,CPT,ECHO TRANSESOPHAG IMAGE ACQUISJ INTERP&REPORT,26,,4,,TotalUnits,,,,2.83 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93317,CPT,ECHO TRANSESOPHAG IMAGE ACQUISJ INTERP&REPORT,TC,,4,,TotalUnits,,,,2.13 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93318,CPT,ECHO TRANSESOPHAG MONTR CARDIAC PUMP FUNCTJ,,,4,,TotalUnits,,,,5.46 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93318,CPT,ECHO TRANSESOPHAG MONTR CARDIAC PUMP FUNCTJ,26,,4,,TotalUnits,,,,3.15 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93318,CPT,ECHO TRANSESOPHAG MONTR CARDIAC PUMP FUNCTJ,TC,,4,,TotalUnits,,,,2.31 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93320,CPT,DOPPLER ECHOCARD PULSE WAVE W/SPECTRAL DISPLAY,,,4,,RBRVS,0.38 ,1.14 ,1.14 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93320,CPT,DOPPLER ECHOCARD PULSE WAVE W/SPECTRAL DISPLAY,26,,4,,RBRVS,0.38 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93320,CPT,DOPPLER ECHOCARD PULSE WAVE W/SPECTRAL DISPLAY,TC,,4,,RBRVS,,1.01 ,1.01 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93321,CPT,DOP ECHOCARD PULSE WAVE W/SPECTRAL F-UP/LMTD STD,,,4,,RBRVS,0.15 ,0.61 ,0.61 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93321,CPT,DOP ECHOCARD PULSE WAVE W/SPECTRAL F-UP/LMTD STD,26,,4,,RBRVS,0.15 ,0.05 ,0.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93321,CPT,DOP ECHOCARD PULSE WAVE W/SPECTRAL F-UP/LMTD STD,TC,,4,,RBRVS,,0.56 ,0.56 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93325,CPT,DOP ECHOCARD COLOR FLOW VELOCITY MAPPING,,,4,,RBRVS,0.07 ,0.65 ,0.65 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93325,CPT,DOP ECHOCARD COLOR FLOW VELOCITY MAPPING,26,,4,,RBRVS,0.07 ,0.02 ,0.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93325,CPT,DOP ECHOCARD COLOR FLOW VELOCITY MAPPING,TC,,4,,RBRVS,,0.63 ,0.63 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93350,CPT,ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,,,4,,RBRVS,1.46 ,5.25 ,5.25 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93350,CPT,ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,26,,4,,RBRVS,1.46 ,0.51 ,0.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93350,CPT,ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,TC,,4,,RBRVS,,4.74 ,4.74 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93351,CPT,ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG,,,4,,RBRVS,1.75 ,5.79 ,5.79 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93351,CPT,ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG,26,,4,,RBRVS,1.75 ,0.61 ,0.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93351,CPT,ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG,TC,,4,,RBRVS,,5.18 ,5.18 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93352,CPT,USE OF ECHO CONTRAST AGENT DURING STRESS ECHO,,,4,,RBRVS,0.19 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93355,CPT,ECHO TEE GUID TCAT ICAR/VESSEL STRUCTURAL INTVN,,,4,,RBRVS,4.66 ,1.45 ,1.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93451,CPT,RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT,,,21,,RBRVS,2.72 ,18.93 ,18.93 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93451,CPT,RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT,26,,21,,RBRVS,2.72 ,0.93 ,0.93 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93451,CPT,RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT,TC,,21,,RBRVS,,18.00 ,18.00 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93452,CPT,L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I,,,21,,RBRVS,4.75 ,19.38 ,19.38 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93452,CPT,L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I,26,,21,,RBRVS,4.75 ,1.66 ,1.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93452,CPT,L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I,TC,,21,,RBRVS,,17.72 ,17.72 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93453,CPT,R & L HRT CATH W/NJX L VENTRICULOG IMG S&I,,,21,,RBRVS,6.24 ,24.77 ,24.77 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93453,CPT,R & L HRT CATH W/NJX L VENTRICULOG IMG S&I,26,,21,,RBRVS,6.24 ,2.16 ,2.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93453,CPT,R & L HRT CATH W/NJX L VENTRICULOG IMG S&I,TC,,21,,RBRVS,,22.61 ,22.61 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93454,CPT,CATH PLACEMENT & NJX CORONARY ART ANGIO IMG S&I,,,21,,RBRVS,4.79 ,19.62 ,19.62 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93454,CPT,CATH PLACEMENT & NJX CORONARY ART ANGIO IMG S&I,26,,21,,RBRVS,4.79 ,1.65 ,1.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93454,CPT,CATH PLACEMENT & NJX CORONARY ART ANGIO IMG S&I,TC,,21,,RBRVS,,17.97 ,17.97 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93455,CPT,CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I,,,21,,RBRVS,5.54 ,22.88 ,22.88 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93455,CPT,CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I,26,,21,,RBRVS,5.54 ,1.90 ,1.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93455,CPT,CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I,TC,,21,,RBRVS,,20.98 ,20.98 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93456,CPT,CATH PLMT R HRT & ARTS W/NJX & ANGIO IMG S&I,,,21,,RBRVS,6.15 ,24.36 ,24.36 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93456,CPT,CATH PLMT R HRT & ARTS W/NJX & ANGIO IMG S&I,26,,21,,RBRVS,6.15 ,2.11 ,2.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93456,CPT,CATH PLMT R HRT & ARTS W/NJX & ANGIO IMG S&I,TC,,21,,RBRVS,,22.25 ,22.25 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93457,CPT,CATH PLMT R HRT/ARTS/GRFTS W/NJX& ANGIO IMG S&I,,,21,,RBRVS,6.89 ,27.58 ,27.58 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93457,CPT,CATH PLMT R HRT/ARTS/GRFTS W/NJX& ANGIO IMG S&I,26,,21,,RBRVS,6.89 ,2.36 ,2.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93457,CPT,CATH PLMT R HRT/ARTS/GRFTS W/NJX& ANGIO IMG S&I,TC,,21,,RBRVS,,25.22 ,25.22 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93458,CPT,CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I,,,21,,RBRVS,5.85 ,23.40 ,23.40 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93458,CPT,CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I,26,,21,,RBRVS,5.85 ,2.01 ,2.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93458,CPT,CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I,TC,,21,,RBRVS,,21.39 ,21.39 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93459,CPT,CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I,,,21,,RBRVS,6.60 ,25.69 ,25.69 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93459,CPT,CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I,26,,21,,RBRVS,6.60 ,2.26 ,2.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93459,CPT,CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I,TC,,21,,RBRVS,,23.43 ,23.43 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93460,CPT,R & L HRT CATH WINJX HRT ART& L VENTR IMG,,,21,,RBRVS,7.35 ,27.25 ,27.25 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93460,CPT,R & L HRT CATH WINJX HRT ART& L VENTR IMG,26,,21,,RBRVS,7.35 ,2.52 ,2.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93460,CPT,R & L HRT CATH WINJX HRT ART& L VENTR IMG,TC,,21,,RBRVS,,24.73 ,24.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93461,CPT,R& L HRT CATH W/INJEC HRT ART/GRFT& L VENT I,,,21,,RBRVS,8.10 ,31.50 ,31.50 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93461,CPT,R& L HRT CATH W/INJEC HRT ART/GRFT& L VENT I,26,,21,,RBRVS,8.10 ,2.78 ,2.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93461,CPT,R& L HRT CATH W/INJEC HRT ART/GRFT& L VENT I,TC,,21,,RBRVS,,28.72 ,28.72 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93462,CPT,LEFT HEART CATH BY TRANSEPTAL PUNCTURE,,,21,,RBRVS,3.73 ,1.47 ,1.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93463,CPT,MEDICATION ADMIN & HEMODYNAMIC MEASURMENT,,,21,,RBRVS,2.00 ,0.68 ,0.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93464,CPT,PHYSIOLOGIC EXERCISE STUDY & HEMODYNAMIC MEASU,,,21,,RBRVS,1.80 ,5.88 ,5.88 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93464,CPT,PHYSIOLOGIC EXERCISE STUDY & HEMODYNAMIC MEASU,26,,21,,RBRVS,1.80 ,0.62 ,0.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93464,CPT,PHYSIOLOGIC EXERCISE STUDY & HEMODYNAMIC MEASU,TC,,21,,RBRVS,,5.26 ,5.26 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93503,CPT,INSERTION FLOW DIRECTED CATHETER FOR MONITORING,,,21,,RBRVS,2.91 ,0.53 ,0.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93505,CPT,ENDOMYOCARDIAL BIOPSY,,,21,,RBRVS,4.37 ,16.41 ,16.41 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93505,CPT,ENDOMYOCARDIAL BIOPSY,26,,21,,RBRVS,4.37 ,1.50 ,1.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93505,CPT,ENDOMYOCARDIAL BIOPSY,TC,,21,,RBRVS,,14.91 ,14.91 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93530,CPT,R HRT CATHETERIZATION CONGENITAL CARDIAC ANOMALY,,,21,,TotalUnits,,,,34.17 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93530,CPT,R HRT CATHETERIZATION CONGENITAL CARDIAC ANOMALY,26,,21,,TotalUnits,,,,5.68 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93530,CPT,R HRT CATHETERIZATION CONGENITAL CARDIAC ANOMALY,TC,,21,,TotalUnits,,,,28.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93531,CPT,CMBN R HRT & RETROGRADE L HRT CATHJ CGEN ANOMA,,,21,,TotalUnits,,,,89.68 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93531,CPT,CMBN R HRT & RETROGRADE L HRT CATHJ CGEN ANOMA,26,,21,,TotalUnits,,,,11.18 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93531,CPT,CMBN R HRT & RETROGRADE L HRT CATHJ CGEN ANOMA,TC,,21,,TotalUnits,,,,78.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93532,CPT,CMBN R HRT T-SEPTAL L HRT CATHJ NTC SEPTUM CGEN,,,21,,TotalUnits,,,,96.16 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93532,CPT,CMBN R HRT T-SEPTAL L HRT CATHJ NTC SEPTUM CGEN,26,,21,,TotalUnits,,,,13.37 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93532,CPT,CMBN R HRT T-SEPTAL L HRT CATHJ NTC SEPTUM CGEN,TC,,21,,TotalUnits,,,,82.79 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93533,CPT,CMBN R HRT T-SEPTAL L HRT CATHJ SEPTAL OPNG CGEN,,,21,,TotalUnits,,,,90.74 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93533,CPT,CMBN R HRT T-SEPTAL L HRT CATHJ SEPTAL OPNG CGEN,26,,21,,TotalUnits,,,,8.97 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93533,CPT,CMBN R HRT T-SEPTAL L HRT CATHJ SEPTAL OPNG CGEN,TC,,21,,TotalUnits,,,,81.77 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93561,CPT,INDIC DIL STD ARTL&/OR VEN CATHJ W/OUTP MEAS,,,4,,TotalUnits,,,,2.24 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93561,CPT,INDIC DIL STD ARTL&/OR VEN CATHJ W/OUTP MEAS,26,,4,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93561,CPT,INDIC DIL STD ARTL&/OR VEN CATHJ W/OUTP MEAS,TC,,4,,TotalUnits,,,,1.59 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93562,CPT,INDIC DIL STD ARTL&/OR VEN CATHJ SBSQ OUTP MEA,,,4,,TotalUnits,,,,1.19 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93562,CPT,INDIC DIL STD ARTL&/OR VEN CATHJ SBSQ OUTP MEA,26,,4,,TotalUnits,,,,0.22 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93562,CPT,INDIC DIL STD ARTL&/OR VEN CATHJ SBSQ OUTP MEA,TC,,4,,TotalUnits,,,,0.97 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93563,CPT,NJX SEL HRT ART CONGENITAL HRT CATH W/S&I,,,4,,RBRVS,1.11 ,0.38 ,0.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93564,CPT,NJX SEL HRT ART/GRFT CONGENITAL HRT CATH W/S&I,,,4,,RBRVS,1.13 ,0.39 ,0.39 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93565,CPT,NJX SEL L VENT/ATRIAL ANGIO HRT CATH W/S&I,,,4,,RBRVS,0.86 ,0.31 ,0.31 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93566,CPT,NJX SEL R VENT/ATRIAL ANGIO HRT CATH W/S&I,,,4,,RBRVS,0.86 ,0.29 ,3.80 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93567,CPT,NJX SUPRAVALV AORTOG HRT CATH W/S&I,,,4,,RBRVS,0.97 ,0.33 ,2.83 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93568,CPT,NJX PULMONARY ANGIO HRT CATH W/S&I,,,4,,RBRVS,0.88 ,0.30 ,3.29 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93571,CPT,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS 1ST VSL,,,4,,TotalUnits,,,,8.26 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93571,CPT,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS 1ST VSL,26,,4,,TotalUnits,,,,2.42 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93571,CPT,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS 1ST VSL,TC,,4,,TotalUnits,,,,5.84 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93572,CPT,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS ADDL VSL,,,4,,TotalUnits,,,,5.10 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93572,CPT,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS ADDL VSL,26,,4,,TotalUnits,,,,1.93 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93572,CPT,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS ADDL VSL,TC,,4,,TotalUnits,,,,3.17 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93580,CPT,PRQ TCAT CLSR CGEN INTRATRL COMUNICAJ W/IMPLT,,,21,,RBRVS,17.97 ,6.47 ,6.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93581,CPT,PRQ TCAT CLSR CGEN VENTR SEPTAL DFCT W/IMPLT,,,21,,RBRVS,24.39 ,8.61 ,8.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93582,CPT,PERCUTAN TRANSCATH CLOSURE PAT DUCT ARTERIOSUS,,,21,,RBRVS,12.56 ,4.25 ,4.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93583,CPT,PERCUTANEOUS TRANSCATHETER SEPTAL REDUCTION THER,,,21,,RBRVS,14.00 ,4.74 ,4.74 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
93600,CPT,BUNDLE OF HIS RECORDING,,,4,,TotalUnits,,,,4.37 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93600,CPT,BUNDLE OF HIS RECORDING,26,,4,,TotalUnits,,,,2.99 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93600,CPT,BUNDLE OF HIS RECORDING,TC,,4,,TotalUnits,,,,1.38 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93602,CPT,INTRA-ATRIAL RECORDING,,,4,,TotalUnits,,,,4.07 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93602,CPT,INTRA-ATRIAL RECORDING,26,,4,,TotalUnits,,,,2.93 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93602,CPT,INTRA-ATRIAL RECORDING,TC,,4,,TotalUnits,,,,1.14 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93603,CPT,RIGHT VENTRICULAR RECORDING,,,4,,TotalUnits,,,,4.65 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93603,CPT,RIGHT VENTRICULAR RECORDING,26,,4,,TotalUnits,,,,2.93 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93603,CPT,RIGHT VENTRICULAR RECORDING,TC,,4,,TotalUnits,,,,1.72 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93609,CPT,INTRA-VENTRIC&/ATRIAL MAPG TACHYCARD W/CATH MA,,,4,,TotalUnits,,,,9.18 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93609,CPT,INTRA-VENTRIC&/ATRIAL MAPG TACHYCARD W/CATH MA,26,,4,,TotalUnits,,,,7.02 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93609,CPT,INTRA-VENTRIC&/ATRIAL MAPG TACHYCARD W/CATH MA,TC,,4,,TotalUnits,,,,2.16 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93610,CPT,INTRA-ATRIAL PACING,,,4,,TotalUnits,,,,4.20 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93610,CPT,INTRA-ATRIAL PACING,26,,4,,TotalUnits,,,,4.14 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93610,CPT,INTRA-ATRIAL PACING,TC,,4,,TotalUnits,,,,0.06 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93612,CPT,INTRAVENTRICULAR PACING,,,4,,TotalUnits,,,,5.73 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93612,CPT,INTRAVENTRICULAR PACING,26,,4,,TotalUnits,,,,4.12 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93612,CPT,INTRAVENTRICULAR PACING,TC,,4,,TotalUnits,,,,1.61 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93613,CPT,INTRACARDIAC ELECTROPHYSIOLOGIC 3D MAPPING,,,4,,RBRVS,6.99 ,2.90 ,2.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93615,CPT,ESOPHGL REC ATRIAL W/WO VENTRICULAR ELECTROGRAMS,,,4,,TotalUnits,,,,1.80 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93615,CPT,ESOPHGL REC ATRIAL W/WO VENTRICULAR ELECTROGRAMS,26,,4,,TotalUnits,,,,1.42 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93615,CPT,ESOPHGL REC ATRIAL W/WO VENTRICULAR ELECTROGRAMS,TC,,4,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93616,CPT,ESOPHGL REC ATRIAL W/WO VENTR ELECTRGRAMS W/PACG,,,4,,TotalUnits,,,,2.32 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93616,CPT,ESOPHGL REC ATRIAL W/WO VENTR ELECTRGRAMS W/PACG,26,,4,,TotalUnits,,,,1.74 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93616,CPT,ESOPHGL REC ATRIAL W/WO VENTR ELECTRGRAMS W/PACG,TC,,4,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93618,CPT,INDUCTION ARRHYTHMIA ELECTRICAL PACING,,,4,,TotalUnits,,,,10.10 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93618,CPT,INDUCTION ARRHYTHMIA ELECTRICAL PACING,26,,4,,TotalUnits,,,,5.95 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93618,CPT,INDUCTION ARRHYTHMIA ELECTRICAL PACING,TC,,4,,TotalUnits,,,,4.15 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93619,CPT,COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION,,,4,,TotalUnits,,,,16.38 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93619,CPT,COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION,26,,4,,TotalUnits,,,,10.22 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93619,CPT,COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION,TC,,4,,TotalUnits,,,,6.16 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93620,CPT,COMPRE ELECTROPHYSIOLOGIC ARRHYTHMIA INDUCTION,,,4,,TotalUnits,,,,19.45 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93620,CPT,COMPRE ELECTROPHYSIOLOGIC ARRHYTHMIA INDUCTION,26,,4,,TotalUnits,,,,16.23 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93620,CPT,COMPRE ELECTROPHYSIOLOGIC ARRHYTHMIA INDUCTION,TC,,4,,TotalUnits,,,,3.22 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93621,CPT,COMPRE ELECTROPHYSIOL XM W/LEFT ATRIAL PACNG/REC,,,4,,TotalUnits,,,,4.83 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93621,CPT,COMPRE ELECTROPHYSIOL XM W/LEFT ATRIAL PACNG/REC,26,,4,,TotalUnits,,,,2.96 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93621,CPT,COMPRE ELECTROPHYSIOL XM W/LEFT ATRIAL PACNG/REC,TC,,4,,TotalUnits,,,,1.87 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93622,CPT,COMPRE ELECTROPHYSIOL XM W/LEFT VENTR PACNG/REC,,,4,,TotalUnits,,,,5.75 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93622,CPT,COMPRE ELECTROPHYSIOL XM W/LEFT VENTR PACNG/REC,26,,4,,TotalUnits,,,,4.31 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93622,CPT,COMPRE ELECTROPHYSIOL XM W/LEFT VENTR PACNG/REC,TC,,4,,TotalUnits,,,,1.44 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93623,CPT,PROGRAMMED STIMJ & PACG AFTER IV DRUG NFS,,,4,,TotalUnits,,,,5.37 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93623,CPT,PROGRAMMED STIMJ & PACG AFTER IV DRUG NFS,26,,4,,TotalUnits,,,,4.03 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93623,CPT,PROGRAMMED STIMJ & PACG AFTER IV DRUG NFS,TC,,4,,TotalUnits,,,,1.34 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93624,CPT,ELECTROPHYSIOLOGIC FOLLOW-UP W/PAC/REC W/ARRHYT,,,4,,TotalUnits,,,,7.96 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93624,CPT,ELECTROPHYSIOLOGIC FOLLOW-UP W/PAC/REC W/ARRHYT,26,,4,,TotalUnits,,,,6.43 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93624,CPT,ELECTROPHYSIOLOGIC FOLLOW-UP W/PAC/REC W/ARRHYT,TC,,4,,TotalUnits,,,,1.53 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93631,CPT,INTRAOP EPICAR& ENDOCAR PACG& MAPG,,,4,,TotalUnits,,,,13.14 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93631,CPT,INTRAOP EPICAR& ENDOCAR PACG& MAPG,26,,4,,TotalUnits,,,,9.96 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93631,CPT,INTRAOP EPICAR& ENDOCAR PACG& MAPG,TC,,4,,TotalUnits,,,,3.18 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93640,CPT,EPHYS EVAL PACG CVDFB LDS INITIAL IMPLAN/REPLACE,,,4,,TotalUnits,,,,11.86 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93640,CPT,EPHYS EVAL PACG CVDFB LDS INITIAL IMPLAN/REPLACE,26,,4,,TotalUnits,,,,4.85 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93640,CPT,EPHYS EVAL PACG CVDFB LDS INITIAL IMPLAN/REPLACE,TC,,4,,TotalUnits,,,,7.01 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93641,CPT,EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN,,,4,,TotalUnits,,,,13.77 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93641,CPT,EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN,26,,4,,TotalUnits,,,,8.27 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93641,CPT,EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN,TC,,4,,TotalUnits,,,,5.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93642,CPT,EPHYS EVAL PACG CVDFB PRGRMG/REPRGRMG PARAMETERS,,,4,,RBRVS,4.88 ,6.23 ,6.23 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93642,CPT,EPHYS EVAL PACG CVDFB PRGRMG/REPRGRMG PARAMETERS,26,,4,,RBRVS,4.88 ,1.97 ,1.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93642,CPT,EPHYS EVAL PACG CVDFB PRGRMG/REPRGRMG PARAMETERS,TC,,4,,RBRVS,,4.26 ,4.26 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93644,CPT,EPHYS EVAL SUBQ IMPLANTABLE DEFIBRILLATOR,,,4,,RBRVS,3.29 ,4.49 ,4.49 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93644,CPT,EPHYS EVAL SUBQ IMPLANTABLE DEFIBRILLATOR,26,,4,,RBRVS,3.29 ,1.52 ,1.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93644,CPT,EPHYS EVAL SUBQ IMPLANTABLE DEFIBRILLATOR,TC,,4,,RBRVS,,2.97 ,2.97 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93650,CPT,ICAR CATHETER ABLATION ATRIOVENTR NODE FUNCTION,,,4,,RBRVS,10.49 ,4.59 ,4.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93653,CPT,EPHYS EVAL W/ABLATION SUPRAVENT ARRHYTHMIA,,,4,,RBRVS,15.00 ,6.14 ,6.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93654,CPT,EPHYS EVAL W/ABLATION VENTRICULAR TACHYCARDIA,,,4,,RBRVS,20.00 ,8.12 ,8.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93655,CPT,ICAR CATHETER ABLATION ARRHYTHMIA ADD ON,,,4,,RBRVS,7.50 ,3.06 ,3.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93656,CPT,EPHYS EVL TRNSPTL TX ATRIAL FIB ISOLAT PULM VEIN,,,4,,RBRVS,20.02 ,8.24 ,8.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93657,CPT,ABLATE L/R ATRIAL FIBRIL W/ISOLATED PULM VEIN,,,4,,RBRVS,7.50 ,3.05 ,3.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93660,CPT,CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR,,,4,,RBRVS,1.89 ,2.48 ,2.48 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93660,CPT,CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR,26,,4,,RBRVS,1.89 ,0.71 ,0.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93660,CPT,CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR,TC,,4,,RBRVS,,1.77 ,1.77 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93662,CPT,INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I,,,4,,TotalUnits,,,,5.37 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93662,CPT,INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I,26,,4,,TotalUnits,,,,3.95 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93662,CPT,INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I,TC,,4,,TotalUnits,,,,1.42 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93668,CPT,PERIPHERAL ARTERIAL DISEASE REHAB PER SESSION,,,4,,RBRVS,,0.53 ,0.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93701,CPT,BIOMPEDANCE-DERIVED PHYSIOLOGIC CV ANALYSIS,,TC,4,,RBRVS,,0.68 ,0.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93701,CPT,BIOMPEDANCE-DERIVED PHYSIOLOGIC CV ANALYSIS,26,,4,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93701,CPT,BIOMPEDANCE-DERIVED PHYSIOLOGIC CV ANALYSIS,TC,,4,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93702,CPT,BIS EXTRACELLULAR FLUID ALYS LYMPHEDEMA ASSMNT,,TC,20,,RBRVS,,3.19 ,3.19 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93724,CPT,ELECTRONIC ANALYSIS ANTITACHY PACEMAKER SYSTEM,,,4,,RBRVS,4.88 ,2.63 ,2.63 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93724,CPT,ELECTRONIC ANALYSIS ANTITACHY PACEMAKER SYSTEM,26,,4,,RBRVS,4.88 ,1.84 ,1.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93724,CPT,ELECTRONIC ANALYSIS ANTITACHY PACEMAKER SYSTEM,TC,,4,,RBRVS,,0.79 ,0.79 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93740,CPT,TEMPRATURE GRADIENT STUDY,,,4,,RBRVS,0.16 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93740,CPT,TEMPRATURE GRADIENT STUDY,26,,4,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93740,CPT,TEMPRATURE GRADIENT STUDY,TC,,4,,TotalUnits,,,,0.04 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93750,CPT,INTERROGATION VAD IN PRSON W/PHYS/QHP ANALYSIS,,,4,,RBRVS,0.92 ,0.30 ,0.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93770,CPT,DERMINATION OF VENOUS PRESSUE,,,4,,RBRVS,0.16 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93770,CPT,DERMINATION OF VENOUS PRESSUE,26,,4,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93770,CPT,DERMINATION OF VENOUS PRESSUE,TC,,4,,TotalUnits,,,,0.02 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93784,CPT,AMBL BLD PRESS W/TAPE&/DISK 24/> HR ALYS I&R,,,4,,RBRVS,0.38 ,1.11 ,1.11 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93786,CPT,BL BLD PRESS W/TAPE&/DISK 24/> HR REC ONL,,TC,4,,RBRVS,,0.83 ,0.83 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93788,CPT,AMBL BLD PRESS W/TAPE/DISK 24/>HR ALYS W/REPRT,,TC,4,,RBRVS,,0.14 ,0.14 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93790,CPT,AMBL BLD PRESS TAPE&/DISK 24/> HR REVIEW,,PC,4,,RBRVS,0.38 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93797,CPT,OUTPATIENT CARDIAC REHAB W/O CONT ECG MONITOR,,,4,,RBRVS,0.18 ,0.06 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93798,CPT,OUTPATIENT CARDIAC REHAB W/CONT ECG MONITORING,,,4,,RBRVS,0.28 ,0.10 ,0.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93799,CPT,UNLISTED CARDIOVASCULAR SERVICE/PROCEDURE,,,4,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93799,CPT,UNLISTED CARDIOVASCULAR SERVICE/PROCEDURE,,PC,4,,TotalUnits,,,,0.11 ,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
93799,CPT,UNLISTED CARDIOVASCULAR SERVICE/PROCEDURE,,TC,4,,TotalUnits,,,,0.35 ,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
93880,CPT,DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY,,,14,,RBRVS,0.80 ,4.84 ,4.84 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93880,CPT,DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY,26,,14,,RBRVS,0.80 ,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93880,CPT,DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY,TC,,14,,RBRVS,,4.57 ,4.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93882,CPT,DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY,,,14,,RBRVS,0.50 ,3.08 ,3.08 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93882,CPT,DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY,26,,14,,RBRVS,0.50 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93882,CPT,DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY,TC,,14,,RBRVS,,2.93 ,2.93 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93886,CPT,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL,,,14,,RBRVS,0.91 ,7.15 ,7.15 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93886,CPT,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL,26,,14,,RBRVS,0.91 ,0.37 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93886,CPT,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL,TC,,14,,RBRVS,,6.78 ,6.78 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93888,CPT,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD,,,14,,RBRVS,0.50 ,3.68 ,3.68 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93888,CPT,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD,26,,14,,RBRVS,0.50 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93888,CPT,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD,TC,,14,,RBRVS,,3.49 ,3.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93890,CPT,TRANSCRANIAL DOPPLER INTRACRAN ART VASOREAC STDY,,,14,,RBRVS,1.00 ,7.16 ,7.16 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93890,CPT,TRANSCRANIAL DOPPLER INTRACRAN ART VASOREAC STDY,26,,14,,RBRVS,1.00 ,0.40 ,0.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93890,CPT,TRANSCRANIAL DOPPLER INTRACRAN ART VASOREAC STDY,TC,,14,,RBRVS,,6.76 ,6.76 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93892,CPT,TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT,,,14,,RBRVS,1.15 ,8.31 ,8.31 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93892,CPT,TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT,26,,14,,RBRVS,1.15 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93892,CPT,TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT,TC,,14,,RBRVS,,7.84 ,7.84 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93893,CPT,TRANSCRAN DOPPLER INTRACRAN ART MICROBUBBLE INJ,,,14,,RBRVS,1.15 ,8.56 ,8.56 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93893,CPT,TRANSCRAN DOPPLER INTRACRAN ART MICROBUBBLE INJ,26,,14,,RBRVS,1.15 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93893,CPT,TRANSCRAN DOPPLER INTRACRAN ART MICROBUBBLE INJ,TC,,14,,RBRVS,,8.09 ,8.09 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93922,CPT,NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,,,14,,RBRVS,0.25 ,2.25 ,2.25 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93922,CPT,NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,26,,14,,RBRVS,0.25 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93922,CPT,NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,TC,,14,,RBRVS,,2.17 ,2.17 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93923,CPT,NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS,,,14,,RBRVS,0.45 ,3.42 ,3.42 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93923,CPT,NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS,26,,14,,RBRVS,0.45 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93923,CPT,NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS,TC,,14,,RBRVS,,3.28 ,3.28 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93924,CPT,N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI,,,14,,RBRVS,0.50 ,4.33 ,4.33 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93924,CPT,N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI,26,,14,,RBRVS,0.50 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93924,CPT,N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI,TC,,14,,RBRVS,,4.17 ,4.17 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93925,CPT,DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY,,,14,,RBRVS,0.80 ,6.49 ,6.49 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93925,CPT,DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY,26,,14,,RBRVS,0.80 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93925,CPT,DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY,TC,,14,,RBRVS,,6.23 ,6.23 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93926,CPT,DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY,,,14,,RBRVS,0.50 ,3.76 ,3.76 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93926,CPT,DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY,26,,14,,RBRVS,0.50 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93926,CPT,DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY,TC,,14,,RBRVS,,3.62 ,3.62 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93930,CPT,DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY,,,14,,RBRVS,0.80 ,5.04 ,5.04 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93930,CPT,DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY,26,,14,,RBRVS,0.80 ,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93930,CPT,DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY,TC,,14,,RBRVS,,4.78 ,4.78 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93931,CPT,DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY,,,14,,RBRVS,0.50 ,3.12 ,3.12 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93931,CPT,DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY,26,,14,,RBRVS,0.50 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93931,CPT,DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY,TC,,14,,RBRVS,,2.96 ,2.96 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93965,CPT,N-INVAS PHYSIOLOGIC STD XTR VEINS COMPL BI STD,,,14,,RBRVS,0.35 ,3.03 ,3.03 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93965,CPT,N-INVAS PHYSIOLOGIC STD XTR VEINS COMPL BI STD,26,,14,,RBRVS,0.35 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93965,CPT,N-INVAS PHYSIOLOGIC STD XTR VEINS COMPL BI STD,TC,,14,,RBRVS,,2.91 ,2.91 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93970,CPT,DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY,,,14,,RBRVS,0.70 ,4.80 ,4.80 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93970,CPT,DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY,26,,14,,RBRVS,0.70 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93970,CPT,DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY,TC,,14,,RBRVS,,4.57 ,4.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93971,CPT,DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY,,,14,,RBRVS,0.45 ,2.93 ,2.93 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93971,CPT,DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY,26,,14,,RBRVS,0.45 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93971,CPT,DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY,TC,,14,,RBRVS,,2.78 ,2.78 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93975,CPT,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM,,,14,,RBRVS,1.16 ,6.72 ,6.72 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93975,CPT,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM,26,,14,,RBRVS,1.16 ,0.39 ,0.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93975,CPT,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM,TC,,14,,RBRVS,,6.33 ,6.33 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93976,CPT,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT,,,14,,RBRVS,0.80 ,3.76 ,3.76 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93976,CPT,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT,26,,14,,RBRVS,0.80 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93976,CPT,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT,TC,,14,,RBRVS,,3.47 ,3.47 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93978,CPT,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE,,,14,,RBRVS,0.80 ,4.51 ,4.51 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93978,CPT,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE,26,,14,,RBRVS,0.80 ,0.24 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93978,CPT,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE,TC,,14,,RBRVS,,4.27 ,4.27 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93979,CPT,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD,,,14,,RBRVS,0.50 ,2.85 ,2.85 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93979,CPT,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD,26,,14,,RBRVS,0.50 ,0.15 ,0.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93979,CPT,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD,TC,,14,,RBRVS,,2.70 ,2.70 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93980,CPT,DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL,,,14,,RBRVS,1.25 ,2.09 ,2.09 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93980,CPT,DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL,26,,14,,RBRVS,1.25 ,0.44 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93980,CPT,DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL,TC,,14,,RBRVS,,1.65 ,1.65 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93981,CPT,DUP-SCAN ARTL INFL&VEN O/F PEN VSL F-UP/LMTD STD,,,14,,RBRVS,0.44 ,1.56 ,1.56 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93981,CPT,DUP-SCAN ARTL INFL&VEN O/F PEN VSL F-UP/LMTD STD,26,,14,,RBRVS,0.44 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93981,CPT,DUP-SCAN ARTL INFL&VEN O/F PEN VSL F-UP/LMTD STD,TC,,14,,RBRVS,,1.42 ,1.42 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93982,CPT,IMPLANT WIRELESS PRESS SENSOR STUDY ANEURYSM SAC,,,14,,RBRVS,0.30 ,0.89 ,0.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93990,CPT,DUPLEX SCAN HEMODIALYSIS ACCESS,,,14,,RBRVS,0.50 ,3.96 ,3.96 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
93990,CPT,DUPLEX SCAN HEMODIALYSIS ACCESS,26,,14,,RBRVS,0.50 ,0.13 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
93990,CPT,DUPLEX SCAN HEMODIALYSIS ACCESS,TC,,14,,RBRVS,,3.83 ,3.83 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
93998,CPT,UNLISTED NONINVASIVE VASCULAR DIAGNOSTIC STUDY,,,14,,TotalUnits,,,,5.31 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94002,CPT,VENTILATION ASSIST & MGMT INPATIENT 1ST DAY,,,14,,RBRVS,1.99 ,0.48 ,0.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94003,CPT,VENTILATION ASSIST & MGMT INPATIENT EA SBSQ DA,,,14,,RBRVS,1.37 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94004,CPT,VENTILATION ASSIST & MGMT NURSING FAC PR DAY,,,14,,RBRVS,1.00 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94005,CPT,HOME VENTILATOR MGMT CARE OVERSIGHT 30 MIN/>,,,14,,RBRVS,1.50 ,1.03 ,1.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94010,CPT,SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ,,,14,,RBRVS,0.17 ,0.83 ,0.83 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
94010,CPT,SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ,26,,14,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94010,CPT,SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ,TC,,14,,RBRVS,,0.77 ,0.77 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94011,CPT,MEAS SPIROMTRC FORCD EXPIRATORY FLO INFANT&/2 Y,,,14,,RBRVS,2.00 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94012,CPT,MEAS SPIRO FRCD EXP FLO PRE&POST BRONCH INF/2YRS,,,14,,RBRVS,3.10 ,1.35 ,1.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94013,CPT,MEASUREMENT LUNG VOLUMES INFANT/CHILD/2 YRS,,,14,,RBRVS,0.66 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94014,CPT,PT-INITIATE SPIROMETRIC RECORDING PHYS/QHP R&I,,,14,,RBRVS,0.52 ,1.03 ,1.03 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
94015,CPT,PATIENT-INITIATED SPIROMETRIC RECORDING,,TC,14,,RBRVS,,0.85 ,0.85 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94016,CPT,PATIENT-INITIATED SPIROMETRIC PHYS/QHP R&I ONLY,,PC,14,,RBRVS,0.52 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94060,CPT,BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN,,,14,,RBRVS,0.27 ,1.43 ,1.43 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
94060,CPT,BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN,26,,14,,RBRVS,0.27 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94060,CPT,BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN,TC,,14,,RBRVS,,1.34 ,1.34 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94070,CPT,BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT,,,14,,RBRVS,0.60 ,1.05 ,1.05 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
94070,CPT,BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT,26,,14,,RBRVS,0.60 ,0.19 ,0.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94070,CPT,BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT,TC,,14,,RBRVS,,0.86 ,0.86 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94150,CPT,VITAL CAPACITY TOTAL SEPARATE PROCEDURE,,,14,,RBRVS,0.07 ,0.63 ,0.63 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
94150,CPT,VITAL CAPACITY TOTAL SEPARATE PROCEDURE,26,,14,,RBRVS,0.07 ,0.03 ,0.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94150,CPT,VITAL CAPACITY TOTAL SEPARATE PROCEDURE,TC,,14,,RBRVS,,0.60 ,0.60 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94200,CPT,MAX BREATHING CAPACITY MAXIMAL VOLUNTARY VENTJ,,,14,,RBRVS,0.11 ,0.59 ,0.59 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
94200,CPT,MAX BREATHING CAPACITY MAXIMAL VOLUNTARY VENTJ,26,,14,,RBRVS,0.11 ,0.04 ,0.04 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94200,CPT,MAX BREATHING CAPACITY MAXIMAL VOLUNTARY VENTJ,TC,,14,,RBRVS,,0.55 ,0.55 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94250,CPT,EXPIRED GAS COLLECTION QUANT 1 PROCEDURE SPX,,,14,,RBRVS,0.11 ,0.61 ,0.61 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
94250,CPT,EXPIRED GAS COLLECTION QUANT 1 PROCEDURE SPX,26,,14,,RBRVS,0.11 ,0.03 ,0.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94250,CPT,EXPIRED GAS COLLECTION QUANT 1 PROCEDURE SPX,TC,,14,,RBRVS,,0.58 ,0.58 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94375,CPT,RESPIRATORY FLOW VOLUME LOOP,,,14,,RBRVS,0.31 ,0.78 ,0.78 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
94375,CPT,RESPIRATORY FLOW VOLUME LOOP,26,,14,,RBRVS,0.31 ,0.10 ,0.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94375,CPT,RESPIRATORY FLOW VOLUME LOOP,TC,,14,,RBRVS,,0.68 ,0.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94400,CPT,BREATHING RESPONSE TO CO2,,,14,,RBRVS,0.40 ,1.18 ,1.18 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
94400,CPT,BREATHING RESPONSE TO CO2,26,,14,,RBRVS,0.40 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94400,CPT,BREATHING RESPONSE TO CO2,TC,,14,,RBRVS,,1.04 ,1.04 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94450,CPT,BREATHING RESPONSE TO HYPOXIA,,,14,,RBRVS,0.40 ,1.46 ,1.46 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
94450,CPT,BREATHING RESPONSE TO HYPOXIA,26,,14,,RBRVS,0.40 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94450,CPT,BREATHING RESPONSE TO HYPOXIA,TC,,14,,RBRVS,,1.32 ,1.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94452,CPT,HIGH ALTITUDE SIMULATJ TEST W/PHYS INTERP&REPORT,,,14,,RBRVS,0.31 ,1.30 ,1.30 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
94452,CPT,HIGH ALTITUDE SIMULATJ TEST W/PHYS INTERP&REPORT,26,,14,,RBRVS,0.31 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94452,CPT,HIGH ALTITUDE SIMULATJ TEST W/PHYS INTERP&REPORT,TC,,14,,RBRVS,,1.21 ,1.21 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94453,CPT,HIGH ALTITUDE SIMULATJ W/PHYS I&R W/O2 TITRATION,,,14,,RBRVS,0.40 ,1.83 ,1.83 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
94453,CPT,HIGH ALTITUDE SIMULATJ W/PHYS I&R W/O2 TITRATION,26,,14,,RBRVS,0.40 ,0.12 ,0.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94453,CPT,HIGH ALTITUDE SIMULATJ W/PHYS I&R W/O2 TITRATION,TC,,14,,RBRVS,,1.71 ,1.71 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94610,CPT,INTRAPULMONARY SURFACTANT ADMINISTJ PHYS/QHP,,,14,,RBRVS,1.16 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94620,CPT,PULMONARY STRESS TESTING SIMPLE,,,14,,RBRVS,0.64 ,0.91 ,0.91 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
94620,CPT,PULMONARY STRESS TESTING SIMPLE,26,,14,,RBRVS,0.64 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94620,CPT,PULMONARY STRESS TESTING SIMPLE,TC,,14,,RBRVS,,0.71 ,0.71 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94621,CPT,PULMONARY STRESS TESTING COMPLEX,,,14,,RBRVS,1.42 ,3.14 ,3.14 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
94621,CPT,PULMONARY STRESS TESTING COMPLEX,26,,14,,RBRVS,1.42 ,0.48 ,0.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94621,CPT,PULMONARY STRESS TESTING COMPLEX,TC,,14,,RBRVS,,2.66 ,2.66 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94640,CPT,PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT,,,14,,RBRVS,,0.51 ,0.51 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
94642,CPT,PENTAMIDINE AERSL INHALATION PNEUMOCYSTIS/PROPH,,,14,,TotalUnits,,,,1.16 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
94644,CPT,CONTINUOUS INHALATION TREATMENT 1ST HR,,,14,,RBRVS,,1.22 ,1.22 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
94645,CPT,CONTINUOUS INHALATION TREATMENT EA ADDL HR,,,14,,RBRVS,,0.38 ,0.38 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
94660,CPT,CPAP VENTILATION CPAP INITIATION&MGMT,,,14,,RBRVS,0.76 ,0.26 ,0.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94662,CPT,CONTINUOUS NEGATIVE PRESSURE VENTJ INITIAT&MGM,,,14,,RBRVS,0.76 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94664,CPT,DEMO&/EVAL OF PT UTILIZ AERSL GEN/NEB/INHLR/IP,,,14,,RBRVS,,0.48 ,0.48 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
94667,CPT,MANJ CH WALL FACILITATE LNG FUNCJ 1 DEMO&/EVAL,,,14,,RBRVS,,0.72 ,0.72 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
94668,CPT,MANJ CHEST WALL FACILITATE LUNG FUNCTION SUBSQ,,,14,,RBRVS,,0.80 ,0.80 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
94669,CPT,MECHANICAL CHEST WALL OSCILLATION LUNG FUNCTION,,,14,,RBRVS,,0.98 ,0.98 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
94680,CPT,O2 UPTK EXP GAS ANALYSIS REST&XERS DIRECT SIMP,,,14,,RBRVS,0.26 ,1.34 ,1.34 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
94680,CPT,O2 UPTK EXP GAS ANALYSIS REST&XERS DIRECT SIMP,26,,14,,RBRVS,0.26 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94680,CPT,O2 UPTK EXP GAS ANALYSIS REST&XERS DIRECT SIMP,TC,,14,,RBRVS,,1.25 ,1.25 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94681,CPT,O2 UPTK EXP GAS ALYS W/CO2 OUTPUT % O2 XTRC,,,14,,RBRVS,0.20 ,1.29 ,1.29 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
94681,CPT,O2 UPTK EXP GAS ALYS W/CO2 OUTPUT % O2 XTRC,26,,14,,RBRVS,0.20 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94681,CPT,O2 UPTK EXP GAS ALYS W/CO2 OUTPUT % O2 XTRC,TC,,14,,RBRVS,,1.22 ,1.22 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94690,CPT,O2 UPTAKE EXP GAS ANALYSIS REST INDIRECT SPX,,,14,,RBRVS,0.07 ,1.31 ,1.31 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
94690,CPT,O2 UPTAKE EXP GAS ANALYSIS REST INDIRECT SPX,26,,14,,RBRVS,0.07 ,0.03 ,0.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94690,CPT,O2 UPTAKE EXP GAS ANALYSIS REST INDIRECT SPX,TC,,14,,RBRVS,,1.28 ,1.28 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94726,CPT,PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST,,,14,,RBRVS,0.26 ,1.21 ,1.21 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
94726,CPT,PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST,26,,14,,RBRVS,0.26 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94726,CPT,PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST,TC,,14,,RBRVS,,1.13 ,1.13 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94727,CPT,GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&V,,,14,,RBRVS,0.26 ,0.91 ,0.91 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
94727,CPT,GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&V,26,,14,,RBRVS,0.26 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94727,CPT,GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&V,TC,,14,,RBRVS,,0.83 ,0.83 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94728,CPT,AIRWAY RESISTANCE BY IMPULSE OSCILLOMETRY,,,14,,RBRVS,0.26 ,0.83 ,0.83 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
94728,CPT,AIRWAY RESISTANCE BY IMPULSE OSCILLOMETRY,26,,14,,RBRVS,0.26 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94728,CPT,AIRWAY RESISTANCE BY IMPULSE OSCILLOMETRY,TC,,14,,RBRVS,,0.75 ,0.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94729,CPT,CO DIFFUSING CAPACITY,,,14,,RBRVS,0.19 ,1.33 ,1.33 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
94729,CPT,CO DIFFUSING CAPACITY,26,,14,,RBRVS,0.19 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94729,CPT,CO DIFFUSING CAPACITY,TC,,14,,RBRVS,,1.27 ,1.27 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94750,CPT,PULMONARY COMPLIANCE STUDY,,,14,,RBRVS,0.23 ,2.04 ,2.04 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
94750,CPT,PULMONARY COMPLIANCE STUDY,26,,14,,RBRVS,0.23 ,0.08 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94750,CPT,PULMONARY COMPLIANCE STUDY,TC,,14,,RBRVS,,1.96 ,1.96 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94760,CPT,NONINVASIVE EAR/PULSE OXIMETRY SINGLE DETER,,TC,14,,RBRVS,,0.08 ,0.08 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94761,CPT,NONINVASIVE EAR/PULSE OXIMETRY MULTIPLE DETER,,TC,14,,RBRVS,,0.13 ,0.13 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94762,CPT,NONINVASIVE EAR/PULSE OXIMETRY OVERNIGHT MONITOR,,TC,14,,RBRVS,,0.68 ,0.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94770,CPT,CARBON DIOXIDE EXP GAS DETER INFRARED ANALYZER,,,14,,RBRVS,0.15 ,0.05 ,0.05 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
94770,CPT,CARBON DIOXIDE EXP GAS DETER INFRARED ANALYZER,26,,14,,TotalUnits,,,,0.04 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94770,CPT,CARBON DIOXIDE EXP GAS DETER INFRARED ANALYZER,TC,,14,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94772,CPT,CIRCADIAN RESPIRATRY PATTERN REC 12-24 HR INFANT,,,14,,TotalUnits,,,,3.43 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
94772,CPT,CIRCADIAN RESPIRATRY PATTERN REC 12-24 HR INFANT,26,,14,,TotalUnits,,,,1.37 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94772,CPT,CIRCADIAN RESPIRATRY PATTERN REC 12-24 HR INFANT,TC,,14,,TotalUnits,,,,2.06 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94774,CPT,PEDIATRIC APNEA MONITOR ATTACHMENT PHYS I&R,,,14,,TotalUnits,,,,2.71 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
94776,CPT,PEDIATRIC APNEA MONITOR ANALYSES COMPUTER,,TC,14,,TotalUnits,,,,1.72 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94777,CPT,PEDIATRIC APNEA MONITOR PHYS/QHP REVIEW,,PC,14,,TotalUnits,,,,1.50 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
94780,CPT,CAR SEAT/BED TESTING W/INTERP & REPORT 60 MIN,,,14,,RBRVS,0.48 ,0.20 ,1.26 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94781,CPT,CAR SEAT/BED TESTNG W/INTERP & REPORT ADDL 30MIN,,,14,,RBRVS,0.17 ,0.07 ,0.47 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
94799,CPT,UNLISTED PULMONARY SERVICE/PROCEDURE,,,14,,TotalUnits,,,,1.46 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
94799,CPT,UNLISTED PULMONARY SERVICE/PROCEDURE,,PC,14,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
94799,CPT,UNLISTED PULMONARY SERVICE/PROCEDURE,,TC,14,,TotalUnits,,,,1.07 ,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
95004,CPT,PERCUTANEOUS TESTS W/ALLERGENIC EXTRACTS,,,2,,RBRVS,0.01 ,0.16 ,0.16 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95012,CPT,NITRIC OXIDE EXPIRED GAS DETERMINATION,,,2,,RBRVS,,0.54 ,0.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95017,CPT,ALLG TSTG PERQ & IC VENOMS IMMED REACT W/I&R,,,2,,RBRVS,0.07 ,0.02 ,0.14 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95018,CPT,ALLG TEST PERQ & IC DRUG/BIOL IMMED REACT W/I&R,,,2,,RBRVS,0.14 ,0.05 ,0.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95024,CPT,INTRACUTANEOUS TESTS W/ALLERGENIC EXTRACTS,,,2,,RBRVS,0.01 ,0.01 ,0.20 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95027,CPT,INTRACUTANEOUS TESTS W/ALLERGENIC XTRCS AIRBORNE,,,2,,RBRVS,0.01 ,0.11 ,0.11 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95028,CPT,IC TSTS W/ALLGIC XTRCS DLYD TYP RXN W/READING,,TC,2,,RBRVS,,0.37 ,0.37 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95044,CPT,PATCH/APPLICATION TEST SPECIFY NUMBER TESTS,,,2,,RBRVS,,0.15 ,0.15 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95052,CPT,PHOTO PATCH TEST SPECIFY NUMBER TSTS,,,2,,RBRVS,,0.18 ,0.18 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95056,CPT,PHOTO TESTS,,,2,,RBRVS,,1.24 ,1.24 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95060,CPT,OPHTHALMIC MUCOUS MEMBRANE TESTS,,TC,2,,RBRVS,,0.98 ,0.98 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95065,CPT,DIRECT NASAL MUCOUS MEMBRANE TEST,,TC,2,,RBRVS,,0.70 ,0.70 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95070,CPT,INHLJ BRNCL CHALLENGE TSTG W/HISTAM/METHACHOL,,TC,2,,RBRVS,,0.84 ,0.84 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95071,CPT,INHLJ BRNCL CHALLENGE TSTG W/AGS/GASES,,TC,2,,RBRVS,,0.97 ,0.97 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95076,CPT,INGESTION CHALLENGE TEST INITIAL 120 MINUTES,,,2,,RBRVS,1.50 ,0.51 ,1.72 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95079,CPT,INGESTION CHALLENGE TEST EACH ADDL 60 MINUTES,,,2,,RBRVS,1.38 ,0.47 ,0.91 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95115,CPT,PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS 1 NJX,,,1,,RBRVS,,0.24 ,0.24 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95117,CPT,PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS NJXS,,,1,,RBRVS,,0.28 ,0.28 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95120,CPT,PROF SVCS ALLG IMMNTX W/PRV ALLGIC XTRC 1 NJX,,,1,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95125,CPT,PROF SVCS ALLG IMMNTX W/PRV ALLGIC XTRC 2/> NJX,,,1,,TotalUnits,,,,0.35 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95130,CPT,PROF SVCS ALLG IMMNTX W/PRV XTRC 1 STING INSECT,,,1,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95131,CPT,PROF SVCS ALLG IMMNTX W/PRV XTRC 2 STING INSECT,,,1,,TotalUnits,,,,0.62 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95132,CPT,PROF SVCS ALLG IMMNTX W/PRV XTRC 3 STING INSECT,,,1,,TotalUnits,,,,0.75 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95133,CPT,PROF SVCS ALLG IMMNTX W/PRV XTRC 4 STING INSECT,,,1,,TotalUnits,,,,0.91 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95134,CPT,PROF SVCS ALLG IMMNTX W/PRV XTRC 5 STING INSECT,,,1,,TotalUnits,,,,1.09 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95144,CPT,PREPJ& ANTIGEN PRV ALLERGEN IMMUNOTHERAPY 1 DO,,,1,,RBRVS,0.06 ,0.02 ,0.28 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95145,CPT,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 1 INSECT,,,1,,RBRVS,0.06 ,0.02 ,0.55 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95146,CPT,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 2 INSECT,,,1,,RBRVS,0.06 ,0.02 ,1.03 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95147,CPT,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 3 INSECT,,,1,,RBRVS,0.06 ,0.02 ,0.92 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95148,CPT,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 4 INSECT,,,1,,RBRVS,0.06 ,0.02 ,1.41 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95149,CPT,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 5 INSECT,,,1,,RBRVS,0.06 ,0.02 ,1.91 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95165,CPT,PREPJ& ALLERGEN IMMUNOTHERAPY 1/MLT ANTIGEN,,,1,,RBRVS,0.06 ,0.02 ,0.29 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95170,CPT,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY WHL INSE,,,1,,RBRVS,0.06 ,0.02 ,0.20 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95180,CPT,RAPID DESENSITIZATION PROCEDURE EACH HOUR,,,1,,RBRVS,2.01 ,0.78 ,1.69 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95199,CPT,UNLISTED ALLERGY/CLINICAL IMMUNOLOGIC SRVC/PX,,,1,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95250,CPT,GLUC MNTR CONT REC FROM INTERSTITIAL TISS FLUID,,TC,14,,RBRVS,,4.42 ,4.42 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95251,CPT,GLUC MNTR CONT REC FROM NTRSTL TISS FLU I&R,,PC,14,,RBRVS,0.85 ,0.33 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95782,CPT,POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND,,,14,,RBRVS,2.60 ,22.84 ,22.84 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95782,CPT,POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND,26,,14,,RBRVS,2.60 ,0.74 ,0.74 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95782,CPT,POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND,TC,,14,,RBRVS,,22.10 ,22.10 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95783,CPT,POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM,,,14,,RBRVS,2.83 ,31.95 ,31.95 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95783,CPT,POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM,26,,14,,RBRVS,2.83 ,1.22 ,1.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95783,CPT,POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM,TC,,14,,RBRVS,,30.73 ,30.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95800,CPT,SLP STDY UNATND W/HRT RATE/O2 SAT/RESP/SLP TIME,,,14,,RBRVS,1.05 ,3.97 ,3.97 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95800,CPT,SLP STDY UNATND W/HRT RATE/O2 SAT/RESP/SLP TIME,26,,14,,RBRVS,1.05 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95800,CPT,SLP STDY UNATND W/HRT RATE/O2 SAT/RESP/SLP TIME,TC,,14,,RBRVS,,3.59 ,3.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95801,CPT,SLP STDY UNATND W/MIN HRT RATE/O2 SAT/RESP ANAL,,,14,,RBRVS,1.00 ,1.54 ,1.54 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95801,CPT,SLP STDY UNATND W/MIN HRT RATE/O2 SAT/RESP ANAL,26,,14,,RBRVS,1.00 ,0.36 ,0.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95801,CPT,SLP STDY UNATND W/MIN HRT RATE/O2 SAT/RESP ANAL,TC,,14,,RBRVS,,1.18 ,1.18 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95803,CPT,ACTIGRAPHY TESTING RECORDING ANALYSIS I&R,,,14,,RBRVS,0.90 ,3.05 ,3.05 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95803,CPT,ACTIGRAPHY TESTING RECORDING ANALYSIS I&R,26,,14,,RBRVS,0.90 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95803,CPT,ACTIGRAPHY TESTING RECORDING ANALYSIS I&R,TC,,14,,RBRVS,,2.76 ,2.76 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95805,CPT,MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG,,,14,,RBRVS,1.20 ,10.52 ,10.52 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95805,CPT,MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG,26,,14,,RBRVS,1.20 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95805,CPT,MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG,TC,,14,,RBRVS,,10.09 ,10.09 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95806,CPT,SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT,,,14,,RBRVS,1.25 ,3.44 ,3.44 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95806,CPT,SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT,26,,14,,RBRVS,1.25 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95806,CPT,SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT,TC,,14,,RBRVS,,3.01 ,3.01 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95807,CPT,SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN,,,14,,RBRVS,1.28 ,11.82 ,11.82 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95807,CPT,SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN,26,,14,,RBRVS,1.28 ,0.43 ,0.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95807,CPT,SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN,TC,,14,,RBRVS,,11.39 ,11.39 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95808,CPT,POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND,,,14,,RBRVS,1.74 ,15.12 ,15.12 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95808,CPT,POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND,26,,14,,RBRVS,1.74 ,0.67 ,0.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95808,CPT,POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND,TC,,14,,RBRVS,,14.45 ,14.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95810,CPT,POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND,,,14,,RBRVS,2.50 ,14.82 ,14.82 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95810,CPT,POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND,26,,14,,RBRVS,2.50 ,0.85 ,0.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95810,CPT,POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND,TC,,14,,RBRVS,,13.97 ,13.97 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95811,CPT,POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND,,,14,,RBRVS,2.60 ,15.59 ,15.59 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95811,CPT,POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND,26,,14,,RBRVS,2.60 ,0.88 ,0.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95811,CPT,POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND,TC,,14,,RBRVS,,14.71 ,14.71 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95812,CPT,ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN,,,14,,RBRVS,1.08 ,10.63 ,10.63 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95812,CPT,ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN,26,,14,,RBRVS,1.08 ,0.50 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95812,CPT,ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN,TC,,14,,RBRVS,,10.13 ,10.13 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95813,CPT,ELECTROENCEPHALOGRAM EXTND MNTR >1 HR,,,14,,RBRVS,1.73 ,12.25 ,12.25 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95813,CPT,ELECTROENCEPHALOGRAM EXTND MNTR >1 HR,26,,14,,RBRVS,1.73 ,0.80 ,0.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95813,CPT,ELECTROENCEPHALOGRAM EXTND MNTR >1 HR,TC,,14,,RBRVS,,11.45 ,11.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95816,CPT,ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY,,,14,,RBRVS,1.08 ,8.96 ,8.96 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95816,CPT,ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY,26,,14,,RBRVS,1.08 ,0.50 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95816,CPT,ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY,TC,,14,,RBRVS,,8.46 ,8.46 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95819,CPT,ELECTROENCEPHALOGRAM W/REC AWAKE&ASLEEP,,,14,,RBRVS,1.08 ,10.37 ,10.37 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95819,CPT,ELECTROENCEPHALOGRAM W/REC AWAKE&ASLEEP,26,,14,,RBRVS,1.08 ,0.50 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95819,CPT,ELECTROENCEPHALOGRAM W/REC AWAKE&ASLEEP,TC,,14,,RBRVS,,9.87 ,9.87 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95822,CPT,ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY,,,14,,RBRVS,1.08 ,9.27 ,9.27 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95822,CPT,ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY,26,,14,,RBRVS,1.08 ,0.50 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95822,CPT,ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY,TC,,14,,RBRVS,,8.77 ,8.77 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95824,CPT,ELECTROENCEPHALOGRAM CERE DEATH EVAL ONLY,,,14,,TotalUnits,,,,2.76 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95824,CPT,ELECTROENCEPHALOGRAM CERE DEATH EVAL ONLY,26,,14,,TotalUnits,,,,1.08 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95824,CPT,ELECTROENCEPHALOGRAM CERE DEATH EVAL ONLY,TC,,14,,TotalUnits,,,,1.68 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95827,CPT,ELECTROENCEPHALOGRAM ALL NIGHT RECORDING,,,14,,RBRVS,1.08 ,20.87 ,20.87 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95827,CPT,ELECTROENCEPHALOGRAM ALL NIGHT RECORDING,26,,14,,RBRVS,1.08 ,0.49 ,0.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95827,CPT,ELECTROENCEPHALOGRAM ALL NIGHT RECORDING,TC,,14,,RBRVS,,20.38 ,20.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95829,CPT,ELECTROCORTICOGRAM SURGERY SPX,,,14,,RBRVS,6.20 ,46.52 ,46.52 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95829,CPT,ELECTROCORTICOGRAM SURGERY SPX,26,,14,,RBRVS,6.20 ,2.85 ,2.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95829,CPT,ELECTROCORTICOGRAM SURGERY SPX,TC,,14,,RBRVS,,43.67 ,43.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95830,CPT,INSERTION SPHENOIDAL ELECTRODES EEG PHYS/QHP,,,14,,RBRVS,1.70 ,0.75 ,5.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95831,CPT,MUSC TSTG MNL W/REPRT XTR EX HAND/TRNK,,,14,,RBRVS,0.28 ,0.12 ,0.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95832,CPT,MUSC TSTG MNL W/REPRT HAND W/WO CMPRSN NRML SIDE,,,14,,RBRVS,0.29 ,0.13 ,0.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95833,CPT,MUSC TSTG MNL W/REPRT TOTAL EVAL BODY EX HANDS,,,14,,RBRVS,0.47 ,0.12 ,0.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95834,CPT,MUSC TSTG MNL W/REPRT TOTAL EVAL BODY W/HANDS,,,14,,RBRVS,0.60 ,0.25 ,0.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95851,CPT,ROM MEAS&REPRT EA XTR EX HAND/EA TRNK SCTJ SPI,,,14,,RBRVS,0.16 ,0.05 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95852,CPT,ROM MEAS&REPRT HAND W/WO COMPARISON NORMAL SID,,,14,,RBRVS,0.11 ,0.05 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95857,CPT,CHOLINESTERASE INHIBITOR CHALLENGE TEST,,,14,,RBRVS,0.53 ,0.27 ,0.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95860,CPT,NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS,,,14,,RBRVS,0.96 ,2.46 ,2.46 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95860,CPT,NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS,26,,14,,RBRVS,0.96 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95860,CPT,NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS,TC,,14,,RBRVS,,1.99 ,1.99 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95861,CPT,NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS,,,14,,RBRVS,1.54 ,3.25 ,3.25 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95861,CPT,NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS,26,,14,,RBRVS,1.54 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95861,CPT,NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS,TC,,14,,RBRVS,,2.53 ,2.53 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95863,CPT,NDL EMG 3 XTR W/WO RELATED PARASPINAL AREAS,,,14,,RBRVS,1.87 ,4.04 ,4.04 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95863,CPT,NDL EMG 3 XTR W/WO RELATED PARASPINAL AREAS,26,,14,,RBRVS,1.87 ,0.89 ,0.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95863,CPT,NDL EMG 3 XTR W/WO RELATED PARASPINAL AREAS,TC,,14,,RBRVS,,3.15 ,3.15 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95864,CPT,NDL EMG 4 XTR W/WO RELATED PARASPINAL AREAS,,,14,,RBRVS,1.99 ,4.74 ,4.74 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95864,CPT,NDL EMG 4 XTR W/WO RELATED PARASPINAL AREAS,26,,14,,RBRVS,1.99 ,0.95 ,0.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95864,CPT,NDL EMG 4 XTR W/WO RELATED PARASPINAL AREAS,TC,,14,,RBRVS,,3.79 ,3.79 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95865,CPT,NEEDLE ELECTROMYOGRAPHY LARYNX,,,14,,RBRVS,1.57 ,2.40 ,2.40 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95865,CPT,NEEDLE ELECTROMYOGRAPHY LARYNX,26,,14,,RBRVS,1.57 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95865,CPT,NEEDLE ELECTROMYOGRAPHY LARYNX,TC,,14,,RBRVS,,1.68 ,1.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95866,CPT,NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM,,,14,,RBRVS,1.25 ,2.45 ,2.45 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95866,CPT,NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM,26,,14,,RBRVS,1.25 ,0.62 ,0.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95866,CPT,NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM,TC,,14,,RBRVS,,1.83 ,1.83 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95867,CPT,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI,,,14,,RBRVS,0.79 ,1.80 ,1.80 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95867,CPT,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI,26,,14,,RBRVS,0.79 ,0.36 ,0.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95867,CPT,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI,TC,,14,,RBRVS,,1.44 ,1.44 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95868,CPT,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI,,,14,,RBRVS,1.18 ,2.48 ,2.48 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95868,CPT,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI,26,,14,,RBRVS,1.18 ,0.55 ,0.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95868,CPT,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI,TC,,14,,RBRVS,,1.93 ,1.93 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95869,CPT,NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12,,,14,,RBRVS,0.37 ,1.90 ,1.90 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95869,CPT,NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12,26,,14,,RBRVS,0.37 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95869,CPT,NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12,TC,,14,,RBRVS,,1.73 ,1.73 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95870,CPT,NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI,,,14,,RBRVS,0.37 ,2.10 ,2.10 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95870,CPT,NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI,26,,14,,RBRVS,0.37 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95870,CPT,NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI,TC,,14,,RBRVS,,1.93 ,1.93 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95872,CPT,NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER,,,14,,RBRVS,2.88 ,2.56 ,2.56 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95872,CPT,NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER,26,,14,,RBRVS,2.88 ,1.35 ,1.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95872,CPT,NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER,TC,,14,,RBRVS,,1.21 ,1.21 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95873,CPT,ELECTRICAL STIMULATION GUID W/CHEMODENERVATION,,,14,,RBRVS,0.37 ,1.72 ,1.72 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95873,CPT,ELECTRICAL STIMULATION GUID W/CHEMODENERVATION,26,,14,,RBRVS,0.37 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95873,CPT,ELECTRICAL STIMULATION GUID W/CHEMODENERVATION,TC,,14,,RBRVS,,1.52 ,1.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95874,CPT,NEEDLE EMG GUID W/CHEMODENERVATION,,,14,,RBRVS,0.37 ,1.64 ,1.64 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95874,CPT,NEEDLE EMG GUID W/CHEMODENERVATION,26,,14,,RBRVS,0.37 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95874,CPT,NEEDLE EMG GUID W/CHEMODENERVATION,TC,,14,,RBRVS,,1.46 ,1.46 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95875,CPT,ISCHEMIC LIMB XERS TST SPEC ACQUISJ METAB,,,14,,RBRVS,1.10 ,2.25 ,2.25 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95875,CPT,ISCHEMIC LIMB XERS TST SPEC ACQUISJ METAB,26,,14,,RBRVS,1.10 ,0.50 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95875,CPT,ISCHEMIC LIMB XERS TST SPEC ACQUISJ METAB,TC,,14,,RBRVS,,1.75 ,1.75 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95885,CPT,NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED,,,14,,RBRVS,0.35 ,1.28 ,1.28 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95885,CPT,NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED,26,,14,,RBRVS,0.35 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95885,CPT,NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED,TC,,14,,RBRVS,,1.11 ,1.11 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95886,CPT,NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE,,,14,,RBRVS,0.86 ,1.67 ,1.67 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95886,CPT,NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE,26,,14,,RBRVS,0.86 ,0.41 ,0.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95886,CPT,NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE,TC,,14,,RBRVS,,1.26 ,1.26 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95887,CPT,NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION,,,14,,RBRVS,0.71 ,1.55 ,1.55 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95887,CPT,NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION,26,,14,,RBRVS,0.71 ,0.34 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95887,CPT,NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION,TC,,14,,RBRVS,,1.21 ,1.21 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95905,CPT,MOTOR &/SENS NRV CNDJ PRECONF ELTRD ARRAY LIMB,,,14,,RBRVS,0.05 ,1.95 ,1.95 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95905,CPT,MOTOR &/SENS NRV CNDJ PRECONF ELTRD ARRAY LIMB,26,,14,,RBRVS,0.05 ,0.02 ,0.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95905,CPT,MOTOR &/SENS NRV CNDJ PRECONF ELTRD ARRAY LIMB,TC,,14,,RBRVS,,1.93 ,1.93 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95907,CPT,NERVE CONDUCTION STUDIES 1-2 STUDIES,,,14,,RBRVS,1.00 ,1.69 ,1.69 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95907,CPT,NERVE CONDUCTION STUDIES 1-2 STUDIES,26,,14,,RBRVS,1.00 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95907,CPT,NERVE CONDUCTION STUDIES 1-2 STUDIES,TC,,14,,RBRVS,,1.22 ,1.22 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95908,CPT,NERVE CONDUCTION STUDIES 3-4 STUDIES,,,14,,RBRVS,1.25 ,2.21 ,2.21 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95908,CPT,NERVE CONDUCTION STUDIES 3-4 STUDIES,26,,14,,RBRVS,1.25 ,0.61 ,0.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95908,CPT,NERVE CONDUCTION STUDIES 3-4 STUDIES,TC,,14,,RBRVS,,1.60 ,1.60 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95909,CPT,NERVE CONDUCTION STUDIES 5-6 STUDIES,,,14,,RBRVS,1.50 ,2.60 ,2.60 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95909,CPT,NERVE CONDUCTION STUDIES 5-6 STUDIES,26,,14,,RBRVS,1.50 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95909,CPT,NERVE CONDUCTION STUDIES 5-6 STUDIES,TC,,14,,RBRVS,,1.88 ,1.88 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95910,CPT,NERVE CONDUCTION STUDIES 7-8 STUDIES,,,14,,RBRVS,2.00 ,3.44 ,3.44 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95910,CPT,NERVE CONDUCTION STUDIES 7-8 STUDIES,26,,14,,RBRVS,2.00 ,0.96 ,0.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95910,CPT,NERVE CONDUCTION STUDIES 7-8 STUDIES,TC,,14,,RBRVS,,2.48 ,2.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95911,CPT,NERVE CONDUCTION STUDIES 9-10 STUDIES,,,14,,RBRVS,2.50 ,3.97 ,3.97 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95911,CPT,NERVE CONDUCTION STUDIES 9-10 STUDIES,26,,14,,RBRVS,2.50 ,1.19 ,1.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95911,CPT,NERVE CONDUCTION STUDIES 9-10 STUDIES,TC,,14,,RBRVS,,2.78 ,2.78 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95912,CPT,NERVE CONDUCTION STUDIES 11-12 STUDIES,,,14,,RBRVS,3.00 ,4.20 ,4.20 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95912,CPT,NERVE CONDUCTION STUDIES 11-12 STUDIES,26,,14,,RBRVS,3.00 ,1.37 ,1.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95912,CPT,NERVE CONDUCTION STUDIES 11-12 STUDIES,TC,,14,,RBRVS,,2.83 ,2.83 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95913,CPT,NERVE CONDUCTION STUDIES 13/> STUDIES,,,14,,RBRVS,3.56 ,4.60 ,4.60 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95913,CPT,NERVE CONDUCTION STUDIES 13/> STUDIES,26,,14,,RBRVS,3.56 ,1.60 ,1.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95913,CPT,NERVE CONDUCTION STUDIES 13/> STUDIES,TC,,14,,RBRVS,,3.00 ,3.00 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95921,CPT,TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP,,,14,,RBRVS,0.90 ,1.53 ,1.53 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95921,CPT,TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP,26,,14,,RBRVS,0.90 ,0.36 ,0.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95921,CPT,TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP,TC,,14,,RBRVS,,1.17 ,1.17 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95922,CPT,TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ,,,14,,RBRVS,0.96 ,1.83 ,1.83 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95922,CPT,TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ,26,,14,,RBRVS,0.96 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95922,CPT,TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ,TC,,14,,RBRVS,,1.45 ,1.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95923,CPT,TESTING AUTONOMIC NERVOUS SYSTEM FUNCTION,,,14,,RBRVS,0.90 ,4.46 ,4.46 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95923,CPT,TESTING AUTONOMIC NERVOUS SYSTEM FUNCTION,26,,14,,RBRVS,0.90 ,0.37 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95923,CPT,TESTING AUTONOMIC NERVOUS SYSTEM FUNCTION,TC,,14,,RBRVS,,4.09 ,4.09 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95924,CPT,TSTG ANS FUNCJ PARASYMP&SYMP W/5 MIN PASIVE TILT,,,14,,RBRVS,1.73 ,2.52 ,2.52 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95924,CPT,TSTG ANS FUNCJ PARASYMP&SYMP W/5 MIN PASIVE TILT,26,,14,,RBRVS,1.73 ,0.72 ,0.72 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95924,CPT,TSTG ANS FUNCJ PARASYMP&SYMP W/5 MIN PASIVE TILT,TC,,14,,RBRVS,,1.80 ,1.80 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95925,CPT,SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS,,,14,,RBRVS,0.54 ,3.84 ,3.84 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95925,CPT,SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS,26,,14,,RBRVS,0.54 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95925,CPT,SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS,TC,,14,,RBRVS,,3.61 ,3.61 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95926,CPT,SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS,,,14,,RBRVS,0.54 ,3.48 ,3.48 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95926,CPT,SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS,26,,14,,RBRVS,0.54 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95926,CPT,SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS,TC,,14,,RBRVS,,3.27 ,3.27 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95927,CPT,SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD,,,14,,RBRVS,0.54 ,3.72 ,3.72 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95927,CPT,SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD,26,,14,,RBRVS,0.54 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95927,CPT,SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD,TC,,14,,RBRVS,,3.50 ,3.50 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95928,CPT,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ UPR LIMBS,,,14,,RBRVS,1.50 ,5.71 ,5.71 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95928,CPT,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ UPR LIMBS,26,,14,,RBRVS,1.50 ,0.70 ,0.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95928,CPT,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ UPR LIMBS,TC,,14,,RBRVS,,5.01 ,5.01 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95929,CPT,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS,,,14,,RBRVS,1.50 ,5.75 ,5.75 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95929,CPT,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS,26,,14,,RBRVS,1.50 ,0.70 ,0.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95929,CPT,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS,TC,,14,,RBRVS,,5.05 ,5.05 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95930,CPT,VISUAL EP TSTG CNS CHECKERBOARD/FLASH,,,14,,RBRVS,0.35 ,3.24 ,3.24 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95930,CPT,VISUAL EP TSTG CNS CHECKERBOARD/FLASH,26,,14,,RBRVS,0.35 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95930,CPT,VISUAL EP TSTG CNS CHECKERBOARD/FLASH,TC,,14,,RBRVS,,3.08 ,3.08 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95933,CPT,ORBICULARIS OCULI REFLX ELECTRODIAGNOSTIC TEST,,,14,,RBRVS,0.59 ,1.74 ,1.74 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95933,CPT,ORBICULARIS OCULI REFLX ELECTRODIAGNOSTIC TEST,26,,14,,RBRVS,0.59 ,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95933,CPT,ORBICULARIS OCULI REFLX ELECTRODIAGNOSTIC TEST,TC,,14,,RBRVS,,1.47 ,1.47 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95937,CPT,NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH,,,14,,RBRVS,0.65 ,1.65 ,1.65 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95937,CPT,NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH,26,,14,,RBRVS,0.65 ,0.30 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95937,CPT,NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH,TC,,14,,RBRVS,,1.35 ,1.35 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95938,CPT,SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMB,,,14,,RBRVS,0.86 ,8.70 ,8.70 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95938,CPT,SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMB,26,,14,,RBRVS,0.86 ,0.40 ,0.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95938,CPT,SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMB,TC,,14,,RBRVS,,8.30 ,8.30 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95939,CPT,CTR MOTR EP STD TRANSCRNL MOTR STIM UPR&LOW LI,,,14,,RBRVS,2.25 ,11.73 ,11.73 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95939,CPT,CTR MOTR EP STD TRANSCRNL MOTR STIM UPR&LOW LI,26,,14,,RBRVS,2.25 ,1.03 ,1.03 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95939,CPT,CTR MOTR EP STD TRANSCRNL MOTR STIM UPR&LOW LI,TC,,14,,RBRVS,,10.70 ,10.70 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95940,CPT,IONM 1 ON 1 IN OR W/ATTENDANCE EACH 15 MINUTES,,,14,,RBRVS,0.60 ,0.28 ,0.28 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95941,CPT,IONM REMOTE/NEARBY/>1 PATIENT IN OR PER HOUR,,,14,,TotalUnits,,,,1.65 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95943,CPT,PARASYMP & SYMP NRV FUNCJ HRT RATE VARIABILITY,,,14,,TotalUnits,,,,4.17 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95950,CPT,MONITOR ID& LATERALIZATION SEIZURE FOCUS EEG,,,14,,RBRVS,1.51 ,7.66 ,7.66 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95950,CPT,MONITOR ID& LATERALIZATION SEIZURE FOCUS EEG,26,,14,,RBRVS,1.51 ,0.68 ,0.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95950,CPT,MONITOR ID& LATERALIZATION SEIZURE FOCUS EEG,TC,,14,,RBRVS,,6.98 ,6.98 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95951,CPT,LOCALIZE CEREBRAL SEIZURE CABLE/RADIO EEG/VIDEO,,,14,,TotalUnits,,,,15.63 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95951,CPT,LOCALIZE CEREBRAL SEIZURE CABLE/RADIO EEG/VIDEO,26,,14,,TotalUnits,,,,8.76 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95951,CPT,LOCALIZE CEREBRAL SEIZURE CABLE/RADIO EEG/VIDEO,TC,,14,,TotalUnits,,,,6.87 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95953,CPT,LOCALIZE CEREBRAL SEIZURE CPTR PORTABLE EEG,,,14,,RBRVS,3.08 ,8.53 ,8.53 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95953,CPT,LOCALIZE CEREBRAL SEIZURE CPTR PORTABLE EEG,26,,14,,RBRVS,3.08 ,1.40 ,1.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95953,CPT,LOCALIZE CEREBRAL SEIZURE CPTR PORTABLE EEG,TC,,14,,RBRVS,,7.13 ,7.13 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95954,CPT,RX/PHYSICAL EEG ACTIVAJ PHYS/QHP ATTENDANCE,,,14,,RBRVS,2.45 ,10.33 ,10.33 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95954,CPT,RX/PHYSICAL EEG ACTIVAJ PHYS/QHP ATTENDANCE,26,,14,,RBRVS,2.45 ,0.97 ,0.97 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95954,CPT,RX/PHYSICAL EEG ACTIVAJ PHYS/QHP ATTENDANCE,TC,,14,,RBRVS,,9.36 ,9.36 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95955,CPT,EEG NONINTRACRANIAL SURGERY,,,14,,RBRVS,1.01 ,4.95 ,4.95 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95955,CPT,EEG NONINTRACRANIAL SURGERY,26,,14,,RBRVS,1.01 ,0.46 ,0.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95955,CPT,EEG NONINTRACRANIAL SURGERY,TC,,14,,RBRVS,,4.49 ,4.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95956,CPT,MNTR SEIZURE CMPTR 16CHAN EEG ATND EA 24 HR,,,14,,RBRVS,3.61 ,43.04 ,43.04 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95956,CPT,MNTR SEIZURE CMPTR 16CHAN EEG ATND EA 24 HR,26,,14,,RBRVS,3.61 ,1.64 ,1.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95956,CPT,MNTR SEIZURE CMPTR 16CHAN EEG ATND EA 24 HR,TC,,14,,RBRVS,,41.40 ,41.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95957,CPT,DIGITAL ANALYSIS ELECTROENCEPHALOGRAM,,,14,,RBRVS,1.98 ,6.81 ,6.81 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95957,CPT,DIGITAL ANALYSIS ELECTROENCEPHALOGRAM,26,,14,,RBRVS,1.98 ,0.90 ,0.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95957,CPT,DIGITAL ANALYSIS ELECTROENCEPHALOGRAM,TC,,14,,RBRVS,,5.91 ,5.91 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95958,CPT,WADA ACTIVATION TEST HEMISPHERIC FUNCTION W/EEG,,,14,,RBRVS,4.24 ,11.87 ,11.87 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95958,CPT,WADA ACTIVATION TEST HEMISPHERIC FUNCTION W/EEG,26,,14,,RBRVS,4.24 ,1.89 ,1.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95958,CPT,WADA ACTIVATION TEST HEMISPHERIC FUNCTION W/EEG,TC,,14,,RBRVS,,9.98 ,9.98 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95961,CPT,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND INIT HR,,,14,,RBRVS,2.97 ,5.04 ,5.04 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95961,CPT,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND INIT HR,26,,14,,RBRVS,2.97 ,1.34 ,1.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95961,CPT,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND INIT HR,TC,,14,,RBRVS,,3.70 ,3.70 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95962,CPT,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND ADDL HR,,,14,,RBRVS,3.21 ,3.92 ,3.92 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95962,CPT,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND ADDL HR,26,,14,,RBRVS,3.21 ,1.47 ,1.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95962,CPT,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND ADDL HR,TC,,14,,RBRVS,,2.45 ,2.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95965,CPT,MAGNETOENCEPHALOGRAPHY SPON BRAIN ACTIVITY,,,14,,RBRVS,7.99 ,50.19 ,50.20 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95965,CPT,MAGNETOENCEPHALOGRAPHY SPON BRAIN ACTIVITY,26,,14,,RBRVS,7.99 ,3.56 ,3.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95965,CPT,MAGNETOENCEPHALOGRAPHY SPON BRAIN ACTIVITY,TC,,14,,RBRVS,,46.63 ,46.63 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95966,CPT,MAGNETOENCEPHALOGRAPY EVOKED FIELDS 1 MODALITY,,,14,,RBRVS,3.99 ,25.33 ,25.33 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95966,CPT,MAGNETOENCEPHALOGRAPY EVOKED FIELDS 1 MODALITY,26,,14,,RBRVS,3.99 ,1.85 ,1.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95966,CPT,MAGNETOENCEPHALOGRAPY EVOKED FIELDS 1 MODALITY,TC,,14,,RBRVS,,23.48 ,23.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95967,CPT,MAGNETOENCEPHALOGRAPY EVOKED FIELDS EACH ADDL,,,14,,RBRVS,3.49 ,22.18 ,22.18 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
95967,CPT,MAGNETOENCEPHALOGRAPY EVOKED FIELDS EACH ADDL,26,,14,,RBRVS,3.49 ,1.62 ,1.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95967,CPT,MAGNETOENCEPHALOGRAPY EVOKED FIELDS EACH ADDL,TC,,14,,RBRVS,,20.56 ,20.56 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
95970,CPT,ELEC ALYS NSTIM PLS GEN BRN/SC/PERPH W/O REPRGRM,,,14,,RBRVS,0.45 ,0.19 ,1.40 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95971,CPT,ELEC ALYS NSTIM PLS GEN SMPL SC/PERPH W/PRGRMG,,,14,,RBRVS,0.78 ,0.31 ,0.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95972,CPT,ELEC ALYS NSTIM PLS GEN CPLX SC/PERPH W/PRGRMG,,,14,,RBRVS,0.80 ,0.31 ,0.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95974,CPT,ELEC ALYS NSTIM PLS GEN CPLX CRNL NRV 1ST HR,,,14,,RBRVS,3.00 ,1.37 ,2.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95975,CPT,ELEC ALYS NSTIM PLS GEN CPLX CRNL NRV EA 30 MIN,,,14,,RBRVS,1.70 ,0.79 ,1.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95978,CPT,ELEC ALYS NSTIM PLS GEN CPLX DP BRN 1ST HR,,,14,,RBRVS,3.50 ,1.62 ,3.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95979,CPT,ELEC ALYS NSTIM PLS GEN CPLX DP BRN EA 30 MIN,,,14,,RBRVS,1.64 ,0.76 ,1.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95980,CPT,ELEC ALYS NSTIM PLS GEN GASTRIC INTRAOP W/PRGRMG,,,14,,RBRVS,0.80 ,0.35 ,0.35 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95981,CPT,ELEC ALYS NSTIM GEN GASTRIC SBSQ W/O REPRGRMG,,,14,,RBRVS,0.30 ,0.17 ,0.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95982,CPT,ELEC ALYS NSTIM PLS GEN GASTRIC SBSQ W/REPRGRMG,,,14,,RBRVS,0.65 ,0.31 ,0.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95990,CPT,REFILL&MAINTENANCE PUMP DRUG DLVR SPINAL/BRAIN,,,14,,RBRVS,,2.51 ,2.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95991,CPT,RFL&MAIN IMPLT PMP/RSVR DLVR SPI/BRN PHY/QHP,,,14,,RBRVS,0.77 ,0.30 ,2.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95992,CPT,CANALITH REPOSITIONING PROCEDURE,,,14,,RBRVS,0.75 ,0.27 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
95999,CPT,UNLIS NEUROLOGICAL/NEUROMUSCULAR DX PX,,,14,,TotalUnits,,,,1.06 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
96000,CPT,COMPRE CPTR MTN ALYS VIDEO TAPING 3D KINEMATICS,,,14,,RBRVS,1.80 ,0.78 ,0.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
96001,CPT,COMPRE CPTR MTN ALYS W/DYN PLNTR PRES MEAS WALKG,,,14,,RBRVS,2.15 ,0.56 ,0.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
96002,CPT,DYN SURF EMG WALKG/FUNCJAL ACTV 1-12 MUSC,,,14,,RBRVS,0.41 ,0.18 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
96003,CPT,DYN FINE WIRE EMG WALKG/FUNCJAL ACTV 1 MUSC,,,14,,RBRVS,0.37 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
96004,CPT,PHYS/QHP R&I CPTR MTN ALYS WALK/FUNCJL ACTV REPR,,PC,14,,RBRVS,2.14 ,1.02 ,1.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
96020,CPT,TEST SELECT & ADMN FUNCTL BRAIN MAP PHYS/QHP,26,,14,,RBRVS,3.43 ,1.07 ,1.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
96040,CPT,MEDICAL GENETICS COUNSELING EACH 30 MINUTES,,,14,,RBRVS,,1.30 ,1.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
96101,CPT,PSYCHOLOGICAL TESTING PR HR WITH PATIENT,,,16,,RBRVS,1.86 ,0.30 ,0.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96102,CPT,PSYCHOLOGICAL TESTING ADMN BY TECH PR HR,,,16,,RBRVS,0.50 ,0.12 ,1.26 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96103,CPT,PSYCHOLOGICAL TESTING COMPUTER W/PROF I&R,,,16,,RBRVS,0.51 ,0.21 ,0.23 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96105,CPT,ASSESSMENT APHASIA W/INTERP & REPORT PER HOUR,,,16,,RBRVS,1.75 ,1.11 ,1.11 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96110,CPT,DEVELOPMENTAL SCREEN W/SCORING & DOC STD INSTRM,,,16,,RBRVS,,0.26 ,0.26 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96111,CPT,DEVELOPMENTAL TESTING W/INTERP & REPORT,,,16,,RBRVS,2.60 ,0.70 ,0.89 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96116,CPT,NUBHVL STATUS XM PR HR W/PT INTERPJ&PREPJ,,,16,,RBRVS,1.86 ,0.49 ,0.66 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96118,CPT,NUROPSYC TESTING PR HR W/PT & INTERPJ TIME,,,16,,RBRVS,1.86 ,0.29 ,0.82 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96119,CPT,NEUROPSYC TSTG W/PROF I&R ADMN BY TECH PR HR,,,16,,RBRVS,0.55 ,0.10 ,1.71 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96120,CPT,NEUROPSYCHOLOG TESTING COMPUTER W/PROF I&R,,,16,,RBRVS,0.51 ,0.19 ,0.81 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96125,CPT,STANDARDIZED COGNITIVE PERFORMANCE TESTING,,,16,,RBRVS,1.70 ,1.51 ,1.51 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96127,CPT,BEHAV ASSMT W/SCORE & DOCD/STAND INSTRUMENT,,TC,16,,RBRVS,,0.14 ,0.14 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96150,CPT,HLTH&BEHAVIOR ASSMT EA 15 MIN W/PT 1ST ASSMT,,,16,,RBRVS,0.50 ,0.08 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
96151,CPT,HLTH&BEHAVIOR ASSMT EA 15 MIN W/PT RE-ASSMT,,,16,,RBRVS,0.48 ,0.07 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
96152,CPT,HLTH&BEHAVIOR IVNTJ EA 15 MIN INDIV,,,16,,RBRVS,0.46 ,0.07 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
96153,CPT,HLTH&BEHAVIOR IVNTJ EA 15 MIN GRP 2/>PTS,,,16,,RBRVS,0.10 ,0.01 ,0.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
96154,CPT,HLTH&BEHAVIOR IVNTJ EA 15 MIN FAM W/PT,,,16,,RBRVS,0.45 ,0.07 ,0.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
96155,CPT,HLTH&BEHAVIOR IVNTJ EA 15 MIN FAM W/O PT,,,16,,RBRVS,0.44 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
96360,CPT,IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR,,,22,,RBRVS,0.17 ,1.42 ,1.42 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
96361,CPT,IV INFUSION HYDRATION EACH ADDITIONAL HOUR,,,22,,RBRVS,0.09 ,0.33 ,0.33 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
96365,CPT,IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR,,,22,,RBRVS,0.21 ,1.71 ,1.71 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
96366,CPT,IV INFUSION THERAPY PROPHYLAXIS/DX EA HOUR,,,22,,RBRVS,0.18 ,0.34 ,0.34 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
96367,CPT,IV INFUSION THER PROPH ADDL SEQUENTIAL TO 1 HR,,,22,,RBRVS,0.19 ,0.65 ,0.65 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
96368,CPT,IV NFS THERAPY PROPHYLAXIS/DX CONCURRENT NFS,,,22,,RBRVS,0.17 ,0.40 ,0.40 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
96369,CPT,SUBCUTANEOUS INFUSION INITIAL 1 HR W/PUMP SET-UP,,,22,,RBRVS,0.21 ,5.24 ,5.24 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
96370,CPT,SUBCUTANEOUS INFUSION EACH ADDITIONAL HOUR,,,22,,RBRVS,0.18 ,0.24 ,0.24 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
96371,CPT,SUBQ INFUSION ADDITIONAL PUMP INFUSION SITE,,,22,,RBRVS,,2.52 ,2.52 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
96372,CPT,THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM,,,22,,RBRVS,0.17 ,0.53 ,0.53 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
96373,CPT,THERAPEUTIC PROPHYLACTIC/DX NJX INTRA-ARTERIAL,,,22,,RBRVS,0.17 ,0.37 ,0.37 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
96374,CPT,THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG,,,22,,RBRVS,0.18 ,1.39 ,1.39 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
96375,CPT,THERAPEUTIC INJECTION IV PUSH EACH NEW DRUG,,,22,,RBRVS,0.10 ,0.52 ,0.52 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
96376,CPT,THER PROPH/DX NJX EA SEQL IV PUSH SBST/DRUG FAC,,,22,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
96379,CPT,UNLISTED THERAPEUTIC PROPH/DX IV/IA NJX/NFS,,,22,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
96401,CPT,CHEMOTX ADMN SUBQ/IM NON-HORMONAL ANTI-NEO,,,14,,RBRVS,0.21 ,1.85 ,1.85 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96402,CPT,CHEMOTX ADMN SUBQ/IM HORMONAL ANTI-NEO,,,14,,RBRVS,0.19 ,0.71 ,0.71 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96405,CPT,CHEMOTHERAPY ADMINISTRATION INTRALESIONAL </7,,,14,,RBRVS,0.52 ,0.30 ,1.76 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96406,CPT,CHEMOTHERAPY ADMINISTRATION INTRALESIONAL >7,,,14,,RBRVS,0.80 ,0.47 ,2.50 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96409,CPT,CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG,,,14,,RBRVS,0.24 ,2.81 ,2.81 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96411,CPT,CHEMOTX ADMN IV PUSH TQ EA SBST/DRUG,,,14,,RBRVS,0.20 ,1.51 ,1.51 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96413,CPT,CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG,,,14,,RBRVS,0.28 ,3.45 ,3.45 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96415,CPT,CHEMOTHERAPY ADMN IV INFUSION TQ EA HR,,,14,,RBRVS,0.19 ,0.59 ,0.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96416,CPT,CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP,,,14,,RBRVS,0.21 ,3.66 ,3.66 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96417,CPT,CHEMOTX ADMN IV NFS TQ EA SEQL NFS TO 1 HR,,,14,,RBRVS,0.21 ,1.52 ,1.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96420,CPT,CHEMOTHERAPY ADMIN INTRA-ARTERIAL PUSH TQ,,,14,,RBRVS,0.17 ,2.69 ,2.69 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96422,CPT,CHEMOTHERAPY ADMIN INTRA-ARTERIAL INFUS </1 HR,,,14,,RBRVS,0.17 ,4.51 ,4.51 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96423,CPT,CHEMOTHERAPY ADMN INTRAARTERIAL INFUSION EA HR,,,14,,RBRVS,0.17 ,2.00 ,2.00 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96425,CPT,CHEMOTX ADMN IA NFS >8 HR PRTBLE IMPLTBL PMP,,,14,,RBRVS,0.17 ,4.78 ,4.78 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96440,CPT,CHEMOTX ADMN PLEURAL CAVITY REQ&W/THORACNTS,,,14,,RBRVS,2.37 ,1.08 ,21.29 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96446,CPT,CHEMOTX ADMN PRTL CAVITY PORT/CATH,,,14,,RBRVS,0.37 ,0.18 ,5.01 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96450,CPT,CHEMOTX ADMN CNS REQ SPINAL PUNCTURE,,,14,,RBRVS,1.53 ,0.64 ,3.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96521,CPT,REFILLING & MAINTENANCE PORTABLE PUMP,,,14,,RBRVS,0.21 ,3.60 ,3.60 ,,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
96522,CPT,REFILL&MAINTENANCE PUMP DRUG DLVR SYSTEMIC,,,14,,RBRVS,0.21 ,2.92 ,2.92 ,,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
96523,CPT,IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST,,,14,,RBRVS,0.04 ,0.65 ,0.65 ,,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
96542,CPT,CHEMOTX NJX SUBARACHND/INTRAVENTR RSVR 1/MULT,,,14,,RBRVS,0.75 ,0.39 ,2.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96549,CPT,UNLISTED CHEMOTHERAPY PROCEDURE,,,14,,TotalUnits,,,,0.69 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96567,CPT,PDT XTRNL APPL LIGHT DSTR LES SKN BY ACTIVJ RX,,,14,,RBRVS,,3.78 ,3.78 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96570,CPT,PDT NDSC ABL ABNOR TISS VIA ACTIVJ RX 30 MIN,,,14,,RBRVS,1.10 ,0.34 ,0.34 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96571,CPT,PDT NDSC ABL ABNOR TISS VIA ACTIVJ RX A 15 MIN,,,14,,RBRVS,0.55 ,0.16 ,0.16 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96900,CPT,ACTINOTHERAPY ULTRAVIOLET LIGHT,,,14,,RBRVS,,0.57 ,0.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96902,CPT,MCRSCP XM HAIR PLUCK/CLIP FOR CNTS/STRUCT ABNORM,,,14,,RBRVS,0.41 ,0.16 ,0.18 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96904,CPT,WHOLE BODY INTEGUMENTARY PHOTOGRAPHY,,,14,,RBRVS,,1.76 ,1.76 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96910,CPT,PHOTOCHEMOTX TAR&UVB/PETROLATUM/UVB,,,14,,RBRVS,,2.00 ,2.00 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96912,CPT,PHOTOCHEMOTX PSORALENS&ULTRAVIOLET PUVA,,,14,,RBRVS,,2.57 ,2.57 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96913,CPT,PHOTOCHEMOTHERAPY DERMATOSES 4-8 HRS SUPERVISION,,,14,,RBRVS,,3.61 ,3.61 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96920,CPT,LASER SKIN DISEASE PSORIASIS TOT AREA <250 SQ CM,,,14,,RBRVS,1.15 ,0.70 ,3.18 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96921,CPT,LASER SKIN DISEASE PSORIASIS 250-500 SQ CM,,,14,,RBRVS,1.30 ,0.79 ,3.48 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96922,CPT,LASER SKIN DISEASE PSORIASIS >500 SQ CM,,,14,,RBRVS,2.10 ,1.27 ,4.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
96999,CPT,UNLISTED SPECIAL DERMATOLOGICAL SERVICE/PROCED,,,14,,TotalUnits,,,,2.00 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
97001,CPT,PHYSICAL THERAPY EVALUATION,,,19,,RBRVS,1.20 ,0.87 ,0.87 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97002,CPT,PHYSICAL THERAPY RE-EVALUATION,,,19,,RBRVS,0.60 ,0.56 ,0.56 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97003,CPT,OCCUPATIONAL THERAPY EVALUATION,,,19,,RBRVS,1.20 ,1.14 ,1.14 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97004,CPT,OCCUPATIONAL THERAPY RE-EVALUATION,,,19,,RBRVS,0.60 ,0.86 ,0.86 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97005,CPT,ATHLETIC TRAINING EVALUATION,,,19,,TotalUnits,,,,1.66 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97006,CPT,ATHLETIC TRAINING RE-EVALUATION,,,19,,TotalUnits,,,,0.83 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97010,CPT,APPLICATION MODALITY 1/> AREAS HOT/COLD PACKS,,,19,,RBRVS,0.06 ,0.10 ,0.10 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97012,CPT,APPL MODALITY 1/> AREAS TRACTION MECHANICAL,,,19,,RBRVS,0.25 ,0.19 ,0.19 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97014,CPT,APPL MODALITY 1/> AREAS ELEC STIMJ UNATTENDED,,,19,,RBRVS,0.18 ,0.26 ,0.26 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97016,CPT,APPL MODALITY 1/> AREAS VASOPNEUMATIC DEVICES,,,19,,RBRVS,0.18 ,0.35 ,0.35 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97018,CPT,APPL MODALITY 1/> AREAS PARAFFIN BATH,,,19,,RBRVS,0.06 ,0.24 ,0.24 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97022,CPT,APPLICATION MODALITY 1/> AREAS WHIRLPOOL,,,19,,RBRVS,0.17 ,0.48 ,0.48 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97024,CPT,APPLICATION MODALITY 1/> AREAS DIATHERMY,,,19,,RBRVS,0.06 ,0.11 ,0.11 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97026,CPT,APPLICATION MODALITY 1/> AREAS INFRARED,,,19,,RBRVS,0.06 ,0.10 ,0.10 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97028,CPT,APPL MODALITY 1/> AREAS ULTRAVIOLET,,,19,,RBRVS,0.08 ,0.12 ,0.12 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97032,CPT,APPL MODALITY 1/> AREAS ELEC STIMJ EA 15 MIN,,,19,,RBRVS,0.25 ,0.28 ,0.28 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97033,CPT,APPL MODALITY 1/> AREAS IONTOPHORESIS EA 15 MIN,,,19,,RBRVS,0.26 ,0.65 ,0.65 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97034,CPT,APPL MODALITY 1/> AREAS CONTRAST BATHS EA 15 MIN,,,19,,RBRVS,0.21 ,0.29 ,0.29 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97035,CPT,APPL MODALITY 1/> AREAS ULTRASOUND EA 15 MIN,,,19,,RBRVS,0.21 ,0.14 ,0.14 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97036,CPT,APPL MODALITY 1/> AREAS HUBBARD TANK EA 15 MIN,,,19,,RBRVS,0.28 ,0.64 ,0.64 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97039,CPT,UNLIST MODALITY SPEC TYPE&TIME CONSTANT ATTEND,,,19,,TotalUnits,,,,0.35 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97110,CPT,THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES,,,19,,RBRVS,0.45 ,0.44 ,0.44 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97112,CPT,THER PX 1/> AREAS EACH 15 MIN NEUROMUSC REEDUCA,,,19,,RBRVS,0.45 ,0.48 ,0.48 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97113,CPT,THER PX 1/> AREAS EACH 15 MIN AQUA THER W/XERSS,,,19,,RBRVS,0.44 ,0.76 ,0.76 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97116,CPT,THER PX 1/> AREAS EA 15 MIN GAIT TRAINJ W/STAIR,,,19,,RBRVS,0.40 ,0.39 ,0.39 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97124,CPT,THER PX 1/> AREAS EACH 15 MINUTES MASSAGE,,,19,,RBRVS,0.35 ,0.38 ,0.38 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97139,CPT,UNLISTED THERAPEUTIC PROCEDURE SPECIFY,,,19,,TotalUnits,,,,0.89 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97140,CPT,MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES,,,19,,RBRVS,0.43 ,0.40 ,0.40 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97150,CPT,THERAPEUTIC PROCEDURES GROUP 2/> INDIVIDUALS,,,19,,RBRVS,0.29 ,0.19 ,0.19 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97530,CPT,THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN,,,19,,RBRVS,0.44 ,0.53 ,0.53 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97532,CPT,DEVELOPMENT OF COGNITIVE SKILLS EACH 15 MINUTES,,,19,,RBRVS,0.44 ,0.30 ,0.30 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97533,CPT,SENSORY INTEGRATIVE TECHNIQUES EACH 15 MINUTES,,,19,,RBRVS,0.44 ,0.37 ,0.37 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97535,CPT,SELF-CARE/HOME MGMT TRAINING EACH 15 MINUTES,,,19,,RBRVS,0.45 ,0.52 ,0.52 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97537,CPT,COMMUNITY/WORK REINTEGRATION TRAINJ EA 15 MIN,,,19,,RBRVS,0.45 ,0.39 ,0.39 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97542,CPT,WHEELCHAIR MGMT EA 15 MIN,,,19,,RBRVS,0.45 ,0.40 ,0.40 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97545,CPT,WORK HARDENING/CONDITIONING 1ST 2 HR,,,19,,TotalUnits,,,,3.01 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97546,CPT,WORK HARDENING/CONDITIONING EACH HOUR,,,19,,TotalUnits,,,,1.20 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97597,CPT,DEBRIDEMENT OPEN WOUND 20 SQ CM/<,,,14,,RBRVS,0.51 ,0.13 ,1.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
97598,CPT,DEBRIDEMENT OPEN WOUND EACH ADDITIONAL 20 SQ CM,,,14,,RBRVS,0.24 ,0.06 ,0.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
97602,CPT,RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANES 1 SESS,,,14,,TotalUnits,,,,0.90 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
97605,CPT,NEGATIVE PRESSURE WOUND THERAPY DME </= 50 SQ CM,,,14,,RBRVS,0.55 ,0.14 ,0.59 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
97606,CPT,NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM,,,14,,RBRVS,0.60 ,0.15 ,0.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
97610,CPT,LOW FREQUENCY NON-THERMAL ULTRASOUND PER DAY,,,19,,RBRVS,0.35 ,0.09 ,3.01 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97750,CPT,PHYSICAL PERFORMANCE TEST/MEAS W/REPRT EA 15 MIN,,,19,,RBRVS,0.45 ,0.46 ,0.46 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97755,CPT,ASSTV TECHNOL ASSMT DIR CNTCT W/REPRT EA 15 MIN,,,19,,RBRVS,0.62 ,0.37 ,0.37 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97760,CPT,ORTHOTIC MGMT&TRAINJ UXTR LXTR&/TRNK EA 15,,,19,,RBRVS,0.45 ,0.60 ,0.60 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97761,CPT,PROSTHETIC TRAINING UPPR&/LOWER EXTREM EA 15 M,,,19,,RBRVS,0.45 ,0.46 ,0.46 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97762,CPT,CHECKOUT ORTHOTIC/PROSTHETIC ESTAB PT EA 15 MIN,,,19,,RBRVS,0.25 ,1.09 ,1.09 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97799,CPT,UNLISTED PHYSICAL MEDICINE/REHAB SERVICE/PROC,,,19,,TotalUnits,,,,0.89 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
97802,CPT,MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI,,,14,,RBRVS,0.53 ,0.37 ,0.43 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
97803,CPT,MEDICAL NUTRITION RE-ASSMT&IVNTJ INDIV EA 15 M,,,14,,RBRVS,0.45 ,0.31 ,0.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
97804,CPT,MEDICAL NUTRITION THERAPY GRP2/ INDIV EA 30 MI,,,14,,RBRVS,0.25 ,0.17 ,0.19 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
97810,CPT,ACUPUNCTURE 1/> NDLES W/O ELEC STIMJ INIT 15 MIN,,,14,,RBRVS,0.60 ,0.23 ,0.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
97811,CPT,ACUPUNCTURE 1/> NDLS W/O ELEC STIMJ EA 15 MIN,,,14,,RBRVS,0.50 ,0.19 ,0.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
97813,CPT,ACUPUNCTURE 1/> NDLS W/ELEC STIMJ 1ST 15 MIN,,,14,,RBRVS,0.65 ,0.25 ,0.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
97814,CPT,ACUP 1/> NDLS W/ELEC STIMJ EA 15 MIN W/RE-INSJ,,,14,,RBRVS,0.55 ,0.21 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
98925,CPT,OSTEOPATHIC MANIPULATIVE TX 1-2 BODY REGIONS,,,19,,RBRVS,0.46 ,0.19 ,0.40 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
98926,CPT,OSTEOPATHIC MANIPULATIVE TX 3-4 BODY REGIONS,,,19,,RBRVS,0.71 ,0.27 ,0.54 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
98927,CPT,OSTEOPATHIC MANIPULATIVE TX 5-6 BODY REGIONS,,,19,,RBRVS,0.96 ,0.34 ,0.67 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
98928,CPT,OSTEOPATHIC MANIPULATIVE TX 7-8 BODY REGIONS,,,19,,RBRVS,1.21 ,0.43 ,0.79 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
98929,CPT,OSTEOPATHIC MANIPULATIVE TX 9-10 BODY REGIONS,,,19,,RBRVS,1.46 ,0.51 ,0.93 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
98940,CPT,CHIROPRACTIC MANIPULATIVE TX SPINAL 1-2 REGIONS,,,5,,RBRVS,0.46 ,0.16 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
98941,CPT,CHIROPRACTIC MANIPULATIVE TX SPINAL 3-4 REGIONS,,,5,,RBRVS,0.71 ,0.25 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
98942,CPT,CHIROPRACTIC MANIPULATIVE TX SPINAL 5 REGIONS,,,5,,RBRVS,0.96 ,0.33 ,0.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
98943,CPT,CHIROPRACTIC MANIPLTV TX EXTRASPINAL 1/> REGION,,,5,,RBRVS,0.46 ,0.18 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
98960,CPT,EDUCATION&TRAINING SELF-MGMT NONPHYS 1 PT,,,14,,RBRVS,,0.77 ,0.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
98961,CPT,EDUCATION&TRAINING SELF-MGMT NONPHYS 2-4 PTS,,,14,,RBRVS,,0.37 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
98962,CPT,EDUCATION&TRAINING SELF-MGMT NONPHYS 5-8 PTS,,,14,,RBRVS,,0.27 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
98966,CPT,NONPHYSICIAN TELEPHONE ASSESSMENT 5-10 MIN,,,15,,RBRVS,0.25 ,0.10 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
98967,CPT,NONPHYSICIAN TELEPHONE ASSESSMENT 11-20 MIN,,,15,,RBRVS,0.50 ,0.19 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
98968,CPT,NONPHYSICIAN TELEPHONE ASSESSMENT 21-30 MIN,,,15,,RBRVS,0.75 ,0.29 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
98969,CPT,NONPHYSICIAN ONLINE ASSESSMENT AND MANAGEMENT,,,15,,TotalUnits,,,,0.69 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99000,CPT,HANDLG&/OR CONVEY OF SPEC FOR TR OFFICE TO LAB,,,14,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
99001,CPT,HANDLG&/OR CONVEY OF SPEC FOR TR FROM PT TO LAB,,,14,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
99002,CPT,HANDLE/CONVEY/ANY OTH SVC DEVICE FIT PHYS/QHP,,,14,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
99024,CPT,POSTOP FOLLOW UP VISIT RELATED TO ORIGINAL PX,,,14,,TotalUnits,,,,0.69 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99026,CPT,HOSPITAL MANDATED CALL SERVICE IN-HOSPITAL EA HR,,,14,,TotalUnits,,,,0.89 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99027,CPT,HOSPITAL MANDATED CALL SVC OUT-OF-HOSPITAL EA HR,,,14,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99050,CPT,SERVICES PROVIDED OFFICE OTH/THN REG SCHED HOURS,,,15,,TotalUnits,,,,0.89 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99051,CPT,SVC PRV OFFICE REG SCHEDD EVN WKEND/HOLIDAY HRS,,,15,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99053,CPT,SERVICES PROVIDED BTW 10 PM&8 AM AT 24-HR FACI,,,15,,TotalUnits,,,,1.10 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99056,CPT,SVC TYPICAL PRV OFFICE PRV OUT OFFICE REQUEST PT,,,15,,TotalUnits,,,,0.85 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99058,CPT,SVC PRV EMER BASIS IN OFFICE DISRUPTING SVCS,,,15,,TotalUnits,,,,1.06 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99060,CPT,SVC PRV EMER OUT OFFICE DISRUPTS OFFICE SVC,,,15,,TotalUnits,,,,1.18 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99070,CPT,SUPPLIES&MATERIALS ABOVE/BEYOND PROV BY PHYS/QHP,,,14,,TotalUnits,,,,0.35 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
99071,CPT,EDUCATIONAL SUPPLIES PRV BY THE PHYS AT COST,,,14,,TotalUnits,,,,0.10 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
99075,CPT,MEDICAL TESTIMONY,,,14,,TotalUnits,,,,1.91 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99078,CPT,PHYS/QHP EDUCATION SVCS RENDERED PTS GRP SETTING,,,14,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99080,CPT,SPEC REPORTS > USUAL MED COMUNICAJ/STAND RPRTG,,,14,,TotalUnits,,,,0.35 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99082,CPT,UNUSUAL TRAVEL,,,14,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99090,CPT,ANALYSIS CLINICAL DATA STORED IN COMPUTERS,,,14,,TotalUnits,,,,0.80 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99091,CPT,COLLJ&INTERPJ PHYS/QHP PHYSIO COMPUTR DATA 30 MI,,,14,,RBRVS,1.10 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99100,CPT,ANESTHESIA EXTREME AGE PATIENT UNDER 1 YR/<,,,14,,TotalUnits,,,,0.94 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99116,CPT,ANES COMPLICJ UTILIZATION TOTAL BODY HYPOTHERMIA,,,14,,TotalUnits,,,,3.18 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99135,CPT,ANES COMPLICJ UTILIZATION CONTROLLED HYPOTENSION,,,14,,TotalUnits,,,,4.76 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99140,CPT,ANES COMPLICJ EMERGENCY CONDITIONS SPECIFY,,,14,,TotalUnits,,,,1.72 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99143,CPT,MODERATE SEDATJ SAME PHYS/QHP <5 YRS INIT 30 MIN,,,14,,TotalUnits,,,,1.32 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99144,CPT,MODERATE SEDATJ SAME PHYS/QHP 5/>YRS INIT 30 MIN,,,14,,TotalUnits,,,,1.10 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99145,CPT,MODERATE SEDATJ SAME PHYS/QHP EACH ADDL 15 MIN,,,14,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99148,CPT,MOD SEDATJ DIFF PHYS/QHP <5 YRS INIT 30 MIN,,,14,,TotalUnits,,,,1.21 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99149,CPT,MODERATE SEDATJ DIFF PHYS/QHP 5/>YRS INIT 30 MIN,,,14,,TotalUnits,,,,0.99 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99150,CPT,MODERATE SEDATJ DIFF PHYS/QHP EA ADDL 15 MIN,,,14,,TotalUnits,,,,0.44 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99170,CPT,ANOGENITAL XM MAGNIFY CHILD/SUSPECT TRAUMA W IMG,,,14,,RBRVS,1.75 ,0.44 ,2.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99172,CPT,VISUAL FUNCT SCRNG AUTO SEMI-AUTO BI QUAN DETERM,,,23,,TotalUnits,,,,1.02 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
99172,CPT,VISUAL FUNCT SCRNG AUTO SEMI-AUTO BI QUAN DETERM,,PC,23,,TotalUnits,,,,0.20 ,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
99172,CPT,VISUAL FUNCT SCRNG AUTO SEMI-AUTO BI QUAN DETERM,,TC,23,,TotalUnits,,,,0.82 ,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
99173,CPT,SCREENING TEST VISUAL ACUITY QUANTITATIVE BILAT,,,23,,RBRVS,,0.08 ,0.08 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
99174,CPT,INSTRUMENT BASED OCULAR SCR BI W/RMT ANAL & RPT,,,23,,TotalUnits,,,,0.77 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
99174,CPT,INSTRUMENT BASED OCULAR SCR BI W/RMT ANAL & RPT,,PC,23,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
99174,CPT,INSTRUMENT BASED OCULAR SCR BI W/RMT ANAL & RPT,,TC,23,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
99175,CPT,IPECAC/SIMILAR ADMN EMESIS&OBS STOMACH EMPTIED,,,14,,RBRVS,,0.47 ,0.47 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
99183,CPT,PHYS/QHP ATTN&SUPVJ HYPRBARIC OXYGEN TX/SESSION,,PC,14,,RBRVS,2.11 ,0.78 ,0.78 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99184,CPT,INITIAT SELECTIVE HEAD/BODY HYPOTHERMIA NEONATE,,,10,,RBRVS,4.50 ,1.72 ,1.72 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
99188,CPT,APPLICATION TOPICAL FLUORIDE VARNISH BY PHS/QHP,,,14,,TotalUnits,,,,0.36 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99190,CPT,ASSEMBLY&OPERJ PUMP OXYGENATOR/HEAT EXCH EA HR,,,14,,TotalUnits,,,,10.98 ,,$0.00,$0.00,1,1,0,0,1,1,20161001,,,,
99191,CPT,ASSEMBLY&OPERJ PUMP OXYGENATOR/HEAT EXCH 45 MI,,,14,,TotalUnits,,,,7.68 ,,$0.00,$0.00,1,1,0,0,1,1,20161001,,,,
99192,CPT,ASSEMBLY&OPERJ PUMP OXYGENATOR/HEAT EXCH 30 MI,,,14,,TotalUnits,,,,5.49 ,,$0.00,$0.00,1,1,0,0,1,1,20161001,,,,
99195,CPT,PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE,,,14,,RBRVS,,2.77 ,2.77 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
99199,CPT,UNLISTED SPECIAL SERVICE PROCEDURE/REPORT,,,14,,TotalUnits,,,,2.77 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
99201,CPT,OFFICE OUTPATIENT NEW 10 MINUTES,,,15,,RBRVS,0.48 ,0.23 ,0.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99202,CPT,OFFICE OUTPATIENT NEW 20 MINUTES,,,15,,RBRVS,0.93 ,0.41 ,1.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99203,CPT,OFFICE OUTPATIENT NEW 30 MINUTES,,,15,,RBRVS,1.42 ,0.60 ,1.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99204,CPT,OFFICE OUTPATIENT NEW 45 MINUTES,,,15,,RBRVS,2.43 ,1.02 ,1.99 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99205,CPT,OFFICE OUTPATIENT NEW 60 MINUTES,,,15,,RBRVS,3.17 ,1.31 ,2.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99211,CPT,OFFICE OUTPATIENT VISIT 5 MINUTES,,,15,,RBRVS,0.18 ,0.07 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99212,CPT,OFFICE OUTPATIENT VISIT 10 MINUTES,,,15,,RBRVS,0.48 ,0.20 ,0.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99213,CPT,OFFICE OUTPATIENT VISIT 15 MINUTES,,,15,,RBRVS,0.97 ,0.40 ,1.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99214,CPT,OFFICE OUTPATIENT VISIT 25 MINUTES,,,15,,RBRVS,1.50 ,0.61 ,1.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99215,CPT,OFFICE OUTPATIENT VISIT 40 MINUTES,,,15,,RBRVS,2.11 ,0.87 ,1.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99217,CPT,OBSERVATION CARE DISCHARGE MANAGEMENT,,,10,,RBRVS,1.28 ,0.68 ,0.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99218,CPT,INITIAL OBSERVATION CARE/DAY 30 MINUTES,,,10,,RBRVS,1.92 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99219,CPT,INITIAL OBSERVATION CARE/DAY 50 MINUTES,,,10,,RBRVS,2.60 ,1.05 ,1.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99220,CPT,INITIAL OBSERVATION CARE/DAY 70 MINUTES,,,10,,RBRVS,3.56 ,1.43 ,1.43 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99221,CPT,INITIAL HOSPITAL CARE/DAY 30 MINUTES,,,10,,RBRVS,1.92 ,0.76 ,0.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99222,CPT,INITIAL HOSPITAL CARE/DAY 50 MINUTES,,,10,,RBRVS,2.61 ,1.05 ,1.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99223,CPT,INITIAL HOSPITAL CARE/DAY 70 MINUTES,,,10,,RBRVS,3.86 ,1.57 ,1.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99224,CPT,SBSQ OBSERVATION CARE/DAY 15 MINUTES,,,10,,RBRVS,0.76 ,0.30 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99225,CPT,SBSQ OBSERVATION CARE/DAY 25 MINUTES,,,10,,RBRVS,1.39 ,0.57 ,0.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99226,CPT,SBSQ OBSERVATION CARE/DAY 35 MINUTES,,,10,,RBRVS,2.00 ,0.83 ,0.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99231,CPT,SBSQ HOSPITAL CARE/DAY 15 MINUTES,,,10,,RBRVS,0.76 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99232,CPT,SBSQ HOSPITAL CARE/DAY 25 MINUTES,,,10,,RBRVS,1.39 ,0.56 ,0.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99233,CPT,SBSQ HOSPITAL CARE/DAY 35 MINUTES,,,10,,RBRVS,2.00 ,0.80 ,0.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99234,CPT,OBSERVATION/INPATIENT HOSPITAL CARE 40 MINUTES,,,10,,RBRVS,2.56 ,1.01 ,1.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99235,CPT,OBSERVATION/INPATIENT HOSPITAL CARE 50 MINUTES,,,10,,RBRVS,3.24 ,1.30 ,1.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99236,CPT,OBSERVATION/INPATIENT HOSPITAL CARE 55 MINUTES,,,10,,RBRVS,4.20 ,1.65 ,1.65 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99238,CPT,HOSPITAL DISCHARGE DAY MANAGEMENT 30 MIN/<,,,10,,RBRVS,1.28 ,0.69 ,0.69 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99239,CPT,HOSPITAL DISCHARGE DAY MANAGEMENT > 30 MIN,,,10,,RBRVS,1.90 ,1.01 ,1.01 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99241,CPT,OFFICE CONSULTATION NEW/ESTAB PATIENT 15 MIN,,,6,,RBRVS,0.64 ,0.24 ,0.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99242,CPT,OFFICE CONSULTATION NEW/ESTAB PATIENT 30 MIN,,,6,,RBRVS,1.34 ,0.51 ,1.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99243,CPT,OFFICE CONSULTATION NEW/ESTAB PATIENT 40 MIN,,,6,,RBRVS,1.88 ,0.71 ,1.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99244,CPT,OFFICE CONSULTATION NEW/ESTAB PATIENT 60 MIN,,,6,,RBRVS,3.02 ,1.14 ,1.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99245,CPT,OFFICE CONSULTATION NEW/ESTAB PATIENT 80 MIN,,,6,,RBRVS,3.77 ,1.38 ,2.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99251,CPT,INITIAL INPATIENT CONSULT NEW/ESTAB PT 20 MIN,,,6,,RBRVS,1.00 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99252,CPT,INITIAL INPATIENT CONSULT NEW/ESTAB PT 40 MIN,,,6,,RBRVS,1.50 ,0.52 ,0.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99253,CPT,INITIAL INPATIENT CONSULT NEW/ESTAB PT 55 MIN,,,6,,RBRVS,2.27 ,0.84 ,0.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99254,CPT,INITIAL INPATIENT CONSULT NEW/ESTAB PT 80 MIN,,,6,,RBRVS,3.29 ,1.23 ,1.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99255,CPT,INITIAL INPATIENT CONSULT NEW/ESTAB PT 110 MIN,,,6,,RBRVS,4.00 ,1.44 ,1.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99281,CPT,EMERGENCY DEPARTMENT VISIT LIMITED/MINOR PROB,,,7,,RBRVS,0.45 ,0.11 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99282,CPT,EMERGENCY DEPARTMENT VISIT LOW/MODER SEVERITY,,,7,,RBRVS,0.88 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99283,CPT,EMERGENCY DEPARTMENT VISIT MODERATE SEVERITY,,,7,,RBRVS,1.34 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99284,CPT,EMERGENCY DEPARTMENT VISIT HIGH/URGENT SEVERITY,,,7,,RBRVS,2.56 ,0.53 ,0.53 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99285,CPT,EMERGENCY DEPT VISIT HIGH SEVERITY&THREAT FUNCJ,,,7,,RBRVS,3.80 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99288,CPT,PHYS/QHP DIRECTION EMERGENCY MEDICAL SYSTEMS,,,7,,TotalUnits,,,,1.10 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99291,CPT,CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN,,,10,,RBRVS,4.50 ,1.43 ,2.87 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99292,CPT,CRITICAL CARE ILL/INJURED PATIENT ADDL 30 MIN,,,10,,RBRVS,2.25 ,0.72 ,1.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99304,CPT,INITIAL NURSING FACILITY CARE/DAY 25 MINUTES,,,10,,RBRVS,1.64 ,0.83 ,0.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99305,CPT,INITIAL NURSING FACILITY CARE/DAY 35 MINUTES,,,10,,RBRVS,2.35 ,1.18 ,1.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99306,CPT,INITIAL NURSING FACILITY CARE/DAY 45 MINUTES,,,10,,RBRVS,3.06 ,1.44 ,1.44 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99307,CPT,SBSQ NURSING FACILITY CARE/DAY E/M STABLE 10 MIN,,,10,,RBRVS,0.76 ,0.45 ,0.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99308,CPT,SBSQ NURSING FACIL CARE/DAY MINOR COMPLJ 15 MIN,,,10,,RBRVS,1.16 ,0.71 ,0.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99309,CPT,SBSQ NURSING FACIL CARE/DAY NEW PROBLEM 25 MIN,,,10,,RBRVS,1.55 ,0.92 ,0.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99310,CPT,SBSQ NURS FACIL CARE/DAY UNSTABL/NEW PROB 35 MIN,,,10,,RBRVS,2.35 ,1.31 ,1.31 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99315,CPT,NURSING FACILITY DISCHARGE MANAGEMENT 30 MINUTES,,,10,,RBRVS,1.28 ,0.70 ,0.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99316,CPT,NURSING FACILITY DISCHARGE MANAGEMENT 30 MINUTES,,,10,,RBRVS,1.90 ,0.95 ,0.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99318,CPT,E/M ANNUAL NURSING FACILITY ASSESS STABLE 30 MIN,,,10,,RBRVS,1.71 ,0.89 ,0.89 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99324,CPT,DOMICIL/REST HOME NEW PT VISIT LOW SEVER 20 MIN,,,15,,RBRVS,1.01 ,0.48 ,0.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99325,CPT,DOMICIL/REST HOME NEW PT VISIT MOD SEVER 30 MIN,,,15,,RBRVS,1.52 ,0.64 ,0.64 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99326,CPT,DOMICIL/REST HOME NEW PT HI-MOD SEVER 45 MINUTES,,,15,,RBRVS,2.63 ,1.12 ,1.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99327,CPT,DOMICIL/REST HOME NEW PT VISIT HI SEVER 60 MIN,,,15,,RBRVS,3.46 ,1.55 ,1.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99328,CPT,DOM/R-HOME E/M NEW PT SIGNIF NEW PROB 75 MINUTES,,,15,,RBRVS,4.09 ,1.76 ,1.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99334,CPT,DOM/R-HOME E/M EST PT SELF-LMTD/MINOR 15 MINUTES,,,15,,RBRVS,1.07 ,0.56 ,0.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99335,CPT,DOM/R-HOME E/M EST PT LW MOD SEVERITY 25 MINUTES,,,15,,RBRVS,1.72 ,0.85 ,0.85 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99336,CPT,DOM/R-HOME E/M EST PT MOD HI SEVERITY 40 MINUTES,,,15,,RBRVS,2.46 ,1.17 ,1.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99337,CPT,DOM/R-HOME E/M EST PT SIGNIF NEW PROB 60 MINUTES,,,15,,RBRVS,3.58 ,1.62 ,1.62 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99339,CPT,INDIV PHYS SUPVJ HOME/DOM/R-HOME MO 15-29 MIN,,,15,,RBRVS,1.25 ,0.86 ,0.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99340,CPT,INDIV PHYS SUPVJ HOME/DOM/R-HOME MO 30 MIN/>,,,15,,RBRVS,1.80 ,1.15 ,1.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99341,CPT,HOME VISIT NEW PATIENT LOW SEVERITY 20 MINUTES,,,15,,RBRVS,1.01 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99342,CPT,HOME VISIT NEW PATIENT MOD SEVERITY 30 MINUTES,,,15,,RBRVS,1.52 ,0.61 ,0.61 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99343,CPT,HOME VST NEW PATIENT MOD-HI SEVERITY 45 MINUTES,,,15,,RBRVS,2.53 ,0.95 ,0.95 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99344,CPT,HOME VISIT NEW PATIENT HI SEVERITY 60 MINUTES,,,15,,RBRVS,3.38 ,1.52 ,1.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99345,CPT,HOME VISIT NEW PT UNSTABL/SIGNIF NEW PROB 75 MIN,,,15,,RBRVS,4.09 ,1.84 ,1.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99347,CPT,HOME VISIT EST PT SELF LIMITED/MINOR 15 MINUTES,,,15,,RBRVS,1.00 ,0.50 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99348,CPT,HOME VISIT EST PT LOW-MOD SEVERITY 25 MINUTES,,,15,,RBRVS,1.56 ,0.70 ,0.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99349,CPT,HOME VISIT EST PT MOD-HI SEVERITY 40 MINUTES,,,15,,RBRVS,2.33 ,1.12 ,1.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99350,CPT,HOME VST EST PT UNSTABLE/SIGNIF NEW PROB 60 MINS,,,15,,RBRVS,3.28 ,1.49 ,1.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99354,CPT,PROLNG E&M/PSYCTX SVC OFFICE O/P DIR CON 1ST HR,,,15,,RBRVS,1.77 ,0.72 ,0.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99355,CPT,PROLNG E&M/PSYCTX SVC OFFICE O/P DIR CON ADDL 30,,,15,,RBRVS,1.77 ,0.63 ,0.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99356,CPT,PROLONGED SERVICE I/P REQ UNIT/FLOOR TIME 1ST HR,,,10,,RBRVS,1.71 ,0.77 ,0.77 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
99357,CPT,PROLONGED SVC I/P REQ UNIT/FLOOR TIME EA 30 MIN,,,10,,RBRVS,1.71 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
99358,CPT,PROLNG E/M SVC BEFORE&/AFTER DIR PT CARE 1ST HR,,,15,,RBRVS,2.10 ,0.84 ,0.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99359,CPT,PROLNG E/M BEFORE&/AFTER DIR CARE EA 30 MINUTES,,,15,,RBRVS,1.00 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99360,CPT,PHYS STANDBY SVC PROLNG PHYS ATTN EA 30 MINUTES,,,14,,RBRVS,1.20 ,0.46 ,0.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99363,CPT,ANTICOAGULANT MGMT OUTPATIENT INIT 90 DAYS,,,14,,RBRVS,1.65 ,0.63 ,1.84 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99364,CPT,ANTICOAGULANT MGMT OUTPATIENT EA SBSQ 90 DAYS,,,14,,RBRVS,0.63 ,0.24 ,0.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99366,CPT,TEAM CONFERENCE FACE-TO-FACE NONPHYSICIAN,,,15,,RBRVS,0.82 ,0.31 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99367,CPT,TEAM CONFERENCE NON-FACE-TO-FACE PHYSICIAN,,,15,,RBRVS,1.10 ,0.42 ,0.42 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99368,CPT,TEAM CONFERENCE NON-FACE-TO-FACE NONPHYSICIAN,,,15,,RBRVS,0.72 ,0.28 ,0.28 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99374,CPT,SUPVJ PT HOME HEALTH AGENCY MO 15-29 MINUTES,,,15,,RBRVS,1.10 ,0.42 ,0.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99375,CPT,SUPERVISION PT HOME HEALTH AGENCY MONTH 30 MIN/>,,,15,,RBRVS,1.73 ,0.66 ,1.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99377,CPT,SUPERVISION HOSPICE PATIENT/MONTH 15-29 MIN,,,15,,RBRVS,1.10 ,0.42 ,0.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99378,CPT,SUPERVISION HOSPICE PATIENT/MONTH 30 MINUTES/>,,,15,,RBRVS,1.73 ,0.66 ,1.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99379,CPT,SUPERVISION NURS FACILITY PATIENT MO 15-29 MIN,,,15,,RBRVS,1.10 ,0.42 ,0.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99380,CPT,SUPERVISION NURS FACILITY PATIENT MONTH 30 MIN/>,,,15,,RBRVS,1.73 ,0.66 ,1.12 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99381,CPT,INITIAL PREVENTIVE MEDICINE NEW PATIENT <1YEAR,,,24,,RBRVS,1.50 ,0.57 ,1.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99382,CPT,INITIAL PREVENTIVE MEDICINE NEW PT AGE 1-4 YRS,,,24,,RBRVS,1.60 ,0.61 ,1.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99383,CPT,INITIAL PREVENTIVE MEDICINE NEW PT AGE 5-11 YRS,,,18,,RBRVS,1.70 ,0.65 ,1.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99384,CPT,INITIAL PREVENTIVE MEDICINE NEW PT AGE 12-17 YR,,,18,,RBRVS,2.00 ,0.77 ,1.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99385,CPT,INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS,,,18,,RBRVS,1.92 ,0.73 ,1.67 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99386,CPT,INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS,,,18,,RBRVS,2.33 ,0.89 ,1.82 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99387,CPT,INITIAL PREVENTIVE MEDICINE NEW PATIENT 65YRS&>,,,18,,RBRVS,2.50 ,0.96 ,2.00 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99391,CPT,PERIODIC PREVENTIVE MED ESTABLISHED PATIENT <1Y,,,24,,RBRVS,1.37 ,0.52 ,1.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99392,CPT,PERIODIC PREVENTIVE MED EST PATIENT 1-4YRS,,,24,,RBRVS,1.50 ,0.57 ,1.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99393,CPT,PERIODIC PREVENTIVE MED EST PATIENT 5-11YRS,,,18,,RBRVS,1.50 ,0.57 ,1.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99394,CPT,PERIODIC PREVENTIVE MED EST PATIENT 12-17YRS,,,18,,RBRVS,1.70 ,0.65 ,1.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99395,CPT,PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS,,,18,,RBRVS,1.75 ,0.67 ,1.48 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99396,CPT,PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS,,,18,,RBRVS,1.90 ,0.73 ,1.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99397,CPT,PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER,,,18,,RBRVS,2.00 ,0.77 ,1.71 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99401,CPT,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 15 MIN,,,18,,RBRVS,0.48 ,0.18 ,0.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99402,CPT,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 30 MIN,,,18,,RBRVS,0.98 ,0.37 ,0.70 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99403,CPT,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 45 MIN,,,18,,RBRVS,1.46 ,0.56 ,0.88 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99404,CPT,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 60 MIN,,,18,,RBRVS,1.95 ,0.75 ,1.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99406,CPT,TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES,,,14,,RBRVS,0.24 ,0.09 ,0.14 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
99407,CPT,TOBACCO USE CESSATION INTENSIVE >10 MINUTES,,,14,,RBRVS,0.50 ,0.19 ,0.24 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
99408,CPT,ALCOHOL/SUBSTANCE SCREEN & INTERVEN 15-30 MIN,,,16,,RBRVS,0.65 ,0.25 ,0.30 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
99409,CPT,ALCOHOL/SUBSTANCE SCREEN & INTERVENTION >30 MIN,,,16,,RBRVS,1.30 ,0.50 ,0.55 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
99411,CPT,PREV MED COUNSEL & RISK FACTOR REDJ GRP SPX 30 M,,,18,,RBRVS,0.15 ,0.06 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99412,CPT,PREV MED COUNSEL & RISK FACTOR REDJ GRP SPX 60 M,,,18,,RBRVS,0.25 ,0.10 ,0.34 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99415,CPT,PROLNG CLINCL STAFF SVC DURING O/P E/M 1ST HR,,TC,15,,RBRVS,,0.24 ,0.24 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
99416,CPT,PROLNG CLINCL STAFF SVC DURING O/P E/M EA 30 MIN,,TC,15,,RBRVS,,0.01 ,0.01 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
99420,CPT,ADMN & INTERPJ HEALTH RISK ASSESSMENT INSTRUMENT,,,18,,RBRVS,,0.30 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99429,CPT,UNLISTED PREVENTIVE MEDICINE SERVICE,,,18,,TotalUnits,,,,1.62 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99441,CPT,PHYS/QHP TELEPHONE EVALUATION 5-10 MIN,,,15,,RBRVS,0.25 ,0.10 ,0.13 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99442,CPT,PHYS/QHP TELEPHONE EVALUATION 11-20 MIN,,,15,,RBRVS,0.50 ,0.19 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99443,CPT,PHYS/QHP TELEPHONE EVALUATION 21-30 MIN,,,15,,RBRVS,0.75 ,0.29 ,0.33 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99444,CPT,PHYS/QHP ONLINE EVALUATION & MANAGEMENT SERVICE,,,15,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99446,CPT,INTERPROF PHONE/INTERNET ASSESS/MANAGE 5-10,,,15,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99447,CPT,INTERPROF PHONE/INTERNET ASSESS/MANAGE 11-20,,,15,,TotalUnits,,,,1.37 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99448,CPT,INTERPROF PHONE/INTERNET ASSESS/MANAGE 21-30,,,15,,TotalUnits,,,,2.01 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99449,CPT,INTERPROF PHONE/INTERNET ASSESS/MANAGE 31/>,,,15,,TotalUnits,,,,2.66 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99450,CPT,BASIC LIFE AND/OR DISABILITY EXAMINATION,,,14,,TotalUnits,,,,1.09 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99455,CPT,WORK RELATED/MED DBLT XM TREATING PHYS,,,14,,TotalUnits,,,,1.74 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99456,CPT,WORK RELATED/MED DBLT XM OTH/THN TREATING PHYS,,,14,,TotalUnits,,,,5.02 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99460,CPT,1ST HOSP/BIRTHING CENTER CARE PER DAY NML NB,,,10,,RBRVS,1.92 ,0.77 ,0.77 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99461,CPT,1ST CARE PR DAY NML NB XCPT HOSP/BIRTHING CENTER,,,24,,RBRVS,1.26 ,0.44 ,1.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99462,CPT,SUBQ HOSPITAL CARE PER DAY E/M NORMAL NEWBORN,,,10,,RBRVS,0.84 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
99463,CPT,1ST HOSP/BIRTHING CENTER NB ADMIT & DSCHG SM DAT,,,10,,RBRVS,2.13 ,1.10 ,1.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99464,CPT,ATTN AT DELIVERY 1ST STABILIZATION OF NEWBORN,,,10,,RBRVS,1.50 ,0.51 ,0.51 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99465,CPT,DELIVERY/BIRTHING ROOM RESUSCITATION,,,10,,RBRVS,2.93 ,1.15 ,1.15 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99466,CPT,CRITICAL CARE INTERFACILITY TRANSPORT 30-74 MIN,,,10,,RBRVS,4.79 ,1.83 ,1.83 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99467,CPT,CRITICAL CARE INTERFACILITY TRANSPORT EA 30 MIN,,,10,,RBRVS,2.40 ,0.92 ,0.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99468,CPT,1ST INPATIENT CRITICAL CARE PR DAY AGE 28 DAYS/<,,,10,,RBRVS,18.46 ,6.30 ,6.30 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
99469,CPT,SUBQ I/P CRITICAL CARE PR DAY AGE 28 DAYS/<,,,10,,RBRVS,7.99 ,2.74 ,2.74 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
99471,CPT,INITIAL PED CRITICAL CARE 29 DAYS THRU 24 MONTHS,,,10,,RBRVS,15.98 ,7.13 ,7.13 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
99472,CPT,SUBSQ PED CRITICAL CARE 29 DAYS THRU 24 MO,,,10,,RBRVS,7.99 ,2.94 ,2.94 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
99475,CPT,INITIAL PED CRITICAL CARE 2 THRU 5 YEARS,,,10,,RBRVS,11.25 ,4.18 ,4.18 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
99476,CPT,SUBSEQUENT PED CRITICAL CARE 2 THRU 5 YEARS,,,10,,RBRVS,6.75 ,2.55 ,2.55 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
99477,CPT,INITIAL HOSP NEONATE 28 D/< NOT CRITICALLY ILL,,,10,,RBRVS,7.00 ,2.68 ,2.68 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
99478,CPT,SUBSEQUENT INTENSIVE CARE INFANT < 1500 GRAMS,,,10,,RBRVS,2.75 ,1.05 ,1.05 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
99479,CPT,SUBSEQUENT INTENSIVE CARE INFANT 1500-2500 GRAMS,,,10,,RBRVS,2.50 ,0.86 ,0.86 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
99480,CPT,SUBSEQUENT INTENSIVE CARE INFANT 2501-5000 GRAMS,,,10,,RBRVS,2.40 ,0.82 ,0.82 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
99485,CPT,SUPERVISION INTERFACILITY TRANSPORT INIT 30 MIN,,,10,,RBRVS,1.50 ,0.57 ,0.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99486,CPT,SUPERVISION INTERFACILITY TRANSPORT ADDL 30 MIN,,,10,,RBRVS,1.30 ,0.50 ,0.50 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99487,CPT,CMPLX CHRON CARE MGMT W/O PT VST 1ST HR PER MO,,,10,,TotalUnits,,,,2.24 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99489,CPT,CMPLX CHRON CARE MGMT EA ADDL 30 MIN PER MONTH,,,10,,TotalUnits,,,,0.71 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99490,CPT,CHRON CARE MANAGEMENT SRVC 20 MIN PER MONTH,,,10,,RBRVS,0.61 ,0.26 ,0.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99495,CPT,TRANSITIONAL CARE MANAGE SRVC 14 DAY DISCHARGE,,,10,,RBRVS,2.11 ,0.88 ,2.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99496,CPT,TRANSITIONAL CARE MANAGE SRVC 7 DAY DISCHARGE,,,10,,RBRVS,3.05 ,1.27 ,3.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99497,CPT,ADVANCE CARE PLANNING FIRST 30 MINS,,,14,,RBRVS,1.50 ,0.62 ,0.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99498,CPT,ADVANCE CARE PLANNING EA ADDL 30 MINS,,,14,,RBRVS,1.40 ,0.58 ,0.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
99499,CPT,UNLISTED EVALUATION AND MANAGEMENT SERVICE,,,15,,TotalUnits,,,,1.96 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
99500,CPT,HOME VISIT PRENATAL MONITORING & ASSESSMENT,,,14,,TotalUnits,,,,1.66 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
99501,CPT,HOME VISIT POSTNATAL ASSMT&F-UP CARE,,,14,,TotalUnits,,,,1.21 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
99502,CPT,HOME VISIT NEWBORN CARE & ASSESSMENT,,,14,,TotalUnits,,,,1.21 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
99503,CPT,HOME VISIT RESPIRATORY THERAPY CARE,,,14,,TotalUnits,,,,1.02 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
99504,CPT,HOME VISIT MECHANICAL VENTILATION CARE,,,14,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
99505,CPT,HOME VISIT STOMA CARE&MAINT CLST&CSTOST,,,14,,TotalUnits,,,,0.73 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
99506,CPT,HOME VISIT INTRAMUSCULAR INJECTIONS,,,14,,TotalUnits,,,,1.18 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
99507,CPT,HOME VISIT CARE&MAINT CATH,,,14,,TotalUnits,,,,0.88 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
99509,CPT,HOME VISIT ASSISTANCE DAILY LIV&PRSONAL CARE,,,14,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
99510,CPT,HOME VISIT INDIV FAM/MARRIAGE COUNSELING,,,14,,TotalUnits,,,,1.27 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
99511,CPT,HOME VISIT FECAL IMPACTION MGMT&ENEMA ADMN,,,14,,TotalUnits,,,,0.99 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
99512,CPT,HOME VISIT HEMODIALYSIS,,,14,,TotalUnits,,,,5.35 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
99600,CPT,UNLISTED HOME VISIT SERVICE/PROCEDURE,,,14,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
99601,CPT,HOME NFS/SPECTY DRUG ADMN PR VST </2 HR,,,14,,TotalUnits,,,,2.08 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
99602,CPT,HOME NFS/SPECTY DRUG ADMN PR VST </2 HR EA HR,,,14,,TotalUnits,,,,1.04 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
99605,CPT,MEDICATION THERAPY INITIAL 15 MIN NEW PATIENT,,,14,,TotalUnits,,,,0.43 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
99606,CPT,MEDICATION THERAPY INITIAL 15 MIN ESTABLISHED PT,,,14,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
99607,CPT,MEDICATION THERAPY EACH ADDITIONAL 15 MIN,,,14,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
0019T,CPT,EXTRACORPOREAL SHOCK WAVE MUSCSKEL NOS LOW ENRGY,,,21,,TotalUnits,,,,3.87 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0042T,CPT,CEREBRAL PERFUSION ANALYS CT W/BLOOD FLOW&VOLUME,,,20,,TotalUnits,,,,2.37 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0054T,CPT,CPTR-ASST MUSCSKEL NAVIGJ ORTHO FLUOR IMAGES,,,21,,TotalUnits,,,,5.60 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
0055T,CPT,CPTR-ASST MUSCSKEL NAVIGJ ORTHO CT/MRI,,,21,,TotalUnits,,,,9.20 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0075T,CPT,TCAT PLMT XTRC VRT CRTD STENT RS&I PRQ 1ST VSL,,,21,,TotalUnits,,,,14.77 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
0075T,CPT,TCAT PLMT XTRC VRT CRTD STENT RS&I PRQ 1ST VSL,26,,21,,TotalUnits,,,,0.92 ,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
0075T,CPT,TCAT PLMT XTRC VRT CRTD STENT RS&I PRQ 1ST VSL,TC,,21,,TotalUnits,,,,13.85 ,,$0.00,$0.00,1,1,0,0,1,1,20161001,,,,
0095T,CPT,RMVL TOT DISC ARTHRP ANT APPR CRV EA NTRSPC,,,21,,RBRVS,4.04 ,1.52 ,1.52 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
0098T,CPT,REVJ TOT DISC ARTHRP ANT APPR CRV EA NTRSPC,,,21,,RBRVS,4.04 ,1.52 ,1.52 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
0100T,CPT,PLMT SCJNCL RTA PROSTH&PLS&IMPLTJ INTRA-OC RTA,,,21,,TotalUnits,,,,12.92 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0101T,CPT,EXTRCORPL SHOCK WAVE MUSCSKELE NOS HIGH ENERGY,,,21,,TotalUnits,,,,5.00 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0102T,CPT,EXTRCRPL SHOCK WAVE W/ANES LAT HUMERL EPICONDYLE,,,21,,TotalUnits,,,,5.00 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0106T,CPT,QUANT SENSORY TEST&INTERPJ/XTR W/TOUCH STIMULI,,,14,,TotalUnits,,,,0.71 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0107T,CPT,QUANT SENSORY TEST&INTERPJ/XTR W/VIBRJ STIMULI,,,14,,TotalUnits,,,,2.14 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0108T,CPT,QUANT SENSORY TEST&INTERPJ/XTR W/COOL STIMULI,,,14,,TotalUnits,,,,2.14 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0110T,CPT,QUANT SENSORY TEST&INTERPJ/XTR OTHER STIMULI,,,14,,TotalUnits,,,,0.07 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0111T,CPT,LONG-CHAIN OMEGA-3 FATTY ACIDS RBC MEMBS,,,17,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
0126T,CPT,COMMON CAROTID INTIMA MEDIA THICKNESS STUDY,,,4,,TotalUnits,,,,1.97 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0159T,CPT,COMPUTER AIDED DETECTION BREAST MRI,,,20,,TotalUnits,,,,1.29 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
0159T,CPT,COMPUTER AIDED DETECTION BREAST MRI,,PC,20,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
0159T,CPT,COMPUTER AIDED DETECTION BREAST MRI,,TC,20,,TotalUnits,,,,0.87 ,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
0171T,CPT,PST SPINOUS PROCESS DEVICE INSERT LMBR 1 LVL,,,21,,TotalUnits,,,,21.26 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0172T,CPT,PST SPINOUS PROCESS DEVICE INSERT LMBR EA LVL,,,21,,TotalUnits,,,,17.72 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0174T,CPT,CAD CHEST RADIOGRAPH CONCURRENT W/INTERPRETATION,,,20,,TotalUnits,,,,0.22 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0191T,CPT,ANT SEGMENT INSERTION DRAINAGE W/O RESERVOIR INT,,,21,,TotalUnits,,,,24.14 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0198T,CPT,MEAS OCULAR BLOOD FLOW REPEAT IO PRES SAMP W/I&R,,,20,,TotalUnits,,,,0.86 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0201T,CPT,PERQ SAC AGMNTJ BI W/WO BALO/MCHNL DEV 2/> NDLS,,,20,,TotalUnits,,,,21.00 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0206T,CPT,CPTR DBS ALYS MLT CYCLS CAR ELEC DTA 2/> ECG LDS,,TC,14,,TotalUnits,,,,3.24 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
0213T,CPT,NJX DX/THER PARAVER FCT JT W/US CER/THOR 1 LVL,,,21,,TotalUnits,,,,2.80 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0214T,CPT,NJX DX/THER PARAVER FCT JT W/US CER/THOR 2ND LVL,,,21,,TotalUnits,,,,1.68 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
0216T,CPT,NJX DX/THER PARAVER FCT JT W/US LUMB/SAC 1 LVL,,,21,,TotalUnits,,,,3.57 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0217T,CPT,NJX DX/THER PARAVER FCT JT W/US LUMB/SAC LVL 2,,,21,,TotalUnits,,,,2.66 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
0228T,CPT,NJX ANES/STEROID TFRML EDRL W/US CER/THOR 1 LVL,,,21,,TotalUnits,,,,7.09 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0229T,CPT,NJX ANES/STERD TFRML EDRL W/US CER/THOR EA ADDL,,,21,,TotalUnits,,,,3.53 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0230T,CPT,NJX ANES/STEROID TFRML EDRL W/US LUM/SAC 1 LVL,,,21,,TotalUnits,,,,6.90 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0231T,CPT,NJX ANES/STEROID TFRML EDRL W/US LUM/SAC EA ADDL,,,21,,TotalUnits,,,,3.48 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0232T,CPT,NJX PLTLT PLASMA W/IMG HARVEST/PREPARATION,,,14,,TotalUnits,,,,9.03 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0234T,CPT,TRLUML PERIPHERAL ATHERECTOMY RENAL ARTERY EA,,,21,,RBRVS,5.53 ,2.54 ,2.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0235T,CPT,TRLUML PERIPHERAL ATHERECTOMY VISCERAL ARTERY EA,,,21,,RBRVS,5.53 ,2.54 ,2.54 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
0236T,CPT,TRLUML PERIPH ATHRC W/RS&I ABDOM AORTA,,,21,,RBRVS,7.60 ,3.18 ,3.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0237T,CPT,TRLUML PERIPH ATHRC W/RS&I BRCHIOCPHL EA VSL,,,21,,RBRVS,10.42 ,4.80 ,4.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0238T,CPT,TRLUML PERIPHERAL ATHERECTOMY ILIAC ARTERY EA,,,21,,TotalUnits,,,,11.08 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0275T,CPT,PERC LAMINO-/LAMINECTOMY INDIR IMAG GUIDE LUMBAR,,,21,,TotalUnits,,,,43.13 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0281T,CPT,PERC TRANSCTH CLOSR LT ATRIAL APPNDGE IMPLNT S&I,,,21,,TotalUnits,,,,39.21 ,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
0290T,CPT,CORNEA INCISNS RECIPIENT CORNEA W/LASR KERTPLSTY,,,21,,TotalUnits,,,,3.36 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
0291T,CPT,INTRAV OPTCL CHERNCE TMGRPHY W/S&I INTL VESL,,,14,,TotalUnits,,,,6.73 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0295T,CPT,EXT ECG > 48HR TO 21 DAY RCRD SCAN ANLYS REP R&I,,,4,,TotalUnits,,,,3.59 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
0296T,CPT,EXT ECG > 48HR TO 21 DAY RCRD W/CONECT INTL RCRD,,TC,4,,TotalUnits,,,,0.85 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
0297T,CPT,EXT ECG > 48HR TO 21 DAY SCAN ANALYSIS W/REPORT,,TC,4,,TotalUnits,,,,1.97 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
0298T,CPT,EXT ECG > 48HR TO 21 DAY REVIEW AND INTERPRETATN,,PC,4,,TotalUnits,,,,1.05 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0330T,CPT,TEAR FILM IMAGING UNILATERAL OR BILATERAL W/I&R,,,14,,TotalUnits,,,,1.64 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0331T,CPT,MYOCRD SYMPATHETIC INNERVAJ IMG PLNR QUAL&QUANT,,,20,,TotalUnits,,,,3.78 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0332T,CPT,MYOCRD SYMP INNERVAJ IMG PLNR QUAL&QUANT W/SPECT,,,20,,TotalUnits,,,,5.25 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0333T,CPT,VISUAL EVOKED POTENTIAL ACUITY SCREENING AUTO,,,14,,TotalUnits,,,,3.72 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0357T,CPT,CRYOPRESERVATION IMMATURE OOCYTE(S),,,17,,TotalUnits,,,,5.78 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
0375T,CPT,TOTAL DISC ARTHRP ANT APPR W/DISCECTOMY CRV 3+,,,21,,RBRVS,10.08 ,4.20 ,4.20 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
0387T,CPT,TRANSCATH INSERT OR REPLACE LEADLESS PM VENTR,,,21,,TotalUnits,,,,160.64 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0388T,CPT,TRANSCATH REMOVAL LEADLESS PM VENTRICULAR,,,21,,TotalUnits,,,,66.58 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0389T,CPT,PROG DEVICE EVAL IN PERSON LEADLESS PM SYSTEM,,,4,,TotalUnits,,,,1.10 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0391T,CPT,INTERROG DEVICE EVAL IN PERSON LEADLESS PM SYST,,,4,,TotalUnits,,,,1.10 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0392T,CPT,LAPS ESOPHGL SPHINCTER AUGMENT PROC PLACE DEVICE,,,21,,TotalUnits,,,,125.39 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0393T,CPT,ESOPHGL SPHINCTER AUGMENT DEVICE REMOVAL,,,21,,TotalUnits,,,,84.07 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0394T,CPT,HDR ELECTRONIC BRACHYTHERAPY SKIN SURFACE,,,20,,TotalUnits,,,,21.54 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
0395T,CPT,HDR ELECTRONIC BRACHYTHERAPY NTRSTL/INTRCAV,,,20,,TotalUnits,,,,21.54 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
A0398,HCPCS,ALS ROUTINE DISPOSBLE SUPPLS,,,28,,NW,,,,,,$109.09,$0.00,1,1,1,0,0,1,20161001,,,,
A0422,HCPCS,AMBULANCE 02 LIFE SUSTAINING,,,28,,NW,,,,,,$134.07,$0.00,1,1,1,0,0,1,20161001,,,,
A4206,HCPCS,1 CC STERILE SYRINGE&NEEDLE,,,28,,NW,,,,,,$1.15,$0.00,1,1,1,0,0,1,20161001,,,,
A4207,HCPCS,2 CC STERILE SYRINGE&NEEDLE,,,28,,NW,,,,,,$1.15,$0.00,1,1,1,0,0,1,20161001,,,,
A4208,HCPCS,3 CC STERILE SYRINGE&NEEDLE,,,28,,NW,,,,,,$1.15,$0.00,1,1,1,0,0,1,20161001,,,,
A4209,HCPCS,5+ CC STERILE SYRINGE&NEEDLE,,,28,,NW,,,,,,$1.15,$0.00,1,1,1,0,0,1,20161001,,,,
A4210,HCPCS,NONNEEDLE INJECTION DEVICE,,,28,,NW,,,,,,"$2,223.17",$0.00,1,1,1,0,0,1,20161001,,,,
A4211,HCPCS,SUPP FOR SELF-ADM INJECTIONS,,,28,,NW,,,,,,$42.46,$0.00,1,1,1,0,0,1,20161001,,,,
A4212,HCPCS,NON CORING NEEDLE OR STYLET,,,28,,NW,,,,,,$16.96,$0.00,1,1,1,0,0,1,20161001,,,,
A4213,HCPCS,20+ CC SYRINGE ONLY,,,28,,NW,,,,,,$2.26,$0.00,1,1,1,0,0,1,20161001,,,,
A4215,HCPCS,STERILE NEEDLE,,,28,,NW,,,,,,$1.11,$0.00,1,1,1,0,0,1,20161001,,,,
A4216,HCPCS,"STERILE WATER/SALINE, 10 ML",,,28,,NW,,,,,,$0.95,$0.00,1,1,1,0,0,1,20161001,,,,
A4217,HCPCS,"STERILE WATER/SALINE, 500 ML",,,28,,NW,,,,,,$5.93,$0.00,1,1,1,0,0,1,20161001,,,,
A4217,HCPCS,"STERILE WATER/SALINE, 500 ML",AU,,28,,NW,,,,,,$5.93,$0.00,1,1,1,0,0,1,20161001,,,,
A4218,HCPCS,STERILE SALINE OR WATER,,,28,,NW,,,,,,$1.33,$0.00,1,1,1,0,0,1,20161001,,,,
A4220,HCPCS,INFUSION PUMP REFILL KIT,,,28,,NW,,,,,,$80.06,$0.00,1,1,1,0,0,1,20161001,,,,
A4221,HCPCS,MAINT DRUG INFUS CATH PER WK,,,28,,NW,,,,,,$45.73,$0.00,1,1,1,0,0,1,20161001,,,,
A4222,HCPCS,INFUSION SUPPLIES WITH PUMP,,,28,,NW,,,,,,$105.82,$0.00,1,1,1,0,0,1,20161001,,,,
A4223,HCPCS,INFUSION SUPPLIES W/O PUMP,,,28,,NW,,,,,,$133.43,$0.00,1,1,1,0,0,1,20161001,,,,
A4230,HCPCS,INFUS INSULIN PUMP NON NEEDL,,,28,,NW,,,,,,$20.82,$0.00,1,1,1,0,0,1,20161001,,,,
A4231,HCPCS,INFUSION INSULIN PUMP NEEDLE,,,28,,NW,,,,,,$11.80,$0.00,1,1,1,0,0,1,20161001,,,,
A4232,HCPCS,SYRINGE W/NEEDLE INSULIN 3CC,,,28,,NW,,,,,,$5.36,$0.00,1,1,1,0,0,1,20161001,,,,
A4233,HCPCS,ALKALIN BATT FOR GLUCOSE MON,,,28,,NW,,,,,,$3.43,$0.00,1,1,1,0,0,1,20161001,,,,
A4233,HCPCS,ALKALIN BATT FOR GLUCOSE MON,NU,,28,,NW,,,,,,$3.43,$0.00,1,1,1,0,0,1,20161001,,,,
A4234,HCPCS,J-CELL BATT FOR GLUCOSE MON,,,28,,NW,,,,,,$13.41,$0.00,1,1,1,0,0,1,20161001,,,,
A4234,HCPCS,J-CELL BATT FOR GLUCOSE MON,NU,,28,,NW,,,,,,$13.41,$0.00,1,1,1,0,0,1,20161001,,,,
A4235,HCPCS,LITHIUM BATT FOR GLUCOSE MON,,,28,,NW,,,,,,$8.37,$0.00,1,1,1,0,0,1,20161001,,,,
A4235,HCPCS,LITHIUM BATT FOR GLUCOSE MON,NU,,28,,NW,,,,,,$8.37,$0.00,1,1,1,0,0,1,20161001,,,,
A4236,HCPCS,SILVR OXIDE BATT GLUCOSE MON,,,28,,NW,,,,,,$7.10,$0.00,1,1,1,0,0,1,20161001,,,,
A4236,HCPCS,SILVR OXIDE BATT GLUCOSE MON,NU,,28,,NW,,,,,,$7.10,$0.00,1,1,1,0,0,1,20161001,,,,
A4244,HCPCS,ALCOHOL OR PEROXIDE PER PINT,,,28,,NW,,,,,,$2.26,$0.00,1,1,1,0,0,1,20161001,,,,
A4245,HCPCS,ALCOHOL WIPES PER BOX,,,28,,NW,,,,,,$6.18,$0.00,1,1,1,0,0,1,20161001,,,,
A4246,HCPCS,BETADINE/PHISOHEX SOLUTION,,,28,,NW,,,,,,$6.18,$0.00,1,1,1,0,0,1,20161001,,,,
A4247,HCPCS,BETADINE/IODINE SWABS/WIPES,,,28,,NW,,,,,,$9.12,$0.00,1,1,1,0,0,1,20161001,,,,
A4248,HCPCS,CHLORHEXIDINE ANTISEPT,,,28,,NW,,,,,,$8.21,$0.00,1,1,1,0,0,1,20161001,,,,
A4250,HCPCS,URINE REAGENT STRIPS/TABLETS,,,28,,NW,,,,,,$40.01,$0.00,1,1,1,0,0,1,20161001,,,,
A4252,HCPCS,BLOOD KETONE TEST OR STRIP,,,28,,NW,,,,,,$12.46,$0.00,1,1,1,0,0,1,20161001,,,,
A4253,HCPCS,BLOOD GLUCOSE/REAGENT STRIPS,,,28,,NW,,,,,,$96.92,$0.00,1,1,1,0,0,1,20161001,,,,
A4253,HCPCS,BLOOD GLUCOSE/REAGENT STRIPS,NU,,28,,NW,,,,,,$96.92,$0.00,1,1,1,0,0,1,20161001,,,,
A4255,HCPCS,GLUCOSE MONITOR PLATFORMS,,,28,,NW,,,,,,$11.31,$0.00,1,1,1,0,0,1,20161001,,,,
A4256,HCPCS,CALIBRATOR SOLUTION/CHIPS,,,28,,NW,,,,,,$18.14,$0.00,1,1,1,0,0,1,20161001,,,,
A4256,HCPCS,CALIBRATOR SOLUTION/CHIPS,KL,,28,,NW,,,,,,$16.46,$0.00,1,1,1,0,0,1,20161001,,,,
A4257,HCPCS,REPLACE LENSSHIELD CARTRIDGE,,,28,,NW,,,,,,$20.18,$0.00,1,1,1,0,0,1,20161001,,,,
A4258,HCPCS,LANCET DEVICE EACH,,,28,,NW,,,,,,$30.60,$0.00,1,1,1,0,0,1,20161001,,,,
A4258,HCPCS,LANCET DEVICE EACH,KL,,28,,NW,,,,,,$27.34,$0.00,1,1,1,0,0,1,20161001,,,,
A4259,HCPCS,LANCETS PER BOX,,,28,,NW,,,,,,$19.11,$0.00,1,1,1,0,0,1,20161001,,,,
A4259,HCPCS,LANCETS PER BOX,KL,,28,,NW,,,,,,$17.29,$0.00,1,1,1,0,0,1,20161001,,,,
A4261,HCPCS,CERVICAL CAP CONTRACEPTIVE,,,28,,NW,,,,,,$72.01,$0.00,1,1,1,1,1,1,20161001,,,,
A4262,HCPCS,TEMPORARY TEAR DUCT PLUG,,,28,,NW,,,,,,$1.15,$0.00,1,1,1,0,0,1,20161001,,,,
A4263,HCPCS,PERMANENT TEAR DUCT PLUG,,,28,,NW,,,,,,$98.11,$0.00,1,1,1,0,0,1,20161001,,,,
A4264,HCPCS,INTRATUBAL OCCLUSION DEVICE,,,28,,NW,,,,,,"$2,084.66",$0.00,1,1,1,1,1,1,20161001,,,,
A4265,HCPCS,PARAFFIN,,,28,,NW,,,,,,$9.59,$0.00,1,1,1,0,0,1,20161001,,,,
A4266,HCPCS,DIAPHRAGM,,,28,,NW,,,,,,$42.43,$0.00,1,1,1,1,1,1,20161001,,,,
A4267,HCPCS,MALE CONDOM,,,28,,NW,,,,,,$1.15,$0.00,1,1,1,1,1,1,20161001,,,,
A4268,HCPCS,FEMALE CONDOM,,,28,,NW,,,,,,$2.12,$0.00,1,1,1,1,1,1,20161001,,,,
A4269,HCPCS,SPERMICIDE,,,28,,NW,,,,,,$2.26,$0.00,1,1,1,1,1,1,20161001,,,,
A4270,HCPCS,DISPOSABLE ENDOSCOPE SHEATH,,,28,,NW,,,,,,$33.36,$0.00,1,1,1,0,0,1,20161001,,,,
A4280,HCPCS,BRST PRSTHS ADHSV ATTCHMNT,,,28,,NW,,,,,,$10.46,$0.00,1,1,1,0,0,1,20161001,,,,
A4281,HCPCS,REPLACEMENT BREASTPUMP TUBE,,,28,,NW,,,,,,$29.97,$0.00,1,1,1,0,0,1,20161001,,,,
A4282,HCPCS,REPLACEMENT BREASTPUMP ADPT,,,28,,NW,,,,,,$5.48,$0.00,1,1,1,0,0,1,20161001,,,,
A4283,HCPCS,REPLACEMENT BREASTPUMP CAP,,,28,,NW,,,,,,$309.65,$0.00,1,1,1,0,0,1,20161001,,,,
A4284,HCPCS,REPLCMNT BREAST PUMP SHIELD,,,28,,NW,,,,,,$40.01,$0.00,1,1,1,0,0,1,20161001,,,,
A4285,HCPCS,REPLCMNT BREAST PUMP BOTTLE,,,28,,NW,,,,,,$8.67,$0.00,1,1,1,0,0,1,20161001,,,,
A4286,HCPCS,REPLCMNT BREASTPUMP LOK RING,,,28,,NW,,,,,,$156.28,$0.00,1,1,1,0,0,1,20161001,,,,
A4290,HCPCS,SACRAL NERVE STIM TEST LEAD,,,28,,NW,,,,,,$667.16,$0.00,1,1,1,0,0,1,20161001,,,,
A4300,HCPCS,CATH IMPL VASC ACCESS PORTAL,,,28,,NW,,,,,,$37.36,$0.00,1,1,1,0,0,1,20161001,,,,
A4301,HCPCS,IMPLANTABLE ACCESS SYST PERC,,,28,,NW,,,,,,$28.39,$0.00,1,1,1,0,0,1,20161001,,,,
A4305,HCPCS,DRUG DELIVERY SYSTEM >=50 ML,,,28,,NW,,,,,,$28.39,$0.00,1,1,1,0,0,1,20161001,,,,
A4306,HCPCS,DRUG DELIVERY SYSTEM <=50 ML,,,28,,NW,,,,,,$41.30,$0.00,1,1,1,0,0,1,20161001,,,,
A4310,HCPCS,INSERT TRAY W/O BAG/CATH,,,28,,NW,,,,,,$14.37,$0.00,1,1,1,0,0,1,20161001,,,,
A4311,HCPCS,CATHETER W/O BAG 2-WAY LATEX,,,28,,NW,,,,,,$30.14,$0.00,1,1,1,0,0,1,20161001,,,,
A4312,HCPCS,CATH W/O BAG 2-WAY SILICONE,,,28,,NW,,,,,,$38.25,$0.00,1,1,1,0,0,1,20161001,,,,
A4313,HCPCS,CATHETER W/BAG 3-WAY,,,28,,NW,,,,,,$39.77,$0.00,1,1,1,0,0,1,20161001,,,,
A4314,HCPCS,CATH W/DRAINAGE 2-WAY LATEX,,,28,,NW,,,,,,$56.03,$0.00,1,1,1,0,0,1,20161001,,,,
A4315,HCPCS,CATH W/DRAINAGE 2-WAY SILCNE,,,28,,NW,,,,,,$58.94,$0.00,1,1,1,0,0,1,20161001,,,,
A4316,HCPCS,CATH W/DRAINAGE 3-WAY,,,28,,NW,,,,,,$64.21,$0.00,1,1,1,0,0,1,20161001,,,,
A4320,HCPCS,IRRIGATION TRAY,,,28,,NW,,,,,,$9.81,$0.00,1,1,1,0,0,1,20161001,,,,
A4321,HCPCS,CATH THERAPEUTIC IRRIG AGENT,,,28,,NW,,,,,,$7.49,$0.00,1,1,1,0,0,1,20161001,,,,
A4322,HCPCS,IRRIGATION SYRINGE,,,28,,NW,,,,,,$5.99,$0.00,1,1,1,0,0,1,20161001,,,,
A4326,HCPCS,MALE EXTERNAL CATHETER,,,28,,NW,,,,,,$20.75,$0.00,1,1,1,0,0,1,20161001,,,,
A4327,HCPCS,FEM URINARY COLLECT DEV CUP,,,28,,NW,,,,,,$105.28,$0.00,1,1,1,0,0,1,20161001,,,,
A4328,HCPCS,FEM URINARY COLLECT POUCH,,,28,,NW,,,,,,$20.31,$0.00,1,1,1,0,0,1,20161001,,,,
A4330,HCPCS,STOOL COLLECTION POUCH,,,28,,NW,,,,,,$13.42,$0.00,1,1,1,0,0,1,20161001,,,,
A4331,HCPCS,EXTENSION DRAINAGE TUBING,,,28,,NW,,,,,,$6.39,$0.00,1,1,1,0,0,1,20161001,,,,
A4332,HCPCS,LUBE STERILE PACKET,,,28,,NW,,,,,,$0.26,$0.00,1,1,1,0,0,1,20161001,,,,
A4333,HCPCS,URINARY CATH ANCHOR DEVICE,,,28,,NW,,,,,,$4.38,$0.00,1,1,1,0,0,1,20161001,,,,
A4334,HCPCS,URINARY CATH LEG STRAP,,,28,,NW,,,,,,$9.70,$0.00,1,1,1,0,0,1,20161001,,,,
A4335,HCPCS,INCONTINENCE SUPPLY,,,28,,NW,,,,,,$0.54,$0.00,1,1,1,0,0,1,20161001,,,,
A4336,HCPCS,URETHRAL INSERT,,,28,,NW,,,,,,$3.06,$0.00,1,1,1,0,0,1,20161001,,,,
A4338,HCPCS,INDWELLING CATHETER LATEX,,,28,,NW,,,,,,$24.66,$0.00,1,1,1,0,0,1,20161001,,,,
A4340,HCPCS,INDWELLING CATHETER SPECIAL,,,28,,NW,,,,,,$69.95,$0.00,1,1,1,0,0,1,20161001,,,,
A4344,HCPCS,CATH INDW FOLEY 2 WAY SILICN,,,28,,NW,,,,,,$33.18,$0.00,1,1,1,0,0,1,20161001,,,,
A4346,HCPCS,CATH INDW FOLEY 3 WAY,,,28,,NW,,,,,,$41.49,$0.00,1,1,1,0,0,1,20161001,,,,
A4349,HCPCS,DISPOSABLE MALE EXTERNAL CAT,,,28,,NW,,,,,,$4.17,$0.00,1,1,1,0,0,1,20161001,,,,
A4351,HCPCS,STRAIGHT TIP URINE CATHETER,,,28,,NW,,,,,,$3.58,$0.00,1,1,1,0,0,1,20161001,,,,
A4352,HCPCS,COUDE TIP URINARY CATHETER,,,28,,NW,,,,,,$12.00,$0.00,1,1,1,0,0,1,20161001,,,,
A4353,HCPCS,INTERMITTENT URINARY CATH,,,28,,NW,,,,,,$13.71,$0.00,1,1,1,0,0,1,20161001,,,,
A4354,HCPCS,CATH INSERTION TRAY W/BAG,,,28,,NW,,,,,,$23.39,$0.00,1,1,1,0,0,1,20161001,,,,
A4355,HCPCS,BLADDER IRRIGATION TUBING,,,28,,NW,,,,,,$16.90,$0.00,1,1,1,0,0,1,20161001,,,,
A4356,HCPCS,EXT URETH CLMP OR COMPR DVC,,,28,,NW,,,,,,$104.74,$0.00,1,1,1,0,0,1,20161001,,,,
A4357,HCPCS,BEDSIDE DRAINAGE BAG,,,28,,NW,,,,,,$18.28,$0.00,1,1,1,0,0,1,20161001,,,,
A4358,HCPCS,URINARY LEG OR ABDOMEN BAG,,,28,,NW,,,,,,$12.42,$0.00,1,1,1,0,0,1,20161001,,,,
A4360,HCPCS,DISPOSABLE EXT URETHRAL DEV,,,28,,NW,,,,,,$1.05,$0.00,1,1,1,0,0,1,20161001,,,,
A4361,HCPCS,OSTOMY FACE PLATE,,,28,,NW,,,,,,$39.74,$0.00,1,1,1,0,0,1,20161001,,,,
A4362,HCPCS,SOLID SKIN BARRIER,,,28,,NW,,,,,,$6.61,$0.00,1,1,1,0,0,1,20161001,,,,
A4363,HCPCS,"OSTOMY CLAMP, REPLACEMENT",,,28,,NW,,,,,,$4.66,$0.00,1,1,1,0,0,1,20161001,,,,
A4364,HCPCS,"ADHESIVE, LIQUID OR EQUAL",,,28,,NW,,,,,,$5.41,$0.00,1,1,1,0,0,1,20161001,,,,
A4366,HCPCS,OSTOMY VENT,,,28,,NW,,,,,,$2.57,$0.00,1,1,1,0,0,1,20161001,,,,
A4367,HCPCS,OSTOMY BELT,,,28,,NW,,,,,,$13.75,$0.00,1,1,1,0,0,1,20161001,,,,
A4368,HCPCS,OSTOMY FILTER,,,28,,NW,,,,,,$0.57,$0.00,1,1,1,0,0,1,20161001,,,,
A4369,HCPCS,SKIN BARRIER LIQUID PER OZ,,,28,,NW,,,,,,$4.76,$0.00,1,1,1,0,0,1,20161001,,,,
A4371,HCPCS,SKIN BARRIER POWDER PER OZ,,,28,,NW,,,,,,$7.27,$0.00,1,1,1,0,0,1,20161001,,,,
A4372,HCPCS,SKIN BARRIER SOLID 4X4 EQUIV,,,28,,NW,,,,,,$8.34,$0.00,1,1,1,0,0,1,20161001,,,,
A4373,HCPCS,SKIN BARRIER WITH FLANGE,,,28,,NW,,,,,,$12.32,$0.00,1,1,1,0,0,1,20161001,,,,
A4375,HCPCS,DRAINABLE PLASTIC PCH W FCPL,,,28,,NW,,,,,,$38.19,$0.00,1,1,1,0,0,1,20161001,,,,
A4376,HCPCS,DRAINABLE RUBBER PCH W FCPLT,,,28,,NW,,,,,,$114.96,$0.00,1,1,1,0,0,1,20161001,,,,
A4377,HCPCS,DRAINABLE PLSTIC PCH W/O FP,,,28,,NW,,,,,,$8.53,$0.00,1,1,1,0,0,1,20161001,,,,
A4378,HCPCS,DRAINABLE RUBBER PCH W/O FP,,,28,,NW,,,,,,$72.42,$0.00,1,1,1,0,0,1,20161001,,,,
A4379,HCPCS,URINARY PLASTIC POUCH W FCPL,,,28,,NW,,,,,,$32.74,$0.00,1,1,1,0,0,1,20161001,,,,
A4380,HCPCS,URINARY RUBBER POUCH W FCPLT,,,28,,NW,,,,,,$89.05,$0.00,1,1,1,0,0,1,20161001,,,,
A4381,HCPCS,URINARY PLASTIC POUCH W/O FP,,,28,,NW,,,,,,$9.16,$0.00,1,1,1,0,0,1,20161001,,,,
A4382,HCPCS,URINARY HVY PLSTC PCH W/O FP,,,28,,NW,,,,,,$56.96,$0.00,1,1,1,0,0,1,20161001,,,,
A4383,HCPCS,URINARY RUBBER POUCH W/O FP,,,28,,NW,,,,,,$65.99,$0.00,1,1,1,0,0,1,20161001,,,,
A4384,HCPCS,OSTOMY FACEPLT/SILICONE RING,,,28,,NW,,,,,,$19.09,$0.00,1,1,1,0,0,1,20161001,,,,
A4385,HCPCS,OST SKN BARRIER SLD EXT WEAR,,,28,,NW,,,,,,$10.07,$0.00,1,1,1,0,0,1,20161001,,,,
A4387,HCPCS,OST CLSD POUCH W ATT ST BARR,,,28,,NW,,,,,,$4.60,$0.00,1,1,1,0,0,1,20161001,,,,
A4388,HCPCS,DRAINABLE PCH W EX WEAR BARR,,,28,,NW,,,,,,$8.67,$0.00,1,1,1,0,0,1,20161001,,,,
A4389,HCPCS,DRAINABLE PCH W ST WEAR BARR,,,28,,NW,,,,,,$12.21,$0.00,1,1,1,0,0,1,20161001,,,,
A4390,HCPCS,DRAINABLE PCH EX WEAR CONVEX,,,28,,NW,,,,,,$19.07,$0.00,1,1,1,0,0,1,20161001,,,,
A4391,HCPCS,URINARY POUCH W EX WEAR BARR,,,28,,NW,,,,,,$13.85,$0.00,1,1,1,0,0,1,20161001,,,,
A4392,HCPCS,URINARY POUCH W ST WEAR BARR,,,28,,NW,,,,,,$15.97,$0.00,1,1,1,0,0,1,20161001,,,,
A4393,HCPCS,URINE PCH W EX WEAR BAR CONV,,,28,,NW,,,,,,$17.65,$0.00,1,1,1,0,0,1,20161001,,,,
A4394,HCPCS,OSTOMY POUCH LIQ DEODORANT,,,28,,NW,,,,,,$5.25,$0.00,1,1,1,0,0,1,20161001,,,,
A4395,HCPCS,OSTOMY POUCH SOLID DEODORANT,,,28,,NW,,,,,,$0.10,$0.00,1,1,1,0,0,1,20161001,,,,
A4396,HCPCS,PERISTOMAL HERNIA SUPPRT BLT,,,28,,NW,,,,,,$96.97,$0.00,1,1,1,0,0,1,20161001,,,,
A4397,HCPCS,IRRIGATION SUPPLY SLEEVE,,,28,,NW,,,,,,$8.77,$0.00,1,1,1,0,0,1,20161001,,,,
A4398,HCPCS,OSTOMY IRRIGATION BAG,,,28,,NW,,,,,,$28.98,$0.00,1,1,1,0,0,1,20161001,,,,
A4399,HCPCS,OSTOMY IRRIG CONE/CATH W BRS,,,28,,NW,,,,,,$23.98,$0.00,1,1,1,0,0,1,20161001,,,,
A4400,HCPCS,OSTOMY IRRIGATION SET,,,28,,NW,,,,,,$110.47,$0.00,1,1,1,0,0,1,20161001,,,,
A4402,HCPCS,LUBRICANT PER OUNCE,,,28,,NW,,,,,,$3.24,$0.00,1,1,1,0,0,1,20161001,,,,
A4404,HCPCS,OSTOMY RING EACH,,,28,,NW,,,,,,$3.44,$0.00,1,1,1,0,0,1,20161001,,,,
A4405,HCPCS,NONPECTIN BASED OSTOMY PASTE,,,28,,NW,,,,,,$6.84,$0.00,1,1,1,0,0,1,20161001,,,,
A4406,HCPCS,PECTIN BASED OSTOMY PASTE,,,28,,NW,,,,,,$11.28,$0.00,1,1,1,0,0,1,20161001,,,,
A4407,HCPCS,EXT WEAR OST SKN BARR <=4SQ,,,28,,NW,,,,,,$17.07,$0.00,1,1,1,0,0,1,20161001,,,,
A4408,HCPCS,EXT WEAR OST SKN BARR >4SQ,,,28,,NW,,,,,,$19.72,$0.00,1,1,1,0,0,1,20161001,,,,
A4409,HCPCS,OST SKN BARR CONVEX <=4 SQ I,,,28,,NW,,,,,,$12.21,$0.00,1,1,1,0,0,1,20161001,,,,
A4410,HCPCS,OST SKN BARR EXTND >4 SQ,,,28,,NW,,,,,,$17.65,$0.00,1,1,1,0,0,1,20161001,,,,
A4411,HCPCS,OST SKN BARR EXTND =4SQ,,,28,,NW,,,,,,$10.07,$0.00,1,1,1,0,0,1,20161001,,,,
A4412,HCPCS,OST POUCH DRAIN HIGH OUTPUT,,,28,,NW,,,,,,$5.48,$0.00,1,1,1,0,0,1,20161001,,,,
A4413,HCPCS,2 PC DRAINABLE OST POUCH,,,28,,NW,,,,,,$10.84,$0.00,1,1,1,0,0,1,20161001,,,,
A4414,HCPCS,OST SKNBAR W/O CONV<=4 SQ IN,,,28,,NW,,,,,,$9.72,$0.00,1,1,1,0,0,1,20161001,,,,
A4415,HCPCS,OST SKN BARR W/O CONV >4 SQI,,,28,,NW,,,,,,$11.78,$0.00,1,1,1,0,0,1,20161001,,,,
A4416,HCPCS,OST PCH CLSD W BARRIER/FILTR,,,28,,NW,,,,,,$5.45,$0.00,1,1,1,0,0,1,20161001,,,,
A4417,HCPCS,OST PCH W BAR/BLTINCONV/FLTR,,,28,,NW,,,,,,$7.36,$0.00,1,1,1,0,0,1,20161001,,,,
A4418,HCPCS,OST PCH CLSD W/O BAR W FILTR,,,28,,NW,,,,,,$3.60,$0.00,1,1,1,0,0,1,20161001,,,,
A4419,HCPCS,OST PCH FOR BAR W FLANGE/FLT,,,28,,NW,,,,,,$3.44,$0.00,1,1,1,0,0,1,20161001,,,,
A4420,HCPCS,OST PCH CLSD FOR BAR W LK FL,,,28,,NW,,,,,,$3.59,$0.00,1,1,1,0,0,1,20161001,,,,
A4421,HCPCS,OSTOMY SUPPLY MISC,,,28,,NW,,,,,,$7.99,$0.00,1,1,1,0,0,1,20161001,,,,
A4422,HCPCS,OST POUCH ABSORBENT MATERIAL,,,28,,NW,,,,,,$0.26,$0.00,1,1,1,0,0,1,20161001,,,,
A4423,HCPCS,OST PCH FOR BAR W LK FL/FLTR,,,28,,NW,,,,,,$3.69,$0.00,1,1,1,0,0,1,20161001,,,,
A4424,HCPCS,OST PCH DRAIN W BAR & FILTER,,,28,,NW,,,,,,$9.41,$0.00,1,1,1,0,0,1,20161001,,,,
A4425,HCPCS,OST PCH DRAIN FOR BARRIER FL,,,28,,NW,,,,,,$7.09,$0.00,1,1,1,0,0,1,20161001,,,,
A4426,HCPCS,OST PCH DRAIN 2 PIECE SYSTEM,,,28,,NW,,,,,,$5.40,$0.00,1,1,1,0,0,1,20161001,,,,
A4427,HCPCS,OST PCH DRAIN/BARR LK FLNG/F,,,28,,NW,,,,,,$5.51,$0.00,1,1,1,0,0,1,20161001,,,,
A4428,HCPCS,URINE OST POUCH W FAUCET/TAP,,,28,,NW,,,,,,$12.88,$0.00,1,1,1,0,0,1,20161001,,,,
A4429,HCPCS,URINE OST POUCH W BLTINCONV,,,28,,NW,,,,,,$15.23,$0.00,1,1,1,0,0,1,20161001,,,,
A4430,HCPCS,OST URINE PCH W B/BLTIN CONV,,,28,,NW,,,,,,$15.47,$0.00,1,1,1,0,0,1,20161001,,,,
A4431,HCPCS,OST PCH URINE W BARRIER/TAPV,,,28,,NW,,,,,,$12.30,$0.00,1,1,1,0,0,1,20161001,,,,
A4432,HCPCS,OS PCH URINE W BAR/FANGE/TAP,,,28,,NW,,,,,,$7.11,$0.00,1,1,1,0,0,1,20161001,,,,
A4433,HCPCS,URINE OST PCH BAR W LOCK FLN,,,28,,NW,,,,,,$6.61,$0.00,1,1,1,0,0,1,20161001,,,,
A4434,HCPCS,OST PCH URINE W LOCK FLNG/FT,,,28,,NW,,,,,,$7.43,$0.00,1,1,1,0,0,1,20161001,,,,
A4435,HCPCS,1PC OST PCH DRAIN HGH OUTPUT,,,28,,NW,,,,,,$11.43,$0.00,1,1,1,0,0,1,20161001,,,,
A4450,HCPCS,NON-WATERPROOF TAPE,,,28,,NW,,,,,,$0.18,$0.00,1,1,1,0,0,1,20161001,,,,
A4450,HCPCS,NON-WATERPROOF TAPE,AU,,28,,NW,,,,,,$0.18,$0.00,1,1,1,0,0,1,20161001,,,,
A4450,HCPCS,NON-WATERPROOF TAPE,AV,,28,,NW,,,,,,$0.18,$0.00,1,1,1,0,0,1,20161001,,,,
A4450,HCPCS,NON-WATERPROOF TAPE,AW,,28,,NW,,,,,,$0.24,$0.00,1,1,1,0,0,1,20161001,,,,
A4452,HCPCS,WATERPROOF TAPE,,,28,,NW,,,,,,$0.81,$0.00,1,1,1,0,0,1,20161001,,,,
A4452,HCPCS,WATERPROOF TAPE,AU,,28,,NW,,,,,,$0.81,$0.00,1,1,1,0,0,1,20161001,,,,
A4452,HCPCS,WATERPROOF TAPE,AV,,28,,NW,,,,,,$0.81,$0.00,1,1,1,0,0,1,20161001,,,,
A4452,HCPCS,WATERPROOF TAPE,AW,,28,,NW,,,,,,$0.89,$0.00,1,1,1,0,0,1,20161001,,,,
A4455,HCPCS,ADHESIVE REMOVER PER OUNCE,,,28,,NW,,,,,,$2.87,$0.00,1,1,1,0,0,1,20161001,,,,
A4456,HCPCS,"ADHESIVE REMOVER, WIPES",,,28,,NW,,,,,,$0.55,$0.00,1,1,1,0,0,1,20161001,,,,
A4458,HCPCS,REUSABLE ENEMA BAG,,,28,,NW,,,,,,$22.63,$0.00,1,1,1,0,0,1,20161001,,,,
A4459,HCPCS,"MANUAL PUMP ENEMA, REUSABLE",,,28,,NW,,,,,,$22.63,$0.00,1,1,1,0,0,1,20161001,,,,
A4461,HCPCS,SURGICL DRESS HOLD NON-REUSE,,,28,,NW,,,,,,$6.60,$0.00,1,1,1,0,0,1,20161001,,,,
A4463,HCPCS,SURGICAL DRESS HOLDER REUSE,,,28,,NW,,,,,,$28.42,$0.00,1,1,1,0,0,1,20161001,,,,
A4465,HCPCS,NON-ELASTIC EXTREMITY BINDER,,,28,,NW,,,,,,$18.06,$0.00,1,1,1,0,0,1,20161001,,,,
A4466,HCPCS,ELASTIC GARMENT/COVERING,,,28,,NW,,,,,,$53.37,$0.00,1,1,1,0,0,1,20161001,,,,
A4470,HCPCS,GRAVLEE JET WASHER,,,28,,NW,,,,,,$13.04,$0.00,1,1,1,0,0,1,20161001,,,,
A4480,HCPCS,VABRA ASPIRATOR,,,28,,NW,,,,,,$10.10,$0.00,1,1,1,0,0,1,20161001,,,,
A4481,HCPCS,TRACHEOSTOMA FILTER,,,28,,NW,,,,,,$1.06,$0.00,1,1,1,0,0,1,20161001,,,,
A4483,HCPCS,MOISTURE EXCHANGER,,,28,,NW,,,,,,$9.11,$0.00,1,1,1,0,0,1,20161001,,,,
A4490,HCPCS,ABOVE KNEE SURGICAL STOCKING,,,28,,NW,,,,,,$13.04,$0.00,1,1,1,0,0,1,20161001,,,,
A4495,HCPCS,THIGH LENGTH SURG STOCKING,,,28,,NW,,,,,,$13.04,$0.00,1,1,1,0,0,1,20161001,,,,
A4500,HCPCS,BELOW KNEE SURGICAL STOCKING,,,28,,NW,,,,,,$10.10,$0.00,1,1,1,0,0,1,20161001,,,,
A4510,HCPCS,FULL LENGTH SURG STOCKING,,,28,,NW,,,,,,$25.81,$0.00,1,1,1,0,0,1,20161001,,,,
A4520,HCPCS,INCONTINENCE GARMENT ANYTYPE,,,28,,NW,,,,,,$1.27,$0.00,1,1,1,0,0,1,20161001,,,,
A4550,HCPCS,SURGICAL TRAYS,,,28,,NW,,,,,,$70.99,$0.00,1,1,1,0,0,1,20161001,,,,
A4554,HCPCS,DISPOSABLE UNDERPADS,,,28,,NW,,,,,,$6.18,$0.00,1,1,1,0,0,1,20161001,,,,
A4555,HCPCS,CA TX E-STIM ELECTR/TRANSDUC,,,28,,NW,,,,,,$18.20,$0.00,1,1,1,0,0,1,20161001,,,,
A4556,HCPCS,"ELECTRODES, PAIR",,,28,,NW,,,,,,$18.20,$0.00,1,1,1,0,0,1,20161001,,,,
A4557,HCPCS,"LEAD WIRES, PAIR",,,28,,NW,,,,,,$37.58,$0.00,1,1,1,0,0,1,20161001,,,,
A4558,HCPCS,CONDUCTIVE GEL OR PASTE,,,28,,NW,,,,,,$13.20,$0.00,1,1,1,0,0,1,20161001,,,,
A4559,HCPCS,COUPLING GEL OR PASTE,,,28,,NW,,,,,,$0.28,$0.00,1,1,1,0,0,1,20161001,,,,
A4561,HCPCS,"PESSARY RUBBER, ANY TYPE",,,28,,NW,,,,,,$45.69,$0.00,1,1,1,0,0,1,20161001,,,,
A4562,HCPCS,"PESSARY, NON RUBBER,ANY TYPE",,,28,,NW,,,,,,$121.35,$0.00,1,1,1,0,0,1,20161001,,,,
A4565,HCPCS,SLINGS,,,28,,NW,,,,,,$15.04,$0.00,1,1,1,0,0,1,20161001,,,,
A4566,HCPCS,SHOULD SLING/VEST/ABRESTRAIN,,,28,,NW,,,,,,$33.36,$0.00,1,1,1,0,0,1,20161001,,,,
A4570,HCPCS,SPLINT,,,28,,NW,,,,,,$40.01,$0.00,1,1,1,0,0,1,20161001,,,,
A4575,HCPCS,HYPERBARIC O2 CHAMBER DISPS,,,28,,NW,,,,,,"$1,116.14",$0.00,1,1,1,0,0,1,20161001,,,,
A4580,HCPCS,CAST SUPPLIES (PLASTER),,,28,,NW,,,,,,$71.87,$0.00,1,1,1,0,0,1,20161001,,,,
A4590,HCPCS,SPECIAL CASTING MATERIAL,,,28,,NW,,,,,,$95.52,$0.00,1,1,1,0,0,1,20161001,,,,
A4595,HCPCS,TENS SUPPL 2 LEAD PER MONTH,,,28,,NW,,,,,,$61.82,$0.00,1,1,1,0,0,1,20161001,,,,
A4600,HCPCS,"SLEEVE, INTER LIMB COMP DEV",,,28,,NW,,,,,,$293.66,$0.00,1,1,1,0,0,1,20161001,,,,
A4601,HCPCS,LITH ION NON PROSTH RECHARGE,,,28,,NW,,,,,,$2.91,$0.00,1,1,1,0,0,1,20161001,,,,
A4602,HCPCS,REPLACE LITHIUM BATTERY 1.5V,,,28,,NW,,,,,,$10.48,$0.00,1,1,1,0,0,1,20161001,,,,
A4602,HCPCS,REPLACE LITHIUM BATTERY 1.5V,NU,,28,,NW,,,,,,$10.48,$0.00,1,1,1,0,0,1,20161001,,,,
A4604,HCPCS,TUBING WITH HEATING ELEMENT,,,28,,NW,,,,,,$137.10,$0.00,1,1,1,0,0,1,20161001,,,,
A4604,HCPCS,TUBING WITH HEATING ELEMENT,NU,,28,,NW,,,,,,$137.10,$0.00,1,1,1,0,0,1,20161001,,,,
A4605,HCPCS,TRACH SUCTION CATH CLOSE SYS,,,28,,NW,,,,,,$29.68,$0.00,1,1,1,0,0,1,20161001,,,,
A4605,HCPCS,TRACH SUCTION CATH CLOSE SYS,NU,,28,,NW,,,,,,$29.68,$0.00,1,1,1,0,0,1,20161001,,,,
A4606,HCPCS,OXYGEN PROBE USED W OXIMETER,,,28,,NW,,,,,,$39.04,$0.00,1,1,1,0,0,1,20161001,,,,
A4608,HCPCS,TRANSTRACHEAL OXYGEN CATH,,,28,,NW,,,,,,$117.66,$0.00,1,1,1,0,0,1,20161001,,,,
A4611,HCPCS,HEAVY DUTY BATTERY,,,28,,NW,,,,,,$389.18,$0.00,1,1,1,0,0,1,20161001,,,,
A4611,HCPCS,HEAVY DUTY BATTERY,NU,,28,,NW,,,,,,$389.18,$0.00,1,1,1,0,0,1,20161001,,,,
A4611,HCPCS,HEAVY DUTY BATTERY,RR,,28,,NW,,,,,,$28.71,$0.00,1,1,1,0,0,1,20161001,,,,
A4611,HCPCS,HEAVY DUTY BATTERY,UE,,28,,NW,,,,,,$288.61,$0.00,1,1,1,0,0,1,20161001,,,,
A4612,HCPCS,BATTERY CABLES,,,28,,NW,,,,,,$150.75,$0.00,1,1,1,0,0,1,20161001,,,,
A4612,HCPCS,BATTERY CABLES,NU,,28,,NW,,,,,,$150.75,$0.00,1,1,1,0,0,1,20161001,,,,
A4612,HCPCS,BATTERY CABLES,RR,,28,,NW,,,,,,$14.31,$0.00,1,1,1,0,0,1,20161001,,,,
A4612,HCPCS,BATTERY CABLES,UE,,28,,NW,,,,,,$111.20,$0.00,1,1,1,0,0,1,20161001,,,,
A4613,HCPCS,BATTERY CHARGER,,,28,,NW,,,,,,$281.83,$0.00,1,1,1,0,0,1,20161001,,,,
A4613,HCPCS,BATTERY CHARGER,NU,,28,,NW,,,,,,$281.83,$0.00,1,1,1,0,0,1,20161001,,,,
A4613,HCPCS,BATTERY CHARGER,RR,,28,,NW,,,,,,$18.19,$0.00,1,1,1,0,0,1,20161001,,,,
A4613,HCPCS,BATTERY CHARGER,UE,,28,,NW,,,,,,$200.47,$0.00,1,1,1,0,0,1,20161001,,,,
A4614,HCPCS,HAND-HELD PEFR METER,,,28,,NW,,,,,,$54.84,$0.00,1,1,1,0,0,1,20161001,,,,
A4615,HCPCS,CANNULA NASAL,,,28,,NW,,,,,,$2.30,$0.00,1,1,1,0,0,1,20161001,,,,
A4616,HCPCS,TUBING (OXYGEN) PER FOOT,,,28,,NW,,,,,,$1.59,$0.00,1,1,1,0,0,1,20161001,,,,
A4617,HCPCS,MOUTH PIECE,,,28,,NW,,,,,,$4.83,$0.00,1,1,1,0,0,1,20161001,,,,
A4618,HCPCS,BREATHING CIRCUITS,,,28,,NW,,,,,,$16.45,$0.00,1,1,1,0,0,1,20161001,,,,
A4618,HCPCS,BREATHING CIRCUITS,NU,,28,,NW,,,,,,$16.45,$0.00,1,1,1,0,0,1,20161001,,,,
A4618,HCPCS,BREATHING CIRCUITS,RR,,28,,NW,,,,,,$2.14,$0.00,1,1,1,0,0,1,20161001,,,,
A4618,HCPCS,BREATHING CIRCUITS,UE,,28,,NW,,,,,,$12.41,$0.00,1,1,1,0,0,1,20161001,,,,
A4619,HCPCS,FACE TENT,,,28,,NW,,,,,,$3.51,$0.00,1,1,1,0,0,1,20161001,,,,
A4619,HCPCS,FACE TENT,NU,,28,,NW,,,,,,$3.51,$0.00,1,1,1,0,0,1,20161001,,,,
A4620,HCPCS,VARIABLE CONCENTRATION MASK,,,28,,NW,,,,,,$2.18,$0.00,1,1,1,0,0,1,20161001,,,,
A4623,HCPCS,TRACHEOSTOMY INNER CANNULA,,,28,,NW,,,,,,$11.83,$0.00,1,1,1,0,0,1,20161001,,,,
A4624,HCPCS,TRACHEAL SUCTION TUBE,,,28,,NW,,,,,,$7.02,$0.00,1,1,1,0,0,1,20161001,,,,
A4624,HCPCS,TRACHEAL SUCTION TUBE,NU,,28,,NW,,,,,,$7.02,$0.00,1,1,1,0,0,1,20161001,,,,
A4625,HCPCS,TRACH CARE KIT FOR NEW TRACH,,,28,,NW,,,,,,$12.94,$0.00,1,1,1,0,0,1,20161001,,,,
A4626,HCPCS,TRACHEOSTOMY CLEANING BRUSH,,,28,,NW,,,,,,$5.91,$0.00,1,1,1,0,0,1,20161001,,,,
A4627,HCPCS,SPACER BAG/RESERVOIR,,,28,,NW,,,,,,$38.72,$0.00,1,1,1,0,0,1,20161001,,,,
A4628,HCPCS,OROPHARYNGEAL SUCTION CATH,,,28,,NW,,,,,,$7.38,$0.00,1,1,1,0,0,1,20161001,,,,
A4628,HCPCS,OROPHARYNGEAL SUCTION CATH,NU,,28,,NW,,,,,,$7.38,$0.00,1,1,1,0,0,1,20161001,,,,
A4629,HCPCS,TRACHEOSTOMY CARE KIT,,,28,,NW,,,,,,$9.18,$0.00,1,1,1,0,0,1,20161001,,,,
A4630,HCPCS,REPL BAT T.E.N.S. OWN BY PT,,,28,,NW,,,,,,$13.70,$0.00,1,1,1,0,0,1,20161001,,,,
A4630,HCPCS,REPL BAT T.E.N.S. OWN BY PT,NU,,28,,NW,,,,,,$13.70,$0.00,1,1,1,0,0,1,20161001,,,,
A4633,HCPCS,UVL REPLACEMENT BULB,,,28,,NW,,,,,,$93.94,$0.00,1,1,1,0,0,1,20161001,,,,
A4633,HCPCS,UVL REPLACEMENT BULB,NU,,28,,NW,,,,,,$93.94,$0.00,1,1,1,0,0,1,20161001,,,,
A4634,HCPCS,REPLACEMENT BULB TH LIGHTBOX,,,28,,NW,,,,,,$116.52,$0.00,1,1,1,0,0,1,20161001,,,,
A4635,HCPCS,UNDERARM CRUTCH PAD,,,28,,NW,,,,,,$12.89,$0.00,1,1,1,0,0,1,20161001,,,,
A4635,HCPCS,UNDERARM CRUTCH PAD,NU,,28,,NW,,,,,,$12.89,$0.00,1,1,1,0,0,1,20161001,,,,
A4635,HCPCS,UNDERARM CRUTCH PAD,RR,,28,,NW,,,,,,$1.83,$0.00,1,1,1,0,0,1,20161001,,,,
A4635,HCPCS,UNDERARM CRUTCH PAD,UE,,28,,NW,,,,,,$8.98,$0.00,1,1,1,0,0,1,20161001,,,,
A4636,HCPCS,HANDGRIP FOR CANE ETC,,,28,,NW,,,,,,$14.96,$0.00,1,1,1,0,0,1,20161001,,,,
A4636,HCPCS,HANDGRIP FOR CANE ETC,NU,,28,,NW,,,,,,$14.96,$0.00,1,1,1,0,0,1,20161001,,,,
A4636,HCPCS,HANDGRIP FOR CANE ETC,RR,,28,,NW,,,,,,$2.06,$0.00,1,1,1,0,0,1,20161001,,,,
A4636,HCPCS,HANDGRIP FOR CANE ETC,UE,,28,,NW,,,,,,$13.36,$0.00,1,1,1,0,0,1,20161001,,,,
A4637,HCPCS,REPL TIP CANE/CRUTCH/WALKER,,,28,,NW,,,,,,$10.51,$0.00,1,1,1,0,0,1,20161001,,,,
A4637,HCPCS,REPL TIP CANE/CRUTCH/WALKER,NU,,28,,NW,,,,,,$10.51,$0.00,1,1,1,0,0,1,20161001,,,,
A4637,HCPCS,REPL TIP CANE/CRUTCH/WALKER,RR,,28,,NW,,,,,,$1.45,$0.00,1,1,1,0,0,1,20161001,,,,
A4637,HCPCS,REPL TIP CANE/CRUTCH/WALKER,UE,,28,,NW,,,,,,$7.95,$0.00,1,1,1,0,0,1,20161001,,,,
A4638,HCPCS,REPL BATT PULSE GEN SYS,,,28,,NW,,,,,,"$15,944.89",$0.00,1,1,1,0,0,1,20161001,,,,
A4638,HCPCS,REPL BATT PULSE GEN SYS,NU,,28,,NW,,,,,,"$15,944.89",$0.00,1,1,1,0,0,1,20161001,,,,
A4638,HCPCS,REPL BATT PULSE GEN SYS,RR,,28,,NW,,,,,,"$1,673.34",$0.00,1,1,1,0,0,1,20161001,,,,
A4638,HCPCS,REPL BATT PULSE GEN SYS,UE,,28,,NW,,,,,,"$11,981.66",$0.00,1,1,1,0,0,1,20161001,,,,
A4639,HCPCS,INFRARED HT SYS REPLCMNT PAD,,,28,,NW,,,,,,$581.54,$0.00,1,1,1,0,0,1,20161001,,,,
A4639,HCPCS,INFRARED HT SYS REPLCMNT PAD,NU,,28,,NW,,,,,,$581.54,$0.00,1,1,1,0,0,1,20161001,,,,
A4639,HCPCS,INFRARED HT SYS REPLCMNT PAD,RR,,28,,NW,,,,,,$61.86,$0.00,1,1,1,0,0,1,20161001,,,,
A4640,HCPCS,ALTERNATING PRESSURE PAD,,,28,,NW,,,,,,$138.04,$0.00,1,1,1,0,0,1,20161001,,,,
A4640,HCPCS,ALTERNATING PRESSURE PAD,NU,,28,,NW,,,,,,$138.04,$0.00,1,1,1,0,0,1,20161001,,,,
A4640,HCPCS,ALTERNATING PRESSURE PAD,RR,,28,,NW,,,,,,$13.81,$0.00,1,1,1,0,0,1,20161001,,,,
A4640,HCPCS,ALTERNATING PRESSURE PAD,UE,,28,,NW,,,,,,$95.83,$0.00,1,1,1,0,0,1,20161001,,,,
A4641,HCPCS,RADIOPHARM DX AGENT NOC,,,28,,NW,,,,,,$41.71,$0.00,1,1,1,0,0,1,20161001,,,,
A4642,HCPCS,IN111 SATUMOMAB,,,28,,NW,,,,,,$27.86,$0.00,1,1,1,0,0,1,20161001,,,,
A4648,HCPCS,IMPLANTABLE TISSUE MARKER,,,28,,NW,,,,,,$283.00,$0.00,1,1,1,0,0,1,20161001,,,,
A4649,HCPCS,SURGICAL SUPPLIES,,,28,,NW,,,,,,$26.69,$0.00,1,1,1,0,0,1,20161001,,,,
A4651,HCPCS,CALIBRATED MICROCAP TUBE,,,28,,NW,,,,,,$4.54,$0.00,1,1,1,0,0,1,20161001,,,,
A4652,HCPCS,MICROCAPILLARY TUBE SEALANT,,,28,,NW,,,,,,$1.53,$0.00,1,1,1,0,0,1,20161001,,,,
A4653,HCPCS,PD CATHETER ANCHOR BELT,,,28,,NW,,,,,,$74.17,$0.00,1,1,1,0,0,1,20161001,,,,
A4657,HCPCS,SYRINGE W/WO NEEDLE,,,28,,NW,,,,,,$4.24,$0.00,1,1,1,0,0,1,20161001,,,,
A4660,HCPCS,SPHYG/BP APP W CUFF AND STET,,,28,,NW,,,,,,$41.97,$0.00,1,1,1,0,0,1,20161001,,,,
A4663,HCPCS,DIALYSIS BLOOD PRESSURE CUFF,,,28,,NW,,,,,,$66.26,$0.00,1,1,1,0,0,1,20161001,,,,
A4670,HCPCS,"AUTOMATIC BP MONITOR, DIAL",,,28,,NW,,,,,,$137.70,$0.00,1,1,1,0,0,1,20161001,,,,
A4671,HCPCS,DISPOSABLE CYCLER SET,,,28,,NW,,,,,,$58.74,$0.00,1,1,1,0,0,1,20161001,,,,
A4672,HCPCS,"DRAINAGE EXT LINE, DIALYSIS",,,28,,NW,,,,,,$22.17,$0.00,1,1,1,0,0,1,20161001,,,,
A4673,HCPCS,EXT LINE W EASY LOCK CONNECT,,,28,,NW,,,,,,$15.66,$0.00,1,1,1,0,0,1,20161001,,,,
A4674,HCPCS,"CHEM/ANTISEPT SOLUTION, 8OZ",,,28,,NW,,,,,,$2.97,$0.00,1,1,1,0,0,1,20161001,,,,
A4680,HCPCS,"ACTIVATED CARBON FILTER, EA",,,28,,NW,,,,,,$172.27,$0.00,1,1,1,0,0,1,20161001,,,,
A4690,HCPCS,"DIALYZER, EACH",,,28,,NW,,,,,,"$1,628.38",$0.00,1,1,1,0,0,1,20161001,,,,
A4706,HCPCS,BICARBONATE CONC SOL PER GAL,,,28,,NW,,,,,,$17.33,$0.00,1,1,1,0,0,1,20161001,,,,
A4707,HCPCS,BICARBONATE CONC POW PER PAC,,,28,,NW,,,,,,$17.63,$0.00,1,1,1,0,0,1,20161001,,,,
A4708,HCPCS,ACETATE CONC SOL PER GALLON,,,28,,NW,,,,,,$21.87,$0.00,1,1,1,0,0,1,20161001,,,,
A4709,HCPCS,ACID CONC SOL PER GALLON,,,28,,NW,,,,,,$34.08,$0.00,1,1,1,0,0,1,20161001,,,,
A4714,HCPCS,TREATED WATER PER GALLON,,,28,,NW,,,,,,$7.61,$0.00,1,1,1,0,0,1,20161001,,,,
A4719,HCPCS,Y SET TUBING,,,28,,NW,,,,,,$34.45,$0.00,1,1,1,0,0,1,20161001,,,,
A4720,HCPCS,DIALYSAT SOL FLD VOL > 249CC,,,28,,NW,,,,,,$31.01,$0.00,1,1,1,0,0,1,20161001,,,,
A4721,HCPCS,DIALYSAT SOL FLD VOL > 999CC,,,28,,NW,,,,,,$45.60,$0.00,1,1,1,0,0,1,20161001,,,,
A4722,HCPCS,DIALYS SOL FLD VOL > 1999CC,,,28,,NW,,,,,,$48.47,$0.00,1,1,1,0,0,1,20161001,,,,
A4723,HCPCS,DIALYS SOL FLD VOL > 2999CC,,,28,,NW,,,,,,$52.50,$0.00,1,1,1,0,0,1,20161001,,,,
A4724,HCPCS,DIALYS SOL FLD VOL > 3999CC,,,28,,NW,,,,,,$59.68,$0.00,1,1,1,0,0,1,20161001,,,,
A4725,HCPCS,DIALYS SOL FLD VOL > 4999CC,,,28,,NW,,,,,,$66.83,$0.00,1,1,1,0,0,1,20161001,,,,
A4726,HCPCS,DIALYS SOL FLD VOL > 5999CC,,,28,,NW,,,,,,$74.29,$0.00,1,1,1,0,0,1,20161001,,,,
A4728,HCPCS,"DIALYSATE SOLUTION, NON-DEX",,,28,,NW,,,,,,$19.16,$0.00,1,1,1,0,0,1,20161001,,,,
A4730,HCPCS,"FISTULA CANNULATION SET, EA",,,28,,NW,,,,,,$3.74,$0.00,1,1,1,0,0,1,20161001,,,,
A4736,HCPCS,"TOPICAL ANESTHETIC, PER GRAM",,,28,,NW,,,,,,$43.45,$0.00,1,1,1,0,0,1,20161001,,,,
A4737,HCPCS,INJ ANESTHETIC PER 10 ML,,,28,,NW,,,,,,$4.32,$0.00,1,1,1,0,0,1,20161001,,,,
A4740,HCPCS,SHUNT ACCESSORY,,,28,,NW,,,,,,$49.44,$0.00,1,1,1,0,0,1,20161001,,,,
A4750,HCPCS,ART OR VENOUS BLOOD TUBING,,,28,,NW,,,,,,$32.86,$0.00,1,1,1,0,0,1,20161001,,,,
A4755,HCPCS,COMB ART/VENOUS BLOOD TUBING,,,28,,NW,,,,,,$36.26,$0.00,1,1,1,0,0,1,20161001,,,,
A4760,HCPCS,"DIALYSATE SOL TEST KIT, EACH",,,28,,NW,,,,,,$177.47,$0.00,1,1,1,0,0,1,20161001,,,,
A4765,HCPCS,DIALYSATE CONC POW PER PACK,,,28,,NW,,,,,,$39.81,$0.00,1,1,1,0,0,1,20161001,,,,
A4766,HCPCS,DIALYSATE CONC SOL ADD 10 ML,,,28,,NW,,,,,,$42.12,$0.00,1,1,1,0,0,1,20161001,,,,
A4770,HCPCS,BLOOD COLLECTION TUBE/VACUUM,,,28,,NW,,,,,,$17.89,$0.00,1,1,1,0,0,1,20161001,,,,
A4771,HCPCS,SERUM CLOTTING TIME TUBE,,,28,,NW,,,,,,$11.86,$0.00,1,1,1,0,0,1,20161001,,,,
A4772,HCPCS,BLOOD GLUCOSE TEST STRIPS,,,28,,NW,,,,,,$68.91,$0.00,1,1,1,0,0,1,20161001,,,,
A4773,HCPCS,OCCULT BLOOD TEST STRIPS,,,28,,NW,,,,,,$43.70,$0.00,1,1,1,0,0,1,20161001,,,,
A4774,HCPCS,AMMONIA TEST STRIPS,,,28,,NW,,,,,,$14.82,$0.00,1,1,1,0,0,1,20161001,,,,
A4802,HCPCS,PROTAMINE SULFATE PER 50 MG,,,28,,NW,,,,,,$12.43,$0.00,1,1,1,0,0,1,20161001,,,,
A4860,HCPCS,DISPOSABLE CATHETER TIPS,,,28,,NW,,,,,,$9.92,$0.00,1,1,1,0,0,1,20161001,,,,
A4870,HCPCS,PLUMB/ELEC WK HM HEMO EQUIP,,,28,,NW,,,,,,$239.47,$0.00,1,1,1,0,0,1,20161001,,,,
A4890,HCPCS,REPAIR/MAINT CONT HEMO EQUIP,,,28,,NW,,,,,,$30.40,$0.00,1,1,1,0,0,1,20161001,,,,
A4911,HCPCS,DRAIN BAG/BOTTLE,,,28,,NW,,,,,,$41.48,$0.00,1,1,1,0,0,1,20161001,,,,
A4913,HCPCS,MISC DIALYSIS SUPPLIES NOC,,,28,,NW,,,,,,$137.70,$0.00,1,1,1,0,0,1,20161001,,,,
A4918,HCPCS,VENOUS PRESSURE CLAMP,,,28,,NW,,,,,,$7.61,$0.00,1,1,1,0,0,1,20161001,,,,
A4927,HCPCS,NON-STERILE GLOVES,,,28,,NW,,,,,,$13.86,$0.00,1,1,1,0,0,1,20161001,,,,
A4928,HCPCS,SURGICAL MASK,,,28,,NW,,,,,,$0.86,$0.00,1,1,1,0,0,1,20161001,,,,
A4929,HCPCS,"TOURNIQUET FOR DIALYSIS, EA",,,28,,NW,,,,,,$0.36,$0.00,1,1,1,0,0,1,20161001,,,,
A4930,HCPCS,"STERILE, GLOVES PER PAIR",,,28,,NW,,,,,,$1.95,$0.00,1,1,1,0,0,1,20161001,,,,
A4931,HCPCS,REUSABLE ORAL THERMOMETER,,,28,,NW,,,,,,$12.69,$0.00,1,1,1,0,0,1,20161001,,,,
A5051,HCPCS,POUCH CLSD W BARR ATTACHED,,,28,,NW,,,,,,$4.25,$0.00,1,1,1,0,0,1,20161001,,,,
A5052,HCPCS,CLSD OSTOMY POUCH W/O BARR,,,28,,NW,,,,,,$3.15,$0.00,1,1,1,0,0,1,20161001,,,,
A5053,HCPCS,CLSD OSTOMY POUCH FACEPLATE,,,28,,NW,,,,,,$3.47,$0.00,1,1,1,0,0,1,20161001,,,,
A5054,HCPCS,CLSD OSTOMY POUCH W/FLANGE,,,28,,NW,,,,,,$3.75,$0.00,1,1,1,0,0,1,20161001,,,,
A5055,HCPCS,STOMA CAP,,,28,,NW,,,,,,$2.98,$0.00,1,1,1,0,0,1,20161001,,,,
A5056,HCPCS,1 PC OST POUCH W FILTER,,,28,,NW,,,,,,$9.24,$0.00,1,1,1,0,0,1,20161001,,,,
A5057,HCPCS,1 PC OST POU W BUILT-IN CONV,,,28,,NW,,,,,,$19.07,$0.00,1,1,1,0,0,1,20161001,,,,
A5061,HCPCS,POUCH DRAINABLE W BARRIER AT,,,28,,NW,,,,,,$7.06,$0.00,1,1,1,0,0,1,20161001,,,,
A5062,HCPCS,DRNBLE OSTOMY POUCH W/O BARR,,,28,,NW,,,,,,$4.42,$0.00,1,1,1,0,0,1,20161001,,,,
A5063,HCPCS,DRAIN OSTOMY POUCH W/FLANGE,,,28,,NW,,,,,,$5.48,$0.00,1,1,1,0,0,1,20161001,,,,
A5071,HCPCS,URINARY POUCH W/BARRIER,,,28,,NW,,,,,,$11.81,$0.00,1,1,1,0,0,1,20161001,,,,
A5072,HCPCS,URINARY POUCH W/O BARRIER,,,28,,NW,,,,,,$6.83,$0.00,1,1,1,0,0,1,20161001,,,,
A5073,HCPCS,URINARY POUCH ON BARR W/FLNG,,,28,,NW,,,,,,$6.27,$0.00,1,1,1,0,0,1,20161001,,,,
A5081,HCPCS,"STOMA PLUG OR SEAL, ANY TYPE",,,28,,NW,,,,,,$6.27,$0.00,1,1,1,0,0,1,20161001,,,,
A5082,HCPCS,CONTINENT STOMA CATHETER,,,28,,NW,,,,,,$22.69,$0.00,1,1,1,0,0,1,20161001,,,,
A5083,HCPCS,STOMA ABSORPTIVE COVER,,,28,,NW,,,,,,$1.44,$0.00,1,1,1,0,0,1,20161001,,,,
A5093,HCPCS,OSTOMY ACCESSORY CONVEX INSE,,,28,,NW,,,,,,$3.91,$0.00,1,1,1,0,0,1,20161001,,,,
A5102,HCPCS,BEDSIDE DRAIN BTL W/WO TUBE,,,28,,NW,,,,,,$51.44,$0.00,1,1,1,0,0,1,20161001,,,,
A5105,HCPCS,URINARY SUSPENSORY,,,28,,NW,,,,,,$94.57,$0.00,1,1,1,0,0,1,20161001,,,,
A5112,HCPCS,URINARY LEG BAG,,,28,,NW,,,,,,$78.16,$0.00,1,1,1,0,0,1,20161001,,,,
A5113,HCPCS,LATEX LEG STRAP,,,28,,NW,,,,,,$8.73,$0.00,1,1,1,0,0,1,20161001,,,,
A5114,HCPCS,FOAM/FABRIC LEG STRAP,,,28,,NW,,,,,,$16.53,$0.00,1,1,1,0,0,1,20161001,,,,
A5120,HCPCS,"SKIN BARRIER, WIPE OR SWAB",,,28,,NW,,,,,,$0.53,$0.00,1,1,1,0,0,1,20161001,,,,
A5120,HCPCS,"SKIN BARRIER, WIPE OR SWAB",AU,,28,,NW,,,,,,$0.53,$0.00,1,1,1,0,0,1,20161001,,,,
A5120,HCPCS,"SKIN BARRIER, WIPE OR SWAB",AV,,28,,NW,,,,,,$0.53,$0.00,1,1,1,0,0,1,20161001,,,,
A5121,HCPCS,SOLID SKIN BARRIER 6X6,,,28,,NW,,,,,,$13.84,$0.00,1,1,1,0,0,1,20161001,,,,
A5122,HCPCS,SOLID SKIN BARRIER 8X8,,,28,,NW,,,,,,$25.58,$0.00,1,1,1,0,0,1,20161001,,,,
A5126,HCPCS,DISK/FOAM PAD +OR- ADHESIVE,,,28,,NW,,,,,,$2.61,$0.00,1,1,1,0,0,1,20161001,,,,
A5131,HCPCS,APPLIANCE CLEANER,,,28,,NW,,,,,,$32.49,$0.00,1,1,1,0,0,1,20161001,,,,
A5200,HCPCS,PERCUTANEOUS CATHETER ANCHOR,,,28,,NW,,,,,,$23.33,$0.00,1,1,1,0,0,1,20161001,,,,
A5500,HCPCS,DIAB SHOE FOR DENSITY INSERT,,,28,,NW,,,,,,$66.63,$0.00,1,1,1,0,0,1,20161001,,,,
A5501,HCPCS,DIABETIC CUSTOM MOLDED SHOE,,,28,,NW,,,,,,$307.04,$0.00,1,1,1,0,0,1,20161001,,,,
A5503,HCPCS,DIABETIC SHOE W/ROLLER/ROCKR,,,28,,NW,,,,,,$36.49,$0.00,1,1,1,0,0,1,20161001,,,,
A5504,HCPCS,DIABETIC SHOE WITH WEDGE,,,28,,NW,,,,,,$36.49,$0.00,1,1,1,0,0,1,20161001,,,,
A5505,HCPCS,DIAB SHOE W/METATARSAL BAR,,,28,,NW,,,,,,$36.49,$0.00,1,1,1,0,0,1,20161001,,,,
A5506,HCPCS,DIABETIC SHOE W/OFF SET HEEL,,,28,,NW,,,,,,$36.49,$0.00,1,1,1,0,0,1,20161001,,,,
A5507,HCPCS,MODIFICATION DIABETIC SHOE,,,28,,NW,,,,,,$36.49,$0.00,1,1,1,0,0,1,20161001,,,,
A5508,HCPCS,DIABETIC DELUXE SHOE,,,28,,NW,,,,,,$36.49,$0.00,1,1,1,0,0,1,20161001,,,,
A5510,HCPCS,COMPRESSION FORM SHOE INSERT,,,28,,NW,,,,,,$33.20,$0.00,1,1,1,0,0,1,20161001,,,,
A5512,HCPCS,MULTI DEN INSERT DIRECT FORM,,,28,,NW,,,,,,$31.66,$0.00,1,1,1,0,0,1,20161001,,,,
A5513,HCPCS,MULTI DEN INSERT CUSTOM MOLD,,,28,,NW,,,,,,$43.52,$0.00,1,1,1,0,0,1,20161001,,,,
A6000,HCPCS,WOUND WARMING WOUND COVER,,,28,,NW,,,,,,$81.71,$0.00,1,1,1,0,0,1,20161001,,,,
A6010,HCPCS,COLLAGEN BASED WOUND FILLER,,,28,,NW,,,,,,$72.99,$0.00,1,1,1,0,0,1,20161001,,,,
A6011,HCPCS,COLLAGEN GEL/PASTE WOUND FIL,,,28,,NW,,,,,,$4.67,$0.00,1,1,1,0,0,1,20161001,,,,
A6021,HCPCS,COLLAGEN DRESSING <=16 SQ IN,,,28,,NW,,,,,,$47.86,$0.00,1,1,1,0,0,1,20161001,,,,
A6022,HCPCS,COLLAGEN DRSG>16<=48 SQ IN,,,28,,NW,,,,,,$47.86,$0.00,1,1,1,0,0,1,20161001,,,,
A6023,HCPCS,COLLAGEN DRESSING >48 SQ IN,,,28,,NW,,,,,,$475.07,$0.00,1,1,1,0,0,1,20161001,,,,
A6024,HCPCS,COLLAGEN DSG WOUND FILLER,,,28,,NW,,,,,,$12.16,$0.00,1,1,1,0,0,1,20161001,,,,
A6025,HCPCS,"SILICONE GEL SHEET, EACH",,,28,,NW,,,,,,$58.08,$0.00,1,1,1,0,0,1,20161001,,,,
A6154,HCPCS,WOUND POUCH EACH,,,28,,NW,,,,,,$30.80,$0.00,1,1,1,0,0,1,20161001,,,,
A6196,HCPCS,ALGINATE DRESSING <=16 SQ IN,,,28,,NW,,,,,,$14.39,$0.00,1,1,1,0,0,1,20161001,,,,
A6197,HCPCS,ALGINATE DRSG >16 <=48 SQ IN,,,28,,NW,,,,,,$36.31,$0.00,1,1,1,0,0,1,20161001,,,,
A6198,HCPCS,ALGINATE DRESSING > 48 SQ IN,,,28,,NW,,,,,,$59.43,$0.00,1,1,1,0,0,1,20161001,,,,
A6199,HCPCS,ALGINATE DRSG WOUND FILLER,,,28,,NW,,,,,,$10.43,$0.00,1,1,1,0,0,1,20161001,,,,
A6203,HCPCS,COMPOSITE DRSG <= 16 SQ IN,,,28,,NW,,,,,,$6.74,$0.00,1,1,1,0,0,1,20161001,,,,
A6204,HCPCS,COMPOSITE DRSG >16<=48 SQ IN,,,28,,NW,,,,,,$12.24,$0.00,1,1,1,0,0,1,20161001,,,,
A6205,HCPCS,COMPOSITE DRSG > 48 SQ IN,,,28,,NW,,,,,,$21.82,$0.00,1,1,1,0,0,1,20161001,,,,
A6206,HCPCS,CONTACT LAYER <= 16 SQ IN,,,28,,NW,,,,,,$9.12,$0.00,1,1,1,0,0,1,20161001,,,,
A6207,HCPCS,CONTACT LAYER >16<= 48 SQ IN,,,28,,NW,,,,,,$14.35,$0.00,1,1,1,0,0,1,20161001,,,,
A6208,HCPCS,CONTACT LAYER > 48 SQ IN,,,28,,NW,,,,,,$44.97,$0.00,1,1,1,0,0,1,20161001,,,,
A6209,HCPCS,FOAM DRSG <=16 SQ IN W/O BDR,,,28,,NW,,,,,,$14.61,$0.00,1,1,1,0,0,1,20161001,,,,
A6210,HCPCS,FOAM DRG >16<=48 SQ IN W/O B,,,28,,NW,,,,,,$45.13,$0.00,1,1,1,0,0,1,20161001,,,,
A6211,HCPCS,FOAM DRG > 48 SQ IN W/O BRDR,,,28,,NW,,,,,,$68.97,$0.00,1,1,1,0,0,1,20161001,,,,
A6212,HCPCS,FOAM DRG <=16 SQ IN W/BORDER,,,28,,NW,,,,,,$19.32,$0.00,1,1,1,0,0,1,20161001,,,,
A6213,HCPCS,FOAM DRG >16<=48 SQ IN W/BDR,,,28,,NW,,,,,,$50.34,$0.00,1,1,1,0,0,1,20161001,,,,
A6214,HCPCS,FOAM DRG > 48 SQ IN W/BORDER,,,28,,NW,,,,,,$68.94,$0.00,1,1,1,0,0,1,20161001,,,,
A6215,HCPCS,FOAM DRESSING WOUND FILLER,,,28,,NW,,,,,,$6.35,$0.00,1,1,1,0,0,1,20161001,,,,
A6216,HCPCS,NON-STERILE GAUZE<=16 SQ IN,,,28,,NW,,,,,,$0.10,$0.00,1,1,1,0,0,1,20161001,,,,
A6217,HCPCS,NON-STERILE GAUZE>16<=48 SQ,,,28,,NW,,,,,,$0.26,$0.00,1,1,1,0,0,1,20161001,,,,
A6218,HCPCS,NON-STERILE GAUZE > 48 SQ IN,,,28,,NW,,,,,,$1.15,$0.00,1,1,1,0,0,1,20161001,,,,
A6219,HCPCS,GAUZE <= 16 SQ IN W/BORDER,,,28,,NW,,,,,,$2.13,$0.00,1,1,1,0,0,1,20161001,,,,
A6220,HCPCS,GAUZE >16 <=48 SQ IN W/BORDR,,,28,,NW,,,,,,$5.25,$0.00,1,1,1,0,0,1,20161001,,,,
A6221,HCPCS,GAUZE > 48 SQ IN W/BORDER,,,28,,NW,,,,,,$15.14,$0.00,1,1,1,0,0,1,20161001,,,,
A6222,HCPCS,GAUZE <=16 IN NO W/SAL W/O B,,,28,,NW,,,,,,$4.37,$0.00,1,1,1,0,0,1,20161001,,,,
A6223,HCPCS,GAUZE >16<=48 NO W/SAL W/O B,,,28,,NW,,,,,,$4.94,$0.00,1,1,1,0,0,1,20161001,,,,
A6224,HCPCS,GAUZE > 48 IN NO W/SAL W/O B,,,28,,NW,,,,,,$7.22,$0.00,1,1,1,0,0,1,20161001,,,,
A6228,HCPCS,GAUZE <= 16 SQ IN WATER/SAL,,,28,,NW,,,,,,$4.22,$0.00,1,1,1,0,0,1,20161001,,,,
A6229,HCPCS,GAUZE >16<=48 SQ IN WATR/SAL,,,28,,NW,,,,,,$7.22,$0.00,1,1,1,0,0,1,20161001,,,,
A6230,HCPCS,GAUZE > 48 SQ IN WATER/SALNE,,,28,,NW,,,,,,$6.18,$0.00,1,1,1,0,0,1,20161001,,,,
A6231,HCPCS,HYDROGEL DSG<=16 SQ IN,,,28,,NW,,,,,,$9.26,$0.00,1,1,1,0,0,1,20161001,,,,
A6232,HCPCS,HYDROGEL DSG>16<=48 SQ IN,,,28,,NW,,,,,,$13.45,$0.00,1,1,1,0,0,1,20161001,,,,
A6233,HCPCS,HYDROGEL DRESSING >48 SQ IN,,,28,,NW,,,,,,$43.23,$0.00,1,1,1,0,0,1,20161001,,,,
A6234,HCPCS,HYDROCOLLD DRG <=16 W/O BDR,,,28,,NW,,,,,,$12.83,$0.00,1,1,1,0,0,1,20161001,,,,
A6235,HCPCS,HYDROCOLLD DRG >16<=48 W/O B,,,28,,NW,,,,,,$37.26,$0.00,1,1,1,0,0,1,20161001,,,,
A6236,HCPCS,HYDROCOLLD DRG > 48 IN W/O B,,,28,,NW,,,,,,$63.62,$0.00,1,1,1,0,0,1,20161001,,,,
A6237,HCPCS,HYDROCOLLD DRG <=16 IN W/BDR,,,28,,NW,,,,,,$15.47,$0.00,1,1,1,0,0,1,20161001,,,,
A6238,HCPCS,HYDROCOLLD DRG >16<=48 W/BDR,,,28,,NW,,,,,,$52.36,$0.00,1,1,1,0,0,1,20161001,,,,
A6239,HCPCS,HYDROCOLLD DRG > 48 IN W/BDR,,,28,,NW,,,,,,$57.82,$0.00,1,1,1,0,0,1,20161001,,,,
A6240,HCPCS,HYDROCOLLD DRG FILLER PASTE,,,28,,NW,,,,,,$25.73,$0.00,1,1,1,0,0,1,20161001,,,,
A6241,HCPCS,HYDROCOLLOID DRG FILLER DRY,,,28,,NW,,,,,,$5.22,$0.00,1,1,1,0,0,1,20161001,,,,
A6242,HCPCS,HYDROGEL DRG <=16 IN W/O BDR,,,28,,NW,,,,,,$11.92,$0.00,1,1,1,0,0,1,20161001,,,,
A6243,HCPCS,HYDROGEL DRG >16<=48 W/O BDR,,,28,,NW,,,,,,$25.91,$0.00,1,1,1,0,0,1,20161001,,,,
A6244,HCPCS,HYDROGEL DRG >48 IN W/O BDR,,,28,,NW,,,,,,$93.99,$0.00,1,1,1,0,0,1,20161001,,,,
A6245,HCPCS,HYDROGEL DRG <= 16 IN W/BDR,,,28,,NW,,,,,,$14.21,$0.00,1,1,1,0,0,1,20161001,,,,
A6246,HCPCS,HYDROGEL DRG >16<=48 IN W/B,,,28,,NW,,,,,,$19.89,$0.00,1,1,1,0,0,1,20161001,,,,
A6247,HCPCS,HYDROGEL DRG > 48 SQ IN W/B,,,28,,NW,,,,,,$54.87,$0.00,1,1,1,0,0,1,20161001,,,,
A6248,HCPCS,HYDROGEL DRSG GEL FILLER,,,28,,NW,,,,,,$35.83,$0.00,1,1,1,0,0,1,20161001,,,,
A6250,HCPCS,SKIN SEAL PROTECT MOISTURIZR,,,28,,NW,,,,,,$8.78,$0.00,1,1,1,0,0,1,20161001,,,,
A6251,HCPCS,ABSORPT DRG <=16 SQ IN W/O B,,,28,,NW,,,,,,$4.12,$0.00,1,1,1,0,0,1,20161001,,,,
A6252,HCPCS,ABSORPT DRG >16 <=48 W/O BDR,,,28,,NW,,,,,,$6.54,$0.00,1,1,1,0,0,1,20161001,,,,
A6253,HCPCS,ABSORPT DRG > 48 SQ IN W/O B,,,28,,NW,,,,,,$12.45,$0.00,1,1,1,0,0,1,20161001,,,,
A6254,HCPCS,ABSORPT DRG <=16 SQ IN W/BDR,,,28,,NW,,,,,,$2.61,$0.00,1,1,1,0,0,1,20161001,,,,
A6255,HCPCS,ABSORPT DRG >16<=48 IN W/BDR,,,28,,NW,,,,,,$6.12,$0.00,1,1,1,0,0,1,20161001,,,,
A6256,HCPCS,ABSORPT DRG > 48 SQ IN W/BDR,,,28,,NW,,,,,,$14.90,$0.00,1,1,1,0,0,1,20161001,,,,
A6257,HCPCS,TRANSPARENT FILM <= 16 SQ IN,,,28,,NW,,,,,,$3.25,$0.00,1,1,1,0,0,1,20161001,,,,
A6258,HCPCS,TRANSPARENT FILM >16<=48 IN,,,28,,NW,,,,,,$8.57,$0.00,1,1,1,0,0,1,20161001,,,,
A6259,HCPCS,TRANSPARENT FILM > 48 SQ IN,,,28,,NW,,,,,,$22.46,$0.00,1,1,1,0,0,1,20161001,,,,
A6260,HCPCS,WOUND CLEANSER ANY TYPE/SIZE,,,28,,NW,,,,,,$2.26,$0.00,1,1,1,0,0,1,20161001,,,,
A6261,HCPCS,WOUND FILLER GEL/PASTE /OZ,,,28,,NW,,,,,,$8.14,$0.00,1,1,1,0,0,1,20161001,,,,
A6262,HCPCS,WOUND FILLER DRY FORM / GRAM,,,28,,NW,,,,,,$2.26,$0.00,1,1,1,0,0,1,20161001,,,,
A6266,HCPCS,IMPREG GAUZE NO H20/SAL/YARD,,,28,,NW,,,,,,$3.99,$0.00,1,1,1,0,0,1,20161001,,,,
A6402,HCPCS,STERILE GAUZE <= 16 SQ IN,,,28,,NW,,,,,,$0.26,$0.00,1,1,1,0,0,1,20161001,,,,
A6403,HCPCS,STERILE GAUZE>16 <= 48 SQ IN,,,28,,NW,,,,,,$0.95,$0.00,1,1,1,0,0,1,20161001,,,,
A6404,HCPCS,STERILE GAUZE > 48 SQ IN,,,28,,NW,,,,,,$1.15,$0.00,1,1,1,0,0,1,20161001,,,,
A6407,HCPCS,"PACKING STRIPS, NON-IMPREG",,,28,,NW,,,,,,$3.91,$0.00,1,1,1,0,0,1,20161001,,,,
A6410,HCPCS,STERILE EYE PAD,,,28,,NW,,,,,,$0.87,$0.00,1,1,1,0,0,1,20161001,,,,
A6411,HCPCS,NON-STERILE EYE PAD,,,28,,NW,,,,,,$0.87,$0.00,1,1,1,0,0,1,20161001,,,,
A6412,HCPCS,OCCLUSIVE EYE PATCH,,,28,,NW,,,,,,$1.15,$0.00,1,1,1,0,0,1,20161001,,,,
A6413,HCPCS,"ADHESIVE BANDAGE, FIRST-AID",,,28,,NW,,,,,,$1.80,$0.00,1,1,1,0,0,1,20161001,,,,
A6441,HCPCS,PAD BAND W>=3 <5/YD,,,28,,NW,,,,,,$1.52,$0.00,1,1,1,0,0,1,20161001,,,,
A6442,HCPCS,CONFORM BAND N/S W<3/YD,,,28,,NW,,,,,,$0.36,$0.00,1,1,1,0,0,1,20161001,,,,
A6443,HCPCS,CONFORM BAND N/S W>=3<5/YD,,,28,,NW,,,,,,$0.63,$0.00,1,1,1,0,0,1,20161001,,,,
A6444,HCPCS,CONFORM BAND N/S W>=5/YD,,,28,,NW,,,,,,$1.26,$0.00,1,1,1,0,0,1,20161001,,,,
A6445,HCPCS,CONFORM BAND S W <3/YD,,,28,,NW,,,,,,$0.73,$0.00,1,1,1,0,0,1,20161001,,,,
A6446,HCPCS,CONFORM BAND S W>=3 <5/YD,,,28,,NW,,,,,,$0.91,$0.00,1,1,1,0,0,1,20161001,,,,
A6447,HCPCS,CONFORM BAND S W >=5/YD,,,28,,NW,,,,,,$1.52,$0.00,1,1,1,0,0,1,20161001,,,,
A6448,HCPCS,LT COMPRES BAND <3/YD,,,28,,NW,,,,,,$2.53,$0.00,1,1,1,0,0,1,20161001,,,,
A6449,HCPCS,LT COMPRES BAND >=3 <5/YD,,,28,,NW,,,,,,$3.66,$0.00,1,1,1,0,0,1,20161001,,,,
A6450,HCPCS,LT COMPRES BAND >=5/YD,,,28,,NW,,,,,,$4.67,$0.00,1,1,1,0,0,1,20161001,,,,
A6451,HCPCS,MOD COMPRES BAND W>=3<5/YD,,,28,,NW,,,,,,$6.39,$0.00,1,1,1,0,0,1,20161001,,,,
A6452,HCPCS,HIGH COMPRES BAND W>=3<5YD,,,28,,NW,,,,,,$11.62,$0.00,1,1,1,0,0,1,20161001,,,,
A6453,HCPCS,SELF-ADHER BAND W <3/YD,,,28,,NW,,,,,,$1.40,$0.00,1,1,1,0,0,1,20161001,,,,
A6454,HCPCS,SELF-ADHER BAND W>=3 <5/YD,,,28,,NW,,,,,,$1.74,$0.00,1,1,1,0,0,1,20161001,,,,
A6455,HCPCS,SELF-ADHER BAND >=5/YD,,,28,,NW,,,,,,$2.97,$0.00,1,1,1,0,0,1,20161001,,,,
A6456,HCPCS,ZINC PASTE BAND W >=3<5/YD,,,28,,NW,,,,,,$2.73,$0.00,1,1,1,0,0,1,20161001,,,,
A6457,HCPCS,TUBULAR DRESSING,,,28,,NW,,,,,,$2.49,$0.00,1,1,1,0,0,1,20161001,,,,
A6504,HCPCS,CMPRSBURNGARMENT GLOVE-WRIST,,,28,,NW,,,,,,$388.83,$0.00,1,1,1,0,0,1,20161001,,,,
A6505,HCPCS,CMPRSBURNGARMENT GLOVE-ELBOW,,,28,,NW,,,,,,$202.86,$0.00,1,1,1,0,0,1,20161001,,,,
A6506,HCPCS,CMPRSBURNGRMNT GLOVE-AXILLA,,,28,,NW,,,,,,$115.21,$0.00,1,1,1,0,0,1,20161001,,,,
A6507,HCPCS,CMPRS BURNGARMENT FOOT-KNEE,,,28,,NW,,,,,,$157.87,$0.00,1,1,1,0,0,1,20161001,,,,
A6509,HCPCS,COMPRES BURN GARMENT JACKET,,,28,,NW,,,,,,$743.46,$0.00,1,1,1,0,0,1,20161001,,,,
A6510,HCPCS,COMPRES BURN GARMENT LEOTARD,,,28,,NW,,,,,,$319.38,$0.00,1,1,1,0,0,1,20161001,,,,
A6511,HCPCS,COMPRES BURN GARMENT PANTY,,,28,,NW,,,,,,$689.61,$0.00,1,1,1,0,0,1,20161001,,,,
A6512,HCPCS,"COMPRES BURN GARMENT, NOC",,,28,,NW,,,,,,$238.23,$0.00,1,1,1,0,0,1,20161001,,,,
A6530,HCPCS,COMPRESSION STOCKING BK18-30,,,28,,NW,,,,,,$50.04,$0.00,1,1,1,0,0,1,20161001,,,,
A6531,HCPCS,COMPRESSION STOCKING BK30-40,,,28,,NW,,,,,,$104.00,$0.00,1,1,1,0,0,1,20161001,,,,
A6531,HCPCS,COMPRESSION STOCKING BK30-40,AW,,28,,NW,,,,,,$104.00,$0.00,1,1,1,0,0,1,20161001,,,,
A6532,HCPCS,COMPRESSION STOCKING BK40-50,,,28,,NW,,,,,,$148.65,$0.00,1,1,1,0,0,1,20161001,,,,
A6532,HCPCS,COMPRESSION STOCKING BK40-50,AW,,28,,NW,,,,,,$148.65,$0.00,1,1,1,0,0,1,20161001,,,,
A6533,HCPCS,GC STOCKING THIGHLNGTH 18-30,,,28,,NW,,,,,,$73.39,$0.00,1,1,1,0,0,1,20161001,,,,
A6534,HCPCS,GC STOCKING THIGHLNGTH 30-40,,,28,,NW,,,,,,$74.72,$0.00,1,1,1,0,0,1,20161001,,,,
A6535,HCPCS,GC STOCKING THIGHLNGTH 40-50,,,28,,NW,,,,,,$78.77,$0.00,1,1,1,0,0,1,20161001,,,,
A6536,HCPCS,GC STOCKING FULL LNGTH 18-30,,,28,,NW,,,,,,$63.18,$0.00,1,1,1,0,0,1,20161001,,,,
A6537,HCPCS,GC STOCKING FULL LNGTH 30-40,,,28,,NW,,,,,,$96.30,$0.00,1,1,1,0,0,1,20161001,,,,
A6538,HCPCS,GC STOCKING FULL LNGTH 40-50,,,28,,NW,,,,,,$156.94,$0.00,1,1,1,0,0,1,20161001,,,,
A6539,HCPCS,GC STOCKING WAISTLNGTH 18-30,,,28,,NW,,,,,,$148.84,$0.00,1,1,1,0,0,1,20161001,,,,
A6540,HCPCS,GC STOCKING WAISTLNGTH 30-40,,,28,,NW,,,,,,$193.50,$0.00,1,1,1,0,0,1,20161001,,,,
A6541,HCPCS,GC STOCKING WAISTLNGTH 40-50,,,28,,NW,,,,,,$236.28,$0.00,1,1,1,0,0,1,20161001,,,,
A6544,HCPCS,GC STOCKING GARTER BELT,,,28,,NW,,,,,,$47.53,$0.00,1,1,1,0,0,1,20161001,,,,
A6545,HCPCS,GRAD COMP NON-ELASTIC BK,,,28,,NW,,,,,,$209.79,$0.00,1,1,1,0,0,1,20161001,,,,
A6545,HCPCS,GRAD COMP NON-ELASTIC BK,AW,,28,,NW,,,,,,$209.79,$0.00,1,1,1,0,0,1,20161001,,,,
A6549,HCPCS,G COMPRESSION STOCKING,,,28,,NW,,,,,,$296.69,$0.00,1,1,1,0,0,1,20161001,,,,
A6550,HCPCS,NEG PRES WOUND THER DRSG SET,,,28,,NW,,,,,,$48.60,$0.00,1,1,1,0,0,1,20161001,,,,
A7000,HCPCS,DISPOSABLE CANISTER FOR PUMP,,,28,,NW,,,,,,$31.00,$0.00,1,1,1,0,0,1,20161001,,,,
A7000,HCPCS,DISPOSABLE CANISTER FOR PUMP,NU,,28,,NW,,,,,,$31.00,$0.00,1,1,1,0,0,1,20161001,,,,
A7001,HCPCS,NONDISPOSABLE PUMP CANISTER,,,28,,NW,,,,,,$68.06,$0.00,1,1,1,0,0,1,20161001,,,,
A7001,HCPCS,NONDISPOSABLE PUMP CANISTER,NU,,28,,NW,,,,,,$68.06,$0.00,1,1,1,0,0,1,20161001,,,,
A7002,HCPCS,TUBING USED W SUCTION PUMP,,,28,,NW,,,,,,$10.07,$0.00,1,1,1,0,0,1,20161001,,,,
A7002,HCPCS,TUBING USED W SUCTION PUMP,NU,,28,,NW,,,,,,$10.07,$0.00,1,1,1,0,0,1,20161001,,,,
A7003,HCPCS,NEBULIZER ADMINISTRATION SET,,,28,,NW,,,,,,$7.40,$0.00,1,1,1,0,0,1,20161001,,,,
A7003,HCPCS,NEBULIZER ADMINISTRATION SET,NU,,28,,NW,,,,,,$7.40,$0.00,1,1,1,0,0,1,20161001,,,,
A7004,HCPCS,DISPOSABLE NEBULIZER SML VOL,,,28,,NW,,,,,,$4.71,$0.00,1,1,1,0,0,1,20161001,,,,
A7004,HCPCS,DISPOSABLE NEBULIZER SML VOL,NU,,28,,NW,,,,,,$4.71,$0.00,1,1,1,0,0,1,20161001,,,,
A7005,HCPCS,NONDISPOSABLE NEBULIZER SET,,,28,,NW,,,,,,$61.94,$0.00,1,1,1,0,0,1,20161001,,,,
A7005,HCPCS,NONDISPOSABLE NEBULIZER SET,NU,,28,,NW,,,,,,$61.94,$0.00,1,1,1,0,0,1,20161001,,,,
A7006,HCPCS,FILTERED NEBULIZER ADMIN SET,,,28,,NW,,,,,,$16.61,$0.00,1,1,1,0,0,1,20161001,,,,
A7006,HCPCS,FILTERED NEBULIZER ADMIN SET,NU,,28,,NW,,,,,,$16.61,$0.00,1,1,1,0,0,1,20161001,,,,
A7007,HCPCS,LG VOL NEBULIZER DISPOSABLE,,,28,,NW,,,,,,$12.41,$0.00,1,1,1,0,0,1,20161001,,,,
A7007,HCPCS,LG VOL NEBULIZER DISPOSABLE,NU,,28,,NW,,,,,,$12.41,$0.00,1,1,1,0,0,1,20161001,,,,
A7008,HCPCS,DISPOSABLE NEBULIZER PREFILL,,,28,,NW,,,,,,$17.53,$0.00,1,1,1,0,0,1,20161001,,,,
A7008,HCPCS,DISPOSABLE NEBULIZER PREFILL,NU,,28,,NW,,,,,,$17.53,$0.00,1,1,1,0,0,1,20161001,,,,
A7009,HCPCS,NEBULIZER RESERVOIR BOTTLE,,,28,,NW,,,,,,$93.25,$0.00,1,1,1,0,0,1,20161001,,,,
A7009,HCPCS,NEBULIZER RESERVOIR BOTTLE,NU,,28,,NW,,,,,,$93.25,$0.00,1,1,1,0,0,1,20161001,,,,
A7010,HCPCS,DISPOSABLE CORRUGATED TUBING,,,28,,NW,,,,,,$45.20,$0.00,1,1,1,0,0,1,20161001,,,,
A7010,HCPCS,DISPOSABLE CORRUGATED TUBING,NU,,28,,NW,,,,,,$45.20,$0.00,1,1,1,0,0,1,20161001,,,,
A7012,HCPCS,NEBULIZER WATER COLLEC DEVIC,,,28,,NW,,,,,,$10.13,$0.00,1,1,1,0,0,1,20161001,,,,
A7012,HCPCS,NEBULIZER WATER COLLEC DEVIC,NU,,28,,NW,,,,,,$10.13,$0.00,1,1,1,0,0,1,20161001,,,,
A7013,HCPCS,DISPOSABLE COMPRESSOR FILTER,,,28,,NW,,,,,,$2.18,$0.00,1,1,1,0,0,1,20161001,,,,
A7013,HCPCS,DISPOSABLE COMPRESSOR FILTER,NU,,28,,NW,,,,,,$2.18,$0.00,1,1,1,0,0,1,20161001,,,,
A7014,HCPCS,COMPRESSOR NONDISPOS FILTER,,,28,,NW,,,,,,$12.37,$0.00,1,1,1,0,0,1,20161001,,,,
A7014,HCPCS,COMPRESSOR NONDISPOS FILTER,NU,,28,,NW,,,,,,$12.37,$0.00,1,1,1,0,0,1,20161001,,,,
A7015,HCPCS,AEROSOL MASK USED W NEBULIZE,,,28,,NW,,,,,,$5.05,$0.00,1,1,1,0,0,1,20161001,,,,
A7015,HCPCS,AEROSOL MASK USED W NEBULIZE,NU,,28,,NW,,,,,,$5.05,$0.00,1,1,1,0,0,1,20161001,,,,
A7016,HCPCS,NEBULIZER DOME & MOUTHPIECE,,,28,,NW,,,,,,$14.71,$0.00,1,1,1,0,0,1,20161001,,,,
A7016,HCPCS,NEBULIZER DOME & MOUTHPIECE,NU,,28,,NW,,,,,,$14.71,$0.00,1,1,1,0,0,1,20161001,,,,
A7017,HCPCS,NEBULIZER NOT USED W OXYGEN,,,28,,NW,,,,,,$336.58,$0.00,1,1,1,0,0,1,20161001,,,,
A7017,HCPCS,NEBULIZER NOT USED W OXYGEN,NU,,28,,NW,,,,,,$336.58,$0.00,1,1,1,0,0,1,20161001,,,,
A7017,HCPCS,NEBULIZER NOT USED W OXYGEN,RR,,28,,NW,,,,,,$21.90,$0.00,1,1,1,0,0,1,20161001,,,,
A7017,HCPCS,NEBULIZER NOT USED W OXYGEN,UE,,28,,NW,,,,,,$249.15,$0.00,1,1,1,0,0,1,20161001,,,,
A7018,HCPCS,WATER DISTILLED W/NEBULIZER,,,28,,NW,,,,,,$1.02,$0.00,1,1,1,0,0,1,20161001,,,,
A7020,HCPCS,"INTERFACE, COUGH STIM DEVICE",,,28,,NW,,,,,,$24.06,$0.00,1,1,1,0,0,1,20161001,,,,
A7020,HCPCS,"INTERFACE, COUGH STIM DEVICE",NU,,28,,NW,,,,,,$24.06,$0.00,1,1,1,0,0,1,20161001,,,,
A7020,HCPCS,"INTERFACE, COUGH STIM DEVICE",RR,,28,,NW,,,,,,$2.56,$0.00,1,1,1,0,0,1,20161001,,,,
A7020,HCPCS,"INTERFACE, COUGH STIM DEVICE",UE,,28,,NW,,,,,,$18.09,$0.00,1,1,1,0,0,1,20161001,,,,
A7025,HCPCS,REPLACE CHEST COMPRESS VEST,,,28,,NW,,,,,,$877.33,$0.00,1,1,1,0,0,1,20161001,,,,
A7025,HCPCS,REPLACE CHEST COMPRESS VEST,NU,,28,,NW,,,,,,$877.33,$0.00,1,1,1,0,0,1,20161001,,,,
A7025,HCPCS,REPLACE CHEST COMPRESS VEST,RR,,28,,NW,,,,,,$100.38,$0.00,1,1,1,0,0,1,20161001,,,,
A7026,HCPCS,REPLACE CHST CMPRSS SYS HOSE,,,28,,NW,,,,,,$61.91,$0.00,1,1,1,0,0,1,20161001,,,,
A7026,HCPCS,REPLACE CHST CMPRSS SYS HOSE,NU,,28,,NW,,,,,,$61.91,$0.00,1,1,1,0,0,1,20161001,,,,
A7027,HCPCS,COMBINATION ORAL/NASAL MASK,,,28,,NW,,,,,,$465.25,$0.00,1,1,1,0,0,1,20161001,,,,
A7027,HCPCS,COMBINATION ORAL/NASAL MASK,NU,,28,,NW,,,,,,$465.25,$0.00,1,1,1,0,0,1,20161001,,,,
A7028,HCPCS,REPL ORAL CUSHION COMBO MASK,,,28,,NW,,,,,,$116.18,$0.00,1,1,1,0,0,1,20161001,,,,
A7028,HCPCS,REPL ORAL CUSHION COMBO MASK,NU,,28,,NW,,,,,,$116.18,$0.00,1,1,1,0,0,1,20161001,,,,
A7029,HCPCS,REPL NASAL PILLOW COMB MASK,,,28,,NW,,,,,,$39.69,$0.00,1,1,1,0,0,1,20161001,,,,
A7029,HCPCS,REPL NASAL PILLOW COMB MASK,NU,,28,,NW,,,,,,$39.69,$0.00,1,1,1,0,0,1,20161001,,,,
A7030,HCPCS,CPAP FULL FACE MASK,,,28,,NW,,,,,,$411.09,$0.00,1,1,1,0,0,1,20161001,,,,
A7030,HCPCS,CPAP FULL FACE MASK,NU,,28,,NW,,,,,,$411.09,$0.00,1,1,1,0,0,1,20161001,,,,
A7031,HCPCS,REPLACEMENT FACEMASK INTERFA,,,28,,NW,,,,,,$143.80,$0.00,1,1,1,0,0,1,20161001,,,,
A7031,HCPCS,REPLACEMENT FACEMASK INTERFA,NU,,28,,NW,,,,,,$143.80,$0.00,1,1,1,0,0,1,20161001,,,,
A7032,HCPCS,REPLACEMENT NASAL CUSHION,,,28,,NW,,,,,,$78.03,$0.00,1,1,1,0,0,1,20161001,,,,
A7032,HCPCS,REPLACEMENT NASAL CUSHION,NU,,28,,NW,,,,,,$78.03,$0.00,1,1,1,0,0,1,20161001,,,,
A7033,HCPCS,REPLACEMENT NASAL PILLOWS,,,28,,NW,,,,,,$50.79,$0.00,1,1,1,0,0,1,20161001,,,,
A7033,HCPCS,REPLACEMENT NASAL PILLOWS,NU,,28,,NW,,,,,,$50.79,$0.00,1,1,1,0,0,1,20161001,,,,
A7034,HCPCS,NASAL APPLICATION DEVICE,,,28,,NW,,,,,,$251.40,$0.00,1,1,1,0,0,1,20161001,,,,
A7034,HCPCS,NASAL APPLICATION DEVICE,NU,,28,,NW,,,,,,$251.40,$0.00,1,1,1,0,0,1,20161001,,,,
A7035,HCPCS,POS AIRWAY PRESS HEADGEAR,,,28,,NW,,,,,,$71.68,$0.00,1,1,1,0,0,1,20161001,,,,
A7035,HCPCS,POS AIRWAY PRESS HEADGEAR,NU,,28,,NW,,,,,,$71.68,$0.00,1,1,1,0,0,1,20161001,,,,
A7036,HCPCS,POS AIRWAY PRESS CHINSTRAP,,,28,,NW,,,,,,$24.42,$0.00,1,1,1,0,0,1,20161001,,,,
A7036,HCPCS,POS AIRWAY PRESS CHINSTRAP,NU,,28,,NW,,,,,,$24.42,$0.00,1,1,1,0,0,1,20161001,,,,
A7037,HCPCS,POS AIRWAY PRESSURE TUBING,,,28,,NW,,,,,,$77.31,$0.00,1,1,1,0,0,1,20161001,,,,
A7037,HCPCS,POS AIRWAY PRESSURE TUBING,NU,,28,,NW,,,,,,$77.31,$0.00,1,1,1,0,0,1,20161001,,,,
A7038,HCPCS,POS AIRWAY PRESSURE FILTER,,,28,,NW,,,,,,$12.19,$0.00,1,1,1,0,0,1,20161001,,,,
A7038,HCPCS,POS AIRWAY PRESSURE FILTER,NU,,28,,NW,,,,,,$12.19,$0.00,1,1,1,0,0,1,20161001,,,,
A7039,HCPCS,"FILTER, NON DISPOSABLE W PAP",,,28,,NW,,,,,,$19.05,$0.00,1,1,1,0,0,1,20161001,,,,
A7039,HCPCS,"FILTER, NON DISPOSABLE W PAP",NU,,28,,NW,,,,,,$19.05,$0.00,1,1,1,0,0,1,20161001,,,,
A7040,HCPCS,ONE WAY CHEST DRAIN VALVE,,,28,,NW,,,,,,$95.38,$0.00,1,1,1,0,0,1,20161001,,,,
A7041,HCPCS,WATER SEAL DRAIN CONTAINER,,,28,,NW,,,,,,$183.78,$0.00,1,1,1,0,0,1,20161001,,,,
A7044,HCPCS,PAP ORAL INTERFACE,,,28,,NW,,,,,,$258.78,$0.00,1,1,1,0,0,1,20161001,,,,
A7044,HCPCS,PAP ORAL INTERFACE,NU,,28,,NW,,,,,,$258.78,$0.00,1,1,1,0,0,1,20161001,,,,
A7045,HCPCS,REPL EXHALATION PORT FOR PAP,,,28,,NW,,,,,,$30.67,$0.00,1,1,1,0,0,1,20161001,,,,
A7045,HCPCS,REPL EXHALATION PORT FOR PAP,NU,,28,,NW,,,,,,$30.67,$0.00,1,1,1,0,0,1,20161001,,,,
A7045,HCPCS,REPL EXHALATION PORT FOR PAP,RR,,28,,NW,,,,,,$4.72,$0.00,1,1,1,0,0,1,20161001,,,,
A7045,HCPCS,REPL EXHALATION PORT FOR PAP,UE,,28,,NW,,,,,,$19.76,$0.00,1,1,1,0,0,1,20161001,,,,
A7046,HCPCS,"REPL WATER CHAMBER, PAP DEV",,,28,,NW,,,,,,$30.76,$0.00,1,1,1,0,0,1,20161001,,,,
A7046,HCPCS,"REPL WATER CHAMBER, PAP DEV",NU,,28,,NW,,,,,,$30.76,$0.00,1,1,1,0,0,1,20161001,,,,
A7047,HCPCS,RESP SUCTION ORAL INTERFACE,,,28,,NW,,,,,,$302.34,$0.00,1,1,1,0,0,1,20161001,,,,
A7047,HCPCS,RESP SUCTION ORAL INTERFACE,NU,,28,,NW,,,,,,$302.34,$0.00,1,1,1,0,0,1,20161001,,,,
A7048,HCPCS,VACUUM DRAIN BOTTLE/TUBE KIT,,,28,,NW,,,,,,$100.70,$0.00,1,1,1,0,0,1,20161001,,,,
A7501,HCPCS,TRACHEOSTOMA VALVE W DIAPHRA,,,28,,NW,,,,,,$259.85,$0.00,1,1,1,0,0,1,20161001,,,,
A7502,HCPCS,REPLACEMENT DIAPHRAGM/FPLATE,,,28,,NW,,,,,,$120.80,$0.00,1,1,1,0,0,1,20161001,,,,
A7503,HCPCS,HMES FILTER HOLDER OR CAP,,,28,,NW,,,,,,$23.45,$0.00,1,1,1,0,0,1,20161001,,,,
A7504,HCPCS,TRACHEOSTOMA HMES FILTER,,,28,,NW,,,,,,$1.52,$0.00,1,1,1,0,0,1,20161001,,,,
A7505,HCPCS,HMES OR TRACH VALVE HOUSING,,,28,,NW,,,,,,$9.27,$0.00,1,1,1,0,0,1,20161001,,,,
A7506,HCPCS,HMES/TRACHVALVE ADHESIVEDISK,,,28,,NW,,,,,,$0.75,$0.00,1,1,1,0,0,1,20161001,,,,
A7507,HCPCS,INTEGRATED FILTER & HOLDER,,,28,,NW,,,,,,$5.06,$0.00,1,1,1,0,0,1,20161001,,,,
A7508,HCPCS,HOUSING & INTEGRATED ADHESIV,,,28,,NW,,,,,,$5.79,$0.00,1,1,1,0,0,1,20161001,,,,
A7509,HCPCS,HEAT & MOISTURE EXCHANGE SYS,,,28,,NW,,,,,,$3.01,$0.00,1,1,1,0,0,1,20161001,,,,
A7520,HCPCS,TRACH/LARYN TUBE NON-CUFFED,,,28,,NW,,,,,,$51.67,$0.00,1,1,1,0,0,1,20161001,,,,
A7521,HCPCS,TRACH/LARYN TUBE CUFFED,,,28,,NW,,,,,,$51.26,$0.00,1,1,1,0,0,1,20161001,,,,
A7522,HCPCS,TRACH/LARYN TUBE STAINLESS,,,28,,NW,,,,,,$49.52,$0.00,1,1,1,0,0,1,20161001,,,,
A7523,HCPCS,TRACHEOSTOMY SHOWER PROTECT,,,28,,NW,,,,,,$21.21,$0.00,1,1,1,0,0,1,20161001,,,,
A7524,HCPCS,TRACHEOSTOMA STENT/STUD/BTTN,,,28,,NW,,,,,,$79.48,$0.00,1,1,1,0,0,1,20161001,,,,
A7525,HCPCS,TRACHEOSTOMY MASK,,,28,,NW,,,,,,$4.08,$0.00,1,1,1,0,0,1,20161001,,,,
A7526,HCPCS,TRACHEOSTOMY TUBE COLLAR,,,28,,NW,,,,,,$6.68,$0.00,1,1,1,0,0,1,20161001,,,,
A7527,HCPCS,TRACH/LARYN TUBE PLUG/STOP,,,28,,NW,,,,,,$7.17,$0.00,1,1,1,0,0,1,20161001,,,,
A8000,HCPCS,SOFT PROTECT HELMET PREFAB,,,28,,NW,,,,,,$387.00,$0.00,1,1,1,0,0,1,20161001,,,,
A8000,HCPCS,SOFT PROTECT HELMET PREFAB,NU,,28,,NW,,,,,,$387.00,$0.00,1,1,1,0,0,1,20161001,,,,
A8000,HCPCS,SOFT PROTECT HELMET PREFAB,RR,,28,,NW,,,,,,$26.91,$0.00,1,1,1,0,0,1,20161001,,,,
A8000,HCPCS,SOFT PROTECT HELMET PREFAB,UE,,28,,NW,,,,,,$287.04,$0.00,1,1,1,0,0,1,20161001,,,,
A8001,HCPCS,HARD PROTECT HELMET PREFAB,,,28,,NW,,,,,,$387.00,$0.00,1,1,1,0,0,1,20161001,,,,
A8001,HCPCS,HARD PROTECT HELMET PREFAB,NU,,28,,NW,,,,,,$387.00,$0.00,1,1,1,0,0,1,20161001,,,,
A8001,HCPCS,HARD PROTECT HELMET PREFAB,RR,,28,,NW,,,,,,$26.91,$0.00,1,1,1,0,0,1,20161001,,,,
A8001,HCPCS,HARD PROTECT HELMET PREFAB,UE,,28,,NW,,,,,,$287.04,$0.00,1,1,1,0,0,1,20161001,,,,
A8002,HCPCS,SOFT PROTECT HELMET CUSTOM,,,28,,NW,,,,,,$485.17,$0.00,1,1,1,0,0,1,20161001,,,,
A8002,HCPCS,SOFT PROTECT HELMET CUSTOM,NU,,28,,NW,,,,,,$485.17,$0.00,1,1,1,0,0,1,20161001,,,,
A8002,HCPCS,SOFT PROTECT HELMET CUSTOM,RR,,28,,NW,,,,,,$51.15,$0.00,1,1,1,0,0,1,20161001,,,,
A8002,HCPCS,SOFT PROTECT HELMET CUSTOM,UE,,28,,NW,,,,,,$363.85,$0.00,1,1,1,0,0,1,20161001,,,,
A8003,HCPCS,HARD PROTECT HELMET CUSTOM,,,28,,NW,,,,,,$506.77,$0.00,1,1,1,0,0,1,20161001,,,,
A8003,HCPCS,HARD PROTECT HELMET CUSTOM,NU,,28,,NW,,,,,,$506.77,$0.00,1,1,1,0,0,1,20161001,,,,
A8003,HCPCS,HARD PROTECT HELMET CUSTOM,RR,,28,,NW,,,,,,$53.90,$0.00,1,1,1,0,0,1,20161001,,,,
A8003,HCPCS,HARD PROTECT HELMET CUSTOM,UE,,28,,NW,,,,,,$380.99,$0.00,1,1,1,0,0,1,20161001,,,,
A8004,HCPCS,"REPL SOFT INTERFACE, HELMET",,,28,,NW,,,,,,$60.54,$0.00,1,1,1,0,0,1,20161001,,,,
A8004,HCPCS,"REPL SOFT INTERFACE, HELMET",NU,,28,,NW,,,,,,$60.54,$0.00,1,1,1,0,0,1,20161001,,,,
A8004,HCPCS,"REPL SOFT INTERFACE, HELMET",RR,,28,,NW,,,,,,$6.44,$0.00,1,1,1,0,0,1,20161001,,,,
A8004,HCPCS,"REPL SOFT INTERFACE, HELMET",UE,,28,,NW,,,,,,$45.51,$0.00,1,1,1,0,0,1,20161001,,,,
A9150,HCPCS,MISC/EXPER NON-PRESCRIPT DRU,,,29,,NW,,,,,,$20.35,$0.00,1,1,1,0,0,1,20161001,,,,
A9152,HCPCS,SINGLE VITAMIN NOS,,,29,,NW,,,,,,$27.58,$0.00,1,1,1,0,0,1,20161001,,,,
A9153,HCPCS,MULTI-VITAMIN NOS,,,29,,NW,,,,,,$26.89,$0.00,1,1,1,0,0,1,20161001,,,,
A9155,HCPCS,ARTIFICIAL SALIVA,,,29,,NW,,,,,,$7.94,$0.00,1,1,1,0,0,1,20161001,,,,
A9180,HCPCS,"LICE TREATMENT, TOPICAL",,,29,,NW,,,,,,$182.13,$0.00,1,1,1,0,0,1,20161001,,,,
A9270,HCPCS,NON-COVERED ITEM OR SERVICE,,,28,,NW,,,,,,$133.43,$0.00,1,1,1,0,0,1,20161001,,,,
A9272,HCPCS,"DISP WOUND SUCT, DRSG/ACCESS",,,28,,NW,,,,,,$374.76,$0.00,1,1,1,0,0,1,20161001,,,,
A9273,HCPCS,HOT/COLD H2OBOT/CAP/COL/WRAP,,,28,,NW,,,,,,$13.01,$0.00,1,1,1,0,0,1,20161001,,,,
A9274,HCPCS,EXT AMB INSULIN DELIVERY SYS,,,28,,NW,,,,,,$60.04,$0.00,1,1,1,0,0,1,20161001,,,,
A9275,HCPCS,DISP HOME GLUCOSE MONITOR,,,28,,NW,,,,,,$18.90,$0.00,1,1,1,0,0,1,20161001,,,,
A9276,HCPCS,"DISPOSABLE SENSOR, CGM SYS",,,28,,NW,,,,,,$32.53,$0.00,1,1,1,0,0,1,20161001,,,,
A9277,HCPCS,"EXTERNAL TRANSMITTER, CGM",,,28,,NW,,,,,,"$1,435.74",$0.00,1,1,1,0,0,1,20161001,,,,
A9278,HCPCS,"EXTERNAL RECEIVER, CGM SYS",,,28,,NW,,,,,,"$1,300.01",$0.00,1,1,1,0,0,1,20161001,,,,
A9279,HCPCS,MONITORING FEATURE/DEVICENOC,,,28,,NW,,,,,,$78.08,$0.00,1,1,1,0,0,1,20161001,,,,
A9280,HCPCS,"ALERT DEVICE, NOC",,,28,,NW,,,,,,$290.52,$0.00,1,1,1,0,0,1,20161001,,,,
A9281,HCPCS,REACHING/GRABBING DEVICE,,,28,,NW,,,,,,$31.80,$0.00,1,1,1,0,0,1,20161001,,,,
A9282,HCPCS,WIG ANY TYPE,,,28,,NW,,,,,,$387.14,$0.00,1,1,1,0,0,1,20161001,,,,
A9283,HCPCS,FOOT PRESS OFF LOAD SUPP DEV,,,28,,NW,,,,,,$71.57,$0.00,1,1,1,0,0,1,20161001,,,,
A9284,HCPCS,NON-ELECTRONIC SPIROMETER,,,28,,NW,,,,,,$47.68,$0.00,1,1,1,0,0,1,20161001,,,,
A9300,HCPCS,EXERCISE EQUIPMENT,,,28,,NW,,,,,,$13.01,$0.00,1,1,1,0,0,1,20161001,,,,
A9500,HCPCS,TC99M SESTAMIBI,,,28,,NW,,,,,,$283.00,$0.00,1,1,1,0,0,1,20161001,,,,
A9501,HCPCS,TECHNETIUM TC-99M TEBOROXIME,,,28,,NW,,,,,,$438.88,$0.00,1,1,1,0,0,1,20161001,,,,
A9502,HCPCS,TC99M TETROFOSMIN,,,28,,NW,,,,,,$297.64,$0.00,1,1,1,0,0,1,20161001,,,,
A9503,HCPCS,TC99M MEDRONATE,,,28,,NW,,,,,,$56.60,$0.00,1,1,1,0,0,1,20161001,,,,
A9504,HCPCS,TC99M APCITIDE,,,28,,NW,,,,,,$313.74,$0.00,1,1,1,0,0,1,20161001,,,,
A9505,HCPCS,TL201 THALLIUM,,,28,,NW,,,,,,$168.10,$0.00,1,1,1,0,0,1,20161001,,,,
A9507,HCPCS,IN111 CAPROMAB,,,28,,NW,,,,,,"$5,041.47",$0.00,1,1,1,0,0,1,20161001,,,,
A9508,HCPCS,"I131 IODOBENGUATE, DX",,,28,,NW,,,,,,$47.26,$0.00,1,1,1,0,0,1,20161001,,,,
A9509,HCPCS,IODINE I-123 SOD IODIDE MIL,,,28,,NW,,,,,,$137.42,$0.00,1,1,1,0,0,1,20161001,,,,
A9510,HCPCS,TC99M DISOFENIN,,,28,,NW,,,,,,$95.51,$0.00,1,1,1,0,0,1,20161001,,,,
A9512,HCPCS,TC99M PERTECHNETATE,,,28,,NW,,,,,,$5.66,$0.00,1,1,1,0,0,1,20161001,,,,
A9516,HCPCS,IODINE I-123 SOD IODIDE MIC,,,28,,NW,,,,,,$121.69,$0.00,1,1,1,0,0,1,20161001,,,,
A9517,HCPCS,"I131 IODIDE CAP, RX",,,28,,NW,,,,,,$59.43,$0.00,1,1,1,0,0,1,20161001,,,,
A9521,HCPCS,TC99M EXAMETAZIME,,,28,,NW,,,,,,"$1,198.71",$0.00,1,1,1,0,0,1,20161001,,,,
A9524,HCPCS,"I131 SERUM ALBUMIN, DX",,,28,,NW,,,,,,$241.38,$0.00,1,1,1,0,0,1,20161001,,,,
A9526,HCPCS,NITROGEN N-13 AMMONIA,,,28,,NW,,,,,,$707.49,$0.00,1,1,1,0,0,1,20161001,,,,
A9527,HCPCS,IODINE I-125 SODIUM IODIDE,,,28,,NW,,,,,,$146.29,$0.00,1,1,1,0,0,1,20161001,,,,
A9528,HCPCS,"IODINE I-131 IODIDE CAP, DX",,,28,,NW,,,,,,$365.68,$0.00,1,1,1,0,0,1,20161001,,,,
A9529,HCPCS,"I131 IODIDE SOL, DX",,,28,,NW,,,,,,$74.61,$0.00,1,1,1,0,0,1,20161001,,,,
A9530,HCPCS,"I131 IODIDE SOL, RX",,,28,,NW,,,,,,$41.19,$0.00,1,1,1,0,0,1,20161001,,,,
A9531,HCPCS,I131 MAX 100UCI,,,28,,NW,,,,,,$17.26,$0.00,1,1,1,0,0,1,20161001,,,,
A9532,HCPCS,"I125 SERUM ALBUMIN, DX",,,28,,NW,,,,,,$792.63,$0.00,1,1,1,0,0,1,20161001,,,,
A9536,HCPCS,TC99M DEPREOTIDE,,,28,,NW,,,,,,$804.61,$0.00,1,1,1,0,0,1,20161001,,,,
A9537,HCPCS,TC99M MEBROFENIN,,,28,,NW,,,,,,$100.46,$0.00,1,1,1,0,0,1,20161001,,,,
A9538,HCPCS,TC99M PYROPHOSPHATE,,,28,,NW,,,,,,$106.12,$0.00,1,1,1,0,0,1,20161001,,,,
A9539,HCPCS,TC99M PENTETATE,,,28,,NW,,,,,,$70.75,$0.00,1,1,1,0,0,1,20161001,,,,
A9540,HCPCS,TC99M MAA,,,28,,NW,,,,,,$36.79,$0.00,1,1,1,0,0,1,20161001,,,,
A9541,HCPCS,TC99M SULFUR COLLOID,,,28,,NW,,,,,,$134.42,$0.00,1,1,1,0,0,1,20161001,,,,
A9546,HCPCS,CO57/58,,,28,,NW,,,,,,$30.32,$0.00,1,1,1,0,0,1,20161001,,,,
A9547,HCPCS,IN111 OXYQUINOLINE,,,28,,NW,,,,,,"$1,142.92",$0.00,1,1,1,0,0,1,20161001,,,,
A9548,HCPCS,IN111 PENTETATE,,,28,,NW,,,,,,$685.75,$0.00,1,1,1,0,0,1,20161001,,,,
A9550,HCPCS,TC99M GLUCEPTATE,,,28,,NW,,,,,,$49.73,$0.00,1,1,1,0,0,1,20161001,,,,
A9551,HCPCS,TC99M SUCCIMER,,,28,,NW,,,,,,$409.62,$0.00,1,1,1,0,0,1,20161001,,,,
A9552,HCPCS,F18 FDG,,,28,,NW,,,,,,$778.24,$0.00,1,1,1,0,0,1,20161001,,,,
A9554,HCPCS,"I125 IOTHALAMATE, DX",,,28,,NW,,,,,,"$1,379.61",$0.00,1,1,1,0,0,1,20161001,,,,
A9555,HCPCS,RB82 RUBIDIUM,,,28,,NW,,,,,,$848.99,$0.00,1,1,1,0,0,1,20161001,,,,
A9556,HCPCS,GA67 GALLIUM,,,28,,NW,,,,,,$85.67,$0.00,1,1,1,0,0,1,20161001,,,,
A9557,HCPCS,TC99M BICISATE,,,28,,NW,,,,,,$365.73,$0.00,1,1,1,0,0,1,20161001,,,,
A9558,HCPCS,XE133 XENON 10MCI,,,28,,NW,,,,,,$124.57,$0.00,1,1,1,0,0,1,20161001,,,,
A9560,HCPCS,TC99M LABELED RBC,,,28,,NW,,,,,,$226.40,$0.00,1,1,1,0,0,1,20161001,,,,
A9561,HCPCS,TC99M OXIDRONATE,,,28,,NW,,,,,,$71.95,$0.00,1,1,1,0,0,1,20161001,,,,
A9562,HCPCS,TC99M MERTIATIDE,,,28,,NW,,,,,,$438.24,$0.00,1,1,1,0,0,1,20161001,,,,
A9564,HCPCS,P32 CHROMIC PHOSPHATE,,,28,,NW,,,,,,$585.18,$0.00,1,1,1,0,0,1,20161001,,,,
A9567,HCPCS,TECHNETIUM TC-99M AEROSOL,,,28,,NW,,,,,,$59.43,$0.00,1,1,1,0,0,1,20161001,,,,
A9569,HCPCS,TECHNETIUM TC-99M AUTO WBC,,,28,,NW,,,,,,$3.45,$0.00,1,1,1,0,0,1,20161001,,,,
A9570,HCPCS,INDIUM IN-111 AUTO WBC,,,28,,NW,,,,,,$338.90,$0.00,1,1,1,0,0,1,20161001,,,,
A9571,HCPCS,INDIUM IN-111 AUTO PLATELET,,,28,,NW,,,,,,$15.15,$0.00,1,1,1,0,0,1,20161001,,,,
A9572,HCPCS,INDIUM IN-111 PENTETREOTIDE,,,28,,NW,,,,,,"$5,398.15",$0.00,1,1,1,0,0,1,20161001,,,,
A9575,HCPCS,INJ GADOTERATE MEGLUMI 0.1ML,,,28,,NW,,,,,,$1.31,$0.00,1,1,1,0,0,1,20161001,,,,
A9576,HCPCS,INJ PROHANCE MULTIPACK,,,28,,NW,,,,,,$5.66,$0.00,1,1,1,0,0,1,20161001,,,,
A9577,HCPCS,INJ MULTIHANCE,,,28,,NW,,,,,,$8.49,$0.00,1,1,1,0,0,1,20161001,,,,
A9578,HCPCS,INJ MULTIHANCE MULTIPACK,,,28,,NW,,,,,,$8.49,$0.00,1,1,1,0,0,1,20161001,,,,
A9579,HCPCS,"GAD-BASE MR CONTRAST NOS,1ML",,,28,,NW,,,,,,$8.49,$0.00,1,1,1,0,0,1,20161001,,,,
A9580,HCPCS,SODIUM FLUORIDE F-18,,,28,,NW,,,,,,$690.51,$0.00,1,1,1,0,0,1,20161001,,,,
A9581,HCPCS,GADOXETATE DISODIUM INJ,,,28,,NW,,,,,,$28.21,$0.00,1,1,1,0,0,1,20161001,,,,
A9582,HCPCS,IODINE I-123 IOBENGUANE,,,28,,NW,,,,,,"$4,192.45",$0.00,1,1,1,0,0,1,20161001,,,,
A9583,HCPCS,GADOFOSVESET TRISODIUM INJ,,,28,,NW,,,,,,$39.62,$0.00,1,1,1,0,0,1,20161001,,,,
A9584,HCPCS,IODINE I-123 IOFLUPANE,,,28,,NW,,,,,,"$3,361.99",$0.00,1,1,1,0,0,1,20161001,,,,
A9585,HCPCS,GADOBUTROL INJECTION,,,28,,NW,,,,,,$1.56,$0.00,1,1,1,0,0,1,20161001,,,,
A9599,HCPCS,RADIOPHA DX BETA AMYLOID PET,,,28,,NW,,,,,,$32.86,$0.00,1,1,1,0,0,1,20161001,,,,
A9600,HCPCS,SR89 STRONTIUM,,,28,,NW,,,,,,"$1,478.94",$0.00,1,1,1,0,0,1,20161001,,,,
A9604,HCPCS,SM 153 LEXIDRONAM,,,28,,NW,,,,,,"$14,106.62",$0.00,1,1,1,0,0,1,20161001,,,,
A9606,HCPCS,RADIUM RA223 DICHLORIDE THER,,,28,,NW,,,,,,$276.31,$0.00,1,1,1,0,0,1,20161001,,,,
A9698,HCPCS,NON-RAD CONTRAST MATERIALNOC,,,28,,NW,,,,,,$32.47,$0.00,1,1,1,0,0,1,20161001,,,,
A9699,HCPCS,RADIOPHARM RX AGENT NOC,,,28,,NW,,,,,,$32.47,$0.00,1,1,1,0,0,1,20161001,,,,
A9700,HCPCS,ECHOCARDIOGRAPHY CONTRAST,,,28,,NW,,,,,,$426.65,$0.00,1,1,1,0,0,1,20161001,,,,
A9900,HCPCS,SUPPLY/ACCESSORY/SERVICE,,,28,,NW,,,,,,$35.73,$0.00,1,1,1,0,0,1,20161001,,,,
A9999,HCPCS,"DME SUPPLY OR ACCESSORY, NOS",,,28,,NW,,,,,,$5.99,$0.00,1,1,1,0,0,1,20161001,,,,
B4034,HCPCS,ENTER FEED SUPKIT SYR BY DAY,,,28,,NW,,,,,,$13.54,$0.00,1,1,1,0,0,1,20161001,,,,
B4035,HCPCS,ENTERAL FEED SUPP PUMP PER D,,,28,,NW,,,,,,$26.52,$0.00,1,1,1,0,0,1,20161001,,,,
B4036,HCPCS,ENTERAL FEED SUP KIT GRAV BY,,,28,,NW,,,,,,$17.96,$0.00,1,1,1,0,0,1,20161001,,,,
B4081,HCPCS,ENTERAL NG TUBING W/ STYLET,,,28,,NW,,,,,,$49.82,$0.00,1,1,1,0,0,1,20161001,,,,
B4082,HCPCS,ENTERAL NG TUBING W/O STYLET,,,28,,NW,,,,,,$36.83,$0.00,1,1,1,0,0,1,20161001,,,,
B4083,HCPCS,ENTERAL STOMACH TUBE LEVINE,,,28,,NW,,,,,,$5.02,$0.00,1,1,1,0,0,1,20161001,,,,
B4087,HCPCS,"GASTRO/JEJUNO TUBE, STD",,,28,,NW,,,,,,$82.70,$0.00,1,1,1,0,0,1,20161001,,,,
B4088,HCPCS,"GASTRO/JEJUNO TUBE, LOW-PRO",,,28,,NW,,,,,,$82.70,$0.00,1,1,1,0,0,1,20161001,,,,
B4100,HCPCS,FOOD THICKENER ORAL,,,28,,NW,,,,,,$0.92,$0.00,1,1,1,0,0,1,20161001,,,,
B4102,HCPCS,EF ADULT FLUIDS AND ELECTRO,,,28,,NW,,,,,,$3.80,$0.00,1,1,1,0,0,1,20161001,,,,
B4103,HCPCS,EF PED FLUID AND ELECTROLYTE,,,28,,NW,,,,,,$12.97,$0.00,1,1,1,0,0,1,20161001,,,,
B4104,HCPCS,ADDITIVE FOR ENTERAL FORMULA,,,28,,NW,,,,,,$10.05,$0.00,1,1,1,0,0,1,20161001,,,,
B4149,HCPCS,EF BLENDERIZED FOODS,,,28,,NW,,,,,,$2.93,$0.00,1,1,1,0,0,1,20161001,,,,
B4150,HCPCS,EF COMPLET W/INTACT NUTRIENT,,,28,,NW,,,,,,$0.85,$0.00,1,1,1,0,0,1,20161001,,,,
B4152,HCPCS,EF CALORIE DENSE>/=1.5KCAL,,,28,,NW,,,,,,$0.69,$0.00,1,1,1,0,0,1,20161001,,,,
B4153,HCPCS,EF HYDROLYZED/AMINO ACIDS,,,28,,NW,,,,,,$3.72,$0.00,1,1,1,0,0,1,20161001,,,,
B4154,HCPCS,EF SPEC METABOLIC NONINHERIT,,,28,,NW,,,,,,$2.10,$0.00,1,1,1,0,0,1,20161001,,,,
B4155,HCPCS,EF INCOMPLETE/MODULAR,,,28,,NW,,,,,,$1.46,$0.00,1,1,1,0,0,1,20161001,,,,
B4157,HCPCS,EF SPECIAL METABOLIC INHERIT,,,28,,NW,,,,,,$10.14,$0.00,1,1,1,0,0,1,20161001,,,,
B4158,HCPCS,EF PED COMPLETE INTACT NUT,,,28,,NW,,,,,,$4.47,$0.00,1,1,1,0,0,1,20161001,,,,
B4159,HCPCS,EF PED COMPLETE SOY BASED,,,28,,NW,,,,,,$4.97,$0.00,1,1,1,0,0,1,20161001,,,,
B4160,HCPCS,EF PED CALORIC DENSE>/=0.7KC,,,28,,NW,,,,,,$4.18,$0.00,1,1,1,0,0,1,20161001,,,,
B4161,HCPCS,EF PED HYDROLYZED/AMINO ACID,,,28,,NW,,,,,,$9.34,$0.00,1,1,1,0,0,1,20161001,,,,
B4162,HCPCS,EF PED SPECMETABOLIC INHERIT,,,28,,NW,,,,,,$15.44,$0.00,1,1,1,0,0,1,20161001,,,,
B4164,HCPCS,PARENTERAL 50% DEXTROSE SOLU,,,28,,NW,,,,,,$43.93,$0.00,1,1,1,0,0,1,20161001,,,,
B4168,HCPCS,PARENTERAL SOL AMINO ACID 3.,,,28,,NW,,,,,,$64.40,$0.00,1,1,1,0,0,1,20161001,,,,
B4172,HCPCS,PARENTERAL SOL AMINO ACID 5.,,,28,,NW,,,,,,$118.95,$0.00,1,1,1,0,0,1,20161001,,,,
B4176,HCPCS,PARENTERAL SOL AMINO ACID 7-,,,28,,NW,,,,,,$125.32,$0.00,1,1,1,0,0,1,20161001,,,,
B4178,HCPCS,PARENTERAL SOL AMINO ACID >,,,28,,NW,,,,,,$150.58,$0.00,1,1,1,0,0,1,20161001,,,,
B4180,HCPCS,PARENTERAL SOL CARB > 50%,,,28,,NW,,,,,,$63.39,$0.00,1,1,1,0,0,1,20161001,,,,
B4185,HCPCS,PARENTERAL SOL 10 GM LIPIDS,,,28,,NW,,,,,,$28.80,$0.00,1,1,1,0,0,1,20161001,,,,
B4189,HCPCS,PARENTERAL SOL AMINO ACID &,,,28,,NW,,,,,,$466.74,$0.00,1,1,1,0,0,1,20161001,,,,
B4193,HCPCS,PARENTERAL SOL 52-73 GM PROT,,,28,,NW,,,,,,$603.30,$0.00,1,1,1,0,0,1,20161001,,,,
B4197,HCPCS,PARENTERAL SOL 74-100 GM PRO,,,28,,NW,,,,,,$734.66,$0.00,1,1,1,0,0,1,20161001,,,,
B4199,HCPCS,PARENTERAL SOL > 100GM PROTE,,,28,,NW,,,,,,$839.57,$0.00,1,1,1,0,0,1,20161001,,,,
B4216,HCPCS,PARENTERAL NUTRITION ADDITIV,,,28,,NW,,,,,,$19.56,$0.00,1,1,1,0,0,1,20161001,,,,
B4220,HCPCS,PARENTERAL SUPPLY KIT PREMIX,,,28,,NW,,,,,,$20.31,$0.00,1,1,1,0,0,1,20161001,,,,
B4222,HCPCS,PARENTERAL SUPPLY KIT HOMEMI,,,28,,NW,,,,,,$25.22,$0.00,1,1,1,0,0,1,20161001,,,,
B4224,HCPCS,PARENTERAL ADMINISTRATION KI,,,28,,NW,,,,,,$65.01,$0.00,1,1,1,0,0,1,20161001,,,,
B5000,HCPCS,PARENTERAL SOL RENAL-AMIROSY,,,28,,NW,,,,,,$30.51,$0.00,1,1,1,0,0,1,20161001,,,,
B5100,HCPCS,PARENTERAL SOLUTION HEPATIC,,,28,,NW,,,,,,$11.46,$0.00,1,1,1,0,0,1,20161001,,,,
B5200,HCPCS,PARENTERAL SOL HEPATIC FREAM,,,28,,NW,,,,,,$604.83,$0.00,1,1,1,0,0,1,20161001,,,,
B9000,HCPCS,ENTER INFUSION PUMP W/O ALRM,,,28,,NW,,,,,,"$2,866.52",$0.00,1,1,1,0,0,1,20161001,,,,
B9000,HCPCS,ENTER INFUSION PUMP W/O ALRM,NU,,28,,NW,,,,,,"$2,866.52",$0.00,1,1,1,0,0,1,20161001,,,,
B9000,HCPCS,ENTER INFUSION PUMP W/O ALRM,RR,,28,,NW,,,,,,$262.73,$0.00,1,1,1,0,0,1,20161001,,,,
B9000,HCPCS,ENTER INFUSION PUMP W/O ALRM,UE,,28,,NW,,,,,,"$2,149.71",$0.00,1,1,1,0,0,1,20161001,,,,
B9002,HCPCS,ENTERAL INFUSION PUMP W/ ALA,,,28,,NW,,,,,,"$2,866.52",$0.00,1,1,1,0,0,1,20161001,,,,
B9002,HCPCS,ENTERAL INFUSION PUMP W/ ALA,NU,,28,,NW,,,,,,"$2,866.52",$0.00,1,1,1,0,0,1,20161001,,,,
B9002,HCPCS,ENTERAL INFUSION PUMP W/ ALA,RR,,28,,NW,,,,,,$276.94,$0.00,1,1,1,0,0,1,20161001,,,,
B9002,HCPCS,ENTERAL INFUSION PUMP W/ ALA,UE,,28,,NW,,,,,,"$2,149.71",$0.00,1,1,1,0,0,1,20161001,,,,
B9004,HCPCS,PARENTERAL INFUS PUMP PORTAB,,,28,,NW,,,,,,"$6,634.99",$0.00,1,1,1,0,0,1,20161001,,,,
B9004,HCPCS,PARENTERAL INFUS PUMP PORTAB,NU,,28,,NW,,,,,,"$6,634.99",$0.00,1,1,1,0,0,1,20161001,,,,
B9004,HCPCS,PARENTERAL INFUS PUMP PORTAB,RR,,28,,NW,,,,,,"$1,049.70",$0.00,1,1,1,0,0,1,20161001,,,,
B9004,HCPCS,PARENTERAL INFUS PUMP PORTAB,UE,,28,,NW,,,,,,"$4,976.05",$0.00,1,1,1,0,0,1,20161001,,,,
B9006,HCPCS,PARENTERAL INFUS PUMP STATIO,,,28,,NW,,,,,,"$6,634.99",$0.00,1,1,1,0,0,1,20161001,,,,
B9006,HCPCS,PARENTERAL INFUS PUMP STATIO,NU,,28,,NW,,,,,,"$6,634.99",$0.00,1,1,1,0,0,1,20161001,,,,
B9006,HCPCS,PARENTERAL INFUS PUMP STATIO,RR,,28,,NW,,,,,,"$1,049.70",$0.00,1,1,1,0,0,1,20161001,,,,
B9006,HCPCS,PARENTERAL INFUS PUMP STATIO,UE,,28,,NW,,,,,,"$4,976.05",$0.00,1,1,1,0,0,1,20161001,,,,
B9998,HCPCS,ENTERAL SUPP NOT OTHERWISE C,,,28,,NW,,,,,,$96.05,$0.00,1,1,1,0,0,1,20161001,,,,
B9999,HCPCS,PARENTERAL SUPP NOT OTHRWS C,,,28,,NW,,,,,,$96.05,$0.00,1,1,1,0,0,1,20161001,,,,
C1713,HCPCS,"ANCHOR/SCREW BN/BN,TIS/BN",,,28,,NW,,,,,,$608.45,$0.00,1,1,1,0,0,1,20161001,,,,
C1714,HCPCS,"CATH, TRANS ATHERECTOMY, DIR",,,28,,NW,,,,,,$268.09,$0.00,1,1,1,0,0,1,20161001,,,,
C1715,HCPCS,BRACHYTHERAPY NEEDLE,,,28,,NW,,,,,,$45.46,$0.00,1,1,1,0,0,1,20161001,,,,
C1717,HCPCS,"BRACHYTX, NON-STR,HDR IR-192",,,28,,NW,,,,,,"$1,008.14",$0.00,1,1,1,0,0,1,20161001,,,,
C1721,HCPCS,"AICD, DUAL CHAMBER",,,28,,NW,,,,,,"$27,760.16",$0.00,1,1,1,0,0,1,20161001,,,,
C1722,HCPCS,"AICD, SINGLE CHAMBER",,,28,,NW,,,,,,"$24,179.05",$0.00,1,1,1,0,0,1,20161001,,,,
C1724,HCPCS,"CATH, TRANS ATHEREC,ROTATION",,,28,,NW,,,,,,"$2,397.38",$0.00,1,1,1,0,0,1,20161001,,,,
C1725,HCPCS,"CATH, TRANSLUMIN NON-LASER",,,28,,NW,,,,,,"$1,283.03",$0.00,1,1,1,0,0,1,20161001,,,,
C1726,HCPCS,"CATH, BAL DIL, NON-VASCULAR",,,28,,NW,,,,,,$696.73,$0.00,1,1,1,0,0,1,20161001,,,,
C1727,HCPCS,"CATH, BAL TIS DIS, NON-VAS",,,28,,NW,,,,,,$894.81,$0.00,1,1,1,0,0,1,20161001,,,,
C1728,HCPCS,"CATH, BRACHYTX SEED ADM",,,28,,NW,,,,,,$39.44,$0.00,1,1,1,0,0,1,20161001,,,,
C1729,HCPCS,"CATH, DRAINAGE",,,28,,NW,,,,,,$293.13,$0.00,1,1,1,0,0,1,20161001,,,,
C1730,HCPCS,"CATH, EP, 19 OR FEW ELECT",,,28,,NW,,,,,,"$1,831.57",$0.00,1,1,1,0,0,1,20161001,,,,
C1731,HCPCS,"CATH, EP, 20 OR MORE ELEC",,,28,,NW,,,,,,"$5,051.52",$0.00,1,1,1,0,0,1,20161001,,,,
C1732,HCPCS,"CATH, EP, DIAG/ABL, 3D/VECT",,,28,,NW,,,,,,"$5,051.52",$0.00,1,1,1,0,0,1,20161001,,,,
C1733,HCPCS,"CATH, EP, OTHR THAN COOL-TIP",,,28,,NW,,,,,,"$1,831.57",$0.00,1,1,1,0,0,1,20161001,,,,
C1750,HCPCS,"CATH, HEMODIALYSIS,LONG-TERM",,,28,,NW,,,,,,$694.37,$0.00,1,1,1,0,0,1,20161001,,,,
C1751,HCPCS,"CATH, INF, PER/CENT/MIDLINE",,,28,,NW,,,,,,$683.65,$0.00,1,1,1,0,0,1,20161001,,,,
C1752,HCPCS,"CATH,HEMODIALYSIS,SHORT-TERM",,,28,,NW,,,,,,$931.45,$0.00,1,1,1,0,0,1,20161001,,,,
C1753,HCPCS,"CATH, INTRAVAS ULTRASOUND",,,28,,NW,,,,,,"$1,420.68",$0.00,1,1,1,0,0,1,20161001,,,,
C1754,HCPCS,"CATHETER, INTRADISCAL",,,28,,NW,,,,,,$736.47,$0.00,1,1,1,0,0,1,20161001,,,,
C1755,HCPCS,"CATHETER, INTRASPINAL",,,28,,NW,,,,,,"$1,288.24",$0.00,1,1,1,0,0,1,20161001,,,,
C1756,HCPCS,"CATH, PACING, TRANSESOPH",,,28,,NW,,,,,,"$1,208.42",$0.00,1,1,1,0,0,1,20161001,,,,
C1757,HCPCS,"CATH, THROMBECTOMY/EMBOLECT",,,28,,NW,,,,,,"$2,988.36",$0.00,1,1,1,0,0,1,20161001,,,,
C1758,HCPCS,"CATHETER, URETERAL",,,28,,NW,,,,,,$511.32,$0.00,1,1,1,0,0,1,20161001,,,,
C1759,HCPCS,"CATH, INTRA ECHOCARDIOGRAPHY",,,28,,NW,,,,,,"$4,010.19",$0.00,1,1,1,0,0,1,20161001,,,,
C1760,HCPCS,"CLOSURE DEV, VASC",,,28,,NW,,,,,,$840.58,$0.00,1,1,1,0,0,1,20161001,,,,
C1762,HCPCS,"CONN TISS, HUMAN(INC FASCIA)",,,28,,NW,,,,,,"$2,359.89",$0.00,1,1,1,0,0,1,20161001,,,,
C1763,HCPCS,"CONN TISS, NON-HUMAN",,,28,,NW,,,,,,"$2,440.72",$0.00,1,1,1,0,0,1,20161001,,,,
C1764,HCPCS,"EVENT RECORDER, CARDIAC",,,28,,NW,,,,,,"$3,441.40",$0.00,1,1,1,0,0,1,20161001,,,,
C1765,HCPCS,ADHESION BARRIER,,,28,,NW,,,,,,$427.72,$0.00,1,1,1,0,0,1,20161001,,,,
C1766,HCPCS,"INTRO/SHEATH,STRBLE,NON-PEEL",,,28,,NW,,,,,,$598.75,$0.00,1,1,1,0,0,1,20161001,,,,
C1767,HCPCS,"GENERATOR, NEURO NON-RECHARG",,,28,,NW,,,,,,"$18,019.87",$0.00,1,1,1,0,0,1,20161001,,,,
C1768,HCPCS,"GRAFT, VASCULAR",,,28,,NW,,,,,,"$3,365.33",$0.00,1,1,1,0,0,1,20161001,,,,
C1769,HCPCS,GUIDE WIRE,,,28,,NW,,,,,,$363.47,$0.00,1,1,1,0,0,1,20161001,,,,
C1770,HCPCS,"IMAGING COIL, MR, INSERTABLE",,,28,,NW,,,,,,$348.58,$0.00,1,1,1,0,0,1,20161001,,,,
C1771,HCPCS,"REP DEV, URINARY, W/SLING",,,28,,NW,,,,,,"$3,622.68",$0.00,1,1,1,0,0,1,20161001,,,,
C1772,HCPCS,"INFUSION PUMP, PROGRAMMABLE",,,28,,NW,,,,,,$222.48,$0.00,1,1,1,0,0,1,20161001,,,,
C1776,HCPCS,JOINT DEVICE (IMPLANTABLE),,,28,,NW,,,,,,"$4,670.25",$0.00,1,1,1,0,0,1,20161001,,,,
C1777,HCPCS,"LEAD, AICD, ENDO SINGLE COIL",,,28,,NW,,,,,,"$6,294.85",$0.00,1,1,1,0,0,1,20161001,,,,
C1778,HCPCS,"LEAD, NEUROSTIMULATOR",,,28,,NW,,,,,,"$5,275.37",$0.00,1,1,1,0,0,1,20161001,,,,
C1779,HCPCS,"LEAD, PMKR, TRANSVENOUS VDD",,,28,,NW,,,,,,"$3,066.96",$0.00,1,1,1,0,0,1,20161001,,,,
C1780,HCPCS,"LENS, INTRAOCULAR (NEW TECH)",,,28,,NW,,,,,,$290.63,$0.00,1,1,1,0,0,1,20161001,,,,
C1781,HCPCS,MESH (IMPLANTABLE),,,28,,NW,,,,,,$750.53,$0.00,1,1,1,0,0,1,20161001,,,,
C1782,HCPCS,MORCELLATOR,,,28,,NW,,,,,,$391.03,$0.00,1,1,1,0,0,1,20161001,,,,
C1783,HCPCS,"OCULAR IMP, AQUEOUS DRAIN DE",,,28,,NW,,,,,,$841.05,$0.00,1,1,1,0,0,1,20161001,,,,
C1784,HCPCS,"OCULAR DEV, INTRAOP, DET RET",,,28,,NW,,,,,,$952.54,$0.00,1,1,1,0,0,1,20161001,,,,
C1785,HCPCS,"PMKR, DUAL, RATE-RESP",,,28,,NW,,,,,,"$8,374.99",$0.00,1,1,1,0,0,1,20161001,,,,
C1786,HCPCS,"PMKR, SINGLE, RATE-RESP",,,28,,NW,,,,,,"$6,551.43",$0.00,1,1,1,0,0,1,20161001,,,,
C1787,HCPCS,"PATIENT PROGR, NEUROSTIM",,,28,,NW,,,,,,"$3,928.79",$0.00,1,1,1,0,0,1,20161001,,,,
C1788,HCPCS,"PORT, INDWELLING, IMP",,,28,,NW,,,,,,$966.77,$0.00,1,1,1,0,0,1,20161001,,,,
C1789,HCPCS,"PROSTHESIS, BREAST, IMP",,,28,,NW,,,,,,"$1,283.55",$0.00,1,1,1,0,0,1,20161001,,,,
C1813,HCPCS,"PROSTHESIS, PENILE, INFLATAB",,,28,,NW,,,,,,"$5,163.67",$0.00,1,1,1,0,0,1,20161001,,,,
C1815,HCPCS,"PROS, URINARY SPH, IMP",,,28,,NW,,,,,,"$4,737.49",$0.00,1,1,1,0,0,1,20161001,,,,
C1816,HCPCS,"RECEIVER/TRANSMITTER, NEURO",,,28,,NW,,,,,,"$1,790.86",$0.00,1,1,1,0,0,1,20161001,,,,
C1817,HCPCS,SEPTAL DEFECT IMP SYS,,,28,,NW,,,,,,"$6,786.07",$0.00,1,1,1,0,0,1,20161001,,,,
C1818,HCPCS,INTEGRATED KERATOPROSTHESIS,,,28,,NW,,,,,,"$3,723.53",$0.00,1,1,1,0,0,1,20161001,,,,
C1821,HCPCS,INTERSPINOUS IMPLANT,,,28,,NW,,,,,,"$1,859.13",$0.00,1,1,1,0,0,1,20161001,,,,
C1830,HCPCS,POWER BONE MARROW BX NEEDLE,,,28,,NW,,,,,,$198.04,$0.00,1,1,1,0,0,1,20161001,,,,
C1840,HCPCS,TELESCOPIC INTRAOCULAR LENS,,,28,,NW,,,,,,$411.24,$0.00,1,1,1,0,0,1,20161001,,,,
C1874,HCPCS,"STENT, COATED/COV W/DEL SYS",,,28,,NW,,,,,,"$2,663.88",$0.00,1,1,1,0,0,1,20161001,,,,
C1875,HCPCS,"STENT, COATED/COV W/O DEL SY",,,28,,NW,,,,,,"$2,867.85",$0.00,1,1,1,0,0,1,20161001,,,,
C1876,HCPCS,"STENT, NON-COA/NON-COV W/DEL",,,28,,NW,,,,,,"$2,166.79",$0.00,1,1,1,0,0,1,20161001,,,,
C1877,HCPCS,"STENT, NON-COAT/COV W/O DEL",,,28,,NW,,,,,,"$2,619.91",$0.00,1,1,1,0,0,1,20161001,,,,
C1878,HCPCS,MATRL FOR VOCAL CORD,,,28,,NW,,,,,,$801.35,$0.00,1,1,1,0,0,1,20161001,,,,
C1880,HCPCS,VENA CAVA FILTER,,,28,,NW,,,,,,"$2,413.17",$0.00,1,1,1,0,0,1,20161001,,,,
C1881,HCPCS,DIALYSIS ACCESS SYSTEM,,,28,,NW,,,,,,$792.72,$0.00,1,1,1,0,0,1,20161001,,,,
C1882,HCPCS,"AICD, OTHER THAN SING/DUAL",,,28,,NW,,,,,,"$34,640.68",$0.00,1,1,1,0,0,1,20161001,,,,
C1883,HCPCS,"ADAPT/EXT, PACING/NEURO LEAD",,,28,,NW,,,,,,"$2,646.77",$0.00,1,1,1,0,0,1,20161001,,,,
C1884,HCPCS,EMBOLIZATION PROTECT SYST,,,28,,NW,,,,,,$292.55,$0.00,1,1,1,0,0,1,20161001,,,,
C1885,HCPCS,"CATH, TRANSLUMIN ANGIO LASER",,,28,,NW,,,,,,$333.43,$0.00,1,1,1,0,0,1,20161001,,,,
C1887,HCPCS,"CATHETER, GUIDING",,,28,,NW,,,,,,$63.77,$0.00,1,1,1,0,0,1,20161001,,,,
C1888,HCPCS,ENDOVAS NON-CARDIAC ABL CATH,,,28,,NW,,,,,,$976.76,$0.00,1,1,1,0,0,1,20161001,,,,
C1891,HCPCS,"INFUSION PUMP,NON-PROG, PERM",,,28,,NW,,,,,,"$6,802.73",$0.00,1,1,1,0,0,1,20161001,,,,
C1892,HCPCS,"INTRO/SHEATH,FIXED,PEEL-AWAY",,,28,,NW,,,,,,"$1,155.95",$0.00,1,1,1,0,0,1,20161001,,,,
C1893,HCPCS,"INTRO/SHEATH, FIXED,NON-PEEL",,,28,,NW,,,,,,$617.32,$0.00,1,1,1,0,0,1,20161001,,,,
C1894,HCPCS,"INTRO/SHEATH, NON-LASER",,,28,,NW,,,,,,$160.63,$0.00,1,1,1,0,0,1,20161001,,,,
C1895,HCPCS,"LEAD, AICD, ENDO DUAL COIL",,,28,,NW,,,,,,"$6,300.05",$0.00,1,1,1,0,0,1,20161001,,,,
C1896,HCPCS,"LEAD, AICD, NON SING/DUAL",,,28,,NW,,,,,,"$5,545.97",$0.00,1,1,1,0,0,1,20161001,,,,
C1897,HCPCS,"LEAD, NEUROSTIM TEST KIT",,,28,,NW,,,,,,"$1,685.81",$0.00,1,1,1,0,0,1,20161001,,,,
C1898,HCPCS,"LEAD, PMKR, OTHER THAN TRANS",,,28,,NW,,,,,,"$1,119.69",$0.00,1,1,1,0,0,1,20161001,,,,
C1899,HCPCS,"LEAD, PMKR/AICD COMBINATION",,,28,,NW,,,,,,"$6,332.65",$0.00,1,1,1,0,0,1,20161001,,,,
C1900,HCPCS,"LEAD, CORONARY VENOUS",,,28,,NW,,,,,,"$3,824.25",$0.00,1,1,1,0,0,1,20161001,,,,
C2613,HCPCS,LUNG BX PLUG W/DEL SYS,,,28,,NW,,,,,,$113.62,$0.00,1,1,1,0,0,1,20161001,,,,
C2614,HCPCS,"PROBE, PERC LUMB DISC",,,28,,NW,,,,,,$816.59,$0.00,1,1,1,0,0,1,20161001,,,,
C2615,HCPCS,"SEALANT, PULMONARY, LIQUID",,,28,,NW,,,,,,$908.31,$0.00,1,1,1,0,0,1,20161001,,,,
C2617,HCPCS,"STENT, NON-COR, TEM W/O DEL",,,28,,NW,,,,,,"$2,704.17",$0.00,1,1,1,0,0,1,20161001,,,,
C2618,HCPCS,"PROBE/NEEDLE, CRYO",,,28,,NW,,,,,,"$2,551.03",$0.00,1,1,1,0,0,1,20161001,,,,
C2619,HCPCS,"PMKR, DUAL, NON RATE-RESP",,,28,,NW,,,,,,"$6,651.21",$0.00,1,1,1,0,0,1,20161001,,,,
C2620,HCPCS,"PMKR, SINGLE, NON RATE-RESP",,,28,,NW,,,,,,"$18,218.73",$0.00,1,1,1,0,0,1,20161001,,,,
C2621,HCPCS,"PMKR, OTHER THAN SING/DUAL",,,28,,NW,,,,,,"$11,512.66",$0.00,1,1,1,0,0,1,20161001,,,,
C2622,HCPCS,"PROSTHESIS, PENILE, NON-INF",,,28,,NW,,,,,,"$5,299.54",$0.00,1,1,1,0,0,1,20161001,,,,
C2623,HCPCS,"CATH, TRANSLUMIN, DRUG-COAT",,,28,,NW,,,,,,"$4,724.36",$0.00,1,1,1,0,0,1,20161001,,,,
C2625,HCPCS,"STENT, NON-COR, TEM W/DEL SY",,,28,,NW,,,,,,"$3,132.91",$0.00,1,1,1,0,0,1,20161001,,,,
C2626,HCPCS,"INFUSION PUMP, NON-PROG,TEMP",,,28,,NW,,,,,,"$1,186.93",$0.00,1,1,1,0,0,1,20161001,,,,
C2627,HCPCS,"CATH, SUPRAPUBIC/CYSTOSCOPIC",,,28,,NW,,,,,,$873.54,$0.00,1,1,1,0,0,1,20161001,,,,
C2628,HCPCS,"CATHETER, OCCLUSION",,,28,,NW,,,,,,"$1,137.83",$0.00,1,1,1,0,0,1,20161001,,,,
C2631,HCPCS,"REP DEV, URINARY, W/O SLING",,,28,,NW,,,,,,"$3,222.18",$0.00,1,1,1,0,0,1,20161001,,,,
C2638,HCPCS,"BRACHYTX, STRANDED, I-125",,,28,,NW,,,,,,$62.31,$0.00,1,1,1,0,0,1,20161001,,,,
C2639,HCPCS,"BRACHYTX, NON-STRANDED,I-125",,,28,,NW,,,,,,$40.56,$0.00,1,1,1,0,0,1,20161001,,,,
C2640,HCPCS,"BRACHYTX, STRANDED, P-103",,,28,,NW,,,,,,$144.73,$0.00,1,1,1,0,0,1,20161001,,,,
C2641,HCPCS,"BRACHYTX, NON-STRANDED,P-103",,,28,,NW,,,,,,$74.09,$0.00,1,1,1,0,0,1,20161001,,,,
C2698,HCPCS,"BRACHYTX, STRANDED, NOS",,,28,,NW,,,,,,"$2,663.88",$0.00,1,1,1,0,0,1,20161001,,,,
C2699,HCPCS,"BRACHYTX, NON-STRANDED, NOS",,,28,,NW,,,,,,"$2,663.88",$0.00,1,1,1,0,0,1,20161001,,,,
C8908,HCPCS,"MRI W/O FOL W/CONT, BREAST,",,,20,,TotalUnits,,,,16.38 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
C9113,HCPCS,"INJ PANTOPRAZOLE SODIUM, VIA",,,29,,NW,,,,,,$184.03,$0.00,1,1,1,0,0,1,20161001,,,,
C9121,HCPCS,"INJECTION, ARGATROBAN",,,29,,NW,,,,,,$213.11,$0.00,1,1,1,0,0,1,20161001,,,,
C9248,HCPCS,"INJ, CLEVIDIPINE BUTYRATE",,,29,,NW,,,,,,$11.29,$0.00,1,1,1,0,0,1,20161001,,,,
C9250,HCPCS,ARTISS FIBRIN SEALANT,,,29,,NW,,,,,,$775.94,$0.00,1,1,1,0,0,1,20161001,,,,
C9254,HCPCS,"INJECTION, LACOSAMIDE",,,29,,NW,,,,,,$1.21,$0.00,1,1,1,0,0,1,20161001,,,,
C9257,HCPCS,BEVACIZUMAB INJECTION,,,29,,NW,,,,,,$23.26,$0.00,1,1,1,0,0,1,20161001,,,,
C9285,HCPCS,"PATCH, LIDOCAINE/TETRACAINE",,,29,,NW,,,,,,$100.18,$0.00,1,1,1,0,0,1,20161001,,,,
C9290,HCPCS,"INJ, BUPIVACAINE LIPOSOME",,,29,,NW,,,,,,$7.75,$0.00,1,1,1,0,0,1,20161001,,,,
C9349,HCPCS,"PURAPLY, PURAPLY ANTIMIC",,,29,,NW,,,,,,$440.07,$0.00,1,1,1,0,0,1,20161001,,,,
C9358,HCPCS,"SURGIMEND, FETAL",,,28,,NW,,,,,,$931.80,$0.00,1,1,1,0,0,1,20161001,,,,
C9359,HCPCS,"IMPLNT,BON VOID FILLER-PUTTY",,,28,,NW,,,,,,"$1,010.52",$0.00,1,1,1,0,0,1,20161001,,,,
C9360,HCPCS,"SURGIMEND, NEONATAL",,,28,,NW,,,,,,$64.44,$0.00,1,1,1,0,0,1,20161001,,,,
C9361,HCPCS,NEUROMEND NERVE WRAP,,,28,,NW,,,,,,"$2,514.12",$0.00,1,1,1,0,0,1,20161001,,,,
C9362,HCPCS,"IMPLNT,BON VOID FILLER-STRIP",,,28,,NW,,,,,,$286.71,$0.00,1,1,1,0,0,1,20161001,,,,
C9363,HCPCS,INTEGRA MESHED BIL WOUND MAT,,,28,,NW,,,,,,$113.20,$0.00,1,1,1,0,0,1,20161001,,,,
C9364,HCPCS,"PORCINE IMPLANT, PERMACOL",,,28,,NW,,,,,,$99.58,$0.00,1,1,1,0,0,1,20161001,,,,
C9399,HCPCS,UNCLASSIFIED DRUGS OR BIOLOG,,,29,,NW,,,,,,"$2,663.88",$0.00,1,1,1,0,0,1,20161001,,,,
C9447,HCPCS,"INJ, PHENYLEPHRINE KETOROLAC",,,29,,NW,,,,,,"$2,497.03",$0.00,1,1,1,0,0,1,20161001,,,,
C9497,HCPCS,"LOXAPINE, INHALATION POWDER",,,29,,NW,,,,,,$7.12,$0.00,1,1,1,0,0,1,20161001,,,,
C9734,HCPCS,"U/S TRTMT, NOT LEIOMYOMATA",,,14,,TotalUnits,,,,133.08 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
C9741,HCPCS,IMPL PRESSURE SENSOR W/ANGIO         ,,,28,,NW,,,,,,"$14,286.40",$0.00,1,0,1,1,1,1,20161001,,,,
C9800,HCPCS,DERMAL FILLER INJ PX/SUPPL,,,28,,NW,,,,,,"$1,639.69",$0.00,1,1,1,0,0,1,20161001,,,,
D0120,HCPCS,PERIODIC ORAL EVALUATION,,,25,,NW,,,,,,$60.53,$0.00,1,0,1,1,1,1,20161001,,,,
D0140,HCPCS,LIMIT ORAL EVAL PROBLM FOCUS,,,25,,NW,,,,,,$91.71,$0.00,1,0,1,1,1,1,20161001,,,,
D0145,HCPCS,"ORAL EVALUATION, PT < 3YRS",,,25,,NW,,,,,,$87.20,$0.00,1,0,1,1,1,1,20161001,,,,
D0150,HCPCS,COMPREHENSVE ORAL EVALUATION,,,25,,NW,,,,,,$101.66,$0.00,1,0,1,1,1,1,20161001,,,,
D0160,HCPCS,EXTENSV ORAL EVAL PROB FOCUS,,,25,,NW,,,,,,$199.20,$0.00,1,0,1,1,1,1,20161001,,,,
D0170,HCPCS,"RE-EVAL,EST PT,PROBLEM FOCUS",,,25,,NW,,,,,,$79.46,$0.00,1,0,1,1,1,1,20161001,,,,
D0171,HCPCS,RE-EVAL POST-OP VISIT,,,25,,NW,,,,,,$70.12,$0.00,1,0,1,1,1,1,20161001,,,,
D0180,HCPCS,COMP PERIODONTAL EVALUATION,,,25,,NW,,,,,,$114.43,$0.00,1,0,1,1,1,1,20161001,,,,
D0190,HCPCS,SCREENING OF A PATIENT,,,25,,NW,,,,,,$79.42,$0.00,1,0,1,1,1,1,20161001,,,,
D0191,HCPCS,ASSESSMENT OF A PATIENT,,,25,,NW,,,,,,$64.41,$0.00,1,0,1,1,1,1,20161001,,,,
D0210,HCPCS,INTRAOR COMPLETE FILM SERIES,,,25,,NW,,,,,,$157.38,$0.00,1,0,1,1,1,1,20161001,,,,
D0220,HCPCS,INTRAORAL PERIAPICAL FIRST,,,25,,NW,,,,,,$35.13,$0.00,1,0,1,1,1,1,20161001,,,,
D0230,HCPCS,INTRAORAL PERIAPICAL EA ADD,,,25,,NW,,,,,,$29.41,$0.00,1,0,1,1,1,1,20161001,,,,
D0240,HCPCS,INTRAORAL OCCLUSAL FILM,,,25,,NW,,,,,,$49.94,$0.00,1,0,1,1,1,1,20161001,,,,
D0250,HCPCS,EXTRAORAL FIRST FILM,,,25,,NW,,,,,,$68.74,$0.00,1,0,1,1,1,1,20161001,,,,
D0270,HCPCS,DENTAL BITEWING SINGLE IMAGE,,,25,,NW,,,,,,$33.61,$0.00,1,0,1,1,1,1,20161001,,,,
D0272,HCPCS,DENTAL BITEWINGS TWO IMAGES,,,25,,NW,,,,,,$53.46,$0.00,1,0,1,1,1,1,20161001,,,,
D0273,HCPCS,BITEWINGS - THREE IMAGES,,,25,,NW,,,,,,$64.84,$0.00,1,0,1,1,1,1,20161001,,,,
D0274,HCPCS,BITEWINGS FOUR IMAGES,,,25,,NW,,,,,,$75.99,$0.00,1,0,1,1,1,1,20161001,,,,
D0277,HCPCS,VERT BITEWINGS 7 TO 8 IMAGES,,,25,,NW,,,,,,$112.10,$0.00,1,0,1,1,1,1,20161001,,,,
D0290,HCPCS,SKULL/FACIAL BONE IMAGE,,,25,,NW,,,,,,$165.67,$0.00,1,0,1,1,1,1,20161001,,,,
D0310,HCPCS,DENTAL SALIOGRAPHY,,,25,,NW,,,,,,$438.71,$0.00,1,0,1,1,1,1,20161001,,,,
D0320,HCPCS,DENTAL TMJ ARTHROGRAM INCL I,,,25,,NW,,,,,,$713.23,$0.00,1,0,1,1,1,1,20161001,,,,
D0321,HCPCS,OTHER TMJ IMAGES BY REPORT,,,25,,NW,,,,,,$243.42,$0.00,1,0,1,1,1,1,20161001,,,,
D0322,HCPCS,DENTAL TOMOGRAPHIC SURVEY,,,25,,NW,,,,,,$604.26,$0.00,1,0,1,1,1,1,20161001,,,,
D0330,HCPCS,PANORAMIC IMAGE,,,25,,NW,,,,,,$133.51,$0.00,1,0,1,1,1,1,20161001,,,,
D0340,HCPCS,CEPHALOMETRIC IMAGE,,,25,,NW,,,,,,$147.57,$0.00,1,0,1,1,1,1,20161001,,,,
D0350,HCPCS,ORAL/FACIAL PHOTO IMAGES,,,25,,NW,,,,,,$79.30,$0.00,1,0,1,1,1,1,20161001,,,,
D0351,HCPCS,3D PHOTOGRAPHIC IMAGE,,,25,,NW,,,,,,$71.89,$0.00,1,0,1,1,1,1,20161001,,,,
D0364,HCPCS,CONE BEAM CT CAPT & INTERP,,,25,,NW,,,,,,$792.54,$0.00,1,0,1,1,1,1,20161001,,,,
D0365,HCPCS,CONE BEAM CT INTERPRETE MAN,,,25,,NW,,,,,,$799.33,$0.00,1,0,1,1,1,1,20161001,,,,
D0366,HCPCS,CONE BEAM CT INTERPRETE MAX,,,25,,NW,,,,,,$788.36,$0.00,1,0,1,1,1,1,20161001,,,,
D0367,HCPCS,CONE BEAM CT INTERP BOTH JAW,,,25,,NW,,,,,,$801.42,$0.00,1,0,1,1,1,1,20161001,,,,
D0368,HCPCS,CONE BEAM CT INTERPRETE TMJ,,,25,,NW,,,,,,"$1,067.15",$0.00,1,0,1,1,1,1,20161001,,,,
D0369,HCPCS,MAX MRI CAPTURE & INTERPRETE,,,25,,NW,,,,,,"$2,168.76",$0.00,1,0,1,1,1,1,20161001,,,,
D0370,HCPCS,MAX ULTRASOUND CAPT & INTERP,,,25,,NW,,,,,,$833.51,$0.00,1,0,1,1,1,1,20161001,,,,
D0371,HCPCS,SIALOENDOSCOPY CAPT & INTERP,,,25,,NW,,,,,,$621.81,$0.00,1,0,1,1,1,1,20161001,,,,
D0380,HCPCS,CONE BEAM CT CAPTURE LIMITED,,,25,,NW,,,,,,$742.48,$0.00,1,0,1,1,1,1,20161001,,,,
D0381,HCPCS,CONE BEAM CT CAPT MANDIBLE,,,25,,NW,,,,,,$757.81,$0.00,1,0,1,1,1,1,20161001,,,,
D0382,HCPCS,CONE BEAM CT CAPT MAXILLA,,,25,,NW,,,,,,$758.85,$0.00,1,0,1,1,1,1,20161001,,,,
D0383,HCPCS,CONE BEAM CT BOTH JAWS,,,25,,NW,,,,,,$753.98,$0.00,1,0,1,1,1,1,20161001,,,,
D0384,HCPCS,CONE BEAM CT CAPTURE TMJ,,,25,,NW,,,,,,"$1,031.87",$0.00,1,0,1,1,1,1,20161001,,,,
D0385,HCPCS,MAX MRI IMAGE CAPTURE,,,25,,NW,,,,,,"$1,619.94",$0.00,1,0,1,1,1,1,20161001,,,,
D0386,HCPCS,MAX ULTRASOUND IMAGE CAPTURE,,,25,,NW,,,,,,$506.94,$0.00,1,0,1,1,1,1,20161001,,,,
D0391,HCPCS,IMTERPRETE DIAGNOSTIC IMAGE,,,25,,NW,,,,,,$528.24,$0.00,1,0,1,1,1,1,20161001,,,,
D0393,HCPCS,TRTMNT SIMULATION 3D IMAGE,,,25,,NW,,,,,,$773.49,$0.00,1,0,1,1,1,1,20161001,,,,
D0394,HCPCS,DIGITAL SUB 2 OR MORE IMAGES,,,25,,NW,,,,,,$533.01,$0.00,1,0,1,1,1,1,20161001,,,,
D0395,HCPCS,FUSION 2 OR MORE 3D IMAGES,,,25,,NW,,,,,,$543.45,$0.00,1,0,1,1,1,1,20161001,,,,
D0415,HCPCS,COLLECTION OF MICROORGANISMS,,,25,,NW,,,,,,$136.33,$0.00,1,0,1,1,1,1,20161001,,,,
D0416,HCPCS,VIRAL CULTURE,,,25,,NW,,,,,,$131.49,$0.00,1,0,1,1,1,1,20161001,,,,
D0417,HCPCS,COLLECT & PREP SALIVA SAMPLE,,,25,,NW,,,,,,$151.75,$0.00,1,0,1,1,1,1,20161001,,,,
D0418,HCPCS,ANALYSIS OF SALIVA SAMPLE,,,25,,NW,,,,,,$126.44,$0.00,1,0,1,1,1,1,20161001,,,,
D0422,HCPCS,COLLECTION AND PREPARATION OF GENETIC SAMPLE MATERIAL FOR LABORATORY ANALYSIS AND REPORT,,,25,,NW,,,,,,$113.34,$0.00,1,0,1,1,1,1,20161001,,,,
D0423,HCPCS,GENETIC TEST FOR SUSCEPTIBILITY TO DISEASES – SPECIMEN ANALYSIS,,,25,,NW,,,,,,$113.34,$0.00,1,0,1,1,1,1,20161001,,,,
D0425,HCPCS,CARIES SUSCEPTIBILITY TEST,,,25,,NW,,,,,,$73.54,$0.00,1,0,1,1,1,1,20161001,,,,
D0431,HCPCS,DIAG TST DETECT MUCOS ABNORM,,,25,,NW,,,,,,$73.68,$0.00,1,0,1,1,1,1,20161001,,,,
D0460,HCPCS,PULP VITALITY TEST,,,25,,NW,,,,,,$66.89,$0.00,1,0,1,1,1,1,20161001,,,,
D0470,HCPCS,DIAGNOSTIC CASTS,,,25,,NW,,,,,,$141.84,$0.00,1,0,1,1,1,1,20161001,,,,
D0472,HCPCS,"GROSS EXAM, PREP & REPORT",,,25,,NW,,,,,,$118.75,$0.00,1,0,1,1,1,1,20161001,,,,
D0473,HCPCS,"MICRO EXAM, PREP & REPORT",,,25,,NW,,,,,,$189.08,$0.00,1,0,1,1,1,1,20161001,,,,
D0474,HCPCS,MICRO W EXAM OF SURG MARGINS,,,25,,NW,,,,,,$211.92,$0.00,1,0,1,1,1,1,20161001,,,,
D0475,HCPCS,DECALCIFICATION PROCEDURE,,,25,,NW,,,,,,$176.88,$0.00,1,0,1,1,1,1,20161001,,,,
D0476,HCPCS,SPEC STAINS FOR MICROORGANIS,,,25,,NW,,,,,,$227.49,$0.00,1,0,1,1,1,1,20161001,,,,
D0477,HCPCS,SPEC STAINS NOT FOR MICROORG,,,25,,NW,,,,,,$243.05,$0.00,1,0,1,1,1,1,20161001,,,,
D0478,HCPCS,IMMUNOHISTOCHEMICAL STAINS,,,25,,NW,,,,,,$168.14,$0.00,1,0,1,1,1,1,20161001,,,,
D0479,HCPCS,TISSUE IN-SITU HYBRIDIZATION,,,25,,NW,,,,,,$235.43,$0.00,1,0,1,1,1,1,20161001,,,,
D0480,HCPCS,CYTOPATH SMEAR PREP & REPORT,,,25,,NW,,,,,,$167.22,$0.00,1,0,1,1,1,1,20161001,,,,
D0481,HCPCS,ELECTRON MICROSCOPY,,,25,,NW,,,,,,$378.95,$0.00,1,0,1,1,1,1,20161001,,,,
D0482,HCPCS,DIRECT IMMUNOFLUORESCENCE,,,25,,NW,,,,,,$143.73,$0.00,1,0,1,1,1,1,20161001,,,,
D0483,HCPCS,INDIRECT IMMUNOFLUORESCENCE,,,25,,NW,,,,,,$155.22,$0.00,1,0,1,1,1,1,20161001,,,,
D0484,HCPCS,CONSULT SLIDES PREP ELSEWHER,,,25,,NW,,,,,,$220.82,$0.00,1,0,1,1,1,1,20161001,,,,
D0485,HCPCS,CONSULT INC PREP OF SLIDES,,,25,,NW,,,,,,$279.55,$0.00,1,0,1,1,1,1,20161001,,,,
D0486,HCPCS,ACCESS OF TRANSEP CYTOL SAMP,,,25,,NW,,,,,,$171.83,$0.00,1,0,1,1,1,1,20161001,,,,
D0502,HCPCS,OTHER ORAL PATHOLOGY PROCEDU,,,25,,NW,,,,,,$191.19,$0.00,1,0,1,1,1,1,20161001,,,,
D0601,HCPCS,CARIES RISK ASSESS LOW RISK,,,25,,NW,,,,,,$83.10,$0.00,1,0,1,1,1,1,20161001,,,,
D0602,HCPCS,CARIES RISK ASSESS MOD RISK,,,25,,NW,,,,,,$82.06,$0.00,1,0,1,1,1,1,20161001,,,,
D0603,HCPCS,CARIES RISK ASSESS HIGH RISK,,,25,,NW,,,,,,$82.06,$0.00,1,0,1,1,1,1,20161001,,,,
D0999,HCPCS,UNSPECIFIED DIAGNOSTIC PROCE,,,25,,NW,,,,,,$75.99,$0.00,1,0,1,1,1,1,20161001,,,,
D1110,HCPCS,DENTAL PROPHYLAXIS ADULT,,,25,,NW,,,,,,$106.95,$0.00,1,0,1,1,1,1,20161001,,,,
D1120,HCPCS,DENTAL PROPHYLAXIS CHILD,,,25,,NW,,,,,,$80.98,$0.00,1,0,1,1,1,1,20161001,,,,
D1206,HCPCS,TOPICAL FLUORIDE VARNISH,,,25,,NW,,,,,,$53.34,$0.00,1,0,1,1,1,1,20161001,,,,
D1208,HCPCS,TOPICAL APP FLUORID EX VRNSH,,,25,,NW,,,,,,$45.38,$0.00,1,0,1,1,1,1,20161001,,,,
D1310,HCPCS,NUTRI COUNSEL-CONTROL CARIES,,,25,,NW,,,,,,$67.32,$0.00,1,0,1,1,1,1,20161001,,,,
D1320,HCPCS,TOBACCO COUNSELING,,,25,,NW,,,,,,$78.66,$0.00,1,0,1,1,1,1,20161001,,,,
D1330,HCPCS,ORAL HYGIENE INSTRUCTION,,,25,,NW,,,,,,$72.22,$0.00,1,0,1,1,1,1,20161001,,,,
D1351,HCPCS,DENTAL SEALANT PER TOOTH,,,25,,NW,,,,,,$65.78,$0.00,1,0,1,1,1,1,20161001,,,,
D1352,HCPCS,"PREV RESIN REST, PERM TOOTH",,,25,,NW,,,,,,$107.81,$0.00,1,0,1,1,1,1,20161001,,,,
D1353,HCPCS,SEALANT REPAIR PER TOOTH,,,25,,NW,,,,,,$81.90,$0.00,1,0,1,1,1,1,20161001,,,,
D1510,HCPCS,SPACE MAINTAINER FXD UNILAT,,,26,,NW,,,,,,$387.96,$0.00,1,0,1,1,1,1,20161001,,,,
D1515,HCPCS,FIXED BILAT SPACE MAINTAINER,,,26,,NW,,,,,,$529.25,$0.00,1,0,1,1,1,1,20161001,,,,
D1520,HCPCS,REMOVE UNILAT SPACE MAINTAIN,,,26,,NW,,,,,,$449.79,$0.00,1,0,1,1,1,1,20161001,,,,
D1525,HCPCS,REMOVE BILAT SPACE MAINTAIN,,,26,,NW,,,,,,$622.81,$0.00,1,0,1,1,1,1,20161001,,,,
D1550,HCPCS,RECEMENT SPACE MAINTAINER,,,26,,NW,,,,,,$93.96,$0.00,1,0,1,1,1,1,20161001,,,,
D1555,HCPCS,REMOVE FIX SPACE MAINTAINER,,,26,,NW,,,,,,$91.31,$0.00,1,0,1,1,1,1,20161001,,,,
D1999,HCPCS,UNSPECIFIED PREVENTIVE PROC,,,26,,NW,,,,,,$72.22,$0.00,1,0,1,1,1,1,20161001,,,,
D2140,HCPCS,AMALGAM ONE SURFACE PERMANEN,,,26,,NW,,,,,,$168.22,$0.00,1,0,1,1,1,1,20161001,,,,
D2150,HCPCS,AMALGAM TWO SURFACES PERMANE,,,26,,NW,,,,,,$213.66,$0.00,1,0,1,1,1,1,20161001,,,,
D2160,HCPCS,AMALGAM THREE SURFACES PERMA,,,26,,NW,,,,,,$259.32,$0.00,1,0,1,1,1,1,20161001,,,,
D2161,HCPCS,AMALGAM 4 OR > SURFACES PERM,,,26,,NW,,,,,,$313.76,$0.00,1,0,1,1,1,1,20161001,,,,
D2330,HCPCS,RESIN ONE SURFACE-ANTERIOR,,,26,,NW,,,,,,$193.67,$0.00,1,0,1,1,1,1,20161001,,,,
D2331,HCPCS,RESIN TWO SURFACES-ANTERIOR,,,26,,NW,,,,,,$235.30,$0.00,1,0,1,1,1,1,20161001,,,,
D2332,HCPCS,RESIN THREE SURFACES-ANTERIO,,,26,,NW,,,,,,$285.12,$0.00,1,0,1,1,1,1,20161001,,,,
D2335,HCPCS,RESIN 4/> SURF OR W INCIS AN,,,26,,NW,,,,,,$346.75,$0.00,1,0,1,1,1,1,20161001,,,,
D2390,HCPCS,ANT RESIN-BASED CMPST CROWN,,,26,,NW,,,,,,$457.96,$0.00,1,0,1,1,1,1,20161001,,,,
D2391,HCPCS,POST 1 SRFC RESINBASED CMPST,,,26,,NW,,,,,,$209.87,$0.00,1,0,1,1,1,1,20161001,,,,
D2392,HCPCS,POST 2 SRFC RESINBASED CMPST,,,26,,NW,,,,,,$268.69,$0.00,1,0,1,1,1,1,20161001,,,,
D2393,HCPCS,POST 3 SRFC RESINBASED CMPST,,,26,,NW,,,,,,$329.90,$0.00,1,0,1,1,1,1,20161001,,,,
D2394,HCPCS,POST >=4SRFC RESINBASE CMPST,,,26,,NW,,,,,,$406.23,$0.00,1,0,1,1,1,1,20161001,,,,
D2410,HCPCS,DENTAL GOLD FOIL ONE SURFACE,,,27,,NW,,,,,,$569.44,$0.00,1,0,1,1,1,1,20161001,,,,
D2420,HCPCS,DENTAL GOLD FOIL TWO SURFACE,,,27,,NW,,,,,,$742.91,$0.00,1,0,1,1,1,1,20161001,,,,
D2430,HCPCS,DENTAL GOLD FOIL THREE SURFA,,,27,,NW,,,,,,"$1,002.78",$0.00,1,0,1,1,1,1,20161001,,,,
D2510,HCPCS,DENTAL INLAY METALIC 1 SURF,,,27,,NW,,,,,,$975.77,$0.00,1,0,1,1,1,1,20161001,,,,
D2520,HCPCS,DENTAL INLAY METALLIC 2 SURF,,,27,,NW,,,,,,"$1,079.40",$0.00,1,0,1,1,1,1,20161001,,,,
D2530,HCPCS,DENTAL INLAY METL 3/MORE SUR,,,27,,NW,,,,,,"$1,182.37",$0.00,1,0,1,1,1,1,20161001,,,,
D2542,HCPCS,DENTAL ONLAY METALLIC 2 SURF,,,27,,NW,,,,,,"$1,182.89",$0.00,1,0,1,1,1,1,20161001,,,,
D2543,HCPCS,DENTAL ONLAY METALLIC 3 SURF,,,27,,NW,,,,,,"$1,232.69",$0.00,1,0,1,1,1,1,20161001,,,,
D2544,HCPCS,DENTAL ONLAY METL 4/MORE SUR,,,27,,NW,,,,,,"$1,276.02",$0.00,1,0,1,1,1,1,20161001,,,,
D2610,HCPCS,INLAY PORCELAIN/CERAMIC 1 SU,,,27,,NW,,,,,,"$1,118.93",$0.00,1,0,1,1,1,1,20161001,,,,
D2620,HCPCS,INLAY PORCELAIN/CERAMIC 2 SU,,,27,,NW,,,,,,"$1,149.87",$0.00,1,0,1,1,1,1,20161001,,,,
D2630,HCPCS,DENTAL ONLAY PORC 3/MORE SUR,,,27,,NW,,,,,,"$1,215.91",$0.00,1,0,1,1,1,1,20161001,,,,
D2642,HCPCS,DENTAL ONLAY PORCELIN 2 SURF,,,27,,NW,,,,,,"$1,206.36",$0.00,1,0,1,1,1,1,20161001,,,,
D2643,HCPCS,DENTAL ONLAY PORCELIN 3 SURF,,,27,,NW,,,,,,"$1,272.19",$0.00,1,0,1,1,1,1,20161001,,,,
D2644,HCPCS,DENTAL ONLAY PORC 4/MORE SUR,,,27,,NW,,,,,,"$1,334.02",$0.00,1,0,1,1,1,1,20161001,,,,
D2650,HCPCS,INLAY COMPOSITE/RESIN ONE SU,,,27,,NW,,,,,,$922.45,$0.00,1,0,1,1,1,1,20161001,,,,
D2651,HCPCS,INLAY COMPOSITE/RESIN TWO SU,,,27,,NW,,,,,,$985.72,$0.00,1,0,1,1,1,1,20161001,,,,
D2652,HCPCS,DENTAL INLAY RESIN 3/MRE SUR,,,27,,NW,,,,,,"$1,020.76",$0.00,1,0,1,1,1,1,20161001,,,,
D2662,HCPCS,DENTAL ONLAY RESIN 2 SURFACE,,,27,,NW,,,,,,$973.48,$0.00,1,0,1,1,1,1,20161001,,,,
D2663,HCPCS,DENTAL ONLAY RESIN 3 SURFACE,,,27,,NW,,,,,,"$1,052.94",$0.00,1,0,1,1,1,1,20161001,,,,
D2664,HCPCS,DENTAL ONLAY RESIN 4/MRE SUR,,,27,,NW,,,,,,"$1,105.50",$0.00,1,0,1,1,1,1,20161001,,,,
D2710,HCPCS,CROWN RESIN-BASED INDIRECT,,,27,,NW,,,,,,$829.30,$0.00,1,0,1,1,1,1,20161001,,,,
D2712,HCPCS,CROWN 3/4 RESIN-BASED COMPOS,,,27,,NW,,,,,,$856.99,$0.00,1,0,1,1,1,1,20161001,,,,
D2720,HCPCS,CROWN RESIN W/ HIGH NOBLE ME,,,27,,NW,,,,,,"$1,279.86",$0.00,1,0,1,1,1,1,20161001,,,,
D2721,HCPCS,CROWN RESIN W/ BASE METAL,,,27,,NW,,,,,,"$1,192.99",$0.00,1,0,1,1,1,1,20161001,,,,
D2722,HCPCS,CROWN RESIN W/ NOBLE METAL,,,27,,NW,,,,,,"$1,226.93",$0.00,1,0,1,1,1,1,20161001,,,,
D2740,HCPCS,CROWN PORCELAIN/CERAMIC SUBS,,,27,,NW,,,,,,"$1,343.04",$0.00,1,0,1,1,1,1,20161001,,,,
D2750,HCPCS,CROWN PORCELAIN W/ H NOBLE M,,,27,,NW,,,,,,"$1,321.79",$0.00,1,0,1,1,1,1,20161001,,,,
D2751,HCPCS,CROWN PORCELAIN FUSED BASE M,,,27,,NW,,,,,,"$1,234.22",$0.00,1,0,1,1,1,1,20161001,,,,
D2752,HCPCS,CROWN PORCELAIN W/ NOBLE MET,,,27,,NW,,,,,,"$1,265.43",$0.00,1,0,1,1,1,1,20161001,,,,
D2780,HCPCS,CROWN 3/4 CAST HI NOBLE MET,,,27,,NW,,,,,,"$1,272.19",$0.00,1,0,1,1,1,1,20161001,,,,
D2781,HCPCS,CROWN 3/4 CAST BASE METAL,,,27,,NW,,,,,,"$1,195.73",$0.00,1,0,1,1,1,1,20161001,,,,
D2782,HCPCS,CROWN 3/4 CAST NOBLE METAL,,,27,,NW,,,,,,"$1,239.12",$0.00,1,0,1,1,1,1,20161001,,,,
D2783,HCPCS,CROWN 3/4 PORCELAIN/CERAMIC,,,27,,NW,,,,,,"$1,288.54",$0.00,1,0,1,1,1,1,20161001,,,,
D2790,HCPCS,CROWN FULL CAST HIGH NOBLE M,,,27,,NW,,,,,,"$1,328.05",$0.00,1,0,1,1,1,1,20161001,,,,
D2791,HCPCS,CROWN FULL CAST BASE METAL,,,27,,NW,,,,,,"$1,200.89",$0.00,1,0,1,1,1,1,20161001,,,,
D2792,HCPCS,CROWN FULL CAST NOBLE METAL,,,27,,NW,,,,,,"$1,254.59",$0.00,1,0,1,1,1,1,20161001,,,,
D2794,HCPCS,CROWN-TITANIUM,,,27,,NW,,,,,,"$1,264.19",$0.00,1,0,1,1,1,1,20161001,,,,
D2799,HCPCS,PROVISIONAL CROWN,,,27,,NW,,,,,,$523.20,$0.00,1,0,1,1,1,1,20161001,,,,
D2910,HCPCS,RECEMENT INLAY ONLAY OR PART,,,27,,NW,,,,,,$128.51,$0.00,1,0,1,1,1,1,20161001,,,,
D2915,HCPCS,RECEMENT CAST OR PREFAB POST,,,27,,NW,,,,,,$129.04,$0.00,1,0,1,1,1,1,20161001,,,,
D2920,HCPCS,RE-CEMENT OR RE-BOND CROWN,,,27,,NW,,,,,,$127.76,$0.00,1,0,1,1,1,1,20161001,,,,
D2921,HCPCS,REATTACH TOOTH FRAGMENT,,,27,,NW,,,,,,$213.64,$0.00,1,0,1,1,1,1,20161001,,,,
D2929,HCPCS,PREFAB PORC/CERAM CROWN PRI,,,27,,NW,,,,,,$456.36,$0.00,1,0,1,1,1,1,20161001,,,,
D2930,HCPCS,PREFAB STNLSS STEEL CRWN PRI,,,27,,NW,,,,,,$319.49,$0.00,1,0,1,1,1,1,20161001,,,,
D2931,HCPCS,PREFAB STNLSS STEEL CROWN PE,,,27,,NW,,,,,,$373.01,$0.00,1,0,1,1,1,1,20161001,,,,
D2932,HCPCS,PREFABRICATED RESIN CROWN,,,27,,NW,,,,,,$404.00,$0.00,1,0,1,1,1,1,20161001,,,,
D2933,HCPCS,PREFAB STAINLESS STEEL CROWN,,,27,,NW,,,,,,$437.67,$0.00,1,0,1,1,1,1,20161001,,,,
D2934,HCPCS,PREFAB STEEL CROWN PRIMARY,,,27,,NW,,,,,,$442.37,$0.00,1,0,1,1,1,1,20161001,,,,
D2940,HCPCS,PROTECTIVE RESTORATION,,,27,,NW,,,,,,$137.51,$0.00,1,0,1,1,1,1,20161001,,,,
D2941,HCPCS,INT THERAPEUTIC RESTORATION,,,27,,NW,,,,,,$154.63,$0.00,1,0,1,1,1,1,20161001,,,,
D2949,HCPCS,RESTORATIVE FOUNDATION,,,27,,NW,,,,,,$197.58,$0.00,1,0,1,1,1,1,20161001,,,,
D2950,HCPCS,CORE BUILD-UP INCL ANY PINS,,,27,,NW,,,,,,$316.54,$0.00,1,0,1,1,1,1,20161001,,,,
D2951,HCPCS,TOOTH PIN RETENTION,,,27,,NW,,,,,,$82.48,$0.00,1,0,1,1,1,1,20161001,,,,
D2952,HCPCS,POST AND CORE CAST + CROWN,,,27,,NW,,,,,,$492.47,$0.00,1,0,1,1,1,1,20161001,,,,
D2953,HCPCS,EACH ADDTNL CAST POST,,,27,,NW,,,,,,$315.19,$0.00,1,0,1,1,1,1,20161001,,,,
D2954,HCPCS,PREFAB POST/CORE + CROWN,,,27,,NW,,,,,,$399.82,$0.00,1,0,1,1,1,1,20161001,,,,
D2955,HCPCS,POST REMOVAL,,,27,,NW,,,,,,$326.39,$0.00,1,0,1,1,1,1,20161001,,,,
D2957,HCPCS,EACH ADDTNL PREFAB POST,,,27,,NW,,,,,,$218.72,$0.00,1,0,1,1,1,1,20161001,,,,
D2960,HCPCS,LAMINATE LABIAL VENEER,,,27,,NW,,,,,,$889.80,$0.00,1,0,1,1,1,1,20161001,,,,
D2961,HCPCS,LAB LABIAL VENEER RESIN,,,27,,NW,,,,,,"$1,130.80",$0.00,1,0,1,1,1,1,20161001,,,,
D2962,HCPCS,LAB LABIAL VENEER PORCELAIN,,,27,,NW,,,,,,"$1,278.46",$0.00,1,0,1,1,1,1,20161001,,,,
D2971,HCPCS,ADD PROC CONSTRUCT NEW CROWN,,,27,,NW,,,,,,$250.17,$0.00,1,0,1,1,1,1,20161001,,,,
D2975,HCPCS,COPING,,,27,,NW,,,,,,$645.41,$0.00,1,0,1,1,1,1,20161001,,,,
D2980,HCPCS,CROWN REPAIR,,,27,,NW,,,,,,$293.48,$0.00,1,0,1,1,1,1,20161001,,,,
D2981,HCPCS,INLAY REPAIR,,,27,,NW,,,,,,$280.42,$0.00,1,0,1,1,1,1,20161001,,,,
D2982,HCPCS,ONLAY REPAIR,,,27,,NW,,,,,,$287.73,$0.00,1,0,1,1,1,1,20161001,,,,
D2983,HCPCS,VENEER REPAIR,,,27,,NW,,,,,,$298.18,$0.00,1,0,1,1,1,1,20161001,,,,
D2990,HCPCS,RESIN INFILTRATION OF LESION,,,27,,NW,,,,,,$132.40,$0.00,1,0,1,1,1,1,20161001,,,,
D2999,HCPCS,DENTAL UNSPEC RESTORATIVE PR,,,27,,NW,,,,,,$250.17,$0.00,1,0,1,1,1,1,20161001,,,,
D3110,HCPCS,PULP CAP DIRECT,,,26,,NW,,,,,,$105.44,$0.00,1,0,1,1,1,1,20161001,,,,
D3120,HCPCS,PULP CAP INDIRECT,,,26,,NW,,,,,,$93.96,$0.00,1,0,1,1,1,1,20161001,,,,
D3220,HCPCS,THERAPEUTIC PULPOTOMY,,,26,,NW,,,,,,$235.03,$0.00,1,0,1,1,1,1,20161001,,,,
D3221,HCPCS,GROSS PULPAL DEBRIDEMENT,,,26,,NW,,,,,,$260.61,$0.00,1,0,1,1,1,1,20161001,,,,
D3222,HCPCS,PART PULP FOR APEXOGENESIS,,,26,,NW,,,,,,$288.05,$0.00,1,0,1,1,1,1,20161001,,,,
D3230,HCPCS,PULPAL THERAPY ANTERIOR PRIM,,,26,,NW,,,,,,$274.91,$0.00,1,0,1,1,1,1,20161001,,,,
D3240,HCPCS,PULPAL THERAPY POSTERIOR PRI,,,26,,NW,,,,,,$317.50,$0.00,1,0,1,1,1,1,20161001,,,,
D3310,HCPCS,"END THXPY, ANTERIOR TOOTH",,,26,,NW,,,,,,$878.07,$0.00,1,0,1,1,1,1,20161001,,,,
D3320,HCPCS,"END THXPY, BICUSPID TOOTH",,,26,,NW,,,,,,"$1,037.40",$0.00,1,0,1,1,1,1,20161001,,,,
D3330,HCPCS,"END THXPY, MOLAR",,,26,,NW,,,,,,"$1,281.68",$0.00,1,0,1,1,1,1,20161001,,,,
D3331,HCPCS,NON-SURG TX ROOT CANAL OBS,,,26,,NW,,,,,,$547.71,$0.00,1,0,1,1,1,1,20161001,,,,
D3332,HCPCS,INCOMPLETE ENDODONTIC TX,,,26,,NW,,,,,,$587.49,$0.00,1,0,1,1,1,1,20161001,,,,
D3333,HCPCS,INTERNAL ROOT REPAIR,,,26,,NW,,,,,,$361.52,$0.00,1,0,1,1,1,1,20161001,,,,
D3346,HCPCS,RETREAT ROOT CANAL ANTERIOR,,,26,,NW,,,,,,"$1,083.36",$0.00,1,0,1,1,1,1,20161001,,,,
D3347,HCPCS,RETREAT ROOT CANAL BICUSPID,,,26,,NW,,,,,,"$1,252.13",$0.00,1,0,1,1,1,1,20161001,,,,
D3348,HCPCS,RETREAT ROOT CANAL MOLAR,,,26,,NW,,,,,,"$1,520.28",$0.00,1,0,1,1,1,1,20161001,,,,
D3351,HCPCS,APEXIFICATION/RECALC INITIAL,,,26,,NW,,,,,,$473.56,$0.00,1,0,1,1,1,1,20161001,,,,
D3352,HCPCS,APEXIFICATION/RECALC INTERIM,,,26,,NW,,,,,,$270.18,$0.00,1,0,1,1,1,1,20161001,,,,
D3353,HCPCS,APEXIFICATION/RECALC FINAL,,,26,,NW,,,,,,$663.08,$0.00,1,0,1,1,1,1,20161001,,,,
D3355,HCPCS,PULPAL REGENERATION INITIAL,,,26,,NW,,,,,,$501.25,$0.00,1,0,1,1,1,1,20161001,,,,
D3356,HCPCS,PULPAL REGENERATION INTERIM,,,26,,NW,,,,,,$262.87,$0.00,1,0,1,1,1,1,20161001,,,,
D3357,HCPCS,PULPAL REGENERATION COMPLETE,,,26,,NW,,,,,,$736.47,$0.00,1,0,1,1,1,1,20161001,,,,
D3410,HCPCS,APICOECTOMY - ANTERIOR,,,26,,NW,,,,,,$920.30,$0.00,1,0,1,1,1,1,20161001,,,,
D3421,HCPCS,ROOT SURGERY BICUSPID,,,26,,NW,,,,,,"$1,027.70",$0.00,1,0,1,1,1,1,20161001,,,,
D3425,HCPCS,ROOT SURGERY MOLAR,,,26,,NW,,,,,,"$1,153.08",$0.00,1,0,1,1,1,1,20161001,,,,
D3426,HCPCS,ROOT SURGERY EA ADD ROOT,,,26,,NW,,,,,,$475.03,$0.00,1,0,1,1,1,1,20161001,,,,
D3427,HCPCS,PERIRADICULAR SURGERY,,,26,,NW,,,,,,$874.90,$0.00,1,0,1,1,1,1,20161001,,,,
D3428,HCPCS,BONE GRAFT PERI PER TOOTH,,,26,,NW,,,,,,"$1,000.10",$0.00,1,0,1,1,1,1,20161001,,,,
D3429,HCPCS,BONE GRAFT PERI EACH ADDL,,,26,,NW,,,,,,$918.36,$0.00,1,0,1,1,1,1,20161001,,,,
D3430,HCPCS,RETROGRADE FILLING,,,26,,NW,,,,,,$332.63,$0.00,1,0,1,1,1,1,20161001,,,,
D3431,HCPCS,BIOLOGICAL MATERIALS,,,26,,NW,,,,,,"$1,006.34",$0.00,1,0,1,1,1,1,20161001,,,,
D3432,HCPCS,GUIDED TISSUE REGENERATION,,,26,,NW,,,,,,$998.38,$0.00,1,0,1,1,1,1,20161001,,,,
D3450,HCPCS,ROOT AMPUTATION,,,26,,NW,,,,,,$626.63,$0.00,1,0,1,1,1,1,20161001,,,,
D3460,HCPCS,ENDODONTIC ENDOSSEOUS IMPLAN,,,26,,NW,,,,,,"$2,098.50",$0.00,1,0,1,1,1,1,20161001,,,,
D3470,HCPCS,INTENTIONAL REPLANTATION,,,26,,NW,,,,,,"$1,100.48",$0.00,1,0,1,1,1,1,20161001,,,,
D3910,HCPCS,ISOLATION- TOOTH W RUBB DAM,,,26,,NW,,,,,,$228.32,$0.00,1,0,1,1,1,1,20161001,,,,
D3920,HCPCS,TOOTH SPLITTING,,,26,,NW,,,,,,$534.49,$0.00,1,0,1,1,1,1,20161001,,,,
D3950,HCPCS,CANAL PREP/FITTING OF DOWEL,,,26,,NW,,,,,,$271.22,$0.00,1,0,1,1,1,1,20161001,,,,
D3999,HCPCS,ENDODONTIC PROCEDURE,,,26,,NW,,,,,,"$1,037.40",$0.00,1,0,1,1,1,1,20161001,,,,
D4210,HCPCS,GINGIVECTOMY/PLASTY 4 OR MOR,,,26,,NW,,,,,,$792.24,$0.00,1,0,1,1,1,1,20161001,,,,
D4211,HCPCS,GINGIVECTOMY/PLASTY 1 TO 3,,,26,,NW,,,,,,$380.72,$0.00,1,0,1,1,1,1,20161001,,,,
D4212,HCPCS,GINGIVECTOMY/PLASTY REST,,,26,,NW,,,,,,$322.02,$0.00,1,0,1,1,1,1,20161001,,,,
D4230,HCPCS,ANA CROWN EXP 4 OR> PER QUAD,,,26,,NW,,,,,,"$1,027.12",$0.00,1,0,1,1,1,1,20161001,,,,
D4231,HCPCS,ANA CROWN EXP 1-3 PER QUAD,,,26,,NW,,,,,,$624.62,$0.00,1,0,1,1,1,1,20161001,,,,
D4240,HCPCS,GINGIVAL FLAP PROC W/ PLANIN,,,26,,NW,,,,,,$968.33,$0.00,1,0,1,1,1,1,20161001,,,,
D4241,HCPCS,GNGVL FLAP W ROOTPLAN 1-3 TH,,,26,,NW,,,,,,$673.61,$0.00,1,0,1,1,1,1,20161001,,,,
D4245,HCPCS,APICALLY POSITIONED FLAP,,,26,,NW,,,,,,$856.08,$0.00,1,0,1,1,1,1,20161001,,,,
D4249,HCPCS,CROWN LENGTHEN HARD TISSUE,,,26,,NW,,,,,,"$1,034.02",$0.00,1,0,1,1,1,1,20161001,,,,
D4260,HCPCS,OSSEOUS SURGERY 4 OR MORE,,,26,,NW,,,,,,"$1,526.47",$0.00,1,0,1,1,1,1,20161001,,,,
D4261,HCPCS,OSSEOUS SURG 1 TO 3 TEETH,,,26,,NW,,,,,,$987.89,$0.00,1,0,1,1,1,1,20161001,,,,
D4263,HCPCS,BONE REPLCE GRAFT FIRST SITE,,,26,,NW,,,,,,$725.63,$0.00,1,0,1,1,1,1,20161001,,,,
D4264,HCPCS,BONE REPLCE GRAFT EACH ADD,,,26,,NW,,,,,,$601.33,$0.00,1,0,1,1,1,1,20161001,,,,
D4265,HCPCS,BIO MTRLS TO AID SOFT/OS REG,,,26,,NW,,,,,,$679.08,$0.00,1,0,1,1,1,1,20161001,,,,
D4266,HCPCS,GUIDED TISS REGEN RESORBLE,,,26,,NW,,,,,,$791.24,$0.00,1,0,1,1,1,1,20161001,,,,
D4267,HCPCS,GUIDED TISS REGEN NONRESORB,,,26,,NW,,,,,,$972.45,$0.00,1,0,1,1,1,1,20161001,,,,
D4268,HCPCS,SURGICAL REVISION PROCEDURE,,,26,,NW,,,,,,$940.26,$0.00,1,0,1,1,1,1,20161001,,,,
D4270,HCPCS,PEDICLE SOFT TISSUE GRAFT PR,,,26,,NW,,,,,,"$1,118.62",$0.00,1,0,1,1,1,1,20161001,,,,
D4273,HCPCS,SUBEPITHELIAL TISSUE GRAFT,,,26,,NW,,,,,,"$1,406.90",$0.00,1,0,1,1,1,1,20161001,,,,
D4274,HCPCS,DISTAL/PROXIMAL WEDGE PROC,,,26,,NW,,,,,,$829.67,$0.00,1,0,1,1,1,1,20161001,,,,
D4275,HCPCS,SOFT TISSUE ALLOGRAFT,,,26,,NW,,,,,,"$1,148.52",$0.00,1,0,1,1,1,1,20161001,,,,
D4276,HCPCS,CON TISSUE W DBLE PED GRAFT,,,26,,NW,,,,,,"$1,489.91",$0.00,1,0,1,1,1,1,20161001,,,,
D4277,HCPCS,SOFT TISSUE GRAFT FIRSTTOOTH,,,26,,NW,,,,,,"$1,209.50",$0.00,1,0,1,1,1,1,20161001,,,,
D4278,HCPCS,SOFT TISSUE GRAFT ADDL TOOTH,,,26,,NW,,,,,,$630.53,$0.00,1,0,1,1,1,1,20161001,,,,
D4283,HCPCS,"AUTOGENOUS CONNECTIVE TISSUE GRAFT PROCEDURE (INCLUDING DONOR AND RECIPIENT SURGICAL SITES) – EACH ADDITIONAL CONTIGUOUS TOOTH, IMPLANT OR EDENTULOUS TOOTH POSITION IN SAME GRAFT SITE",,,26,,NW,,,,,,"$1,406.90",$0.00,1,0,1,1,1,1,20161001,,,,
D4285,HCPCS,"NON-AUTOGENOUS CONNECTIVE TISSUE GRAFT PROCEDURE (INCLUDING RECIPIENT SURGICAL SITE AND DONOR MATERIAL) – EACH ADDITIONAL CONTIGUOUS TOOTH, IMPLANT OR EDENTULOUS TOOTH POSITION IN SAME GRAFT SITE",,,26,,NW,,,,,,"$1,148.52",$0.00,1,0,1,1,1,1,20161001,,,,
D4320,HCPCS,PROVISION SPLNT INTRACORONAL,,,26,,NW,,,,,,$559.41,$0.00,1,0,1,1,1,1,20161001,,,,
D4321,HCPCS,PROVISIONAL SPLINT EXTRACORO,,,26,,NW,,,,,,$509.36,$0.00,1,0,1,1,1,1,20161001,,,,
D4341,HCPCS,PERIODONTAL SCALING & ROOT,,,26,,NW,,,,,,$298.29,$0.00,1,0,1,1,1,1,20161001,,,,
D4342,HCPCS,PERIODONTAL SCALING 1-3TEETH,,,26,,NW,,,,,,$194.83,$0.00,1,0,1,1,1,1,20161001,,,,
D4355,HCPCS,FULL MOUTH DEBRIDEMENT,,,26,,NW,,,,,,$203.99,$0.00,1,0,1,1,1,1,20161001,,,,
D4381,HCPCS,LOCALIZED DELIVERY ANTIMICRO,,,26,,NW,,,,,,$172.38,$0.00,1,0,1,1,1,1,20161001,,,,
D4910,HCPCS,PERIODONTAL MAINT PROCEDURES,,,26,,NW,,,,,,$163.30,$0.00,1,0,1,1,1,1,20161001,,,,
D4920,HCPCS,UNSCHEDULED DRESSING CHANGE,,,26,,NW,,,,,,$127.09,$0.00,1,0,1,1,1,1,20161001,,,,
D4921,HCPCS,GINGIVAL IRRIGATION PER QUAD,,,26,,NW,,,,,,$103.76,$0.00,1,0,1,1,1,1,20161001,,,,
D4999,HCPCS,UNSPECIFIED PERIODONTAL PROC,,,26,,NW,,,,,,$194.83,$0.00,1,0,1,1,1,1,20161001,,,,
D5110,HCPCS,DENTURES COMPLETE MAXILLARY,,,27,,NW,,,,,,"$1,952.65",$0.00,1,0,1,1,1,1,20161001,,,,
D5120,HCPCS,DENTURES COMPLETE MANDIBLE,,,27,,NW,,,,,,"$1,954.22",$0.00,1,0,1,1,1,1,20161001,,,,
D5130,HCPCS,DENTURES IMMEDIAT MAXILLARY,,,27,,NW,,,,,,"$2,100.48",$0.00,1,0,1,1,1,1,20161001,,,,
D5140,HCPCS,DENTURES IMMEDIAT MANDIBLE,,,27,,NW,,,,,,"$2,113.02",$0.00,1,0,1,1,1,1,20161001,,,,
D5211,HCPCS,DENTURES MAXILL PART RESIN,,,27,,NW,,,,,,"$1,609.06",$0.00,1,0,1,1,1,1,20161001,,,,
D5212,HCPCS,DENTURES MAND PART RESIN,,,27,,NW,,,,,,"$1,701.97",$0.00,1,0,1,1,1,1,20161001,,,,
D5213,HCPCS,DENTURES MAXILL PART METAL,,,27,,NW,,,,,,"$2,072.82",$0.00,1,0,1,1,1,1,20161001,,,,
D5214,HCPCS,DENTURES MANDIBL PART METAL,,,27,,NW,,,,,,"$2,076.48",$0.00,1,0,1,1,1,1,20161001,,,,
D5223,HCPCS,"IMMEDIATE MAXILLARY PARTIAL DENTURE –CAST METAL FRAMEWORK WITH RESIN DENTURE BASES (INCLUDING ANY CONVENTIONAL CLASPS, RESTS AND TEETH)",,,27,,NW,,,,,,"$2,072.82",$0.00,1,0,1,1,1,1,20161001,,,,
D5224,HCPCS,"IMMEDIATE MANDIBULAR PARTIALDENTURE – CAST METAL FRAMEWORK WITH RESIN DENTURE BASES (INCLUDING ANY CONVENTIONAL CLASPS, RESTS AND TEETH)",,,27,,NW,,,,,,"$2,076.48",$0.00,1,0,1,1,1,1,20161001,,,,
D5225,HCPCS,MAXILLARY PART DENTURE FLEX,,,27,,NW,,,,,,"$1,703.09",$0.00,1,0,1,1,1,1,20161001,,,,
D5226,HCPCS,MANDIBULAR PART DENTURE FLEX,,,27,,NW,,,,,,"$1,819.51",$0.00,1,0,1,1,1,1,20161001,,,,
D5281,HCPCS,REMOVABLE PARTIAL DENTURE,,,27,,NW,,,,,,"$1,204.28",$0.00,1,0,1,1,1,1,20161001,,,,
D5410,HCPCS,DENTURES ADJUST CMPLT MAXIL,,,27,,NW,,,,,,$103.92,$0.00,1,0,1,1,1,1,20161001,,,,
D5411,HCPCS,DENTURES ADJUST CMPLT MAND,,,27,,NW,,,,,,$102.88,$0.00,1,0,1,1,1,1,20161001,,,,
D5421,HCPCS,DENTURES ADJUST PART MAXILL,,,27,,NW,,,,,,$102.36,$0.00,1,0,1,1,1,1,20161001,,,,
D5422,HCPCS,DENTURES ADJUST PART MANDBL,,,27,,NW,,,,,,$102.36,$0.00,1,0,1,1,1,1,20161001,,,,
D5510,HCPCS,DENTUR REPR BROKEN COMPL BAS,,,27,,NW,,,,,,$230.31,$0.00,1,0,1,1,1,1,20161001,,,,
D5520,HCPCS,REPLACE DENTURE TEETH COMPLT,,,27,,NW,,,,,,$196.71,$0.00,1,0,1,1,1,1,20161001,,,,
D5610,HCPCS,DENTURES REPAIR RESIN BASE,,,27,,NW,,,,,,$234.31,$0.00,1,0,1,1,1,1,20161001,,,,
D5620,HCPCS,REP PART DENTURE CAST FRAME,,,27,,NW,,,,,,$291.59,$0.00,1,0,1,1,1,1,20161001,,,,
D5630,HCPCS,REP PARTIAL DENTURE CLASP,,,27,,NW,,,,,,$301.50,$0.00,1,0,1,1,1,1,20161001,,,,
D5640,HCPCS,REPLACE PART DENTURE TEETH,,,27,,NW,,,,,,$208.02,$0.00,1,0,1,1,1,1,20161001,,,,
D5650,HCPCS,ADD TOOTH TO PARTIAL DENTURE,,,27,,NW,,,,,,$261.64,$0.00,1,0,1,1,1,1,20161001,,,,
D5660,HCPCS,ADD CLASP TO PARTIAL DENTURE,,,27,,NW,,,,,,$309.16,$0.00,1,0,1,1,1,1,20161001,,,,
D5670,HCPCS,REPLC TTH&ACRLC ON MTL FRMWK,,,27,,NW,,,,,,$800.76,$0.00,1,0,1,1,1,1,20161001,,,,
D5671,HCPCS,REPLC TTH&ACRLC MANDIBULAR,,,27,,NW,,,,,,$805.98,$0.00,1,0,1,1,1,1,20161001,,,,
D5710,HCPCS,DENTURES REBASE CMPLT MAXIL,,,27,,NW,,,,,,$716.04,$0.00,1,0,1,1,1,1,20161001,,,,
D5711,HCPCS,DENTURES REBASE CMPLT MAND,,,27,,NW,,,,,,$699.16,$0.00,1,0,1,1,1,1,20161001,,,,
D5720,HCPCS,DENTURES REBASE PART MAXILL,,,27,,NW,,,,,,$683.06,$0.00,1,0,1,1,1,1,20161001,,,,
D5721,HCPCS,DENTURES REBASE PART MANDBL,,,27,,NW,,,,,,$682.54,$0.00,1,0,1,1,1,1,20161001,,,,
D5730,HCPCS,DENTURE RELN CMPLT MAXIL CH,,,27,,NW,,,,,,$435.66,$0.00,1,0,1,1,1,1,20161001,,,,
D5731,HCPCS,DENTURE RELN CMPLT MAND CHR,,,27,,NW,,,,,,$433.57,$0.00,1,0,1,1,1,1,20161001,,,,
D5740,HCPCS,DENTURE RELN PART MAXIL CHR,,,27,,NW,,,,,,$410.12,$0.00,1,0,1,1,1,1,20161001,,,,
D5741,HCPCS,DENTURE RELN PART MAND CHR,,,27,,NW,,,,,,$411.69,$0.00,1,0,1,1,1,1,20161001,,,,
D5750,HCPCS,DENTURE RELN CMPLT MAX LAB,,,27,,NW,,,,,,$558.69,$0.00,1,0,1,1,1,1,20161001,,,,
D5751,HCPCS,DENTURE RELN CMPLT MAND LAB,,,27,,NW,,,,,,$560.78,$0.00,1,0,1,1,1,1,20161001,,,,
D5760,HCPCS,DENTURE RELN PART MAXIL LAB,,,27,,NW,,,,,,$551.99,$0.00,1,0,1,1,1,1,20161001,,,,
D5761,HCPCS,DENTURE RELN PART MAND LAB,,,27,,NW,,,,,,$550.94,$0.00,1,0,1,1,1,1,20161001,,,,
D5810,HCPCS,DENTURE INTERM CMPLT MAXILL,,,27,,NW,,,,,,$961.08,$0.00,1,0,1,1,1,1,20161001,,,,
D5811,HCPCS,DENTURE INTERM CMPLT MANDBL,,,27,,NW,,,,,,"$1,002.68",$0.00,1,0,1,1,1,1,20161001,,,,
D5820,HCPCS,DENTURE INTERM PART MAXILL,,,27,,NW,,,,,,$779.35,$0.00,1,0,1,1,1,1,20161001,,,,
D5821,HCPCS,DENTURE INTERM PART MANDBL,,,27,,NW,,,,,,$796.67,$0.00,1,0,1,1,1,1,20161001,,,,
D5850,HCPCS,DENTURE TISS CONDITN MAXILL,,,27,,NW,,,,,,$215.43,$0.00,1,0,1,1,1,1,20161001,,,,
D5851,HCPCS,DENTURE TISS CONDTIN MANDBL,,,27,,NW,,,,,,$211.25,$0.00,1,0,1,1,1,1,20161001,,,,
D5862,HCPCS,PRECISION ATTACHMENT,,,27,,NW,,,,,,$864.00,$0.00,1,0,1,1,1,1,20161001,,,,
D5863,HCPCS,OVERDENTURE COMPLETE MAX,,,27,,NW,,,,,,"$2,249.46",$0.00,1,0,1,1,1,1,20161001,,,,
D5864,HCPCS,OVERDENTURE PARTIAL MAX,,,27,,NW,,,,,,"$2,557.31",$0.00,1,0,1,1,1,1,20161001,,,,
D5865,HCPCS,OVERDENTURE COMPLETE MANDIB,,,27,,NW,,,,,,"$2,254.69",$0.00,1,0,1,1,1,1,20161001,,,,
D5866,HCPCS,OVERDENTURE PARTIAL MANDIB,,,27,,NW,,,,,,"$2,672.72",$0.00,1,0,1,1,1,1,20161001,,,,
D5867,HCPCS,REPLACEMENT OF PRECISION ATT,,,27,,NW,,,,,,$475.36,$0.00,1,0,1,1,1,1,20161001,,,,
D5875,HCPCS,PROSTHESIS MODIFICATION,,,27,,NW,,,,,,$523.41,$0.00,1,0,1,1,1,1,20161001,,,,
D5899,HCPCS,REMOVABLE PROSTHODONTIC PROC,,,27,,NW,,,,,,$550.94,$0.00,1,0,1,1,1,1,20161001,,,,
D5911,HCPCS,FACIAL MOULAGE SECTIONAL,,,27,,NW,,,,,,$494.31,$0.00,1,0,1,1,1,1,20161001,,,,
D5912,HCPCS,FACIAL MOULAGE COMPLETE,,,27,,NW,,,,,,$519.90,$0.00,1,0,1,1,1,1,20161001,,,,
D5913,HCPCS,NASAL PROSTHESIS,,,27,,NW,,,,,,"$7,484.98",$0.00,1,0,1,1,1,1,20161001,,,,
D5914,HCPCS,AURICULAR PROSTHESIS,,,27,,NW,,,,,,"$7,494.38",$0.00,1,0,1,1,1,1,20161001,,,,
D5915,HCPCS,ORBITAL PROSTHESIS,,,27,,NW,,,,,,"$12,958.81",$0.00,1,0,1,1,1,1,20161001,,,,
D5916,HCPCS,OCULAR PROSTHESIS,,,27,,NW,,,,,,"$3,456.45",$0.00,1,0,1,1,1,1,20161001,,,,
D5919,HCPCS,FACIAL PROSTHESIS,,,27,,NW,,,,,,"$1,490.49",$0.00,1,0,1,1,1,1,20161001,,,,
D5922,HCPCS,NASAL SEPTAL PROSTHESIS,,,27,,NW,,,,,,"$1,490.49",$0.00,1,0,1,1,1,1,20161001,,,,
D5923,HCPCS,OCULAR PROSTHESIS INTERIM,,,27,,NW,,,,,,"$1,490.49",$0.00,1,0,1,1,1,1,20161001,,,,
D5924,HCPCS,CRANIAL PROSTHESIS,,,27,,NW,,,,,,"$1,135.38",$0.00,1,0,1,1,1,1,20161001,,,,
D5925,HCPCS,FACIAL AUGMENTATION IMPLANT,,,27,,NW,,,,,,$365.24,$0.00,1,0,1,1,1,1,20161001,,,,
D5926,HCPCS,REPLACEMENT NASAL PROSTHESIS,,,27,,NW,,,,,,"$1,490.49",$0.00,1,0,1,1,1,1,20161001,,,,
D5927,HCPCS,AURICULAR REPLACEMENT,,,27,,NW,,,,,,"$1,490.49",$0.00,1,0,1,1,1,1,20161001,,,,
D5928,HCPCS,ORBITAL REPLACEMENT,,,27,,NW,,,,,,"$1,490.49",$0.00,1,0,1,1,1,1,20161001,,,,
D5929,HCPCS,FACIAL REPLACEMENT,,,27,,NW,,,,,,"$1,490.49",$0.00,1,0,1,1,1,1,20161001,,,,
D5931,HCPCS,SURGICAL OBTURATOR,,,27,,NW,,,,,,"$5,156.04",$0.00,1,0,1,1,1,1,20161001,,,,
D5932,HCPCS,POSTSURGICAL OBTURATOR,,,27,,NW,,,,,,"$9,643.05",$0.00,1,0,1,1,1,1,20161001,,,,
D5933,HCPCS,REFITTING OF OBTURATOR,,,27,,NW,,,,,,$297.46,$0.00,1,0,1,1,1,1,20161001,,,,
D5934,HCPCS,MANDIBULAR FLANGE PROSTHESIS,,,27,,NW,,,,,,"$8,789.16",$0.00,1,0,1,1,1,1,20161001,,,,
D5935,HCPCS,MANDIBULAR DENTURE PROSTH,,,27,,NW,,,,,,"$7,647.37",$0.00,1,0,1,1,1,1,20161001,,,,
D5936,HCPCS,TEMP OBTURATOR PROSTHESIS,,,27,,NW,,,,,,"$8,589.59",$0.00,1,0,1,1,1,1,20161001,,,,
D5937,HCPCS,TRISMUS APPLIANCE,,,27,,NW,,,,,,$954.57,$0.00,1,0,1,1,1,1,20161001,,,,
D5951,HCPCS,FEEDING AID,,,27,,NW,,,,,,"$1,272.18",$0.00,1,0,1,1,1,1,20161001,,,,
D5952,HCPCS,PEDIATRIC SPEECH AID,,,27,,NW,,,,,,"$4,557.34",$0.00,1,0,1,1,1,1,20161001,,,,
D5953,HCPCS,ADULT SPEECH AID,,,27,,NW,,,,,,"$8,655.02",$0.00,1,0,1,1,1,1,20161001,,,,
D5954,HCPCS,SUPERIMPOSED PROSTHESIS,,,27,,NW,,,,,,"$8,020.33",$0.00,1,0,1,1,1,1,20161001,,,,
D5955,HCPCS,PALATAL LIFT PROSTHESIS,,,27,,NW,,,,,,"$7,418.36",$0.00,1,0,1,1,1,1,20161001,,,,
D5958,HCPCS,INTRAORAL CON DEF INTER PLT,,,27,,NW,,,,,,"$1,490.49",$0.00,1,0,1,1,1,1,20161001,,,,
D5959,HCPCS,INTRAORAL CON DEF MOD PALAT,,,27,,NW,,,,,,"$1,490.49",$0.00,1,0,1,1,1,1,20161001,,,,
D5960,HCPCS,MODIFY SPEECH AID PROSTHESIS,,,27,,NW,,,,,,$537.61,$0.00,1,0,1,1,1,1,20161001,,,,
D5982,HCPCS,SURGICAL STENT,,,27,,NW,,,,,,$640.82,$0.00,1,0,1,1,1,1,20161001,,,,
D5983,HCPCS,RADIATION APPLICATOR,,,27,,NW,,,,,,"$1,635.80",$0.00,1,0,1,1,1,1,20161001,,,,
D5984,HCPCS,RADIATION SHIELD,,,27,,NW,,,,,,"$1,635.80",$0.00,1,0,1,1,1,1,20161001,,,,
D5985,HCPCS,RADIATION CONE LOCATOR,,,27,,NW,,,,,,"$1,635.80",$0.00,1,0,1,1,1,1,20161001,,,,
D5986,HCPCS,FLUORIDE APPLICATOR,,,27,,NW,,,,,,$212.38,$0.00,1,0,1,1,1,1,20161001,,,,
D5987,HCPCS,COMMISSURE SPLINT,,,27,,NW,,,,,,"$1,773.25",$0.00,1,0,1,1,1,1,20161001,,,,
D5988,HCPCS,SURGICAL SPLINT,,,27,,NW,,,,,,$705.05,$0.00,1,0,1,1,1,1,20161001,,,,
D5991,HCPCS,VESICULOBULLOUS DISEASE CARR,,,27,,NW,,,,,,$226.22,$0.00,1,0,1,1,1,1,20161001,,,,
D5992,HCPCS,ADJUST MAX PROST APPLIANCE,,,27,,NW,,,,,,$573.56,$0.00,1,0,1,1,1,1,20161001,,,,
D5993,HCPCS,MAIN/CLEAN MAX PROSTHESIS,,,27,,NW,,,,,,$573.56,$0.00,1,0,1,1,1,1,20161001,,,,
D5994,HCPCS,PERIDONTAL MEDICAMENT,,,27,,NW,,,,,,$234.93,$0.00,1,0,1,1,1,1,20161001,,,,
D5999,HCPCS,MAXILLOFACIAL PROSTHESIS,,,27,,NW,,,,,,"$8,218.22",$0.00,1,0,1,1,1,1,20161001,,,,
D6010,HCPCS,ODONTICS ENDOSTEAL IMPLANT,,,27,,NW,,,,,,"$2,659.32",$0.00,1,0,1,1,1,1,20161001,,,,
D6011,HCPCS,SECOND STAGE IMPLANT SURGERY,,,27,,NW,,,,,,"$1,877.24",$0.00,1,0,1,1,1,1,20161001,,,,
D6012,HCPCS,ENDOSTEAL IMPLANT,,,27,,NW,,,,,,"$2,401.72",$0.00,1,0,1,1,1,1,20161001,,,,
D6013,HCPCS,SURGICAL PLACE MINI IMPLANT,,,27,,NW,,,,,,"$2,153.15",$0.00,1,0,1,1,1,1,20161001,,,,
D6040,HCPCS,ODONTICS EPOSTEAL IMPLANT,,,27,,NW,,,,,,"$9,683.80",$0.00,1,0,1,1,1,1,20161001,,,,
D6050,HCPCS,ODONTICS TRANSOSTEAL IMPLNT,,,27,,NW,,,,,,"$7,021.18",$0.00,1,0,1,1,1,1,20161001,,,,
D6051,HCPCS,INTERIM ABUTMENT,,,27,,NW,,,,,,$574.61,$0.00,1,0,1,1,1,1,20161001,,,,
D6052,HCPCS,SEMI PRECISION ATTACH ABUT,,,27,,NW,,,,,,"$1,159.15",$0.00,1,0,1,1,1,1,20161001,,,,
D6055,HCPCS,IMPLANT CONNECTING BAR,,,27,,NW,,,,,,"$2,252.02",$0.00,1,0,1,1,1,1,20161001,,,,
D6056,HCPCS,PREFABRICATED ABUTMENT,,,27,,NW,,,,,,$774.14,$0.00,1,0,1,1,1,1,20161001,,,,
D6057,HCPCS,CUSTOM ABUTMENT,,,27,,NW,,,,,,$932.90,$0.00,1,0,1,1,1,1,20161001,,,,
D6058,HCPCS,ABUTMENT SUPPORTED CROWN,,,27,,NW,,,,,,"$1,703.08",$0.00,1,0,1,1,1,1,20161001,,,,
D6059,HCPCS,ABUTMENT SUPPORTED MTL CROWN,,,27,,NW,,,,,,"$1,707.82",$0.00,1,0,1,1,1,1,20161001,,,,
D6060,HCPCS,ABUTMENT SUPPORTED MTL CROWN,,,27,,NW,,,,,,"$1,639.79",$0.00,1,0,1,1,1,1,20161001,,,,
D6061,HCPCS,ABUTMENT SUPPORTED MTL CROWN,,,27,,NW,,,,,,"$1,655.62",$0.00,1,0,1,1,1,1,20161001,,,,
D6062,HCPCS,ABUTMENT SUPPORTED MTL CROWN,,,27,,NW,,,,,,"$1,652.87",$0.00,1,0,1,1,1,1,20161001,,,,
D6063,HCPCS,ABUTMENT SUPPORTED MTL CROWN,,,27,,NW,,,,,,"$1,547.36",$0.00,1,0,1,1,1,1,20161001,,,,
D6064,HCPCS,ABUTMENT SUPPORTED MTL CROWN,,,27,,NW,,,,,,"$1,557.09",$0.00,1,0,1,1,1,1,20161001,,,,
D6065,HCPCS,IMPLANT SUPPORTED CROWN,,,27,,NW,,,,,,"$1,758.13",$0.00,1,0,1,1,1,1,20161001,,,,
D6066,HCPCS,IMPLANT SUPPORTED MTL CROWN,,,27,,NW,,,,,,"$1,740.22",$0.00,1,0,1,1,1,1,20161001,,,,
D6067,HCPCS,IMPLANT SUPPORTED MTL CROWN,,,27,,NW,,,,,,"$1,713.60",$0.00,1,0,1,1,1,1,20161001,,,,
D6068,HCPCS,ABUTMENT SUPPORTED RETAINER,,,27,,NW,,,,,,"$1,716.61",$0.00,1,0,1,1,1,1,20161001,,,,
D6069,HCPCS,ABUTMENT SUPPORTED RETAINER,,,27,,NW,,,,,,"$1,712.52",$0.00,1,0,1,1,1,1,20161001,,,,
D6070,HCPCS,ABUTMENT SUPPORTED RETAINER,,,27,,NW,,,,,,"$1,618.89",$0.00,1,0,1,1,1,1,20161001,,,,
D6071,HCPCS,ABUTMENT SUPPORTED RETAINER,,,27,,NW,,,,,,"$1,635.77",$0.00,1,0,1,1,1,1,20161001,,,,
D6072,HCPCS,ABUTMENT SUPPORTED RETAINER,,,27,,NW,,,,,,"$1,680.06",$0.00,1,0,1,1,1,1,20161001,,,,
D6073,HCPCS,ABUTMENT SUPPORTED RETAINER,,,27,,NW,,,,,,"$1,586.15",$0.00,1,0,1,1,1,1,20161001,,,,
D6074,HCPCS,ABUTMENT SUPPORTED RETAINER,,,27,,NW,,,,,,"$1,591.27",$0.00,1,0,1,1,1,1,20161001,,,,
D6075,HCPCS,IMPLANT SUPPORTED RETAINER,,,27,,NW,,,,,,"$1,736.19",$0.00,1,0,1,1,1,1,20161001,,,,
D6076,HCPCS,IMPLANT SUPPORTED RETAINER,,,27,,NW,,,,,,"$1,714.11",$0.00,1,0,1,1,1,1,20161001,,,,
D6077,HCPCS,IMPLANT SUPPORTED RETAINER,,,27,,NW,,,,,,"$1,694.27",$0.00,1,0,1,1,1,1,20161001,,,,
D6080,HCPCS,IMPLANT MAINTENANCE,,,27,,NW,,,,,,$253.17,$0.00,1,0,1,1,1,1,20161001,,,,
D6090,HCPCS,REPAIR IMPLANT,,,27,,NW,,,,,,$860.86,$0.00,1,0,1,1,1,1,20161001,,,,
D6091,HCPCS,REPL SEMI/PRECISION ATTACH,,,27,,NW,,,,,,$692.03,$0.00,1,0,1,1,1,1,20161001,,,,
D6092,HCPCS,RECEMENT SUPP CROWN,,,27,,NW,,,,,,$159.75,$0.00,1,0,1,1,1,1,20161001,,,,
D6093,HCPCS,RECEMENT SUPP PART DENTURE,,,27,,NW,,,,,,$213.57,$0.00,1,0,1,1,1,1,20161001,,,,
D6094,HCPCS,ABUT SUPPORT CROWN TITANIUM,,,27,,NW,,,,,,"$1,475.56",$0.00,1,0,1,1,1,1,20161001,,,,
D6095,HCPCS,ODONTICS REPR ABUTMENT,,,27,,NW,,,,,,$835.79,$0.00,1,0,1,1,1,1,20161001,,,,
D6100,HCPCS,REMOVAL OF IMPLANT,,,27,,NW,,,,,,$888.03,$0.00,1,0,1,1,1,1,20161001,,,,
D6101,HCPCS,DEBRIDEMENT OF A PERIIMPLANT,,,27,,NW,,,,,,$701.27,$0.00,1,0,1,1,1,1,20161001,,,,
D6102,HCPCS,DEBRIDEMENT & CONTOURING,,,27,,NW,,,,,,$915.68,$0.00,1,0,1,1,1,1,20161001,,,,
D6103,HCPCS,BONE GRAFT REPAIR PERIMPLANT,,,27,,NW,,,,,,$725.76,$0.00,1,0,1,1,1,1,20161001,,,,
D6104,HCPCS,BONE GRAFT TIME OF IMPLANT,,,27,,NW,,,,,,$805.09,$0.00,1,0,1,1,1,1,20161001,,,,
D6110,HCPCS,IMPLNT/ABUT REMOV DENT MAX,,,27,,NW,,,,,,"$2,549.83",$0.00,1,0,1,1,1,1,20161001,,,,
D6111,HCPCS,IMPLNT/ABUT REMOV DENT MAND,,,27,,NW,,,,,,"$2,549.83",$0.00,1,0,1,1,1,1,20161001,,,,
D6112,HCPCS,IMP/ABUT REM DENT PART MAX,,,27,,NW,,,,,,"$2,523.09",$0.00,1,0,1,1,1,1,20161001,,,,
D6113,HCPCS,IMP/ABUT REM DENT PART MAND,,,27,,NW,,,,,,"$2,523.09",$0.00,1,0,1,1,1,1,20161001,,,,
D6114,HCPCS,IMPLNT/ABUT FIXED DENT MAX,,,27,,NW,,,,,,"$6,204.25",$0.00,1,0,1,1,1,1,20161001,,,,
D6115,HCPCS,IMPLNT/ABUT FIXED DENT MAND,,,27,,NW,,,,,,"$6,204.25",$0.00,1,0,1,1,1,1,20161001,,,,
D6116,HCPCS,IMP/ABUT FIXED DENT PART MAX,,,27,,NW,,,,,,"$4,171.69",$0.00,1,0,1,1,1,1,20161001,,,,
D6117,HCPCS,IMP/ABUT FIXED DENT PART MAN,,,27,,NW,,,,,,"$4,171.69",$0.00,1,0,1,1,1,1,20161001,,,,
D6190,HCPCS,RADIO/SURGICAL IMPLANT INDEX,,,27,,NW,,,,,,$412.50,$0.00,1,0,1,1,1,1,20161001,,,,
D6194,HCPCS,ABUT SUPPORT RETAINER TITANI,,,27,,NW,,,,,,"$1,561.30",$0.00,1,0,1,1,1,1,20161001,,,,
D6199,HCPCS,IMPLANT PROCEDURE,,,27,,NW,,,,,,$932.90,$0.00,1,0,1,1,1,1,20161001,,,,
D6205,HCPCS,PONTIC-INDIRECT RESIN BASED,,,27,,NW,,,,,,$987.77,$0.00,1,0,1,1,1,1,20161001,,,,
D6210,HCPCS,PROSTHODONT HIGH NOBLE METAL,,,27,,NW,,,,,,"$1,310.74",$0.00,1,0,1,1,1,1,20161001,,,,
D6211,HCPCS,BRIDGE BASE METAL CAST,,,27,,NW,,,,,,"$1,218.78",$0.00,1,0,1,1,1,1,20161001,,,,
D6212,HCPCS,BRIDGE NOBLE METAL CAST,,,27,,NW,,,,,,"$1,263.51",$0.00,1,0,1,1,1,1,20161001,,,,
D6214,HCPCS,PONTIC TITANIUM,,,27,,NW,,,,,,"$1,280.76",$0.00,1,0,1,1,1,1,20161001,,,,
D6240,HCPCS,BRIDGE PORCELAIN HIGH NOBLE,,,27,,NW,,,,,,"$1,306.97",$0.00,1,0,1,1,1,1,20161001,,,,
D6241,HCPCS,BRIDGE PORCELAIN BASE METAL,,,27,,NW,,,,,,"$1,213.33",$0.00,1,0,1,1,1,1,20161001,,,,
D6242,HCPCS,BRIDGE PORCELAIN NOBEL METAL,,,27,,NW,,,,,,"$1,260.78",$0.00,1,0,1,1,1,1,20161001,,,,
D6245,HCPCS,BRIDGE PORCELAIN/CERAMIC,,,27,,NW,,,,,,"$1,320.05",$0.00,1,0,1,1,1,1,20161001,,,,
D6250,HCPCS,BRIDGE RESIN W/HIGH NOBLE,,,27,,NW,,,,,,"$1,273.95",$0.00,1,0,1,1,1,1,20161001,,,,
D6251,HCPCS,BRIDGE RESIN BASE METAL,,,27,,NW,,,,,,"$1,210.09",$0.00,1,0,1,1,1,1,20161001,,,,
D6252,HCPCS,BRIDGE RESIN W/NOBLE METAL,,,27,,NW,,,,,,"$1,230.97",$0.00,1,0,1,1,1,1,20161001,,,,
D6253,HCPCS,PROVISIONAL PONTIC,,,27,,NW,,,,,,$722.45,$0.00,1,0,1,1,1,1,20161001,,,,
D6545,HCPCS,DENTAL RETAINR CAST METL,,,27,,NW,,,,,,$754.69,$0.00,1,0,1,1,1,1,20161001,,,,
D6548,HCPCS,PORCELAIN/CERAMIC RETAINER,,,27,,NW,,,,,,$817.73,$0.00,1,0,1,1,1,1,20161001,,,,
D6549,HCPCS,RESIN RETAINER,,,27,,NW,,,,,,$581.35,$0.00,1,0,1,1,1,1,20161001,,,,
D6600,HCPCS,PORCELAIN/CERAMIC INLAY 2SRF,,,27,,NW,,,,,,"$1,049.82",$0.00,1,0,1,1,1,1,20161001,,,,
D6601,HCPCS,PORC/CERAM INLAY >= 3 SURFAC,,,27,,NW,,,,,,"$1,099.61",$0.00,1,0,1,1,1,1,20161001,,,,
D6602,HCPCS,CST HGH NBLE MTL INLAY 2 SRF,,,27,,NW,,,,,,"$1,093.13",$0.00,1,0,1,1,1,1,20161001,,,,
D6603,HCPCS,CST HGH NBLE MTL INLAY >=3SR,,,27,,NW,,,,,,"$1,150.99",$0.00,1,0,1,1,1,1,20161001,,,,
D6604,HCPCS,CST BSE MTL INLAY 2 SURFACES,,,27,,NW,,,,,,"$1,065.99",$0.00,1,0,1,1,1,1,20161001,,,,
D6605,HCPCS,CST BSE MTL INLAY >= 3 SURFA,,,27,,NW,,,,,,"$1,121.11",$0.00,1,0,1,1,1,1,20161001,,,,
D6606,HCPCS,CAST NOBLE METAL INLAY 2 SUR,,,27,,NW,,,,,,"$1,059.78",$0.00,1,0,1,1,1,1,20161001,,,,
D6607,HCPCS,CST NOBLE MTL INLAY >=3 SURF,,,27,,NW,,,,,,"$1,131.96",$0.00,1,0,1,1,1,1,20161001,,,,
D6608,HCPCS,ONLAY PORC/CRMC 2 SURFACES,,,27,,NW,,,,,,"$1,119.90",$0.00,1,0,1,1,1,1,20161001,,,,
D6609,HCPCS,ONLAY PORC/CRMC >=3 SURFACES,,,27,,NW,,,,,,"$1,185.18",$0.00,1,0,1,1,1,1,20161001,,,,
D6610,HCPCS,ONLAY CST HGH NBL MTL 2 SRFC,,,27,,NW,,,,,,"$1,165.46",$0.00,1,0,1,1,1,1,20161001,,,,
D6611,HCPCS,ONLAY CST HGH NBL MTL >=3SRF,,,27,,NW,,,,,,"$1,239.70",$0.00,1,0,1,1,1,1,20161001,,,,
D6612,HCPCS,ONLAY CST BASE MTL 2 SURFACE,,,27,,NW,,,,,,"$1,135.47",$0.00,1,0,1,1,1,1,20161001,,,,
D6613,HCPCS,ONLAY CST BASE MTL >=3 SURFA,,,27,,NW,,,,,,"$1,190.33",$0.00,1,0,1,1,1,1,20161001,,,,
D6614,HCPCS,ONLAY CST NBL MTL 2 SURFACES,,,27,,NW,,,,,,"$1,135.64",$0.00,1,0,1,1,1,1,20161001,,,,
D6615,HCPCS,ONLAY CST NBL MTL >=3 SURFAC,,,27,,NW,,,,,,"$1,180.18",$0.00,1,0,1,1,1,1,20161001,,,,
D6624,HCPCS,INLAY TITANIUM,,,27,,NW,,,,,,"$1,116.64",$0.00,1,0,1,1,1,1,20161001,,,,
D6634,HCPCS,ONLAY TITANIUM,,,27,,NW,,,,,,"$1,153.41",$0.00,1,0,1,1,1,1,20161001,,,,
D6710,HCPCS,CROWN-INDIRECT RESIN BASED,,,27,,NW,,,,,,"$1,131.10",$0.00,1,0,1,1,1,1,20161001,,,,
D6720,HCPCS,RETAIN CROWN RESIN W HI NBLE,,,27,,NW,,,,,,"$1,279.05",$0.00,1,0,1,1,1,1,20161001,,,,
D6721,HCPCS,CROWN RESIN W/BASE METAL,,,27,,NW,,,,,,"$1,203.87",$0.00,1,0,1,1,1,1,20161001,,,,
D6722,HCPCS,CROWN RESIN W/NOBLE METAL,,,27,,NW,,,,,,"$1,241.12",$0.00,1,0,1,1,1,1,20161001,,,,
D6740,HCPCS,CROWN PORCELAIN/CERAMIC,,,27,,NW,,,,,,"$1,329.68",$0.00,1,0,1,1,1,1,20161001,,,,
D6750,HCPCS,CROWN PORCELAIN HIGH NOBLE,,,27,,NW,,,,,,"$1,330.47",$0.00,1,0,1,1,1,1,20161001,,,,
D6751,HCPCS,CROWN PORCELAIN BASE METAL,,,27,,NW,,,,,,"$1,221.17",$0.00,1,0,1,1,1,1,20161001,,,,
D6752,HCPCS,CROWN PORCELAIN NOBLE METAL,,,27,,NW,,,,,,"$1,258.30",$0.00,1,0,1,1,1,1,20161001,,,,
D6780,HCPCS,CROWN 3/4 HIGH NOBLE METAL,,,27,,NW,,,,,,"$1,250.52",$0.00,1,0,1,1,1,1,20161001,,,,
D6781,HCPCS,CROWN 3/4 CAST BASED METAL,,,27,,NW,,,,,,"$1,222.84",$0.00,1,0,1,1,1,1,20161001,,,,
D6782,HCPCS,CROWN 3/4 CAST NOBLE METAL,,,27,,NW,,,,,,"$1,191.90",$0.00,1,0,1,1,1,1,20161001,,,,
D6783,HCPCS,CROWN 3/4 PORCELAIN/CERAMIC,,,27,,NW,,,,,,"$1,267.16",$0.00,1,0,1,1,1,1,20161001,,,,
D6790,HCPCS,CROWN FULL HIGH NOBLE METAL,,,27,,NW,,,,,,"$1,290.78",$0.00,1,0,1,1,1,1,20161001,,,,
D6791,HCPCS,CROWN FULL BASE METAL CAST,,,27,,NW,,,,,,"$1,204.63",$0.00,1,0,1,1,1,1,20161001,,,,
D6792,HCPCS,CROWN FULL NOBLE METAL CAST,,,27,,NW,,,,,,"$1,251.97",$0.00,1,0,1,1,1,1,20161001,,,,
D6793,HCPCS,PROVISIONAL RETAINER CROWN,,,27,,NW,,,,,,$601.03,$0.00,1,0,1,1,1,1,20161001,,,,
D6794,HCPCS,CROWN TITANIUM,,,27,,NW,,,,,,"$1,227.42",$0.00,1,0,1,1,1,1,20161001,,,,
D6920,HCPCS,DENTAL CONNECTOR BAR,,,27,,NW,,,,,,$764.98,$0.00,1,0,1,1,1,1,20161001,,,,
D6930,HCPCS,RECEMENT/BOND PART DENTURE,,,27,,NW,,,,,,$193.98,$0.00,1,0,1,1,1,1,20161001,,,,
D6940,HCPCS,STRESS BREAKER,,,27,,NW,,,,,,$462.63,$0.00,1,0,1,1,1,1,20161001,,,,
D6950,HCPCS,PRECISION ATTACHMENT,,,27,,NW,,,,,,$792.44,$0.00,1,0,1,1,1,1,20161001,,,,
D6980,HCPCS,FIXED PARTIAL REPAIR,,,27,,NW,,,,,,$467.00,$0.00,1,0,1,1,1,1,20161001,,,,
D6985,HCPCS,PEDIATRIC PARTIAL DENTURE FX,,,27,,NW,,,,,,$855.39,$0.00,1,0,1,1,1,1,20161001,,,,
D6999,HCPCS,FIXED PROSTHODONTIC PROC,,,27,,NW,,,,,,"$1,306.97",$0.00,1,0,1,1,1,1,20161001,,,,
D7111,HCPCS,EXTRACTION CORONAL REMNANTS,,,26,,NW,,,,,,$155.32,$0.00,1,0,1,1,1,1,20161001,,,,
D7140,HCPCS,EXTRACTION ERUPTED TOOTH/EXR,,,26,,NW,,,,,,$205.85,$0.00,1,0,1,1,1,1,20161001,,,,
D7210,HCPCS,REM IMP TOOTH W MUCOPER FLP,,,26,,NW,,,,,,$330.39,$0.00,1,0,1,1,1,1,20161001,,,,
D7220,HCPCS,IMPACT TOOTH REMOV SOFT TISS,,,26,,NW,,,,,,$381.55,$0.00,1,0,1,1,1,1,20161001,,,,
D7230,HCPCS,IMPACT TOOTH REMOV PART BONY,,,26,,NW,,,,,,$493.22,$0.00,1,0,1,1,1,1,20161001,,,,
D7240,HCPCS,IMPACT TOOTH REMOV COMP BONY,,,26,,NW,,,,,,$591.24,$0.00,1,0,1,1,1,1,20161001,,,,
D7241,HCPCS,IMPACT TOOTH REM BONY W/COMP,,,26,,NW,,,,,,$716.65,$0.00,1,0,1,1,1,1,20161001,,,,
D7250,HCPCS,TOOTH ROOT REMOVAL,,,26,,NW,,,,,,$349.79,$0.00,1,0,1,1,1,1,20161001,,,,
D7251,HCPCS,CORONECTOMY,,,26,,NW,,,,,,$583.43,$0.00,1,0,1,1,1,1,20161001,,,,
D7260,HCPCS,ORAL ANTRAL FISTULA CLOSURE,,,26,,NW,,,,,,"$1,769.01",$0.00,1,0,1,1,1,1,20161001,,,,
D7261,HCPCS,PRIMARY CLOSURE SINUS PERF,,,26,,NW,,,,,,$894.80,$0.00,1,0,1,1,1,1,20161001,,,,
D7270,HCPCS,TOOTH REIMPLANTATION,,,26,,NW,,,,,,$666.92,$0.00,1,0,1,1,1,1,20161001,,,,
D7272,HCPCS,TOOTH TRANSPLANTATION,,,26,,NW,,,,,,$882.78,$0.00,1,0,1,1,1,1,20161001,,,,
D7280,HCPCS,EXPOSURE IMPACT TOOTH ORTHOD,,,26,,NW,,,,,,$597.21,$0.00,1,0,1,1,1,1,20161001,,,,
D7282,HCPCS,MOBILIZE ERUPTED/MALPOS TOOT,,,26,,NW,,,,,,$449.83,$0.00,1,0,1,1,1,1,20161001,,,,
D7283,HCPCS,PLACE DEVICE IMPACTED TOOTH,,,26,,NW,,,,,,$426.09,$0.00,1,0,1,1,1,1,20161001,,,,
D7285,HCPCS,BIOPSY OF ORAL TISSUE HARD,,,26,,NW,,,,,,$908.16,$0.00,1,0,1,1,1,1,20161001,,,,
D7286,HCPCS,BIOPSY OF ORAL TISSUE SOFT,,,26,,NW,,,,,,$463.54,$0.00,1,0,1,1,1,1,20161001,,,,
D7287,HCPCS,EXFOLIATIVE CYTOLOG COLLECT,,,26,,NW,,,,,,$222.92,$0.00,1,0,1,1,1,1,20161001,,,,
D7288,HCPCS,BRUSH BIOPSY,,,26,,NW,,,,,,$223.97,$0.00,1,0,1,1,1,1,20161001,,,,
D7290,HCPCS,REPOSITIONING OF TEETH,,,26,,NW,,,,,,$567.49,$0.00,1,0,1,1,1,1,20161001,,,,
D7291,HCPCS,TRANSSEPTAL FIBEROTOMY,,,26,,NW,,,,,,$368.79,$0.00,1,0,1,1,1,1,20161001,,,,
D7292,HCPCS,SCREW RETAINED PLATE,,,26,,NW,,,,,,"$2,199.70",$0.00,1,0,1,1,1,1,20161001,,,,
D7293,HCPCS,TEMP ANCHORAGE DEV W FLAP,,,26,,NW,,,,,,"$1,673.87",$0.00,1,0,1,1,1,1,20161001,,,,
D7294,HCPCS,TEMP ANCHORAGE DEV W/O FLAP,,,26,,NW,,,,,,"$1,157.82",$0.00,1,0,1,1,1,1,20161001,,,,
D7295,HCPCS,"BONE HARVEST,AUTO GRAFT PROC",,,26,,NW,,,,,,$982.05,$0.00,1,0,1,1,1,1,20161001,,,,
D7310,HCPCS,ALVEOPLASTY W/ EXTRACTION,,,26,,NW,,,,,,$396.92,$0.00,1,0,1,1,1,1,20161001,,,,
D7311,HCPCS,ALVEOLOPLASTY W/EXTRACT 1-3,,,26,,NW,,,,,,$369.29,$0.00,1,0,1,1,1,1,20161001,,,,
D7320,HCPCS,ALVEOPLASTY W/O EXTRACTION,,,26,,NW,,,,,,$617.35,$0.00,1,0,1,1,1,1,20161001,,,,
D7321,HCPCS,ALVEOLOPLASTY NOT W/EXTRACTS,,,26,,NW,,,,,,$551.91,$0.00,1,0,1,1,1,1,20161001,,,,
D7340,HCPCS,VESTIBULOPLASTY RIDGE EXTENS,,,26,,NW,,,,,,"$2,252.89",$0.00,1,0,1,1,1,1,20161001,,,,
D7350,HCPCS,VESTIBULOPLASTY EXTEN GRAFT,,,26,,NW,,,,,,"$5,796.90",$0.00,1,0,1,1,1,1,20161001,,,,
D7410,HCPCS,RAD EXC LESION UP TO 1.25 CM,,,26,,NW,,,,,,$904.11,$0.00,1,0,1,1,1,1,20161001,,,,
D7411,HCPCS,EXCISION BENIGN LESION>1.25C,,,26,,NW,,,,,,"$1,396.24",$0.00,1,0,1,1,1,1,20161001,,,,
D7412,HCPCS,EXCISION BENIGN LESION COMPL,,,26,,NW,,,,,,"$1,665.13",$0.00,1,0,1,1,1,1,20161001,,,,
D7413,HCPCS,EXCISION MALIG LESION<=1.25C,,,26,,NW,,,,,,"$1,193.75",$0.00,1,0,1,1,1,1,20161001,,,,
D7414,HCPCS,EXCISION MALIG LESION>1.25CM,,,26,,NW,,,,,,"$1,826.54",$0.00,1,0,1,1,1,1,20161001,,,,
D7415,HCPCS,EXCISION MALIG LES COMPLICAT,,,26,,NW,,,,,,"$2,005.61",$0.00,1,0,1,1,1,1,20161001,,,,
D7440,HCPCS,MALIG TUMOR EXC TO 1.25 CM,,,26,,NW,,,,,,"$1,500.08",$0.00,1,0,1,1,1,1,20161001,,,,
D7441,HCPCS,MALIG TUMOR > 1.25 CM,,,26,,NW,,,,,,"$2,329.18",$0.00,1,0,1,1,1,1,20161001,,,,
D7450,HCPCS,REM ODONTOGEN CYST TO 1.25CM,,,26,,NW,,,,,,"$1,017.94",$0.00,1,0,1,1,1,1,20161001,,,,
D7451,HCPCS,REM ODONTOGEN CYST > 1.25 CM,,,26,,NW,,,,,,"$1,389.67",$0.00,1,0,1,1,1,1,20161001,,,,
D7460,HCPCS,REM NONODONTO CYST TO 1.25CM,,,26,,NW,,,,,,$996.59,$0.00,1,0,1,1,1,1,20161001,,,,
D7461,HCPCS,REM NONODONTO CYST > 1.25 CM,,,26,,NW,,,,,,"$1,452.83",$0.00,1,0,1,1,1,1,20161001,,,,
D7465,HCPCS,LESION DESTRUCTION,,,26,,NW,,,,,,$626.85,$0.00,1,0,1,1,1,1,20161001,,,,
D7471,HCPCS,REM EXOSTOSIS ANY SITE,,,26,,NW,,,,,,"$1,233.68",$0.00,1,0,1,1,1,1,20161001,,,,
D7472,HCPCS,REMOVAL OF TORUS PALATINUS,,,26,,NW,,,,,,"$1,487.38",$0.00,1,0,1,1,1,1,20161001,,,,
D7473,HCPCS,REMOVE TORUS MANDIBULARIS,,,26,,NW,,,,,,"$1,393.62",$0.00,1,0,1,1,1,1,20161001,,,,
D7485,HCPCS,SURG REDUCT OSSEOUSTUBEROSIT,,,26,,NW,,,,,,"$1,261.95",$0.00,1,0,1,1,1,1,20161001,,,,
D7490,HCPCS,MAXILLA OR MANDIBLE RESECTIO,,,26,,NW,,,,,,"$10,981.45",$0.00,1,0,1,1,1,1,20161001,,,,
D7510,HCPCS,I&D ABSC INTRAORAL SOFT TISS,,,26,,NW,,,,,,$378.56,$0.00,1,0,1,1,1,1,20161001,,,,
D7511,HCPCS,INCISION/DRAIN ABSCESS INTRA,,,26,,NW,,,,,,$561.39,$0.00,1,0,1,1,1,1,20161001,,,,
D7520,HCPCS,I&D ABSCESS EXTRAORAL,,,26,,NW,,,,,,"$1,396.42",$0.00,1,0,1,1,1,1,20161001,,,,
D7521,HCPCS,INCISION/DRAIN ABSCESS EXTRA,,,26,,NW,,,,,,"$1,603.06",$0.00,1,0,1,1,1,1,20161001,,,,
D7530,HCPCS,REMOVAL FB SKIN/AREOLAR TISS,,,26,,NW,,,,,,$617.15,$0.00,1,0,1,1,1,1,20161001,,,,
D7540,HCPCS,REMOVAL OF FB REACTION,,,26,,NW,,,,,,$842.29,$0.00,1,0,1,1,1,1,20161001,,,,
D7550,HCPCS,REMOVAL OF SLOUGHED OFF BONE,,,26,,NW,,,,,,$591.44,$0.00,1,0,1,1,1,1,20161001,,,,
D7560,HCPCS,MAXILLARY SINUSOTOMY,,,26,,NW,,,,,,"$3,097.08",$0.00,1,0,1,1,1,1,20161001,,,,
D7610,HCPCS,MAXILLA OPEN REDUCT SIMPLE,,,26,,NW,,,,,,"$6,132.45",$0.00,1,0,1,1,1,1,20161001,,,,
D7620,HCPCS,CLSD REDUCT SIMPL MAXILLA FX,,,26,,NW,,,,,,"$4,684.66",$0.00,1,0,1,1,1,1,20161001,,,,
D7630,HCPCS,OPEN RED SIMPL MANDIBLE FX,,,26,,NW,,,,,,"$7,273.04",$0.00,1,0,1,1,1,1,20161001,,,,
D7640,HCPCS,CLSD RED SIMPL MANDIBLE FX,,,26,,NW,,,,,,"$4,944.72",$0.00,1,0,1,1,1,1,20161001,,,,
D7650,HCPCS,OPEN RED SIMP MALAR/ZYGOM FX,,,26,,NW,,,,,,"$4,421.79",$0.00,1,0,1,1,1,1,20161001,,,,
D7660,HCPCS,CLSD RED SIMP MALAR/ZYGOM FX,,,26,,NW,,,,,,"$2,923.94",$0.00,1,0,1,1,1,1,20161001,,,,
D7670,HCPCS,CLOSD RDUCTN SPLINT ALVEOLUS,,,26,,NW,,,,,,"$2,082.23",$0.00,1,0,1,1,1,1,20161001,,,,
D7671,HCPCS,ALVEOLUS OPEN REDUCTION,,,26,,NW,,,,,,"$2,721.34",$0.00,1,0,1,1,1,1,20161001,,,,
D7680,HCPCS,REDUCT SIMPLE FACIAL BONE FX,,,26,,NW,,,,,,"$10,606.00",$0.00,1,0,1,1,1,1,20161001,,,,
D7710,HCPCS,MAXILLA OPEN REDUCT COMPOUND,,,26,,NW,,,,,,"$6,811.85",$0.00,1,0,1,1,1,1,20161001,,,,
D7720,HCPCS,CLSD REDUCT COMPD MAXILLA FX,,,26,,NW,,,,,,"$4,977.84",$0.00,1,0,1,1,1,1,20161001,,,,
D7730,HCPCS,OPEN REDUCT COMPD MANDBLE FX,,,26,,NW,,,,,,"$8,892.84",$0.00,1,0,1,1,1,1,20161001,,,,
D7740,HCPCS,CLSD REDUCT COMPD MANDBLE FX,,,26,,NW,,,,,,"$5,070.12",$0.00,1,0,1,1,1,1,20161001,,,,
D7750,HCPCS,OPEN RED COMP MALAR/ZYGMA FX,,,26,,NW,,,,,,"$6,289.22",$0.00,1,0,1,1,1,1,20161001,,,,
D7760,HCPCS,CLSD RED COMP MALAR/ZYGMA FX,,,26,,NW,,,,,,"$4,630.17",$0.00,1,0,1,1,1,1,20161001,,,,
D7770,HCPCS,OPEN REDUC COMPD ALVEOLUS FX,,,26,,NW,,,,,,"$3,703.56",$0.00,1,0,1,1,1,1,20161001,,,,
D7771,HCPCS,ALVEOLUS CLSD REDUC STBLZ TE,,,26,,NW,,,,,,"$2,721.00",$0.00,1,0,1,1,1,1,20161001,,,,
D7780,HCPCS,REDUCT COMPND FACIAL BONE FX,,,26,,NW,,,,,,"$13,771.94",$0.00,1,0,1,1,1,1,20161001,,,,
D7810,HCPCS,TMJ OPEN REDUCT-DISLOCATION,,,26,,NW,,,,,,"$6,351.96",$0.00,1,0,1,1,1,1,20161001,,,,
D7820,HCPCS,CLOSED TMP MANIPULATION,,,26,,NW,,,,,,"$1,017.98",$0.00,1,0,1,1,1,1,20161001,,,,
D7830,HCPCS,TMJ MANIPULATION UNDER ANEST,,,26,,NW,,,,,,$891.08,$0.00,1,0,1,1,1,1,20161001,,,,
D7840,HCPCS,REMOVAL OF TMJ CONDYLE,,,26,,NW,,,,,,"$8,462.20",$0.00,1,0,1,1,1,1,20161001,,,,
D7850,HCPCS,TMJ MENISCECTOMY,,,26,,NW,,,,,,"$7,591.72",$0.00,1,0,1,1,1,1,20161001,,,,
D7852,HCPCS,TMJ REPAIR OF JOINT DISC,,,26,,NW,,,,,,"$8,655.24",$0.00,1,0,1,1,1,1,20161001,,,,
D7854,HCPCS,TMJ EXCISN OF JOINT MEMBRANE,,,26,,NW,,,,,,"$8,632.82",$0.00,1,0,1,1,1,1,20161001,,,,
D7856,HCPCS,TMJ CUTTING OF A MUSCLE,,,26,,NW,,,,,,"$6,073.17",$0.00,1,0,1,1,1,1,20161001,,,,
D7858,HCPCS,TMJ RECONSTRUCTION,,,26,,NW,,,,,,"$23,816.12",$0.00,1,0,1,1,1,1,20161001,,,,
D7860,HCPCS,TMJ CUTTING INTO JOINT,,,26,,NW,,,,,,"$10,151.17",$0.00,1,0,1,1,1,1,20161001,,,,
D7865,HCPCS,TMJ RESHAPING COMPONENTS,,,26,,NW,,,,,,"$16,358.46",$0.00,1,0,1,1,1,1,20161001,,,,
D7870,HCPCS,TMJ ASPIRATION JOINT FLUID,,,26,,NW,,,,,,$532.80,$0.00,1,0,1,1,1,1,20161001,,,,
D7871,HCPCS,LYSIS + LAVAGE W CATHETERS,,,26,,NW,,,,,,"$1,081.16",$0.00,1,0,1,1,1,1,20161001,,,,
D7872,HCPCS,TMJ DIAGNOSTIC ARTHROSCOPY,,,26,,NW,,,,,,"$5,770.12",$0.00,1,0,1,1,1,1,20161001,,,,
D7873,HCPCS,TMJ ARTHROSCOPY LYSIS ADHESN,,,26,,NW,,,,,,"$6,947.64",$0.00,1,0,1,1,1,1,20161001,,,,
D7874,HCPCS,TMJ ARTHROSCOPY DISC REPOSIT,,,26,,NW,,,,,,"$9,965.49",$0.00,1,0,1,1,1,1,20161001,,,,
D7875,HCPCS,TMJ ARTHROSCOPY SYNOVECTOMY,,,26,,NW,,,,,,"$10,917.39",$0.00,1,0,1,1,1,1,20161001,,,,
D7876,HCPCS,TMJ ARTHROSCOPY DISCECTOMY,,,26,,NW,,,,,,"$11,770.56",$0.00,1,0,1,1,1,1,20161001,,,,
D7877,HCPCS,TMJ ARTHROSCOPY DEBRIDEMENT,,,26,,NW,,,,,,"$10,388.56",$0.00,1,0,1,1,1,1,20161001,,,,
D7880,HCPCS,OCCLUSAL ORTHOTIC APPLIANCE,,,26,,NW,,,,,,"$1,232.51",$0.00,1,0,1,1,1,1,20161001,,,,
D7881,HCPCS,OCCLUSAL ORTHOTIC DEVICE ADJUSTMENT,,,26,,NW,,,,,,"$1,232.51",$0.00,1,0,1,1,1,1,20161001,,,,
D7899,HCPCS,TMJ UNSPECIFIED THERAPY,,,26,,NW,,,,,,"$1,232.51",$0.00,1,0,1,1,1,1,20161001,,,,
D7910,HCPCS,DENT SUTUR RECENT WND TO 5CM,,,26,,NW,,,,,,$539.98,$0.00,1,0,1,1,1,1,20161001,,,,
D7911,HCPCS,DENTAL SUTURE WOUND TO 5 CM,,,26,,NW,,,,,,"$1,205.36",$0.00,1,0,1,1,1,1,20161001,,,,
D7912,HCPCS,SUTURE COMPLICATE WND > 5 CM,,,26,,NW,,,,,,"$2,091.81",$0.00,1,0,1,1,1,1,20161001,,,,
D7920,HCPCS,DENTAL SKIN GRAFT,,,26,,NW,,,,,,"$4,261.98",$0.00,1,0,1,1,1,1,20161001,,,,
D7921,HCPCS,COLLECT & APPL BLOOD PRODUCT,,,26,,NW,,,,,,$509.96,$0.00,1,0,1,1,1,1,20161001,,,,
D7940,HCPCS,RESHAPING BONE ORTHOGNATHIC,,,26,,NW,,,,,,"$4,590.57",$0.00,1,0,1,1,1,1,20161001,,,,
D7941,HCPCS,BONE CUTTING RAMUS CLOSED,,,26,,NW,,,,,,"$11,843.17",$0.00,1,0,1,1,1,1,20161001,,,,
D7943,HCPCS,CUTTING RAMUS OPEN W/GRAFT,,,26,,NW,,,,,,"$11,198.27",$0.00,1,0,1,1,1,1,20161001,,,,
D7944,HCPCS,BONE CUTTING SEGMENTED,,,26,,NW,,,,,,"$9,546.66",$0.00,1,0,1,1,1,1,20161001,,,,
D7945,HCPCS,BONE CUTTING BODY MANDIBLE,,,26,,NW,,,,,,"$11,457.44",$0.00,1,0,1,1,1,1,20161001,,,,
D7946,HCPCS,RECONSTRUCTION MAXILLA TOTAL,,,26,,NW,,,,,,"$14,095.67",$0.00,1,0,1,1,1,1,20161001,,,,
D7947,HCPCS,RECONSTRUCT MAXILLA SEGMENT,,,26,,NW,,,,,,"$12,548.31",$0.00,1,0,1,1,1,1,20161001,,,,
D7948,HCPCS,RECONSTRUCT MIDFACE NO GRAFT,,,26,,NW,,,,,,"$15,769.03",$0.00,1,0,1,1,1,1,20161001,,,,
D7949,HCPCS,RECONSTRUCT MIDFACE W/GRAFT,,,26,,NW,,,,,,"$19,687.03",$0.00,1,0,1,1,1,1,20161001,,,,
D7950,HCPCS,MANDIBLE GRAFT,,,26,,NW,,,,,,"$3,545.84",$0.00,1,0,1,1,1,1,20161001,,,,
D7951,HCPCS,SINUS AUG W BONE OR BONE SUB,,,26,,NW,,,,,,"$3,656.58",$0.00,1,0,1,1,1,1,20161001,,,,
D7952,HCPCS,SINUS AUGMENTATION VERTICAL,,,26,,NW,,,,,,"$2,981.40",$0.00,1,0,1,1,1,1,20161001,,,,
D7953,HCPCS,BONE REPLACEMENT GRAFT,,,26,,NW,,,,,,$756.02,$0.00,1,0,1,1,1,1,20161001,,,,
D7955,HCPCS,REPAIR MAXILLOFACIAL DEFECTS,,,26,,NW,,,,,,"$4,103.73",$0.00,1,0,1,1,1,1,20161001,,,,
D7960,HCPCS,FRENULECTOMY/FRENECTOMY,,,26,,NW,,,,,,$566.94,$0.00,1,0,1,1,1,1,20161001,,,,
D7963,HCPCS,FRENULOPLASTY,,,26,,NW,,,,,,$777.62,$0.00,1,0,1,1,1,1,20161001,,,,
D7970,HCPCS,EXCISION HYPERPLASTIC TISSUE,,,26,,NW,,,,,,$746.26,$0.00,1,0,1,1,1,1,20161001,,,,
D7971,HCPCS,EXCISION PERICORONAL GINGIVA,,,26,,NW,,,,,,$324.84,$0.00,1,0,1,1,1,1,20161001,,,,
D7972,HCPCS,SURG REDCT FIBROUS TUBEROSIT,,,26,,NW,,,,,,"$1,047.89",$0.00,1,0,1,1,1,1,20161001,,,,
D7980,HCPCS,SIALOLITHOTOMY,,,26,,NW,,,,,,"$1,181.22",$0.00,1,0,1,1,1,1,20161001,,,,
D7981,HCPCS,EXCISION OF SALIVARY GLAND,,,26,,NW,,,,,,$696.04,$0.00,1,0,1,1,1,1,20161001,,,,
D7982,HCPCS,SIALODOCHOPLASTY,,,26,,NW,,,,,,"$2,653.49",$0.00,1,0,1,1,1,1,20161001,,,,
D7983,HCPCS,CLOSURE OF SALIVARY FISTULA,,,26,,NW,,,,,,"$2,485.17",$0.00,1,0,1,1,1,1,20161001,,,,
D7990,HCPCS,EMERGENCY TRACHEOTOMY,,,26,,NW,,,,,,"$2,245.28",$0.00,1,0,1,1,1,1,20161001,,,,
D7991,HCPCS,DENTAL CORONOIDECTOMY,,,26,,NW,,,,,,"$5,613.76",$0.00,1,0,1,1,1,1,20161001,,,,
D7995,HCPCS,SYNTHETIC GRAFT FACIAL BONES,,,26,,NW,,,,,,$523.52,$0.00,1,0,1,1,1,1,20161001,,,,
D7996,HCPCS,IMPLANT MANDIBLE FOR AUGMENT,,,26,,NW,,,,,,"$2,201.16",$0.00,1,0,1,1,1,1,20161001,,,,
D7997,HCPCS,APPLIANCE REMOVAL,,,26,,NW,,,,,,$454.66,$0.00,1,0,1,1,1,1,20161001,,,,
D7998,HCPCS,INTRAORAL PLACE OF FIX DEV,,,26,,NW,,,,,,"$2,418.72",$0.00,1,0,1,1,1,1,20161001,,,,
D7999,HCPCS,ORAL SURGERY PROCEDURE,,,26,,NW,,,,,,$756.02,$0.00,1,0,1,1,1,1,20161001,,,,
D8010,HCPCS,LIMITED DENTAL TX PRIMARY,,,27,,NW,,,,,,"$2,738.26",$0.00,1,0,1,1,1,1,20161001,,,,
D8020,HCPCS,LIMITED DENTAL TX TRANSITION,,,27,,NW,,,,,,"$3,134.21",$0.00,1,0,1,1,1,1,20161001,,,,
D8030,HCPCS,LIMITED DENTAL TX ADOLESCENT,,,27,,NW,,,,,,"$3,761.05",$0.00,1,0,1,1,1,1,20161001,,,,
D8040,HCPCS,LIMITED DENTAL TX ADULT,,,27,,NW,,,,,,"$4,038.95",$0.00,1,0,1,1,1,1,20161001,,,,
D8050,HCPCS,INTERCEP DENTAL TX PRIMARY,,,27,,NW,,,,,,"$3,055.86",$0.00,1,0,1,1,1,1,20161001,,,,
D8060,HCPCS,INTERCEP DENTAL TX TRANSITN,,,27,,NW,,,,,,"$3,427.78",$0.00,1,0,1,1,1,1,20161001,,,,
D8070,HCPCS,COMPRE DENTAL TX TRANSITION,,,27,,NW,,,,,,"$6,156.64",$0.00,1,0,1,1,1,1,20161001,,,,
D8080,HCPCS,COMPRE DENTAL TX ADOLESCENT,,,27,,NW,,,,,,"$6,241.26",$0.00,1,0,1,1,1,1,20161001,,,,
D8090,HCPCS,COMPRE DENTAL TX ADULT,,,27,,NW,,,,,,"$6,264.24",$0.00,1,0,1,1,1,1,20161001,,,,
D8210,HCPCS,ORTHODONTIC REM APPLIANCE TX,,,27,,NW,,,,,,"$1,044.74",$0.00,1,0,1,1,1,1,20161001,,,,
D8220,HCPCS,FIXED APPLIANCE THERAPY HABT,,,27,,NW,,,,,,"$1,158.61",$0.00,1,0,1,1,1,1,20161001,,,,
D8660,HCPCS,PREORTHODONTIC TX VISIT,,,27,,NW,,,,,,$541.17,$0.00,1,0,1,1,1,1,20161001,,,,
D8670,HCPCS,PERIODIC ORTHODONTC TX VISIT,,,27,,NW,,,,,,$362.52,$0.00,1,0,1,1,1,1,20161001,,,,
D8680,HCPCS,ORTHODONTIC RETENTION,,,27,,NW,,,,,,$646.69,$0.00,1,0,1,1,1,1,20161001,,,,
D8690,HCPCS,ORTHODONTIC TREATMENT,,,27,,NW,,,,,,$412.67,$0.00,1,0,1,1,1,1,20161001,,,,
D8691,HCPCS,REPAIR ORTHO APPLIANCE,,,27,,NW,,,,,,$261.18,$0.00,1,0,1,1,1,1,20161001,,,,
D8692,HCPCS,REPLACEMENT RETAINER,,,27,,NW,,,,,,$406.40,$0.00,1,0,1,1,1,1,20161001,,,,
D8693,HCPCS,REBOND/RECEMENT RETAINERS,,,27,,NW,,,,,,$383.42,$0.00,1,0,1,1,1,1,20161001,,,,
D8694,HCPCS,REPAIR FIXED RETAINERS,,,27,,NW,,,,,,$401.28,$0.00,1,0,1,1,1,1,20161001,,,,
D8999,HCPCS,ORTHODONTIC PROCEDURE,,,27,,NW,,,,,,$362.52,$0.00,1,0,1,1,1,1,20161001,,,,
D9110,HCPCS,TX DENTAL PAIN MINOR PROC,,,26,,NW,,,,,,$149.68,$0.00,1,0,1,1,1,1,20161001,,,,
D9120,HCPCS,FIX PARTIAL DENTURE SECTION,,,27,,NW,,,,,,$222.22,$0.00,1,0,1,1,1,1,20161001,,,,
D9210,HCPCS,DENT ANESTHESIA W/O SURGERY,,,26,,NW,,,,,,$70.04,$0.00,1,0,1,1,1,1,20161001,,,,
D9211,HCPCS,REGIONAL BLOCK ANESTHESIA,,,26,,NW,,,,,,$83.66,$0.00,1,0,1,1,1,1,20161001,,,,
D9212,HCPCS,TRIGEMINAL BLOCK ANESTHESIA,,,26,,NW,,,,,,$193.61,$0.00,1,0,1,1,1,1,20161001,,,,
D9215,HCPCS,LOCAL ANESTHESIA,,,26,,NW,,,,,,$60.40,$0.00,1,0,1,1,1,1,20161001,,,,
D9219,HCPCS,EVAL FOR DEEP SED/GEN ANESTH,,,26,,NW,,,,,,$130.14,$0.00,1,0,1,1,1,1,20161001,,,,
D9223,HCPCS,DEEP SEDATION/GENERAL ANESTHESIA – EACH 15 MINUTE INCREMENT,,,26,,NW,,,,,,$211.21,$0.00,1,0,1,1,1,1,20161001,,,,
D9230,HCPCS,ANALGESIA,,,26,,NW,,,,,,$89.45,$0.00,1,0,1,1,1,1,20161001,,,,
D9243,HCPCS,INTRAVENOUS MODERATE (CONSCIOUS) SEDATION/ANALGESIA – EACH 15 MINUTE INCREMENT,,,26,,NW,,,,,,$192.81,$0.00,1,0,1,1,1,1,20161001,,,,
D9248,HCPCS,SEDATION (NON-IV),,,26,,NW,,,,,,$252.56,$0.00,1,0,1,1,1,1,20161001,,,,
D9310,HCPCS,DENTAL CONSULTATION,,,25,,NW,,,,,,$165.31,$0.00,1,0,1,1,1,1,20161001,,,,
D9410,HCPCS,DENTAL HOUSE CALL,,,25,,NW,,,,,,$235.04,$0.00,1,0,1,1,1,1,20161001,,,,
D9420,HCPCS,HOSPITAL/ASC CALL,,,25,,NW,,,,,,$334.03,$0.00,1,0,1,1,1,1,20161001,,,,
D9430,HCPCS,OFFICE VISIT DURING HOURS,,,25,,NW,,,,,,$94.03,$0.00,1,0,1,1,1,1,20161001,,,,
D9440,HCPCS,OFFICE VISIT AFTER HOURS,,,25,,NW,,,,,,$155.55,$0.00,1,0,1,1,1,1,20161001,,,,
D9450,HCPCS,CASE PRESENTATION TX PLAN,,,25,,NW,,,,,,$115.39,$0.00,1,0,1,1,1,1,20161001,,,,
D9610,HCPCS,DENT THERAPEUTIC DRUG INJECT,,,27,,NW,,,,,,$130.59,$0.00,1,0,1,1,1,1,20161001,,,,
D9612,HCPCS,THERA PAR DRUGS 2 OR > ADMIN,,,27,,NW,,,,,,$218.35,$0.00,1,0,1,1,1,1,20161001,,,,
D9630,HCPCS,OTHER DRUGS/MEDICAMENTS,,,27,,NW,,,,,,$59.55,$0.00,1,0,1,1,1,1,20161001,,,,
D9910,HCPCS,DENT APPL DESENSITIZING MED,,,27,,NW,,,,,,$75.10,$0.00,1,0,1,1,1,1,20161001,,,,
D9911,HCPCS,APPL DESENSITIZING RESIN,,,27,,NW,,,,,,$97.31,$0.00,1,0,1,1,1,1,20161001,,,,
D9920,HCPCS,BEHAVIOR MANAGEMENT,,,27,,NW,,,,,,$181.78,$0.00,1,0,1,1,1,1,20161001,,,,
D9930,HCPCS,TREATMENT OF COMPLICATIONS,,,27,,NW,,,,,,$152.53,$0.00,1,0,1,1,1,1,20161001,,,,
D9932,HCPCS,"CLEANING AND INSPECTION OF REMOVABLE COMPLETE DENTURE, MAXILLARY",,,27,,NW,,,,,,$164.91,$0.00,1,0,1,1,1,1,20161001,,,,
D9933,HCPCS,"CLEANING AND INSPECTION OF REMOVABLE COMPLETE DENTURE, MANDIBULAR",,,27,,NW,,,,,,$164.91,$0.00,1,0,1,1,1,1,20161001,,,,
D9934,HCPCS,"CLEANING AND INSPECTION OF REMOVABLE PARTIAL DENTURE, MAXILLARY",,,27,,NW,,,,,,$164.91,$0.00,1,0,1,1,1,1,20161001,,,,
D9935,HCPCS,"CLEANING AND INSPECTION OF REMOVABLE PARTIAL DENTURE, MANDIBULAR",,,27,,NW,,,,,,$164.91,$0.00,1,0,1,1,1,1,20161001,,,,
D9940,HCPCS,DENTAL OCCLUSAL GUARD,,,27,,NW,,,,,,$656.52,$0.00,1,0,1,1,1,1,20161001,,,,
D9941,HCPCS,FABRICATION ATHLETIC GUARD,,,27,,NW,,,,,,$275.02,$0.00,1,0,1,1,1,1,20161001,,,,
D9942,HCPCS,REPAIR/RELINE OCCLUSAL GUARD,,,27,,NW,,,,,,$275.17,$0.00,1,0,1,1,1,1,20161001,,,,
D9943,HCPCS,OCCLUSAL GUARD ADJUSTMENT,,,27,,NW,,,,,,$275.17,$0.00,1,0,1,1,1,1,20161001,,,,
D9950,HCPCS,OCCLUSION ANALYSIS,,,27,,NW,,,,,,$403.96,$0.00,1,0,1,1,1,1,20161001,,,,
D9951,HCPCS,LIMITED OCCLUSAL ADJUSTMENT,,,27,,NW,,,,,,$202.16,$0.00,1,0,1,1,1,1,20161001,,,,
D9952,HCPCS,COMPLETE OCCLUSAL ADJUSTMENT,,,27,,NW,,,,,,$812.77,$0.00,1,0,1,1,1,1,20161001,,,,
D9970,HCPCS,ENAMEL MICROABRASION,,,27,,NW,,,,,,$170.51,$0.00,1,0,1,1,1,1,20161001,,,,
D9971,HCPCS,ODONTOPLASTY 1-2 TEETH,,,27,,NW,,,,,,$163.48,$0.00,1,0,1,1,1,1,20161001,,,,
D9972,HCPCS,EXTRNL BLEACHING PER ARCH,,,27,,NW,,,,,,$401.69,$0.00,1,0,1,1,1,1,20161001,,,,
D9973,HCPCS,EXTRNL BLEACHING PER TOOTH,,,27,,NW,,,,,,$173.34,$0.00,1,0,1,1,1,1,20161001,,,,
D9974,HCPCS,INTRNL BLEACHING PER TOOTH,,,27,,NW,,,,,,$350.43,$0.00,1,0,1,1,1,1,20161001,,,,
D9975,HCPCS,EXTERNAL BLEACHING HOME APP,,,27,,NW,,,,,,$409.52,$0.00,1,0,1,1,1,1,20161001,,,,
D9999,HCPCS,ADJUNCTIVE PROCEDURE,,,27,,NW,,,,,,$165.31,$0.00,1,0,1,1,1,1,20161001,,,,
E0100,HCPCS,CANE ADJUST/FIXED WITH TIP,,,28,,NW,,,,,,$39.54,$0.00,1,1,1,1,1,1,20161001,,,,
E0100,HCPCS,CANE ADJUST/FIXED WITH TIP,NU,,28,,NW,,,,,,$39.54,$0.00,1,1,1,1,1,1,20161001,,,,
E0100,HCPCS,CANE ADJUST/FIXED WITH TIP,RR,,28,,NW,,,,,,$13.61,$0.00,1,1,1,1,1,1,20161001,,,,
E0100,HCPCS,CANE ADJUST/FIXED WITH TIP,UE,,28,,NW,,,,,,$28.10,$0.00,1,1,1,1,1,1,20161001,,,,
E0105,HCPCS,CANE ADJUST/FIXED QUAD/3 PRO,,,28,,NW,,,,,,$112.62,$0.00,1,1,1,1,1,1,20161001,,,,
E0105,HCPCS,CANE ADJUST/FIXED QUAD/3 PRO,NU,,28,,NW,,,,,,$112.62,$0.00,1,1,1,1,1,1,20161001,,,,
E0105,HCPCS,CANE ADJUST/FIXED QUAD/3 PRO,RR,,28,,NW,,,,,,$15.83,$0.00,1,1,1,1,1,1,20161001,,,,
E0105,HCPCS,CANE ADJUST/FIXED QUAD/3 PRO,UE,,28,,NW,,,,,,$82.43,$0.00,1,1,1,1,1,1,20161001,,,,
E0110,HCPCS,CRUTCH FOREARM PAIR,,,28,,NW,,,,,,$178.49,$0.00,1,1,1,1,1,1,20161001,,,,
E0110,HCPCS,CRUTCH FOREARM PAIR,NU,,28,,NW,,,,,,$178.49,$0.00,1,1,1,1,1,1,20161001,,,,
E0110,HCPCS,CRUTCH FOREARM PAIR,RR,,28,,NW,,,,,,$26.09,$0.00,1,1,1,1,1,1,20161001,,,,
E0110,HCPCS,CRUTCH FOREARM PAIR,UE,,28,,NW,,,,,,$130.50,$0.00,1,1,1,1,1,1,20161001,,,,
E0111,HCPCS,CRUTCH FOREARM EACH,,,28,,NW,,,,,,$117.82,$0.00,1,1,1,1,1,1,20161001,,,,
E0111,HCPCS,CRUTCH FOREARM EACH,NU,,28,,NW,,,,,,$117.82,$0.00,1,1,1,1,1,1,20161001,,,,
E0111,HCPCS,CRUTCH FOREARM EACH,RR,,28,,NW,,,,,,$15.44,$0.00,1,1,1,1,1,1,20161001,,,,
E0111,HCPCS,CRUTCH FOREARM EACH,UE,,28,,NW,,,,,,$87.40,$0.00,1,1,1,1,1,1,20161001,,,,
E0112,HCPCS,CRUTCH UNDERARM PAIR WOOD,,,28,,NW,,,,,,$78.51,$0.00,1,1,1,1,1,1,20161001,,,,
E0112,HCPCS,CRUTCH UNDERARM PAIR WOOD,NU,,28,,NW,,,,,,$78.51,$0.00,1,1,1,1,1,1,20161001,,,,
E0112,HCPCS,CRUTCH UNDERARM PAIR WOOD,RR,,28,,NW,,,,,,$16.58,$0.00,1,1,1,1,1,1,20161001,,,,
E0112,HCPCS,CRUTCH UNDERARM PAIR WOOD,UE,,28,,NW,,,,,,$57.13,$0.00,1,1,1,1,1,1,20161001,,,,
E0113,HCPCS,CRUTCH UNDERARM EACH WOOD,,,28,,NW,,,,,,$38.77,$0.00,1,1,1,1,1,1,20161001,,,,
E0113,HCPCS,CRUTCH UNDERARM EACH WOOD,NU,,28,,NW,,,,,,$38.77,$0.00,1,1,1,1,1,1,20161001,,,,
E0113,HCPCS,CRUTCH UNDERARM EACH WOOD,RR,,28,,NW,,,,,,$12.96,$0.00,1,1,1,1,1,1,20161001,,,,
E0113,HCPCS,CRUTCH UNDERARM EACH WOOD,UE,,28,,NW,,,,,,$25.80,$0.00,1,1,1,1,1,1,20161001,,,,
E0114,HCPCS,CRUTCH UNDERARM PAIR NO WOOD,,,28,,NW,,,,,,$102.49,$0.00,1,1,1,1,1,1,20161001,,,,
E0114,HCPCS,CRUTCH UNDERARM PAIR NO WOOD,NU,,28,,NW,,,,,,$102.49,$0.00,1,1,1,1,1,1,20161001,,,,
E0114,HCPCS,CRUTCH UNDERARM PAIR NO WOOD,RR,,28,,NW,,,,,,$15.54,$0.00,1,1,1,1,1,1,20161001,,,,
E0114,HCPCS,CRUTCH UNDERARM PAIR NO WOOD,UE,,28,,NW,,,,,,$74.10,$0.00,1,1,1,1,1,1,20161001,,,,
E0116,HCPCS,CRUTCH UNDERARM EACH NO WOOD,,,28,,NW,,,,,,$52.32,$0.00,1,1,1,1,1,1,20161001,,,,
E0116,HCPCS,CRUTCH UNDERARM EACH NO WOOD,NU,,28,,NW,,,,,,$52.32,$0.00,1,1,1,1,1,1,20161001,,,,
E0116,HCPCS,CRUTCH UNDERARM EACH NO WOOD,RR,,28,,NW,,,,,,$13.07,$0.00,1,1,1,1,1,1,20161001,,,,
E0116,HCPCS,CRUTCH UNDERARM EACH NO WOOD,UE,,28,,NW,,,,,,$36.13,$0.00,1,1,1,1,1,1,20161001,,,,
E0117,HCPCS,UNDERARM SPRINGASSIST CRUTCH,,,28,,NW,,,,,,$488.61,$0.00,1,1,1,1,1,1,20161001,,,,
E0117,HCPCS,UNDERARM SPRINGASSIST CRUTCH,NU,,28,,NW,,,,,,$488.61,$0.00,1,1,1,1,1,1,20161001,,,,
E0117,HCPCS,UNDERARM SPRINGASSIST CRUTCH,RR,,28,,NW,,,,,,$37.16,$0.00,1,1,1,1,1,1,20161001,,,,
E0117,HCPCS,UNDERARM SPRINGASSIST CRUTCH,UE,,28,,NW,,,,,,$363.19,$0.00,1,1,1,1,1,1,20161001,,,,
E0118,HCPCS,CRUTCH SUBSTITUTE,,,28,,NW,,,,,,$482.86,$0.00,1,1,1,1,1,1,20161001,,,,
E0118,HCPCS,CRUTCH SUBSTITUTE,RR,,28,,NW,,,,,,$117.12,$0.00,1,1,1,1,1,1,20161001,,,,
E0130,HCPCS,WALKER RIGID ADJUST/FIXED HT,,,28,,NW,,,,,,$139.09,$0.00,1,1,1,1,1,1,20161001,,,,
E0130,HCPCS,WALKER RIGID ADJUST/FIXED HT,NU,,28,,NW,,,,,,$139.09,$0.00,1,1,1,1,1,1,20161001,,,,
E0130,HCPCS,WALKER RIGID ADJUST/FIXED HT,RR,,28,,NW,,,,,,$22.80,$0.00,1,1,1,1,1,1,20161001,,,,
E0130,HCPCS,WALKER RIGID ADJUST/FIXED HT,UE,,28,,NW,,,,,,$105.86,$0.00,1,1,1,1,1,1,20161001,,,,
E0135,HCPCS,WALKER FOLDING ADJUST/FIXED,,,28,,NW,,,,,,$170.33,$0.00,1,1,1,1,1,1,20161001,,,,
E0135,HCPCS,WALKER FOLDING ADJUST/FIXED,NU,,28,,NW,,,,,,$170.33,$0.00,1,1,1,1,1,1,20161001,,,,
E0135,HCPCS,WALKER FOLDING ADJUST/FIXED,RR,,28,,NW,,,,,,$24.26,$0.00,1,1,1,1,1,1,20161001,,,,
E0135,HCPCS,WALKER FOLDING ADJUST/FIXED,UE,,28,,NW,,,,,,$125.60,$0.00,1,1,1,1,1,1,20161001,,,,
E0140,HCPCS,WALKER W TRUNK SUPPORT,,,28,,NW,,,,,,$798.01,$0.00,1,1,1,1,1,1,20161001,,,,
E0140,HCPCS,WALKER W TRUNK SUPPORT,NU,,28,,NW,,,,,,$798.01,$0.00,1,1,1,1,1,1,20161001,,,,
E0140,HCPCS,WALKER W TRUNK SUPPORT,RR,,28,,NW,,,,,,$68.04,$0.00,1,1,1,1,1,1,20161001,,,,
E0140,HCPCS,WALKER W TRUNK SUPPORT,UE,,28,,NW,,,,,,$595.23,$0.00,1,1,1,1,1,1,20161001,,,,
E0141,HCPCS,RIGID WHEELED WALKER ADJ/FIX,,,28,,NW,,,,,,$238.23,$0.00,1,1,1,1,1,1,20161001,,,,
E0141,HCPCS,RIGID WHEELED WALKER ADJ/FIX,NU,,28,,NW,,,,,,$238.23,$0.00,1,1,1,1,1,1,20161001,,,,
E0141,HCPCS,RIGID WHEELED WALKER ADJ/FIX,RR,,28,,NW,,,,,,$34.08,$0.00,1,1,1,1,1,1,20161001,,,,
E0141,HCPCS,RIGID WHEELED WALKER ADJ/FIX,UE,,28,,NW,,,,,,$173.57,$0.00,1,1,1,1,1,1,20161001,,,,
E0143,HCPCS,WALKER FOLDING WHEELED W/O S,,,28,,NW,,,,,,$246.51,$0.00,1,1,1,1,1,1,20161001,,,,
E0143,HCPCS,WALKER FOLDING WHEELED W/O S,NU,,28,,NW,,,,,,$246.51,$0.00,1,1,1,1,1,1,20161001,,,,
E0143,HCPCS,WALKER FOLDING WHEELED W/O S,RR,,28,,NW,,,,,,$33.15,$0.00,1,1,1,1,1,1,20161001,,,,
E0143,HCPCS,WALKER FOLDING WHEELED W/O S,UE,,28,,NW,,,,,,$178.13,$0.00,1,1,1,1,1,1,20161001,,,,
E0144,HCPCS,ENCLOSED WALKER W REAR SEAT,,,28,,NW,,,,,,$701.05,$0.00,1,1,1,1,1,1,20161001,,,,
E0144,HCPCS,ENCLOSED WALKER W REAR SEAT,NU,,28,,NW,,,,,,$701.05,$0.00,1,1,1,1,1,1,20161001,,,,
E0144,HCPCS,ENCLOSED WALKER W REAR SEAT,RR,,28,,NW,,,,,,$58.54,$0.00,1,1,1,1,1,1,20161001,,,,
E0144,HCPCS,ENCLOSED WALKER W REAR SEAT,UE,,28,,NW,,,,,,$522.51,$0.00,1,1,1,1,1,1,20161001,,,,
E0147,HCPCS,WALKER VARIABLE WHEEL RESIST,,,28,,NW,,,,,,"$1,279.43",$0.00,1,1,1,1,1,1,20161001,,,,
E0147,HCPCS,WALKER VARIABLE WHEEL RESIST,NU,,28,,NW,,,,,,"$1,279.43",$0.00,1,1,1,1,1,1,20161001,,,,
E0147,HCPCS,WALKER VARIABLE WHEEL RESIST,RR,,28,,NW,,,,,,$116.18,$0.00,1,1,1,1,1,1,20161001,,,,
E0147,HCPCS,WALKER VARIABLE WHEEL RESIST,UE,,28,,NW,,,,,,$956.34,$0.00,1,1,1,1,1,1,20161001,,,,
E0148,HCPCS,HEAVYDUTY WALKER NO WHEELS,,,28,,NW,,,,,,$272.63,$0.00,1,1,1,1,1,1,20161001,,,,
E0148,HCPCS,HEAVYDUTY WALKER NO WHEELS,NU,,28,,NW,,,,,,$272.63,$0.00,1,1,1,1,1,1,20161001,,,,
E0148,HCPCS,HEAVYDUTY WALKER NO WHEELS,RR,,28,,NW,,,,,,$17.95,$0.00,1,1,1,1,1,1,20161001,,,,
E0148,HCPCS,HEAVYDUTY WALKER NO WHEELS,UE,,28,,NW,,,,,,$201.17,$0.00,1,1,1,1,1,1,20161001,,,,
E0149,HCPCS,HEAVY DUTY WHEELED WALKER,,,28,,NW,,,,,,$488.80,$0.00,1,1,1,1,1,1,20161001,,,,
E0149,HCPCS,HEAVY DUTY WHEELED WALKER,NU,,28,,NW,,,,,,$488.80,$0.00,1,1,1,1,1,1,20161001,,,,
E0149,HCPCS,HEAVY DUTY WHEELED WALKER,RR,,28,,NW,,,,,,$37.11,$0.00,1,1,1,1,1,1,20161001,,,,
E0149,HCPCS,HEAVY DUTY WHEELED WALKER,UE,,28,,NW,,,,,,$363.31,$0.00,1,1,1,1,1,1,20161001,,,,
E0153,HCPCS,FOREARM CRUTCH PLATFORM ATTA,,,28,,NW,,,,,,$158.64,$0.00,1,1,1,1,1,1,20161001,,,,
E0153,HCPCS,FOREARM CRUTCH PLATFORM ATTA,NU,,28,,NW,,,,,,$158.64,$0.00,1,1,1,1,1,1,20161001,,,,
E0153,HCPCS,FOREARM CRUTCH PLATFORM ATTA,RR,,28,,NW,,,,,,$15.16,$0.00,1,1,1,1,1,1,20161001,,,,
E0153,HCPCS,FOREARM CRUTCH PLATFORM ATTA,UE,,28,,NW,,,,,,$115.68,$0.00,1,1,1,1,1,1,20161001,,,,
E0154,HCPCS,WALKER PLATFORM ATTACHMENT,,,28,,NW,,,,,,$138.40,$0.00,1,1,1,1,1,1,20161001,,,,
E0154,HCPCS,WALKER PLATFORM ATTACHMENT,NU,,28,,NW,,,,,,$138.40,$0.00,1,1,1,1,1,1,20161001,,,,
E0154,HCPCS,WALKER PLATFORM ATTACHMENT,RR,,28,,NW,,,,,,$14.74,$0.00,1,1,1,1,1,1,20161001,,,,
E0154,HCPCS,WALKER PLATFORM ATTACHMENT,UE,,28,,NW,,,,,,$101.68,$0.00,1,1,1,1,1,1,20161001,,,,
E0155,HCPCS,"WALKER WHEEL ATTACHMENT,PAIR",,,28,,NW,,,,,,$53.98,$0.00,1,1,1,1,1,1,20161001,,,,
E0155,HCPCS,"WALKER WHEEL ATTACHMENT,PAIR",NU,,28,,NW,,,,,,$53.98,$0.00,1,1,1,1,1,1,20161001,,,,
E0155,HCPCS,"WALKER WHEEL ATTACHMENT,PAIR",RR,,28,,NW,,,,,,$8.84,$0.00,1,1,1,1,1,1,20161001,,,,
E0155,HCPCS,"WALKER WHEEL ATTACHMENT,PAIR",UE,,28,,NW,,,,,,$37.93,$0.00,1,1,1,1,1,1,20161001,,,,
E0156,HCPCS,WALKER SEAT ATTACHMENT,,,28,,NW,,,,,,$43.03,$0.00,1,1,1,1,1,1,20161001,,,,
E0156,HCPCS,WALKER SEAT ATTACHMENT,NU,,28,,NW,,,,,,$43.03,$0.00,1,1,1,1,1,1,20161001,,,,
E0156,HCPCS,WALKER SEAT ATTACHMENT,RR,,28,,NW,,,,,,$7.53,$0.00,1,1,1,1,1,1,20161001,,,,
E0156,HCPCS,WALKER SEAT ATTACHMENT,UE,,28,,NW,,,,,,$29.04,$0.00,1,1,1,1,1,1,20161001,,,,
E0157,HCPCS,WALKER CRUTCH ATTACHMENT,,,28,,NW,,,,,,$154.49,$0.00,1,1,1,1,1,1,20161001,,,,
E0157,HCPCS,WALKER CRUTCH ATTACHMENT,NU,,28,,NW,,,,,,$154.49,$0.00,1,1,1,1,1,1,20161001,,,,
E0157,HCPCS,WALKER CRUTCH ATTACHMENT,RR,,28,,NW,,,,,,$14.79,$0.00,1,1,1,1,1,1,20161001,,,,
E0157,HCPCS,WALKER CRUTCH ATTACHMENT,UE,,28,,NW,,,,,,$112.59,$0.00,1,1,1,1,1,1,20161001,,,,
E0158,HCPCS,WALKER LEG EXTENDERS SET OF4,,,28,,NW,,,,,,$55.03,$0.00,1,1,1,1,1,1,20161001,,,,
E0158,HCPCS,WALKER LEG EXTENDERS SET OF4,NU,,28,,NW,,,,,,$55.03,$0.00,1,1,1,1,1,1,20161001,,,,
E0158,HCPCS,WALKER LEG EXTENDERS SET OF4,RR,,28,,NW,,,,,,$8.09,$0.00,1,1,1,1,1,1,20161001,,,,
E0158,HCPCS,WALKER LEG EXTENDERS SET OF4,UE,,28,,NW,,,,,,$38.31,$0.00,1,1,1,1,1,1,20161001,,,,
E0159,HCPCS,BRAKE FOR WHEELED WALKER,,,28,,NW,,,,,,$27.07,$0.00,1,1,1,1,1,1,20161001,,,,
E0159,HCPCS,BRAKE FOR WHEELED WALKER,NU,,28,,NW,,,,,,$27.07,$0.00,1,1,1,1,1,1,20161001,,,,
E0159,HCPCS,BRAKE FOR WHEELED WALKER,RR,,28,,NW,,,,,,$4.44,$0.00,1,1,1,1,1,1,20161001,,,,
E0159,HCPCS,BRAKE FOR WHEELED WALKER,UE,,28,,NW,,,,,,$18.43,$0.00,1,1,1,1,1,1,20161001,,,,
E0160,HCPCS,SITZ TYPE BATH OR EQUIPMENT,,,28,,NW,,,,,,$67.18,$0.00,1,1,1,1,1,1,20161001,,,,
E0160,HCPCS,SITZ TYPE BATH OR EQUIPMENT,NU,,28,,NW,,,,,,$67.18,$0.00,1,1,1,1,1,1,20161001,,,,
E0160,HCPCS,SITZ TYPE BATH OR EQUIPMENT,RR,,28,,NW,,,,,,$11.66,$0.00,1,1,1,1,1,1,20161001,,,,
E0160,HCPCS,SITZ TYPE BATH OR EQUIPMENT,UE,,28,,NW,,,,,,$47.65,$0.00,1,1,1,1,1,1,20161001,,,,
E0161,HCPCS,SITZ BATH/EQUIPMENT W/FAUCET,,,28,,NW,,,,,,$51.06,$0.00,1,1,1,1,1,1,20161001,,,,
E0161,HCPCS,SITZ BATH/EQUIPMENT W/FAUCET,NU,,28,,NW,,,,,,$51.06,$0.00,1,1,1,1,1,1,20161001,,,,
E0161,HCPCS,SITZ BATH/EQUIPMENT W/FAUCET,RR,,28,,NW,,,,,,$9.22,$0.00,1,1,1,1,1,1,20161001,,,,
E0161,HCPCS,SITZ BATH/EQUIPMENT W/FAUCET,UE,,28,,NW,,,,,,$34.90,$0.00,1,1,1,1,1,1,20161001,,,,
E0162,HCPCS,SITZ BATH CHAIR,,,28,,NW,,,,,,$335.86,$0.00,1,1,1,1,1,1,20161001,,,,
E0162,HCPCS,SITZ BATH CHAIR,NU,,28,,NW,,,,,,$335.86,$0.00,1,1,1,1,1,1,20161001,,,,
E0162,HCPCS,SITZ BATH CHAIR,RR,,28,,NW,,,,,,$23.48,$0.00,1,1,1,1,1,1,20161001,,,,
E0162,HCPCS,SITZ BATH CHAIR,UE,,28,,NW,,,,,,$256.15,$0.00,1,1,1,1,1,1,20161001,,,,
E0163,HCPCS,COMMODE CHAIR WITH FIXED ARM,,,28,,NW,,,,,,$267.55,$0.00,1,1,1,1,1,1,20161001,,,,
E0163,HCPCS,COMMODE CHAIR WITH FIXED ARM,NU,,28,,NW,,,,,,$267.55,$0.00,1,1,1,1,1,1,20161001,,,,
E0163,HCPCS,COMMODE CHAIR WITH FIXED ARM,RR,,28,,NW,,,,,,$48.04,$0.00,1,1,1,1,1,1,20161001,,,,
E0163,HCPCS,COMMODE CHAIR WITH FIXED ARM,UE,,28,,NW,,,,,,$198.63,$0.00,1,1,1,1,1,1,20161001,,,,
E0165,HCPCS,COMMODE CHAIR WITH DETACHARM,,,28,,NW,,,,,,$307.94,$0.00,1,1,1,1,1,1,20161001,,,,
E0165,HCPCS,COMMODE CHAIR WITH DETACHARM,RR,,28,,NW,,,,,,$32.76,$0.00,1,1,1,1,1,1,20161001,,,,
E0167,HCPCS,COMMODE CHAIR PAIL OR PAN,,,28,,NW,,,,,,$18.39,$0.00,1,1,1,1,1,1,20161001,,,,
E0167,HCPCS,COMMODE CHAIR PAIL OR PAN,NU,,28,,NW,,,,,,$18.39,$0.00,1,1,1,1,1,1,20161001,,,,
E0167,HCPCS,COMMODE CHAIR PAIL OR PAN,RR,,28,,NW,,,,,,$3.35,$0.00,1,1,1,1,1,1,20161001,,,,
E0167,HCPCS,COMMODE CHAIR PAIL OR PAN,UE,,28,,NW,,,,,,$16.15,$0.00,1,1,1,1,1,1,20161001,,,,
E0168,HCPCS,HEAVYDUTY/WIDE COMMODE CHAIR,,,28,,NW,,,,,,$380.66,$0.00,1,1,1,1,1,1,20161001,,,,
E0168,HCPCS,HEAVYDUTY/WIDE COMMODE CHAIR,NU,,28,,NW,,,,,,$380.66,$0.00,1,1,1,1,1,1,20161001,,,,
E0168,HCPCS,HEAVYDUTY/WIDE COMMODE CHAIR,RR,,28,,NW,,,,,,$26.36,$0.00,1,1,1,1,1,1,20161001,,,,
E0168,HCPCS,HEAVYDUTY/WIDE COMMODE CHAIR,UE,,28,,NW,,,,,,$282.19,$0.00,1,1,1,1,1,1,20161001,,,,
E0170,HCPCS,COMMODE CHAIR ELECTRIC,,,28,,NW,,,,,,"$3,819.01",$0.00,1,1,1,1,1,1,20161001,,,,
E0170,HCPCS,COMMODE CHAIR ELECTRIC,RR,,28,,NW,,,,,,$406.23,$0.00,1,1,1,1,1,1,20161001,,,,
E0171,HCPCS,COMMODE CHAIR NON-ELECTRIC,,,28,,NW,,,,,,$586.18,$0.00,1,1,1,1,1,1,20161001,,,,
E0171,HCPCS,COMMODE CHAIR NON-ELECTRIC,RR,,28,,NW,,,,,,$62.35,$0.00,1,1,1,1,1,1,20161001,,,,
E0172,HCPCS,SEAT LIFT MECHANISM TOILET,,,28,,NW,,,,,,$334.31,$0.00,1,1,1,1,1,1,20161001,,,,
E0175,HCPCS,COMMODE CHAIR FOOT REST,,,28,,NW,,,,,,$148.89,$0.00,1,1,1,1,1,1,20161001,,,,
E0175,HCPCS,COMMODE CHAIR FOOT REST,NU,,28,,NW,,,,,,$148.89,$0.00,1,1,1,1,1,1,20161001,,,,
E0175,HCPCS,COMMODE CHAIR FOOT REST,RR,,28,,NW,,,,,,$14.06,$0.00,1,1,1,1,1,1,20161001,,,,
E0175,HCPCS,COMMODE CHAIR FOOT REST,UE,,28,,NW,,,,,,$106.03,$0.00,1,1,1,1,1,1,20161001,,,,
E0181,HCPCS,PRESS PAD ALTERNATING W/ PUM,,,28,,NW,,,,,,$515.72,$0.00,1,1,1,1,1,1,20161001,,,,
E0181,HCPCS,PRESS PAD ALTERNATING W/ PUM,RR,,28,,NW,,,,,,$54.86,$0.00,1,1,1,1,1,1,20161001,,,,
E0182,HCPCS,"REPLACE PUMP, ALT PRESS PAD",,,28,,NW,,,,,,$471.36,$0.00,1,1,1,1,1,1,20161001,,,,
E0182,HCPCS,"REPLACE PUMP, ALT PRESS PAD",RR,,28,,NW,,,,,,$50.14,$0.00,1,1,1,1,1,1,20161001,,,,
E0184,HCPCS,DRY PRESSURE MATTRESS,,,28,,NW,,,,,,$455.28,$0.00,1,1,1,1,1,1,20161001,,,,
E0184,HCPCS,DRY PRESSURE MATTRESS,NU,,28,,NW,,,,,,$455.28,$0.00,1,1,1,1,1,1,20161001,,,,
E0184,HCPCS,DRY PRESSURE MATTRESS,RR,,28,,NW,,,,,,$49.07,$0.00,1,1,1,1,1,1,20161001,,,,
E0184,HCPCS,DRY PRESSURE MATTRESS,UE,,28,,NW,,,,,,$346.06,$0.00,1,1,1,1,1,1,20161001,,,,
E0185,HCPCS,GEL PRESSURE MATTRESS PAD,,,28,,NW,,,,,,$769.07,$0.00,1,1,1,1,1,1,20161001,,,,
E0185,HCPCS,GEL PRESSURE MATTRESS PAD,NU,,28,,NW,,,,,,$769.07,$0.00,1,1,1,1,1,1,20161001,,,,
E0185,HCPCS,GEL PRESSURE MATTRESS PAD,RR,,28,,NW,,,,,,$99.44,$0.00,1,1,1,1,1,1,20161001,,,,
E0185,HCPCS,GEL PRESSURE MATTRESS PAD,UE,,28,,NW,,,,,,$590.65,$0.00,1,1,1,1,1,1,20161001,,,,
E0186,HCPCS,AIR PRESSURE MATTRESS,,,28,,NW,,,,,,$353.85,$0.00,1,1,1,1,1,1,20161001,,,,
E0186,HCPCS,AIR PRESSURE MATTRESS,RR,,28,,NW,,,,,,$37.64,$0.00,1,1,1,1,1,1,20161001,,,,
E0187,HCPCS,WATER PRESSURE MATTRESS,,,28,,NW,,,,,,$418.79,$0.00,1,1,1,1,1,1,20161001,,,,
E0187,HCPCS,WATER PRESSURE MATTRESS,RR,,28,,NW,,,,,,$44.55,$0.00,1,1,1,1,1,1,20161001,,,,
E0188,HCPCS,SYNTHETIC SHEEPSKIN PAD,,,28,,NW,,,,,,$52.51,$0.00,1,1,1,1,1,1,20161001,,,,
E0188,HCPCS,SYNTHETIC SHEEPSKIN PAD,NU,,28,,NW,,,,,,$52.51,$0.00,1,1,1,1,1,1,20161001,,,,
E0188,HCPCS,SYNTHETIC SHEEPSKIN PAD,RR,,28,,NW,,,,,,$8.26,$0.00,1,1,1,1,1,1,20161001,,,,
E0188,HCPCS,SYNTHETIC SHEEPSKIN PAD,UE,,28,,NW,,,,,,$36.09,$0.00,1,1,1,1,1,1,20161001,,,,
E0189,HCPCS,LAMBSWOOL SHEEPSKIN PAD,,,28,,NW,,,,,,$116.33,$0.00,1,1,1,1,1,1,20161001,,,,
E0189,HCPCS,LAMBSWOOL SHEEPSKIN PAD,NU,,28,,NW,,,,,,$116.33,$0.00,1,1,1,1,1,1,20161001,,,,
E0189,HCPCS,LAMBSWOOL SHEEPSKIN PAD,RR,,28,,NW,,,,,,$13.44,$0.00,1,1,1,1,1,1,20161001,,,,
E0189,HCPCS,LAMBSWOOL SHEEPSKIN PAD,UE,,28,,NW,,,,,,$83.98,$0.00,1,1,1,1,1,1,20161001,,,,
E0190,HCPCS,POSITIONING CUSHION,,,28,,NW,,,,,,$51.40,$0.00,1,1,1,1,1,1,20161001,,,,
E0191,HCPCS,PROTECTOR HEEL OR ELBOW,,,28,,NW,,,,,,$16.56,$0.00,1,1,1,1,1,1,20161001,,,,
E0191,HCPCS,PROTECTOR HEEL OR ELBOW,NU,,28,,NW,,,,,,$16.56,$0.00,1,1,1,1,1,1,20161001,,,,
E0191,HCPCS,PROTECTOR HEEL OR ELBOW,RR,,28,,NW,,,,,,$2.65,$0.00,1,1,1,1,1,1,20161001,,,,
E0191,HCPCS,PROTECTOR HEEL OR ELBOW,UE,,28,,NW,,,,,,$14.66,$0.00,1,1,1,1,1,1,20161001,,,,
E0193,HCPCS,POWERED AIR FLOTATION BED,,,28,,NW,,,,,,"$12,216.66",$0.00,1,1,1,1,1,1,20161001,,,,
E0193,HCPCS,POWERED AIR FLOTATION BED,RR,,28,,NW,,,,,,"$1,299.49",$0.00,1,1,1,1,1,1,20161001,,,,
E0194,HCPCS,AIR FLUIDIZED BED,,,28,,NW,,,,,,"$47,775.29",$0.00,1,1,1,1,1,1,20161001,,,,
E0194,HCPCS,AIR FLUIDIZED BED,RR,,28,,NW,,,,,,"$5,081.86",$0.00,1,1,1,1,1,1,20161001,,,,
E0194,HCPCS,AIR FLUIDIZED BED,UE,,28,,NW,,,,,,"$38,703.09",$0.00,1,1,1,1,1,1,20161001,,,,
E0196,HCPCS,GEL PRESSURE MATTRESS,,,28,,NW,,,,,,$598.75,$0.00,1,1,1,1,1,1,20161001,,,,
E0196,HCPCS,GEL PRESSURE MATTRESS,RR,,28,,NW,,,,,,$63.69,$0.00,1,1,1,1,1,1,20161001,,,,
E0196,HCPCS,GEL PRESSURE MATTRESS,UE,,28,,NW,,,,,,$420.43,$0.00,1,1,1,1,1,1,20161001,,,,
E0197,HCPCS,AIR PRESSURE PAD FOR MATTRES,,,28,,NW,,,,,,$525.70,$0.00,1,1,1,1,1,1,20161001,,,,
E0197,HCPCS,AIR PRESSURE PAD FOR MATTRES,NU,,28,,NW,,,,,,$525.70,$0.00,1,1,1,1,1,1,20161001,,,,
E0197,HCPCS,AIR PRESSURE PAD FOR MATTRES,RR,,28,,NW,,,,,,$61.26,$0.00,1,1,1,1,1,1,20161001,,,,
E0197,HCPCS,AIR PRESSURE PAD FOR MATTRES,UE,,28,,NW,,,,,,$456.66,$0.00,1,1,1,1,1,1,20161001,,,,
E0198,HCPCS,WATER PRESSURE PAD FOR MATTR,,,28,,NW,,,,,,$563.19,$0.00,1,1,1,1,1,1,20161001,,,,
E0198,HCPCS,WATER PRESSURE PAD FOR MATTR,NU,,28,,NW,,,,,,$563.19,$0.00,1,1,1,1,1,1,20161001,,,,
E0198,HCPCS,WATER PRESSURE PAD FOR MATTR,RR,,28,,NW,,,,,,$41.34,$0.00,1,1,1,1,1,1,20161001,,,,
E0198,HCPCS,WATER PRESSURE PAD FOR MATTR,UE,,28,,NW,,,,,,$424.21,$0.00,1,1,1,1,1,1,20161001,,,,
E0199,HCPCS,DRY PRESSURE PAD FOR MATTRES,,,28,,NW,,,,,,$67.59,$0.00,1,1,1,1,1,1,20161001,,,,
E0199,HCPCS,DRY PRESSURE PAD FOR MATTRES,NU,,28,,NW,,,,,,$67.59,$0.00,1,1,1,1,1,1,20161001,,,,
E0199,HCPCS,DRY PRESSURE PAD FOR MATTRES,RR,,28,,NW,,,,,,$9.33,$0.00,1,1,1,1,1,1,20161001,,,,
E0199,HCPCS,DRY PRESSURE PAD FOR MATTRES,UE,,28,,NW,,,,,,$49.09,$0.00,1,1,1,1,1,1,20161001,,,,
E0200,HCPCS,HEAT LAMP WITHOUT STAND,,,28,,NW,,,,,,$185.84,$0.00,1,1,1,1,1,1,20161001,,,,
E0200,HCPCS,HEAT LAMP WITHOUT STAND,NU,,28,,NW,,,,,,$185.84,$0.00,1,1,1,1,1,1,20161001,,,,
E0200,HCPCS,HEAT LAMP WITHOUT STAND,RR,,28,,NW,,,,,,$17.54,$0.00,1,1,1,1,1,1,20161001,,,,
E0200,HCPCS,HEAT LAMP WITHOUT STAND,UE,,28,,NW,,,,,,$136.18,$0.00,1,1,1,1,1,1,20161001,,,,
E0202,HCPCS,PHOTOTHERAPY LIGHT W/ PHOTOM,,,28,,NW,,,,,,"$1,322.31",$0.00,1,1,1,1,1,1,20161001,,,,
E0202,HCPCS,PHOTOTHERAPY LIGHT W/ PHOTOM,RR,,28,,NW,,,,,,$140.65,$0.00,1,1,1,1,1,1,20161001,,,,
E0203,HCPCS,THERAPEUTIC LIGHTBOX TABLETP,,,28,,NW,,,,,,$352.20,$0.00,1,1,1,1,1,1,20161001,,,,
E0205,HCPCS,HEAT LAMP WITH STAND,,,28,,NW,,,,,,$457.50,$0.00,1,1,1,1,1,1,20161001,,,,
E0205,HCPCS,HEAT LAMP WITH STAND,NU,,28,,NW,,,,,,$457.50,$0.00,1,1,1,1,1,1,20161001,,,,
E0205,HCPCS,HEAT LAMP WITH STAND,RR,,28,,NW,,,,,,$41.00,$0.00,1,1,1,1,1,1,20161001,,,,
E0205,HCPCS,HEAT LAMP WITH STAND,UE,,28,,NW,,,,,,$339.85,$0.00,1,1,1,1,1,1,20161001,,,,
E0210,HCPCS,ELECTRIC HEAT PAD STANDARD,,,28,,NW,,,,,,$66.88,$0.00,1,1,1,1,1,1,20161001,,,,
E0210,HCPCS,ELECTRIC HEAT PAD STANDARD,NU,,28,,NW,,,,,,$66.88,$0.00,1,1,1,1,1,1,20161001,,,,
E0210,HCPCS,ELECTRIC HEAT PAD STANDARD,RR,,28,,NW,,,,,,$9.04,$0.00,1,1,1,1,1,1,20161001,,,,
E0210,HCPCS,ELECTRIC HEAT PAD STANDARD,UE,,28,,NW,,,,,,$46.83,$0.00,1,1,1,1,1,1,20161001,,,,
E0215,HCPCS,ELECTRIC HEAT PAD MOIST,,,28,,NW,,,,,,$159.69,$0.00,1,1,1,1,1,1,20161001,,,,
E0215,HCPCS,ELECTRIC HEAT PAD MOIST,NU,,28,,NW,,,,,,$159.69,$0.00,1,1,1,1,1,1,20161001,,,,
E0215,HCPCS,ELECTRIC HEAT PAD MOIST,RR,,28,,NW,,,,,,$14.95,$0.00,1,1,1,1,1,1,20161001,,,,
E0215,HCPCS,ELECTRIC HEAT PAD MOIST,UE,,28,,NW,,,,,,$116.73,$0.00,1,1,1,1,1,1,20161001,,,,
E0217,HCPCS,WATER CIRC HEAT PAD W PUMP,,,28,,NW,,,,,,"$1,198.62",$0.00,1,1,1,1,1,1,20161001,,,,
E0217,HCPCS,WATER CIRC HEAT PAD W PUMP,NU,,28,,NW,,,,,,"$1,198.62",$0.00,1,1,1,1,1,1,20161001,,,,
E0217,HCPCS,WATER CIRC HEAT PAD W PUMP,RR,,28,,NW,,,,,,$121.43,$0.00,1,1,1,1,1,1,20161001,,,,
E0217,HCPCS,WATER CIRC HEAT PAD W PUMP,UE,,28,,NW,,,,,,$895.62,$0.00,1,1,1,1,1,1,20161001,,,,
E0218,HCPCS,WATER CIRC COLD PAD W PUMP,,,28,,NW,,,,,,"$1,198.62",$0.00,1,1,1,1,1,1,20161001,,,,
E0221,HCPCS,INFRARED HEATING PAD SYSTEM,,,28,,NW,,,,,,$210.84,$0.00,1,1,1,1,1,1,20161001,,,,
E0225,HCPCS,HYDROCOLLATOR UNIT,,,28,,NW,,,,,,$933.65,$0.00,1,1,1,1,1,1,20161001,,,,
E0225,HCPCS,HYDROCOLLATOR UNIT,NU,,28,,NW,,,,,,$933.65,$0.00,1,1,1,1,1,1,20161001,,,,
E0225,HCPCS,HYDROCOLLATOR UNIT,RR,,28,,NW,,,,,,$80.04,$0.00,1,1,1,1,1,1,20161001,,,,
E0225,HCPCS,HYDROCOLLATOR UNIT,UE,,28,,NW,,,,,,$696.31,$0.00,1,1,1,1,1,1,20161001,,,,
E0231,HCPCS,WOUND WARMING DEVICE,,,28,,NW,,,,,,$479.66,$0.00,1,1,1,1,1,1,20161001,,,,
E0231,HCPCS,WOUND WARMING DEVICE,RR,,28,,NW,,,,,,$52.49,$0.00,1,1,1,1,1,1,20161001,,,,
E0232,HCPCS,WARMING CARD FOR NWT,,,28,,NW,,,,,,$151.30,$0.00,1,1,1,1,1,1,20161001,,,,
E0235,HCPCS,PARAFFIN BATH UNIT PORTABLE,,,28,,NW,,,,,,$291.04,$0.00,1,1,1,1,1,1,20161001,,,,
E0235,HCPCS,PARAFFIN BATH UNIT PORTABLE,RR,,28,,NW,,,,,,$30.96,$0.00,1,1,1,1,1,1,20161001,,,,
E0235,HCPCS,PARAFFIN BATH UNIT PORTABLE,UE,,28,,NW,,,,,,$323.64,$0.00,1,1,1,1,1,1,20161001,,,,
E0236,HCPCS,PUMP FOR WATER CIRCULATING P,,,28,,NW,,,,,,$899.24,$0.00,1,1,1,1,1,1,20161001,,,,
E0236,HCPCS,PUMP FOR WATER CIRCULATING P,RR,,28,,NW,,,,,,$95.65,$0.00,1,1,1,1,1,1,20161001,,,,
E0236,HCPCS,PUMP FOR WATER CIRCULATING P,UE,,28,,NW,,,,,,$692.35,$0.00,1,1,1,1,1,1,20161001,,,,
E0239,HCPCS,HYDROCOLLATOR UNIT PORTABLE,,,28,,NW,,,,,,"$1,110.76",$0.00,1,1,1,1,1,1,20161001,,,,
E0239,HCPCS,HYDROCOLLATOR UNIT PORTABLE,NU,,28,,NW,,,,,,"$1,110.76",$0.00,1,1,1,1,1,1,20161001,,,,
E0239,HCPCS,HYDROCOLLATOR UNIT PORTABLE,RR,,28,,NW,,,,,,$99.52,$0.00,1,1,1,1,1,1,20161001,,,,
E0239,HCPCS,HYDROCOLLATOR UNIT PORTABLE,UE,,28,,NW,,,,,,$829.82,$0.00,1,1,1,1,1,1,20161001,,,,
E0240,HCPCS,BATH/SHOWER CHAIR,,,28,,NW,,,,,,$97.51,$0.00,1,1,1,1,1,1,20161001,,,,
E0241,HCPCS,BATH TUB WALL RAIL,,,28,,NW,,,,,,$55.83,$0.00,1,1,1,1,1,1,20161001,,,,
E0242,HCPCS,BATH TUB RAIL FLOOR,,,28,,NW,,,,,,$141.71,$0.00,1,1,1,1,1,1,20161001,,,,
E0243,HCPCS,TOILET RAIL,,,28,,NW,,,,,,$110.07,$0.00,1,1,1,1,1,1,20161001,,,,
E0244,HCPCS,TOILET SEAT RAISED,,,28,,NW,,,,,,$80.69,$0.00,1,1,1,1,1,1,20161001,,,,
E0245,HCPCS,TUB STOOL OR BENCH,,,28,,NW,,,,,,$140.58,$0.00,1,1,1,1,1,1,20161001,,,,
E0246,HCPCS,TRANSFER TUB RAIL ATTACHMENT,,,28,,NW,,,,,,$197.08,$0.00,1,1,1,1,1,1,20161001,,,,
E0247,HCPCS,TRANS BENCH W/WO COMM OPEN,,,28,,NW,,,,,,$156.56,$0.00,1,1,1,1,1,1,20161001,,,,
E0248,HCPCS,HDTRANS BENCH W/WO COMM OPEN,,,28,,NW,,,,,,$187.32,$0.00,1,1,1,1,1,1,20161001,,,,
E0249,HCPCS,PAD WATER CIRCULATING HEAT U,,,28,,NW,,,,,,$230.85,$0.00,1,1,1,1,1,1,20161001,,,,
E0249,HCPCS,PAD WATER CIRCULATING HEAT U,NU,,28,,NW,,,,,,$230.85,$0.00,1,1,1,1,1,1,20161001,,,,
E0249,HCPCS,PAD WATER CIRCULATING HEAT U,RR,,28,,NW,,,,,,$17.38,$0.00,1,1,1,1,1,1,20161001,,,,
E0249,HCPCS,PAD WATER CIRCULATING HEAT U,UE,,28,,NW,,,,,,$169.86,$0.00,1,1,1,1,1,1,20161001,,,,
E0250,HCPCS,HOSP BED FIXED HT W/ MATTRES,,,28,,NW,,,,,,"$1,477.78",$0.00,1,1,1,1,1,1,20161001,,,,
E0250,HCPCS,HOSP BED FIXED HT W/ MATTRES,RR,,28,,NW,,,,,,$157.19,$0.00,1,1,1,1,1,1,20161001,,,,
E0250,HCPCS,HOSP BED FIXED HT W/ MATTRES,UE,,28,,NW,,,,,,"$1,035.53",$0.00,1,1,1,1,1,1,20161001,,,,
E0251,HCPCS,HOSP BED FIXD HT W/O MATTRES,,,28,,NW,,,,,,"$1,140.93",$0.00,1,1,1,1,1,1,20161001,,,,
E0251,HCPCS,HOSP BED FIXD HT W/O MATTRES,RR,,28,,NW,,,,,,$121.36,$0.00,1,1,1,1,1,1,20161001,,,,
E0251,HCPCS,HOSP BED FIXD HT W/O MATTRES,UE,,28,,NW,,,,,,$793.34,$0.00,1,1,1,1,1,1,20161001,,,,
E0255,HCPCS,HOSPITAL BED VAR HT W/ MATTR,,,28,,NW,,,,,,"$1,768.88",$0.00,1,1,1,1,1,1,20161001,,,,
E0255,HCPCS,HOSPITAL BED VAR HT W/ MATTR,RR,,28,,NW,,,,,,$188.16,$0.00,1,1,1,1,1,1,20161001,,,,
E0255,HCPCS,HOSPITAL BED VAR HT W/ MATTR,UE,,28,,NW,,,,,,"$1,237.81",$0.00,1,1,1,1,1,1,20161001,,,,
E0256,HCPCS,HOSPITAL BED VAR HT W/O MATT,,,28,,NW,,,,,,"$1,247.33",$0.00,1,1,1,1,1,1,20161001,,,,
E0256,HCPCS,HOSPITAL BED VAR HT W/O MATT,RR,,28,,NW,,,,,,$132.68,$0.00,1,1,1,1,1,1,20161001,,,,
E0256,HCPCS,HOSPITAL BED VAR HT W/O MATT,UE,,28,,NW,,,,,,$888.29,$0.00,1,1,1,1,1,1,20161001,,,,
E0260,HCPCS,HOSP BED SEMI-ELECTR W/ MATT,,,28,,NW,,,,,,"$2,216.79",$0.00,1,1,1,1,1,1,20161001,,,,
E0260,HCPCS,HOSP BED SEMI-ELECTR W/ MATT,RR,,28,,NW,,,,,,$235.80,$0.00,1,1,1,1,1,1,20161001,,,,
E0260,HCPCS,HOSP BED SEMI-ELECTR W/ MATT,UE,,28,,NW,,,,,,"$1,666.62",$0.00,1,1,1,1,1,1,20161001,,,,
E0261,HCPCS,HOSP BED SEMI-ELECTR W/O MAT,,,28,,NW,,,,,,"$2,025.30",$0.00,1,1,1,1,1,1,20161001,,,,
E0261,HCPCS,HOSP BED SEMI-ELECTR W/O MAT,RR,,28,,NW,,,,,,$215.43,$0.00,1,1,1,1,1,1,20161001,,,,
E0261,HCPCS,HOSP BED SEMI-ELECTR W/O MAT,UE,,28,,NW,,,,,,"$1,436.65",$0.00,1,1,1,1,1,1,20161001,,,,
E0265,HCPCS,HOSP BED TOTAL ELECTR W/ MAT,,,28,,NW,,,,,,"$2,918.09",$0.00,1,1,1,1,1,1,20161001,,,,
E0265,HCPCS,HOSP BED TOTAL ELECTR W/ MAT,RR,,28,,NW,,,,,,$310.40,$0.00,1,1,1,1,1,1,20161001,,,,
E0265,HCPCS,HOSP BED TOTAL ELECTR W/ MAT,UE,,28,,NW,,,,,,"$2,081.33",$0.00,1,1,1,1,1,1,20161001,,,,
E0266,HCPCS,HOSP BED TOTAL ELEC W/O MATT,,,28,,NW,,,,,,"$2,634.95",$0.00,1,1,1,1,1,1,20161001,,,,
E0266,HCPCS,HOSP BED TOTAL ELEC W/O MATT,RR,,28,,NW,,,,,,$280.28,$0.00,1,1,1,1,1,1,20161001,,,,
E0266,HCPCS,HOSP BED TOTAL ELEC W/O MATT,UE,,28,,NW,,,,,,"$1,852.91",$0.00,1,1,1,1,1,1,20161001,,,,
E0270,HCPCS,HOSPITAL BED INSTITUTIONAL T,,,28,,NW,,,,,,$472.66,$0.00,1,1,1,1,1,1,20161001,,,,
E0270,HCPCS,HOSPITAL BED INSTITUTIONAL T,RR,,28,,NW,,,,,,$49.79,$0.00,1,1,1,1,1,1,20161001,,,,
E0270,HCPCS,HOSPITAL BED INSTITUTIONAL T,UE,,28,,NW,,,,,,$355.27,$0.00,1,1,1,1,1,1,20161001,,,,
E0271,HCPCS,MATTRESS INNERSPRING,,,28,,NW,,,,,,$329.65,$0.00,1,1,1,1,1,1,20161001,,,,
E0271,HCPCS,MATTRESS INNERSPRING,NU,,28,,NW,,,,,,$329.65,$0.00,1,1,1,1,1,1,20161001,,,,
E0271,HCPCS,MATTRESS INNERSPRING,RR,,28,,NW,,,,,,$39.59,$0.00,1,1,1,1,1,1,20161001,,,,
E0271,HCPCS,MATTRESS INNERSPRING,UE,,28,,NW,,,,,,$262.66,$0.00,1,1,1,1,1,1,20161001,,,,
E0272,HCPCS,MATTRESS FOAM RUBBER,,,28,,NW,,,,,,$311.42,$0.00,1,1,1,1,1,1,20161001,,,,
E0272,HCPCS,MATTRESS FOAM RUBBER,NU,,28,,NW,,,,,,$311.42,$0.00,1,1,1,1,1,1,20161001,,,,
E0272,HCPCS,MATTRESS FOAM RUBBER,RR,,28,,NW,,,,,,$36.63,$0.00,1,1,1,1,1,1,20161001,,,,
E0272,HCPCS,MATTRESS FOAM RUBBER,UE,,28,,NW,,,,,,$236.93,$0.00,1,1,1,1,1,1,20161001,,,,
E0273,HCPCS,BED BOARD,,,28,,NW,,,,,,$58.54,$0.00,1,1,1,1,1,1,20161001,,,,
E0273,HCPCS,BED BOARD,RR,,28,,NW,,,,,,$24.33,$0.00,1,1,1,1,1,1,20161001,,,,
E0273,HCPCS,BED BOARD,UE,,28,,NW,,,,,,$44.95,$0.00,1,1,1,1,1,1,20161001,,,,
E0274,HCPCS,OVER-BED TABLE,,,28,,NW,,,,,,$123.89,$0.00,1,1,1,1,1,1,20161001,,,,
E0274,HCPCS,OVER-BED TABLE,RR,,28,,NW,,,,,,$40.19,$0.00,1,1,1,1,1,1,20161001,,,,
E0274,HCPCS,OVER-BED TABLE,UE,,28,,NW,,,,,,$71.12,$0.00,1,1,1,1,1,1,20161001,,,,
E0275,HCPCS,BED PAN STANDARD,,,28,,NW,,,,,,$24.86,$0.00,1,1,1,1,1,1,20161001,,,,
E0275,HCPCS,BED PAN STANDARD,NU,,28,,NW,,,,,,$24.86,$0.00,1,1,1,1,1,1,20161001,,,,
E0275,HCPCS,BED PAN STANDARD,RR,,28,,NW,,,,,,$4.27,$0.00,1,1,1,1,1,1,20161001,,,,
E0275,HCPCS,BED PAN STANDARD,UE,,28,,NW,,,,,,$17.90,$0.00,1,1,1,1,1,1,20161001,,,,
E0276,HCPCS,BED PAN FRACTURE,,,28,,NW,,,,,,$19.90,$0.00,1,1,1,1,1,1,20161001,,,,
E0276,HCPCS,BED PAN FRACTURE,NU,,28,,NW,,,,,,$19.90,$0.00,1,1,1,1,1,1,20161001,,,,
E0276,HCPCS,BED PAN FRACTURE,RR,,28,,NW,,,,,,$4.21,$0.00,1,1,1,1,1,1,20161001,,,,
E0276,HCPCS,BED PAN FRACTURE,UE,,28,,NW,,,,,,$17.14,$0.00,1,1,1,1,1,1,20161001,,,,
E0277,HCPCS,POWERED PRES-REDU AIR MATTRS,,,28,,NW,,,,,,"$9,683.03",$0.00,1,1,1,1,1,1,20161001,,,,
E0277,HCPCS,POWERED PRES-REDU AIR MATTRS,RR,,28,,NW,,,,,,"$1,029.98",$0.00,1,1,1,1,1,1,20161001,,,,
E0277,HCPCS,POWERED PRES-REDU AIR MATTRS,UE,,28,,NW,,,,,,"$7,279.85",$0.00,1,1,1,1,1,1,20161001,,,,
E0280,HCPCS,BED CRADLE,,,28,,NW,,,,,,$64.42,$0.00,1,1,1,1,1,1,20161001,,,,
E0280,HCPCS,BED CRADLE,NU,,28,,NW,,,,,,$64.42,$0.00,1,1,1,1,1,1,20161001,,,,
E0280,HCPCS,BED CRADLE,RR,,28,,NW,,,,,,$10.26,$0.00,1,1,1,1,1,1,20161001,,,,
E0280,HCPCS,BED CRADLE,UE,,28,,NW,,,,,,$49.24,$0.00,1,1,1,1,1,1,20161001,,,,
E0290,HCPCS,HOSP BED FX HT W/O RAILS W/M,,,28,,NW,,,,,,"$1,117.10",$0.00,1,1,1,1,1,1,20161001,,,,
E0290,HCPCS,HOSP BED FX HT W/O RAILS W/M,RR,,28,,NW,,,,,,$118.83,$0.00,1,1,1,1,1,1,20161001,,,,
E0290,HCPCS,HOSP BED FX HT W/O RAILS W/M,UE,,28,,NW,,,,,,$799.53,$0.00,1,1,1,1,1,1,20161001,,,,
E0291,HCPCS,HOSP BED FX HT W/O RAIL W/O,,,28,,NW,,,,,,$814.18,$0.00,1,1,1,1,1,1,20161001,,,,
E0291,HCPCS,HOSP BED FX HT W/O RAIL W/O,RR,,28,,NW,,,,,,$86.60,$0.00,1,1,1,1,1,1,20161001,,,,
E0291,HCPCS,HOSP BED FX HT W/O RAIL W/O,UE,,28,,NW,,,,,,$590.37,$0.00,1,1,1,1,1,1,20161001,,,,
E0292,HCPCS,HOSP BED VAR HT W/O RAIL W/O,,,28,,NW,,,,,,"$1,253.89",$0.00,1,1,1,1,1,1,20161001,,,,
E0292,HCPCS,HOSP BED VAR HT W/O RAIL W/O,RR,,28,,NW,,,,,,$133.38,$0.00,1,1,1,1,1,1,20161001,,,,
E0292,HCPCS,HOSP BED VAR HT W/O RAIL W/O,UE,,28,,NW,,,,,,$895.17,$0.00,1,1,1,1,1,1,20161001,,,,
E0293,HCPCS,HOSP BED VAR HT W/O RAIL W/,,,28,,NW,,,,,,"$1,075.18",$0.00,1,1,1,1,1,1,20161001,,,,
E0293,HCPCS,HOSP BED VAR HT W/O RAIL W/,RR,,28,,NW,,,,,,$114.37,$0.00,1,1,1,1,1,1,20161001,,,,
E0293,HCPCS,HOSP BED VAR HT W/O RAIL W/,UE,,28,,NW,,,,,,$766.51,$0.00,1,1,1,1,1,1,20161001,,,,
E0294,HCPCS,HOSP BED SEMI-ELECT W/ MATTR,,,28,,NW,,,,,,"$1,955.69",$0.00,1,1,1,1,1,1,20161001,,,,
E0294,HCPCS,HOSP BED SEMI-ELECT W/ MATTR,RR,,28,,NW,,,,,,$208.03,$0.00,1,1,1,1,1,1,20161001,,,,
E0294,HCPCS,HOSP BED SEMI-ELECT W/ MATTR,UE,,28,,NW,,,,,,"$1,372.66",$0.00,1,1,1,1,1,1,20161001,,,,
E0295,HCPCS,HOSP BED SEMI-ELECT W/O MATT,,,28,,NW,,,,,,"$1,898.43",$0.00,1,1,1,1,1,1,20161001,,,,
E0295,HCPCS,HOSP BED SEMI-ELECT W/O MATT,RR,,28,,NW,,,,,,$201.94,$0.00,1,1,1,1,1,1,20161001,,,,
E0295,HCPCS,HOSP BED SEMI-ELECT W/O MATT,UE,,28,,NW,,,,,,"$1,338.95",$0.00,1,1,1,1,1,1,20161001,,,,
E0296,HCPCS,HOSP BED TOTAL ELECT W/ MATT,,,28,,NW,,,,,,"$2,375.57",$0.00,1,1,1,1,1,1,20161001,,,,
E0296,HCPCS,HOSP BED TOTAL ELECT W/ MATT,RR,,28,,NW,,,,,,$252.69,$0.00,1,1,1,1,1,1,20161001,,,,
E0296,HCPCS,HOSP BED TOTAL ELECT W/ MATT,UE,,28,,NW,,,,,,"$1,715.99",$0.00,1,1,1,1,1,1,20161001,,,,
E0297,HCPCS,HOSP BED TOTAL ELECT W/O MAT,,,28,,NW,,,,,,"$2,118.26",$0.00,1,1,1,1,1,1,20161001,,,,
E0297,HCPCS,HOSP BED TOTAL ELECT W/O MAT,RR,,28,,NW,,,,,,$225.32,$0.00,1,1,1,1,1,1,20161001,,,,
E0297,HCPCS,HOSP BED TOTAL ELECT W/O MAT,UE,,28,,NW,,,,,,"$1,475.18",$0.00,1,1,1,1,1,1,20161001,,,,
E0300,HCPCS,ENCLOSED PED CRIB HOSP GRADE,,,28,,NW,,,,,,"$3,910.81",$0.00,1,1,1,1,1,1,20161001,,,,
E0300,HCPCS,ENCLOSED PED CRIB HOSP GRADE,NU,,28,,NW,,,,,,"$3,910.81",$0.00,1,1,1,1,1,1,20161001,,,,
E0300,HCPCS,ENCLOSED PED CRIB HOSP GRADE,RR,,28,,NW,,,,,,$441.33,$0.00,1,1,1,1,1,1,20161001,,,,
E0300,HCPCS,ENCLOSED PED CRIB HOSP GRADE,UE,,28,,NW,,,,,,"$2,941.37",$0.00,1,1,1,1,1,1,20161001,,,,
E0301,HCPCS,"HD HOSP BED, 350-600 LBS",,,28,,NW,,,,,,"$3,867.83",$0.00,1,1,1,1,1,1,20161001,,,,
E0301,HCPCS,"HD HOSP BED, 350-600 LBS",RR,,28,,NW,,,,,,$411.42,$0.00,1,1,1,1,1,1,20161001,,,,
E0302,HCPCS,EX HD HOSP BED > 600 LBS,,,28,,NW,,,,,,"$9,951.79",$0.00,1,1,1,1,1,1,20161001,,,,
E0302,HCPCS,EX HD HOSP BED > 600 LBS,RR,,28,,NW,,,,,,"$1,058.57",$0.00,1,1,1,1,1,1,20161001,,,,
E0303,HCPCS,HOSP BED HVY DTY XTRA WIDE,,,28,,NW,,,,,,"$4,315.57",$0.00,1,1,1,1,1,1,20161001,,,,
E0303,HCPCS,HOSP BED HVY DTY XTRA WIDE,RR,,28,,NW,,,,,,$459.05,$0.00,1,1,1,1,1,1,20161001,,,,
E0304,HCPCS,HOSP BED XTRA HVY DTY X WIDE,,,28,,NW,,,,,,"$10,695.24",$0.00,1,1,1,1,1,1,20161001,,,,
E0304,HCPCS,HOSP BED XTRA HVY DTY X WIDE,RR,,28,,NW,,,,,,"$1,137.65",$0.00,1,1,1,1,1,1,20161001,,,,
E0305,HCPCS,RAILS BED SIDE HALF LENGTH,,,28,,NW,,,,,,$294.86,$0.00,1,1,1,1,1,1,20161001,,,,
E0305,HCPCS,RAILS BED SIDE HALF LENGTH,RR,,28,,NW,,,,,,$31.36,$0.00,1,1,1,1,1,1,20161001,,,,
E0305,HCPCS,RAILS BED SIDE HALF LENGTH,UE,,28,,NW,,,,,,$213.87,$0.00,1,1,1,1,1,1,20161001,,,,
E0310,HCPCS,RAILS BED SIDE FULL LENGTH,,,28,,NW,,,,,,$299.17,$0.00,1,1,1,1,1,1,20161001,,,,
E0310,HCPCS,RAILS BED SIDE FULL LENGTH,NU,,28,,NW,,,,,,$299.17,$0.00,1,1,1,1,1,1,20161001,,,,
E0310,HCPCS,RAILS BED SIDE FULL LENGTH,RR,,28,,NW,,,,,,$39.47,$0.00,1,1,1,1,1,1,20161001,,,,
E0310,HCPCS,RAILS BED SIDE FULL LENGTH,UE,,28,,NW,,,,,,$237.06,$0.00,1,1,1,1,1,1,20161001,,,,
E0315,HCPCS,BED ACCESSORY BRD/TBL/SUPPRT,,,28,,NW,,,,,,$139.57,$0.00,1,1,1,1,1,1,20161001,,,,
E0316,HCPCS,BED SAFETY ENCLOSURE,,,28,,NW,,,,,,"$3,078.02",$0.00,1,1,1,1,1,1,20161001,,,,
E0316,HCPCS,BED SAFETY ENCLOSURE,RR,,28,,NW,,,,,,$327.41,$0.00,1,1,1,1,1,1,20161001,,,,
E0325,HCPCS,URINAL MALE JUG-TYPE,,,28,,NW,,,,,,$16.53,$0.00,1,1,1,1,1,1,20161001,,,,
E0325,HCPCS,URINAL MALE JUG-TYPE,NU,,28,,NW,,,,,,$16.53,$0.00,1,1,1,1,1,1,20161001,,,,
E0325,HCPCS,URINAL MALE JUG-TYPE,RR,,28,,NW,,,,,,$4.05,$0.00,1,1,1,1,1,1,20161001,,,,
E0325,HCPCS,URINAL MALE JUG-TYPE,UE,,28,,NW,,,,,,$14.07,$0.00,1,1,1,1,1,1,20161001,,,,
E0326,HCPCS,URINAL FEMALE JUG-TYPE,,,28,,NW,,,,,,$17.16,$0.00,1,1,1,1,1,1,20161001,,,,
E0326,HCPCS,URINAL FEMALE JUG-TYPE,NU,,28,,NW,,,,,,$17.16,$0.00,1,1,1,1,1,1,20161001,,,,
E0326,HCPCS,URINAL FEMALE JUG-TYPE,RR,,28,,NW,,,,,,$3.26,$0.00,1,1,1,1,1,1,20161001,,,,
E0326,HCPCS,URINAL FEMALE JUG-TYPE,UE,,28,,NW,,,,,,$15.13,$0.00,1,1,1,1,1,1,20161001,,,,
E0328,HCPCS,"PED HOSPITAL BED, MANUAL",,,28,,NW,,,,,,$137.06,$0.00,1,1,1,1,1,1,20161001,,,,
E0329,HCPCS,PED HOSPITAL BED SEMI/ELECT,,,28,,NW,,,,,,$573.09,$0.00,1,1,1,1,1,1,20161001,,,,
E0352,HCPCS,DISPOSABLE PACK W/BOWEL SYST,,,28,,NW,,,,,,$73.45,$0.00,1,1,1,1,1,1,20161001,,,,
E0370,HCPCS,AIR ELEVATOR FOR HEEL,,,28,,NW,,,,,,$86.77,$0.00,1,1,1,1,1,1,20161001,,,,
E0371,HCPCS,NONPOWER MATTRESS OVERLAY,,,28,,NW,,,,,,"$9,010.17",$0.00,1,1,1,1,1,1,20161001,,,,
E0371,HCPCS,NONPOWER MATTRESS OVERLAY,RR,,28,,NW,,,,,,$958.41,$0.00,1,1,1,1,1,1,20161001,,,,
E0372,HCPCS,POWERED AIR MATTRESS OVERLAY,,,28,,NW,,,,,,"$10,959.27",$0.00,1,1,1,1,1,1,20161001,,,,
E0372,HCPCS,POWERED AIR MATTRESS OVERLAY,RR,,28,,NW,,,,,,"$1,165.74",$0.00,1,1,1,1,1,1,20161001,,,,
E0373,HCPCS,NONPOWERED PRESSURE MATTRESS,,,28,,NW,,,,,,"$12,536.27",$0.00,1,1,1,1,1,1,20161001,,,,
E0373,HCPCS,NONPOWERED PRESSURE MATTRESS,RR,,28,,NW,,,,,,"$1,333.48",$0.00,1,1,1,1,1,1,20161001,,,,
E0424,HCPCS,STATIONARY COMPRESSED GAS 02,,,28,,NW,,,,,,"$5,573.76",$0.00,1,1,1,1,1,1,20161001,,,,
E0424,HCPCS,STATIONARY COMPRESSED GAS 02,RR,,28,,NW,,,,,,$592.88,$0.00,1,1,1,1,1,1,20161001,,,,
E0425,HCPCS,GAS SYSTEM STATIONARY COMPRE,,,28,,NW,,,,,,"$13,145.63",$0.00,1,1,1,1,1,1,20161001,,,,
E0425,HCPCS,GAS SYSTEM STATIONARY COMPRE,NU,,28,,NW,,,,,,"$13,145.63",$0.00,1,1,1,1,1,1,20161001,,,,
E0430,HCPCS,OXYGEN SYSTEM GAS PORTABLE,,,28,,NW,,,,,,"$5,932.88",$0.00,1,1,1,1,1,1,20161001,,,,
E0430,HCPCS,OXYGEN SYSTEM GAS PORTABLE,NU,,28,,NW,,,,,,"$5,932.88",$0.00,1,1,1,1,1,1,20161001,,,,
E0430,HCPCS,OXYGEN SYSTEM GAS PORTABLE,UE,,28,,NW,,,,,,"$4,440.20",$0.00,1,1,1,1,1,1,20161001,,,,
E0431,HCPCS,PORTABLE GASEOUS 02,,,28,,NW,,,,,,$653.83,$0.00,1,1,1,1,1,1,20161001,,,,
E0431,HCPCS,PORTABLE GASEOUS 02,RR,,28,,NW,,,,,,$69.55,$0.00,1,1,1,1,1,1,20161001,,,,
E0433,HCPCS,PORTABLE LIQUID OXYGEN SYS,,,28,,NW,,,,,,"$1,347.19",$0.00,1,1,1,1,1,1,20161001,,,,
E0433,HCPCS,PORTABLE LIQUID OXYGEN SYS,RR,,28,,NW,,,,,,$143.30,$0.00,1,1,1,1,1,1,20161001,,,,
E0434,HCPCS,PORTABLE LIQUID 02,,,28,,NW,,,,,,$653.83,$0.00,1,1,1,1,1,1,20161001,,,,
E0434,HCPCS,PORTABLE LIQUID 02,RR,,28,,NW,,,,,,$69.55,$0.00,1,1,1,1,1,1,20161001,,,,
E0435,HCPCS,OXYGEN SYSTEM LIQUID PORTABL,,,28,,NW,,,,,,"$4,067.43",$0.00,1,1,1,1,1,1,20161001,,,,
E0435,HCPCS,OXYGEN SYSTEM LIQUID PORTABL,NU,,28,,NW,,,,,,"$4,067.43",$0.00,1,1,1,1,1,1,20161001,,,,
E0435,HCPCS,OXYGEN SYSTEM LIQUID PORTABL,UE,,28,,NW,,,,,,"$3,042.32",$0.00,1,1,1,1,1,1,20161001,,,,
E0439,HCPCS,STATIONARY LIQUID 02,,,28,,NW,,,,,,"$5,573.76",$0.00,1,1,1,1,1,1,20161001,,,,
E0439,HCPCS,STATIONARY LIQUID 02,RR,,28,,NW,,,,,,$592.88,$0.00,1,1,1,1,1,1,20161001,,,,
E0440,HCPCS,OXYGEN SYSTEM LIQUID STATION,,,28,,NW,,,,,,"$8,296.43",$0.00,1,1,1,1,1,1,20161001,,,,
E0440,HCPCS,OXYGEN SYSTEM LIQUID STATION,NU,,28,,NW,,,,,,"$8,296.43",$0.00,1,1,1,1,1,1,20161001,,,,
E0440,HCPCS,OXYGEN SYSTEM LIQUID STATION,UE,,28,,NW,,,,,,"$6,212.46",$0.00,1,1,1,1,1,1,20161001,,,,
E0441,HCPCS,"STATIONARY O2 CONTENTS, GAS",,,28,,NW,,,,,,$233.09,$0.00,1,1,1,1,1,1,20161001,,,,
E0442,HCPCS,"STATIONARY O2 CONTENTS, LIQ",,,28,,NW,,,,,,$233.09,$0.00,1,1,1,1,1,1,20161001,,,,
E0443,HCPCS,"PORTABLE 02 CONTENTS, GAS",,,28,,NW,,,,,,$233.09,$0.00,1,1,1,1,1,1,20161001,,,,
E0444,HCPCS,"PORTABLE 02 CONTENTS, LIQUID",,,28,,NW,,,,,,$233.09,$0.00,1,1,1,1,1,1,20161001,,,,
E0445,HCPCS,OXIMETER NON-INVASIVE,,,28,,NW,,,,,,$260.65,$0.00,1,1,1,1,1,1,20161001,,,,
E0446,HCPCS,"TOPICAL OX DELIVER SYS, NOS",,,28,,NW,,,,,,$412.31,$0.00,1,1,1,1,1,1,20161001,,,,
E0455,HCPCS,OXYGEN TENT EXCL CROUP/PED T,,,28,,NW,,,,,,$26.08,$0.00,1,1,1,1,1,1,20161001,,,,
E0457,HCPCS,CHEST SHELL,,,28,,NW,,,,,,"$1,585.83",$0.00,1,1,1,1,1,1,20161001,,,,
E0457,HCPCS,CHEST SHELL,NU,,28,,NW,,,,,,"$1,585.83",$0.00,1,1,1,1,1,1,20161001,,,,
E0457,HCPCS,CHEST SHELL,RR,,28,,NW,,,,,,$146.23,$0.00,1,1,1,1,1,1,20161001,,,,
E0457,HCPCS,CHEST SHELL,UE,,28,,NW,,,,,,"$1,185.81",$0.00,1,1,1,1,1,1,20161001,,,,
E0459,HCPCS,CHEST WRAP,,,28,,NW,,,,,,"$1,311.24",$0.00,1,1,1,1,1,1,20161001,,,,
E0459,HCPCS,CHEST WRAP,NU,,28,,NW,,,,,,"$1,311.24",$0.00,1,1,1,1,1,1,20161001,,,,
E0459,HCPCS,CHEST WRAP,RR,,28,,NW,,,,,,$119.11,$0.00,1,1,1,1,1,1,20161001,,,,
E0459,HCPCS,CHEST WRAP,UE,,28,,NW,,,,,,$980.16,$0.00,1,1,1,1,1,1,20161001,,,,
E0462,HCPCS,ROCKING BED W/ OR W/O SIDE R,,,28,,NW,,,,,,"$4,651.13",$0.00,1,1,1,1,1,1,20161001,,,,
E0462,HCPCS,ROCKING BED W/ OR W/O SIDE R,NU,,28,,NW,,,,,,"$4,651.13",$0.00,1,1,1,1,1,1,20161001,,,,
E0462,HCPCS,ROCKING BED W/ OR W/O SIDE R,RR,,28,,NW,,,,,,$499.26,$0.00,1,1,1,1,1,1,20161001,,,,
E0462,HCPCS,ROCKING BED W/ OR W/O SIDE R,UE,,28,,NW,,,,,,"$3,496.61",$0.00,1,1,1,1,1,1,20161001,,,,
E0465,HCPCS,HOME VENT INVASIVE INTERFACE,,,28,,NW,,,,,,"$29,596.96",$0.00,1,1,1,1,1,1,20161001,,,,
E0466,HCPCS,HOME VENT NON-INVASIVE INTER,,,28,,NW,,,,,,"$25,208.66",$0.00,1,1,1,1,1,1,20161001,,,,
E0470,HCPCS,RAD W/O BACKUP NON-INV INTFC,,,28,,NW,,,,,,"$5,067.70",$0.00,1,1,1,1,1,1,20161001,,,,
E0470,HCPCS,RAD W/O BACKUP NON-INV INTFC,RR,,28,,NW,,,,,,$539.05,$0.00,1,1,1,1,1,1,20161001,,,,
E0471,HCPCS,RAD W/BACKUP NON INV INTRFC,,,28,,NW,,,,,,"$12,639.56",$0.00,1,1,1,1,1,1,20161001,,,,
E0471,HCPCS,RAD W/BACKUP NON INV INTRFC,RR,,28,,NW,,,,,,"$1,344.47",$0.00,1,1,1,1,1,1,20161001,,,,
E0472,HCPCS,RAD W BACKUP INVASIVE INTRFC,,,28,,NW,,,,,,"$12,639.56",$0.00,1,1,1,1,1,1,20161001,,,,
E0472,HCPCS,RAD W BACKUP INVASIVE INTRFC,RR,,28,,NW,,,,,,"$1,344.47",$0.00,1,1,1,1,1,1,20161001,,,,
E0480,HCPCS,PERCUSSOR ELECT/PNEUM HOME M,,,28,,NW,,,,,,"$1,130.45",$0.00,1,1,1,1,1,1,20161001,,,,
E0480,HCPCS,PERCUSSOR ELECT/PNEUM HOME M,NU,,28,,NW,,,,,,"$1,130.45",$0.00,1,1,1,1,1,1,20161001,,,,
E0480,HCPCS,PERCUSSOR ELECT/PNEUM HOME M,RR,,28,,NW,,,,,,$95.11,$0.00,1,1,1,1,1,1,20161001,,,,
E0480,HCPCS,PERCUSSOR ELECT/PNEUM HOME M,UE,,28,,NW,,,,,,$844.56,$0.00,1,1,1,1,1,1,20161001,,,,
E0481,HCPCS,INTRPULMNRY PERCUSS VENT SYS,,,28,,NW,,,,,,$590.17,$0.00,1,1,1,1,1,1,20161001,,,,
E0482,HCPCS,COUGH STIMULATING DEVICE,,,28,,NW,,,,,,"$10,125.40",$0.00,1,1,1,1,1,1,20161001,,,,
E0482,HCPCS,COUGH STIMULATING DEVICE,RR,,28,,NW,,,,,,"$1,077.04",$0.00,1,1,1,1,1,1,20161001,,,,
E0483,HCPCS,CHEST COMPRESSION GEN SYSTEM,,,28,,NW,,,,,,"$25,952.06",$0.00,1,1,1,1,1,1,20161001,,,,
E0483,HCPCS,CHEST COMPRESSION GEN SYSTEM,RR,,28,,NW,,,,,,"$2,760.52",$0.00,1,1,1,1,1,1,20161001,,,,
E0484,HCPCS,NON-ELEC OSCILLATORY PEP DVC,,,28,,NW,,,,,,$83.25,$0.00,1,1,1,1,1,1,20161001,,,,
E0484,HCPCS,NON-ELEC OSCILLATORY PEP DVC,NU,,28,,NW,,,,,,$83.25,$0.00,1,1,1,1,1,1,20161001,,,,
E0484,HCPCS,NON-ELEC OSCILLATORY PEP DVC,RR,,28,,NW,,,,,,$10.38,$0.00,1,1,1,1,1,1,20161001,,,,
E0484,HCPCS,NON-ELEC OSCILLATORY PEP DVC,UE,,28,,NW,,,,,,$59.18,$0.00,1,1,1,1,1,1,20161001,,,,
E0485,HCPCS,ORAL DEVICE/APPLIANCE PREFAB,,,28,,NW,,,,,,"$1,512.31",$0.00,1,1,1,1,1,1,20161001,,,,
E0485,HCPCS,ORAL DEVICE/APPLIANCE PREFAB,NU,,28,,NW,,,,,,"$1,512.31",$0.00,1,1,1,1,1,1,20161001,,,,
E0485,HCPCS,ORAL DEVICE/APPLIANCE PREFAB,RR,,28,,NW,,,,,,$165.51,$0.00,1,1,1,1,1,1,20161001,,,,
E0485,HCPCS,ORAL DEVICE/APPLIANCE PREFAB,UE,,28,,NW,,,,,,"$1,138.86",$0.00,1,1,1,1,1,1,20161001,,,,
E0486,HCPCS,ORAL DEVICE/APPLIANCE CUSFAB,,,28,,NW,,,,,,"$3,383.41",$0.00,1,1,1,1,1,1,20161001,,,,
E0486,HCPCS,ORAL DEVICE/APPLIANCE CUSFAB,NU,,28,,NW,,,,,,"$3,383.41",$0.00,1,1,1,1,1,1,20161001,,,,
E0486,HCPCS,ORAL DEVICE/APPLIANCE CUSFAB,RR,,28,,NW,,,,,,$376.15,$0.00,1,1,1,1,1,1,20161001,,,,
E0486,HCPCS,ORAL DEVICE/APPLIANCE CUSFAB,UE,,28,,NW,,,,,,"$2,588.30",$0.00,1,1,1,1,1,1,20161001,,,,
E0487,HCPCS,ELECTRONIC SPIROMETER,,,28,,NW,,,,,,$296.53,$0.00,1,1,1,1,1,1,20161001,,,,
E0500,HCPCS,IPPB ALL TYPES,,,28,,NW,,,,,,"$2,843.50",$0.00,1,1,1,1,1,1,20161001,,,,
E0500,HCPCS,IPPB ALL TYPES,NU,,28,,NW,,,,,,"$2,843.50",$0.00,1,1,1,1,1,1,20161001,,,,
E0500,HCPCS,IPPB ALL TYPES,RR,,28,,NW,,,,,,$264.41,$0.00,1,1,1,1,1,1,20161001,,,,
E0500,HCPCS,IPPB ALL TYPES,UE,,28,,NW,,,,,,"$2,129.35",$0.00,1,1,1,1,1,1,20161001,,,,
E0550,HCPCS,HUMIDIF EXTENS SUPPLE W IPPB,,,28,,NW,,,,,,"$1,290.90",$0.00,1,1,1,1,1,1,20161001,,,,
E0550,HCPCS,HUMIDIF EXTENS SUPPLE W IPPB,NU,,28,,NW,,,,,,"$1,290.90",$0.00,1,1,1,1,1,1,20161001,,,,
E0550,HCPCS,HUMIDIF EXTENS SUPPLE W IPPB,RR,,28,,NW,,,,,,$111.29,$0.00,1,1,1,1,1,1,20161001,,,,
E0550,HCPCS,HUMIDIF EXTENS SUPPLE W IPPB,UE,,28,,NW,,,,,,$965.47,$0.00,1,1,1,1,1,1,20161001,,,,
E0555,HCPCS,HUMIDIFIER FOR USE W/ REGULA,,,28,,NW,,,,,,$9.51,$0.00,1,1,1,1,1,1,20161001,,,,
E0555,HCPCS,HUMIDIFIER FOR USE W/ REGULA,NU,,28,,NW,,,,,,$9.51,$0.00,1,1,1,1,1,1,20161001,,,,
E0555,HCPCS,HUMIDIFIER FOR USE W/ REGULA,RR,,28,,NW,,,,,,$0.97,$0.00,1,1,1,1,1,1,20161001,,,,
E0555,HCPCS,HUMIDIFIER FOR USE W/ REGULA,UE,,28,,NW,,,,,,$8.77,$0.00,1,1,1,1,1,1,20161001,,,,
E0560,HCPCS,HUMIDIFIER SUPPLEMENTAL W/ I,,,28,,NW,,,,,,$345.52,$0.00,1,1,1,1,1,1,20161001,,,,
E0560,HCPCS,HUMIDIFIER SUPPLEMENTAL W/ I,NU,,28,,NW,,,,,,$345.52,$0.00,1,1,1,1,1,1,20161001,,,,
E0560,HCPCS,HUMIDIFIER SUPPLEMENTAL W/ I,RR,,28,,NW,,,,,,$29.93,$0.00,1,1,1,1,1,1,20161001,,,,
E0560,HCPCS,HUMIDIFIER SUPPLEMENTAL W/ I,UE,,28,,NW,,,,,,$255.86,$0.00,1,1,1,1,1,1,20161001,,,,
E0561,HCPCS,HUMIDIFIER NONHEATED W PAP,,,28,,NW,,,,,,$227.59,$0.00,1,1,1,1,1,1,20161001,,,,
E0561,HCPCS,HUMIDIFIER NONHEATED W PAP,NU,,28,,NW,,,,,,$227.59,$0.00,1,1,1,1,1,1,20161001,,,,
E0561,HCPCS,HUMIDIFIER NONHEATED W PAP,RR,,28,,NW,,,,,,$16.52,$0.00,1,1,1,1,1,1,20161001,,,,
E0561,HCPCS,HUMIDIFIER NONHEATED W PAP,UE,,28,,NW,,,,,,$167.41,$0.00,1,1,1,1,1,1,20161001,,,,
E0562,HCPCS,HUMIDIFIER HEATED USED W PAP,,,28,,NW,,,,,,$664.24,$0.00,1,1,1,1,1,1,20161001,,,,
E0562,HCPCS,HUMIDIFIER HEATED USED W PAP,NU,,28,,NW,,,,,,$664.24,$0.00,1,1,1,1,1,1,20161001,,,,
E0562,HCPCS,HUMIDIFIER HEATED USED W PAP,RR,,28,,NW,,,,,,$54.60,$0.00,1,1,1,1,1,1,20161001,,,,
E0562,HCPCS,HUMIDIFIER HEATED USED W PAP,UE,,28,,NW,,,,,,$494.89,$0.00,1,1,1,1,1,1,20161001,,,,
E0565,HCPCS,COMPRESSOR AIR POWER SOURCE,,,28,,NW,,,,,,"$1,574.53",$0.00,1,1,1,1,1,1,20161001,,,,
E0565,HCPCS,COMPRESSOR AIR POWER SOURCE,NU,,28,,NW,,,,,,"$1,574.53",$0.00,1,1,1,1,1,1,20161001,,,,
E0565,HCPCS,COMPRESSOR AIR POWER SOURCE,RR,,28,,NW,,,,,,$137.92,$0.00,1,1,1,1,1,1,20161001,,,,
E0565,HCPCS,COMPRESSOR AIR POWER SOURCE,UE,,28,,NW,,,,,,"$1,177.90",$0.00,1,1,1,1,1,1,20161001,,,,
E0570,HCPCS,NEBULIZER WITH COMPRESSION,,,28,,NW,,,,,,$271.79,$0.00,1,1,1,1,1,1,20161001,,,,
E0570,HCPCS,NEBULIZER WITH COMPRESSION,NU,,28,,NW,,,,,,$271.79,$0.00,1,1,1,1,1,1,20161001,,,,
E0570,HCPCS,NEBULIZER WITH COMPRESSION,RR,,28,,NW,,,,,,$28.91,$0.00,1,1,1,1,1,1,20161001,,,,
E0570,HCPCS,NEBULIZER WITH COMPRESSION,UE,,28,,NW,,,,,,$204.34,$0.00,1,1,1,1,1,1,20161001,,,,
E0572,HCPCS,AEROSOL COMPRESSOR ADJUST PR,,,28,,NW,,,,,,"$1,006.30",$0.00,1,1,1,1,1,1,20161001,,,,
E0572,HCPCS,AEROSOL COMPRESSOR ADJUST PR,RR,,28,,NW,,,,,,$107.04,$0.00,1,1,1,1,1,1,20161001,,,,
E0574,HCPCS,ULTRASONIC GENERATOR W SVNEB,,,28,,NW,,,,,,"$1,083.24",$0.00,1,1,1,1,1,1,20161001,,,,
E0574,HCPCS,ULTRASONIC GENERATOR W SVNEB,RR,,28,,NW,,,,,,$115.22,$0.00,1,1,1,1,1,1,20161001,,,,
E0575,HCPCS,NEBULIZER ULTRASONIC,,,28,,NW,,,,,,"$2,661.57",$0.00,1,1,1,1,1,1,20161001,,,,
E0575,HCPCS,NEBULIZER ULTRASONIC,NU,,28,,NW,,,,,,"$2,661.57",$0.00,1,1,1,1,1,1,20161001,,,,
E0575,HCPCS,NEBULIZER ULTRASONIC,RR,,28,,NW,,,,,,$245.28,$0.00,1,1,1,1,1,1,20161001,,,,
E0575,HCPCS,NEBULIZER ULTRASONIC,UE,,28,,NW,,,,,,"$1,992.62",$0.00,1,1,1,1,1,1,20161001,,,,
E0580,HCPCS,NEBULIZER FOR USE W/ REGULAT,,,28,,NW,,,,,,$288.33,$0.00,1,1,1,1,1,1,20161001,,,,
E0580,HCPCS,NEBULIZER FOR USE W/ REGULAT,NU,,28,,NW,,,,,,$288.33,$0.00,1,1,1,1,1,1,20161001,,,,
E0580,HCPCS,NEBULIZER FOR USE W/ REGULAT,RR,,28,,NW,,,,,,$18.43,$0.00,1,1,1,1,1,1,20161001,,,,
E0580,HCPCS,NEBULIZER FOR USE W/ REGULAT,UE,,28,,NW,,,,,,$212.92,$0.00,1,1,1,1,1,1,20161001,,,,
E0585,HCPCS,NEBULIZER W/ COMPRESSOR & HE,,,28,,NW,,,,,,$899.93,$0.00,1,1,1,1,1,1,20161001,,,,
E0585,HCPCS,NEBULIZER W/ COMPRESSOR & HE,NU,,28,,NW,,,,,,$899.93,$0.00,1,1,1,1,1,1,20161001,,,,
E0585,HCPCS,NEBULIZER W/ COMPRESSOR & HE,RR,,28,,NW,,,,,,$74.22,$0.00,1,1,1,1,1,1,20161001,,,,
E0585,HCPCS,NEBULIZER W/ COMPRESSOR & HE,UE,,28,,NW,,,,,,$671.67,$0.00,1,1,1,1,1,1,20161001,,,,
E0600,HCPCS,SUCTION PUMP PORTAB HOM MODL,,,28,,NW,,,,,,"$1,177.90",$0.00,1,1,1,1,1,1,20161001,,,,
E0600,HCPCS,SUCTION PUMP PORTAB HOM MODL,NU,,28,,NW,,,,,,"$1,177.90",$0.00,1,1,1,1,1,1,20161001,,,,
E0600,HCPCS,SUCTION PUMP PORTAB HOM MODL,RR,,28,,NW,,,,,,$101.16,$0.00,1,1,1,1,1,1,20161001,,,,
E0600,HCPCS,SUCTION PUMP PORTAB HOM MODL,UE,,28,,NW,,,,,,$880.72,$0.00,1,1,1,1,1,1,20161001,,,,
E0601,HCPCS,CONT AIRWAY PRESSURE DEVICE,,,28,,NW,,,,,,"$2,492.08",$0.00,1,1,1,1,1,1,20161001,,,,
E0601,HCPCS,CONT AIRWAY PRESSURE DEVICE,NU,,28,,NW,,,,,,"$2,492.08",$0.00,1,1,1,1,1,1,20161001,,,,
E0601,HCPCS,CONT AIRWAY PRESSURE DEVICE,RR,,28,,NW,,,,,,$225.52,$0.00,1,1,1,1,1,1,20161001,,,,
E0601,HCPCS,CONT AIRWAY PRESSURE DEVICE,UE,,28,,NW,,,,,,"$1,866.06",$0.00,1,1,1,1,1,1,20161001,,,,
E0602,HCPCS,MANUAL BREAST PUMP,,,28,,NW,,,,,,$63.90,$0.00,1,1,1,1,1,1,20161001,,,,
E0602,HCPCS,MANUAL BREAST PUMP,NU,,28,,NW,,,,,,$63.90,$0.00,1,1,1,1,1,1,20161001,,,,
E0602,HCPCS,MANUAL BREAST PUMP,RR,,28,,NW,,,,,,$8.35,$0.00,1,1,1,1,1,1,20161001,,,,
E0602,HCPCS,MANUAL BREAST PUMP,UE,,28,,NW,,,,,,$44.68,$0.00,1,1,1,1,1,1,20161001,,,,
E0603,HCPCS,ELECTRIC BREAST PUMP,,,28,,NW,,,,,,$206.12,$0.00,1,1,1,1,1,1,20161001,,,,
E0603,HCPCS,ELECTRIC BREAST PUMP,NU,,28,,NW,,,,,,$206.12,$0.00,1,1,1,1,1,1,20161001,,,,
E0603,HCPCS,ELECTRIC BREAST PUMP,RR,,28,,NW,,,,,,$60.35,$0.00,1,1,1,1,1,1,20161001,,,,
E0603,HCPCS,ELECTRIC BREAST PUMP,UE,,28,,NW,,,,,,$162.05,$0.00,1,1,1,1,1,1,20161001,,,,
E0604,HCPCS,HOSP GRADE ELEC BREAST PUMP,,,28,,NW,,,,,,$616.30,$0.00,1,1,1,1,1,1,20161001,,,,
E0604,HCPCS,HOSP GRADE ELEC BREAST PUMP,NU,,28,,NW,,,,,,$616.30,$0.00,1,1,1,1,1,1,20161001,,,,
E0604,HCPCS,HOSP GRADE ELEC BREAST PUMP,RR,,28,,NW,,,,,,$228.72,$0.00,1,1,1,1,1,1,20161001,,,,
E0604,HCPCS,HOSP GRADE ELEC BREAST PUMP,UE,,28,,NW,,,,,,$459.23,$0.00,1,1,1,1,1,1,20161001,,,,
E0605,HCPCS,VAPORIZER ROOM TYPE,,,28,,NW,,,,,,$55.09,$0.00,1,1,1,1,1,1,20161001,,,,
E0605,HCPCS,VAPORIZER ROOM TYPE,NU,,28,,NW,,,,,,$55.09,$0.00,1,1,1,1,1,1,20161001,,,,
E0605,HCPCS,VAPORIZER ROOM TYPE,RR,,28,,NW,,,,,,$9.02,$0.00,1,1,1,1,1,1,20161001,,,,
E0605,HCPCS,VAPORIZER ROOM TYPE,UE,,28,,NW,,,,,,$41.72,$0.00,1,1,1,1,1,1,20161001,,,,
E0606,HCPCS,DRAINAGE BOARD POSTURAL,,,28,,NW,,,,,,$583.53,$0.00,1,1,1,1,1,1,20161001,,,,
E0606,HCPCS,DRAINAGE BOARD POSTURAL,NU,,28,,NW,,,,,,$583.53,$0.00,1,1,1,1,1,1,20161001,,,,
E0606,HCPCS,DRAINAGE BOARD POSTURAL,RR,,28,,NW,,,,,,$43.08,$0.00,1,1,1,1,1,1,20161001,,,,
E0606,HCPCS,DRAINAGE BOARD POSTURAL,UE,,28,,NW,,,,,,$434.38,$0.00,1,1,1,1,1,1,20161001,,,,
E0607,HCPCS,BLOOD GLUCOSE MONITOR HOME,,,28,,NW,,,,,,$161.38,$0.00,1,1,1,1,1,1,20161001,,,,
E0607,HCPCS,BLOOD GLUCOSE MONITOR HOME,NU,,28,,NW,,,,,,$161.38,$0.00,1,1,1,1,1,1,20161001,,,,
E0607,HCPCS,BLOOD GLUCOSE MONITOR HOME,RR,,28,,NW,,,,,,$14.46,$0.00,1,1,1,1,1,1,20161001,,,,
E0607,HCPCS,BLOOD GLUCOSE MONITOR HOME,UE,,28,,NW,,,,,,$117.74,$0.00,1,1,1,1,1,1,20161001,,,,
E0610,HCPCS,PACEMAKER MONITR AUDIBLE/VIS,,,28,,NW,,,,,,$590.97,$0.00,1,1,1,1,1,1,20161001,,,,
E0610,HCPCS,PACEMAKER MONITR AUDIBLE/VIS,NU,,28,,NW,,,,,,$590.97,$0.00,1,1,1,1,1,1,20161001,,,,
E0610,HCPCS,PACEMAKER MONITR AUDIBLE/VIS,RR,,28,,NW,,,,,,$50.39,$0.00,1,1,1,1,1,1,20161001,,,,
E0610,HCPCS,PACEMAKER MONITR AUDIBLE/VIS,UE,,28,,NW,,,,,,$439.83,$0.00,1,1,1,1,1,1,20161001,,,,
E0615,HCPCS,PACEMAKER MONITR DIGITAL/VIS,,,28,,NW,,,,,,"$1,177.45",$0.00,1,1,1,1,1,1,20161001,,,,
E0615,HCPCS,PACEMAKER MONITR DIGITAL/VIS,NU,,28,,NW,,,,,,"$1,177.45",$0.00,1,1,1,1,1,1,20161001,,,,
E0615,HCPCS,PACEMAKER MONITR DIGITAL/VIS,RR,,28,,NW,,,,,,$130.46,$0.00,1,1,1,1,1,1,20161001,,,,
E0615,HCPCS,PACEMAKER MONITR DIGITAL/VIS,UE,,28,,NW,,,,,,$878.13,$0.00,1,1,1,1,1,1,20161001,,,,
E0616,HCPCS,CARDIAC EVENT RECORDER,,,28,,NW,,,,,,"$6,278.82",$0.00,1,1,1,1,1,1,20161001,,,,
E0617,HCPCS,AUTOMATIC EXT DEFIBRILLATOR,,,28,,NW,,,,,,"$15,613.86",$0.00,1,1,1,1,1,1,20161001,,,,
E0617,HCPCS,AUTOMATIC EXT DEFIBRILLATOR,RR,,28,,NW,,,,,,"$1,660.85",$0.00,1,1,1,1,1,1,20161001,,,,
E0618,HCPCS,APNEA MONITOR,,,28,,NW,,,,,,"$6,340.33",$0.00,1,1,1,1,1,1,20161001,,,,
E0618,HCPCS,APNEA MONITOR,RR,,28,,NW,,,,,,$674.42,$0.00,1,1,1,1,1,1,20161001,,,,
E0619,HCPCS,APNEA MONITOR W RECORDER,,,28,,NW,,,,,,"$6,340.33",$0.00,1,1,1,1,1,1,20161001,,,,
E0619,HCPCS,APNEA MONITOR W RECORDER,RR,,28,,NW,,,,,,$674.42,$0.00,1,1,1,1,1,1,20161001,,,,
E0620,HCPCS,CAP BLD SKIN PIERCING LASER,,,28,,NW,,,,,,"$2,261.56",$0.00,1,1,1,1,1,1,20161001,,,,
E0620,HCPCS,CAP BLD SKIN PIERCING LASER,NU,,28,,NW,,,,,,"$2,261.56",$0.00,1,1,1,1,1,1,20161001,,,,
E0620,HCPCS,CAP BLD SKIN PIERCING LASER,RR,,28,,NW,,,,,,$214.99,$0.00,1,1,1,1,1,1,20161001,,,,
E0620,HCPCS,CAP BLD SKIN PIERCING LASER,UE,,28,,NW,,,,,,"$1,693.18",$0.00,1,1,1,1,1,1,20161001,,,,
E0621,HCPCS,PATIENT LIFT SLING OR SEAT,,,28,,NW,,,,,,$219.81,$0.00,1,1,1,1,1,1,20161001,,,,
E0621,HCPCS,PATIENT LIFT SLING OR SEAT,NU,,28,,NW,,,,,,$219.81,$0.00,1,1,1,1,1,1,20161001,,,,
E0621,HCPCS,PATIENT LIFT SLING OR SEAT,RR,,28,,NW,,,,,,$16.14,$0.00,1,1,1,1,1,1,20161001,,,,
E0621,HCPCS,PATIENT LIFT SLING OR SEAT,UE,,28,,NW,,,,,,$162.42,$0.00,1,1,1,1,1,1,20161001,,,,
E0625,HCPCS,PATIENT LIFT BATHROOM OR TOI,,,28,,NW,,,,,,"$1,590.31",$0.00,1,1,1,1,1,1,20161001,,,,
E0625,HCPCS,PATIENT LIFT BATHROOM OR TOI,NU,,28,,NW,,,,,,"$1,590.31",$0.00,1,1,1,1,1,1,20161001,,,,
E0625,HCPCS,PATIENT LIFT BATHROOM OR TOI,RR,,28,,NW,,,,,,$169.16,$0.00,1,1,1,1,1,1,20161001,,,,
E0625,HCPCS,PATIENT LIFT BATHROOM OR TOI,UE,,28,,NW,,,,,,"$1,195.62",$0.00,1,1,1,1,1,1,20161001,,,,
E0627,HCPCS,SEAT LIFT INCORP LIFT-CHAIR,,,28,,NW,,,,,,$855.79,$0.00,1,1,1,1,1,1,20161001,,,,
E0627,HCPCS,SEAT LIFT INCORP LIFT-CHAIR,NU,,28,,NW,,,,,,$855.79,$0.00,1,1,1,1,1,1,20161001,,,,
E0627,HCPCS,SEAT LIFT INCORP LIFT-CHAIR,RR,,28,,NW,,,,,,$73.79,$0.00,1,1,1,1,1,1,20161001,,,,
E0627,HCPCS,SEAT LIFT INCORP LIFT-CHAIR,UE,,28,,NW,,,,,,$638.54,$0.00,1,1,1,1,1,1,20161001,,,,
E0628,HCPCS,SEAT LIFT FOR PT FURN-ELECTR,,,28,,NW,,,,,,$855.79,$0.00,1,1,1,1,1,1,20161001,,,,
E0628,HCPCS,SEAT LIFT FOR PT FURN-ELECTR,NU,,28,,NW,,,,,,$855.79,$0.00,1,1,1,1,1,1,20161001,,,,
E0628,HCPCS,SEAT LIFT FOR PT FURN-ELECTR,RR,,28,,NW,,,,,,$73.79,$0.00,1,1,1,1,1,1,20161001,,,,
E0628,HCPCS,SEAT LIFT FOR PT FURN-ELECTR,UE,,28,,NW,,,,,,$638.54,$0.00,1,1,1,1,1,1,20161001,,,,
E0629,HCPCS,SEAT LIFT FOR PT FURN-NON-EL,,,28,,NW,,,,,,$841.21,$0.00,1,1,1,1,1,1,20161001,,,,
E0629,HCPCS,SEAT LIFT FOR PT FURN-NON-EL,NU,,28,,NW,,,,,,$841.21,$0.00,1,1,1,1,1,1,20161001,,,,
E0629,HCPCS,SEAT LIFT FOR PT FURN-NON-EL,RR,,28,,NW,,,,,,$72.33,$0.00,1,1,1,1,1,1,20161001,,,,
E0629,HCPCS,SEAT LIFT FOR PT FURN-NON-EL,UE,,28,,NW,,,,,,$627.58,$0.00,1,1,1,1,1,1,20161001,,,,
E0630,HCPCS,PATIENT LIFT HYDRAULIC,,,28,,NW,,,,,,"$2,637.84",$0.00,1,1,1,1,1,1,20161001,,,,
E0630,HCPCS,PATIENT LIFT HYDRAULIC,NU,,28,,NW,,,,,,"$2,637.84",$0.00,1,1,1,1,1,1,20161001,,,,
E0630,HCPCS,PATIENT LIFT HYDRAULIC,RR,,28,,NW,,,,,,$240.38,$0.00,1,1,1,1,1,1,20161001,,,,
E0630,HCPCS,PATIENT LIFT HYDRAULIC,UE,,28,,NW,,,,,,"$1,975.67",$0.00,1,1,1,1,1,1,20161001,,,,
E0635,HCPCS,PATIENT LIFT ELECTRIC,,,28,,NW,,,,,,"$3,171.20",$0.00,1,1,1,1,1,1,20161001,,,,
E0635,HCPCS,PATIENT LIFT ELECTRIC,NU,,28,,NW,,,,,,"$3,171.20",$0.00,1,1,1,1,1,1,20161001,,,,
E0635,HCPCS,PATIENT LIFT ELECTRIC,RR,,28,,NW,,,,,,$287.11,$0.00,1,1,1,1,1,1,20161001,,,,
E0635,HCPCS,PATIENT LIFT ELECTRIC,UE,,28,,NW,,,,,,"$2,374.56",$0.00,1,1,1,1,1,1,20161001,,,,
E0636,HCPCS,PT SUPPORT & POSITIONING SYS,,,28,,NW,,,,,,"$25,741.92",$0.00,1,1,1,1,1,1,20161001,,,,
E0636,HCPCS,PT SUPPORT & POSITIONING SYS,RR,,28,,NW,,,,,,"$2,738.17",$0.00,1,1,1,1,1,1,20161001,,,,
E0637,HCPCS,COMBINATION SIT TO STAND SYS,,,28,,NW,,,,,,"$2,784.65",$0.00,1,1,1,1,1,1,20161001,,,,
E0638,HCPCS,STANDING FRAME SYS,,,28,,NW,,,,,,"$1,534.53",$0.00,1,1,1,1,1,1,20161001,,,,
E0639,HCPCS,MOVEABLE PATIENT LIFT SYSTEM,,,28,,NW,,,,,,"$2,483.95",$0.00,1,1,1,1,1,1,20161001,,,,
E0639,HCPCS,MOVEABLE PATIENT LIFT SYSTEM,RR,,28,,NW,,,,,,$264.22,$0.00,1,1,1,1,1,1,20161001,,,,
E0640,HCPCS,FIXED PATIENT LIFT SYSTEM,,,28,,NW,,,,,,"$2,483.95",$0.00,1,1,1,1,1,1,20161001,,,,
E0640,HCPCS,FIXED PATIENT LIFT SYSTEM,RR,,28,,NW,,,,,,$264.22,$0.00,1,1,1,1,1,1,20161001,,,,
E0641,HCPCS,MULTI-POSITION STND FRAM SYS,,,28,,NW,,,,,,"$1,145.25",$0.00,1,1,1,1,1,1,20161001,,,,
E0642,HCPCS,DYNAMIC STANDING FRAME,,,28,,NW,,,,,,"$2,352.24",$0.00,1,1,1,1,1,1,20161001,,,,
E0650,HCPCS,PNEUMA COMPRESOR NON-SEGMENT,,,28,,NW,,,,,,"$1,777.17",$0.00,1,1,1,1,1,1,20161001,,,,
E0650,HCPCS,PNEUMA COMPRESOR NON-SEGMENT,NU,,28,,NW,,,,,,"$1,777.17",$0.00,1,1,1,1,1,1,20161001,,,,
E0650,HCPCS,PNEUMA COMPRESOR NON-SEGMENT,RR,,28,,NW,,,,,,$207.93,$0.00,1,1,1,1,1,1,20161001,,,,
E0650,HCPCS,PNEUMA COMPRESOR NON-SEGMENT,UE,,28,,NW,,,,,,"$1,322.76",$0.00,1,1,1,1,1,1,20161001,,,,
E0651,HCPCS,PNEUM COMPRESSOR SEGMENTAL,,,28,,NW,,,,,,"$2,249.70",$0.00,1,1,1,1,1,1,20161001,,,,
E0651,HCPCS,PNEUM COMPRESSOR SEGMENTAL,NU,,28,,NW,,,,,,"$2,249.70",$0.00,1,1,1,1,1,1,20161001,,,,
E0651,HCPCS,PNEUM COMPRESSOR SEGMENTAL,RR,,28,,NW,,,,,,$220.30,$0.00,1,1,1,1,1,1,20161001,,,,
E0651,HCPCS,PNEUM COMPRESSOR SEGMENTAL,UE,,28,,NW,,,,,,"$1,684.04",$0.00,1,1,1,1,1,1,20161001,,,,
E0652,HCPCS,PNEUM COMPRES W/CAL PRESSURE,,,28,,NW,,,,,,"$13,433.13",$0.00,1,1,1,1,1,1,20161001,,,,
E0652,HCPCS,PNEUM COMPRES W/CAL PRESSURE,NU,,28,,NW,,,,,,"$13,433.13",$0.00,1,1,1,1,1,1,20161001,,,,
E0652,HCPCS,PNEUM COMPRES W/CAL PRESSURE,RR,,28,,NW,,,,,,"$1,300.42",$0.00,1,1,1,1,1,1,20161001,,,,
E0652,HCPCS,PNEUM COMPRES W/CAL PRESSURE,UE,,28,,NW,,,,,,"$9,967.20",$0.00,1,1,1,1,1,1,20161001,,,,
E0655,HCPCS,PNEUMATIC APPLIANCE HALF ARM,,,28,,NW,,,,,,$256.30,$0.00,1,1,1,1,1,1,20161001,,,,
E0655,HCPCS,PNEUMATIC APPLIANCE HALF ARM,NU,,28,,NW,,,,,,$256.30,$0.00,1,1,1,1,1,1,20161001,,,,
E0655,HCPCS,PNEUMATIC APPLIANCE HALF ARM,RR,,28,,NW,,,,,,$18.48,$0.00,1,1,1,1,1,1,20161001,,,,
E0655,HCPCS,PNEUMATIC APPLIANCE HALF ARM,UE,,28,,NW,,,,,,$190.17,$0.00,1,1,1,1,1,1,20161001,,,,
E0656,HCPCS,SEGMENTAL PNEUMATIC TRUNK,,,28,,NW,,,,,,"$1,489.78",$0.00,1,1,1,1,1,1,20161001,,,,
E0656,HCPCS,SEGMENTAL PNEUMATIC TRUNK,NU,,28,,NW,,,,,,"$1,489.78",$0.00,1,1,1,1,1,1,20161001,,,,
E0656,HCPCS,SEGMENTAL PNEUMATIC TRUNK,RR,,28,,NW,,,,,,$137.66,$0.00,1,1,1,1,1,1,20161001,,,,
E0656,HCPCS,SEGMENTAL PNEUMATIC TRUNK,UE,,28,,NW,,,,,,"$1,114.63",$0.00,1,1,1,1,1,1,20161001,,,,
E0657,HCPCS,SEGMENTAL PNEUMATIC CHEST,,,28,,NW,,,,,,"$1,399.38",$0.00,1,1,1,1,1,1,20161001,,,,
E0657,HCPCS,SEGMENTAL PNEUMATIC CHEST,NU,,28,,NW,,,,,,"$1,399.38",$0.00,1,1,1,1,1,1,20161001,,,,
E0657,HCPCS,SEGMENTAL PNEUMATIC CHEST,RR,,28,,NW,,,,,,$128.52,$0.00,1,1,1,1,1,1,20161001,,,,
E0657,HCPCS,SEGMENTAL PNEUMATIC CHEST,UE,,28,,NW,,,,,,"$1,045.70",$0.00,1,1,1,1,1,1,20161001,,,,
E0660,HCPCS,PNEUMATIC APPLIANCE FULL LEG,,,28,,NW,,,,,,$381.12,$0.00,1,1,1,1,1,1,20161001,,,,
E0660,HCPCS,PNEUMATIC APPLIANCE FULL LEG,NU,,28,,NW,,,,,,$381.12,$0.00,1,1,1,1,1,1,20161001,,,,
E0660,HCPCS,PNEUMATIC APPLIANCE FULL LEG,RR,,28,,NW,,,,,,$27.62,$0.00,1,1,1,1,1,1,20161001,,,,
E0660,HCPCS,PNEUMATIC APPLIANCE FULL LEG,UE,,28,,NW,,,,,,$281.95,$0.00,1,1,1,1,1,1,20161001,,,,
E0665,HCPCS,PNEUMATIC APPLIANCE FULL ARM,,,28,,NW,,,,,,$324.04,$0.00,1,1,1,1,1,1,20161001,,,,
E0665,HCPCS,PNEUMATIC APPLIANCE FULL ARM,NU,,28,,NW,,,,,,$324.04,$0.00,1,1,1,1,1,1,20161001,,,,
E0665,HCPCS,PNEUMATIC APPLIANCE FULL ARM,RR,,28,,NW,,,,,,$21.67,$0.00,1,1,1,1,1,1,20161001,,,,
E0665,HCPCS,PNEUMATIC APPLIANCE FULL ARM,UE,,28,,NW,,,,,,$238.02,$0.00,1,1,1,1,1,1,20161001,,,,
E0666,HCPCS,PNEUMATIC APPLIANCE HALF LEG,,,28,,NW,,,,,,$328.32,$0.00,1,1,1,1,1,1,20161001,,,,
E0666,HCPCS,PNEUMATIC APPLIANCE HALF LEG,NU,,28,,NW,,,,,,$328.32,$0.00,1,1,1,1,1,1,20161001,,,,
E0666,HCPCS,PNEUMATIC APPLIANCE HALF LEG,RR,,28,,NW,,,,,,$22.13,$0.00,1,1,1,1,1,1,20161001,,,,
E0666,HCPCS,PNEUMATIC APPLIANCE HALF LEG,UE,,28,,NW,,,,,,$243.53,$0.00,1,1,1,1,1,1,20161001,,,,
E0667,HCPCS,SEG PNEUMATIC APPL FULL LEG,,,28,,NW,,,,,,$815.62,$0.00,1,1,1,1,1,1,20161001,,,,
E0667,HCPCS,SEG PNEUMATIC APPL FULL LEG,NU,,28,,NW,,,,,,$815.62,$0.00,1,1,1,1,1,1,20161001,,,,
E0667,HCPCS,SEG PNEUMATIC APPL FULL LEG,RR,,28,,NW,,,,,,$79.03,$0.00,1,1,1,1,1,1,20161001,,,,
E0667,HCPCS,SEG PNEUMATIC APPL FULL LEG,UE,,28,,NW,,,,,,$608.45,$0.00,1,1,1,1,1,1,20161001,,,,
E0668,HCPCS,SEG PNEUMATIC APPL FULL ARM,,,28,,NW,,,,,,"$1,078.22",$0.00,1,1,1,1,1,1,20161001,,,,
E0668,HCPCS,SEG PNEUMATIC APPL FULL ARM,NU,,28,,NW,,,,,,"$1,078.22",$0.00,1,1,1,1,1,1,20161001,,,,
E0668,HCPCS,SEG PNEUMATIC APPL FULL ARM,RR,,28,,NW,,,,,,$94.62,$0.00,1,1,1,1,1,1,20161001,,,,
E0668,HCPCS,SEG PNEUMATIC APPL FULL ARM,UE,,28,,NW,,,,,,$805.43,$0.00,1,1,1,1,1,1,20161001,,,,
E0669,HCPCS,SEG PNEUMATIC APPLI HALF LEG,,,28,,NW,,,,,,$455.26,$0.00,1,1,1,1,1,1,20161001,,,,
E0669,HCPCS,SEG PNEUMATIC APPLI HALF LEG,NU,,28,,NW,,,,,,$455.26,$0.00,1,1,1,1,1,1,20161001,,,,
E0669,HCPCS,SEG PNEUMATIC APPLI HALF LEG,RR,,28,,NW,,,,,,$33.76,$0.00,1,1,1,1,1,1,20161001,,,,
E0669,HCPCS,SEG PNEUMATIC APPLI HALF LEG,UE,,28,,NW,,,,,,$338.21,$0.00,1,1,1,1,1,1,20161001,,,,
E0670,HCPCS,SEG PNEUM INT LEGS/TRUNK,,,28,,NW,,,,,,"$3,185.04",$0.00,1,1,1,1,1,1,20161001,,,,
E0670,HCPCS,SEG PNEUM INT LEGS/TRUNK,NU,,28,,NW,,,,,,"$3,185.04",$0.00,1,1,1,1,1,1,20161001,,,,
E0670,HCPCS,SEG PNEUM INT LEGS/TRUNK,RR,,28,,NW,,,,,,$326.86,$0.00,1,1,1,1,1,1,20161001,,,,
E0670,HCPCS,SEG PNEUM INT LEGS/TRUNK,UE,,28,,NW,,,,,,"$2,385.44",$0.00,1,1,1,1,1,1,20161001,,,,
E0671,HCPCS,PRESSURE PNEUM APPL FULL LEG,,,28,,NW,,,,,,"$1,070.93",$0.00,1,1,1,1,1,1,20161001,,,,
E0671,HCPCS,PRESSURE PNEUM APPL FULL LEG,NU,,28,,NW,,,,,,"$1,070.93",$0.00,1,1,1,1,1,1,20161001,,,,
E0671,HCPCS,PRESSURE PNEUM APPL FULL LEG,RR,,28,,NW,,,,,,$95.35,$0.00,1,1,1,1,1,1,20161001,,,,
E0671,HCPCS,PRESSURE PNEUM APPL FULL LEG,UE,,28,,NW,,,,,,$799.88,$0.00,1,1,1,1,1,1,20161001,,,,
E0672,HCPCS,PRESSURE PNEUM APPL FULL ARM,,,28,,NW,,,,,,$829.16,$0.00,1,1,1,1,1,1,20161001,,,,
E0672,HCPCS,PRESSURE PNEUM APPL FULL ARM,NU,,28,,NW,,,,,,$829.16,$0.00,1,1,1,1,1,1,20161001,,,,
E0672,HCPCS,PRESSURE PNEUM APPL FULL ARM,RR,,28,,NW,,,,,,$71.15,$0.00,1,1,1,1,1,1,20161001,,,,
E0672,HCPCS,PRESSURE PNEUM APPL FULL ARM,UE,,28,,NW,,,,,,$618.64,$0.00,1,1,1,1,1,1,20161001,,,,
E0673,HCPCS,PRESSURE PNEUM APPL HALF LEG,,,28,,NW,,,,,,$686.78,$0.00,1,1,1,1,1,1,20161001,,,,
E0673,HCPCS,PRESSURE PNEUM APPL HALF LEG,NU,,28,,NW,,,,,,$686.78,$0.00,1,1,1,1,1,1,20161001,,,,
E0673,HCPCS,PRESSURE PNEUM APPL HALF LEG,RR,,28,,NW,,,,,,$56.90,$0.00,1,1,1,1,1,1,20161001,,,,
E0673,HCPCS,PRESSURE PNEUM APPL HALF LEG,UE,,28,,NW,,,,,,$511.89,$0.00,1,1,1,1,1,1,20161001,,,,
E0675,HCPCS,PNEUMATIC COMPRESSION DEVICE,,,28,,NW,,,,,,"$9,308.63",$0.00,1,1,1,1,1,1,20161001,,,,
E0675,HCPCS,PNEUMATIC COMPRESSION DEVICE,RR,,28,,NW,,,,,,$990.16,$0.00,1,1,1,1,1,1,20161001,,,,
E0676,HCPCS,INTER LIMB COMPRESS DEV NOS,,,28,,NW,,,,,,$143.16,$0.00,1,1,1,1,1,1,20161001,,,,
E0691,HCPCS,UVL PNL 2 SQ FT OR LESS,,,28,,NW,,,,,,"$2,331.25",$0.00,1,1,1,1,1,1,20161001,,,,
E0691,HCPCS,UVL PNL 2 SQ FT OR LESS,NU,,28,,NW,,,,,,"$2,331.25",$0.00,1,1,1,1,1,1,20161001,,,,
E0691,HCPCS,UVL PNL 2 SQ FT OR LESS,RR,,28,,NW,,,,,,$221.32,$0.00,1,1,1,1,1,1,20161001,,,,
E0691,HCPCS,UVL PNL 2 SQ FT OR LESS,UE,,28,,NW,,,,,,"$1,745.16",$0.00,1,1,1,1,1,1,20161001,,,,
E0692,HCPCS,UVL SYS PANEL 4 FT,,,28,,NW,,,,,,"$2,930.77",$0.00,1,1,1,1,1,1,20161001,,,,
E0692,HCPCS,UVL SYS PANEL 4 FT,NU,,28,,NW,,,,,,"$2,930.77",$0.00,1,1,1,1,1,1,20161001,,,,
E0692,HCPCS,UVL SYS PANEL 4 FT,RR,,28,,NW,,,,,,$281.19,$0.00,1,1,1,1,1,1,20161001,,,,
E0692,HCPCS,UVL SYS PANEL 4 FT,UE,,28,,NW,,,,,,"$2,194.78",$0.00,1,1,1,1,1,1,20161001,,,,
E0693,HCPCS,UVL SYS PANEL 6 FT,,,28,,NW,,,,,,"$3,615.87",$0.00,1,1,1,1,1,1,20161001,,,,
E0693,HCPCS,UVL SYS PANEL 6 FT,NU,,28,,NW,,,,,,"$3,615.87",$0.00,1,1,1,1,1,1,20161001,,,,
E0693,HCPCS,UVL SYS PANEL 6 FT,RR,,28,,NW,,,,,,$349.82,$0.00,1,1,1,1,1,1,20161001,,,,
E0693,HCPCS,UVL SYS PANEL 6 FT,UE,,28,,NW,,,,,,"$2,708.60",$0.00,1,1,1,1,1,1,20161001,,,,
E0694,HCPCS,UVL MD CABINET SYS 6 FT,,,28,,NW,,,,,,"$11,537.48",$0.00,1,1,1,1,1,1,20161001,,,,
E0694,HCPCS,UVL MD CABINET SYS 6 FT,NU,,28,,NW,,,,,,"$11,537.48",$0.00,1,1,1,1,1,1,20161001,,,,
E0694,HCPCS,UVL MD CABINET SYS 6 FT,RR,,28,,NW,,,,,,"$1,141.95",$0.00,1,1,1,1,1,1,20161001,,,,
E0694,HCPCS,UVL MD CABINET SYS 6 FT,UE,,28,,NW,,,,,,"$8,649.88",$0.00,1,1,1,1,1,1,20161001,,,,
E0700,HCPCS,SAFETY EQUIPMENT,,,28,,NW,,,,,,$49.07,$0.00,1,1,1,1,1,1,20161001,,,,
E0705,HCPCS,TRANSFER DEVICE,,,28,,NW,,,,,,$120.92,$0.00,1,1,1,1,1,1,20161001,,,,
E0705,HCPCS,TRANSFER DEVICE,NU,,28,,NW,,,,,,$120.92,$0.00,1,1,1,1,1,1,20161001,,,,
E0705,HCPCS,TRANSFER DEVICE,RR,,28,,NW,,,,,,$13.27,$0.00,1,1,1,1,1,1,20161001,,,,
E0705,HCPCS,TRANSFER DEVICE,UE,,28,,NW,,,,,,$85.57,$0.00,1,1,1,1,1,1,20161001,,,,
E0710,HCPCS,RESTRAINTS ANY TYPE,,,28,,NW,,,,,,$87.70,$0.00,1,1,1,1,1,1,20161001,,,,
E0720,HCPCS,TENS TWO LEAD,,,28,,NW,,,,,,$892.36,$0.00,1,1,1,1,1,1,20161001,,,,
E0720,HCPCS,TENS TWO LEAD,NU,,28,,NW,,,,,,$892.36,$0.00,1,1,1,1,1,1,20161001,,,,
E0720,HCPCS,TENS TWO LEAD,RR,,28,,NW,,,,,,$82.95,$0.00,1,1,1,1,1,1,20161001,,,,
E0720,HCPCS,TENS TWO LEAD,UE,,28,,NW,,,,,,$704.44,$0.00,1,1,1,1,1,1,20161001,,,,
E0730,HCPCS,TENS FOUR LEAD,,,28,,NW,,,,,,$908.75,$0.00,1,1,1,1,1,1,20161001,,,,
E0730,HCPCS,TENS FOUR LEAD,NU,,28,,NW,,,,,,$908.75,$0.00,1,1,1,1,1,1,20161001,,,,
E0730,HCPCS,TENS FOUR LEAD,RR,,28,,NW,,,,,,$82.95,$0.00,1,1,1,1,1,1,20161001,,,,
E0730,HCPCS,TENS FOUR LEAD,UE,,28,,NW,,,,,,$710.09,$0.00,1,1,1,1,1,1,20161001,,,,
E0731,HCPCS,CONDUCTIVE GARMENT FOR TENS/,,,28,,NW,,,,,,$862.11,$0.00,1,1,1,1,1,1,20161001,,,,
E0731,HCPCS,CONDUCTIVE GARMENT FOR TENS/,NU,,28,,NW,,,,,,$862.11,$0.00,1,1,1,1,1,1,20161001,,,,
E0731,HCPCS,CONDUCTIVE GARMENT FOR TENS/,RR,,28,,NW,,,,,,$91.70,$0.00,1,1,1,1,1,1,20161001,,,,
E0740,HCPCS,INCONTINENCE TREATMENT SYSTM,,,28,,NW,,,,,,"$1,347.40",$0.00,1,1,1,1,1,1,20161001,,,,
E0740,HCPCS,INCONTINENCE TREATMENT SYSTM,NU,,28,,NW,,,,,,"$1,347.40",$0.00,1,1,1,1,1,1,20161001,,,,
E0740,HCPCS,INCONTINENCE TREATMENT SYSTM,RR,,28,,NW,,,,,,$123.35,$0.00,1,1,1,1,1,1,20161001,,,,
E0740,HCPCS,INCONTINENCE TREATMENT SYSTM,UE,,28,,NW,,,,,,"$1,007.28",$0.00,1,1,1,1,1,1,20161001,,,,
E0744,HCPCS,NEUROMUSCULAR STIM FOR SCOLI,,,28,,NW,,,,,,"$2,370.04",$0.00,1,1,1,1,1,1,20161001,,,,
E0744,HCPCS,NEUROMUSCULAR STIM FOR SCOLI,NU,,28,,NW,,,,,,"$2,370.04",$0.00,1,1,1,1,1,1,20161001,,,,
E0744,HCPCS,NEUROMUSCULAR STIM FOR SCOLI,RR,,28,,NW,,,,,,$211.52,$0.00,1,1,1,1,1,1,20161001,,,,
E0744,HCPCS,NEUROMUSCULAR STIM FOR SCOLI,UE,,28,,NW,,,,,,"$1,773.41",$0.00,1,1,1,1,1,1,20161001,,,,
E0745,HCPCS,NEUROMUSCULAR STIM FOR SHOCK,,,28,,NW,,,,,,"$2,315.80",$0.00,1,1,1,1,1,1,20161001,,,,
E0745,HCPCS,NEUROMUSCULAR STIM FOR SHOCK,NU,,28,,NW,,,,,,"$2,315.80",$0.00,1,1,1,1,1,1,20161001,,,,
E0745,HCPCS,NEUROMUSCULAR STIM FOR SHOCK,RR,,28,,NW,,,,,,$208.57,$0.00,1,1,1,1,1,1,20161001,,,,
E0745,HCPCS,NEUROMUSCULAR STIM FOR SHOCK,UE,,28,,NW,,,,,,"$1,733.86",$0.00,1,1,1,1,1,1,20161001,,,,
E0746,HCPCS,ELECTROMYOGRAPH BIOFEEDBACK,,,28,,NW,,,,,,$225.21,$0.00,1,1,1,1,1,1,20161001,,,,
E0746,HCPCS,ELECTROMYOGRAPH BIOFEEDBACK,NU,,28,,NW,,,,,,$225.21,$0.00,1,1,1,1,1,1,20161001,,,,
E0746,HCPCS,ELECTROMYOGRAPH BIOFEEDBACK,RR,,28,,NW,,,,,,$24.65,$0.00,1,1,1,1,1,1,20161001,,,,
E0746,HCPCS,ELECTROMYOGRAPH BIOFEEDBACK,UE,,28,,NW,,,,,,$169.58,$0.00,1,1,1,1,1,1,20161001,,,,
E0747,HCPCS,ELEC OSTEOGEN STIM NOT SPINE,,,28,,NW,,,,,,"$9,718.66",$0.00,1,1,1,1,1,1,20161001,,,,
E0747,HCPCS,ELEC OSTEOGEN STIM NOT SPINE,NU,,28,,NW,,,,,,"$9,718.66",$0.00,1,1,1,1,1,1,20161001,,,,
E0747,HCPCS,ELEC OSTEOGEN STIM NOT SPINE,RR,,28,,NW,,,,,,$957.28,$0.00,1,1,1,1,1,1,20161001,,,,
E0747,HCPCS,ELEC OSTEOGEN STIM NOT SPINE,UE,,28,,NW,,,,,,"$7,231.74",$0.00,1,1,1,1,1,1,20161001,,,,
E0748,HCPCS,ELEC OSTEOGEN STIM SPINAL,,,28,,NW,,,,,,"$10,141.20",$0.00,1,1,1,1,1,1,20161001,,,,
E0748,HCPCS,ELEC OSTEOGEN STIM SPINAL,NU,,28,,NW,,,,,,"$10,141.20",$0.00,1,1,1,1,1,1,20161001,,,,
E0748,HCPCS,ELEC OSTEOGEN STIM SPINAL,RR,,28,,NW,,,,,,"$1,002.29",$0.00,1,1,1,1,1,1,20161001,,,,
E0748,HCPCS,ELEC OSTEOGEN STIM SPINAL,UE,,28,,NW,,,,,,"$7,602.65",$0.00,1,1,1,1,1,1,20161001,,,,
E0749,HCPCS,ELEC OSTEOGEN STIM IMPLANTED,,,28,,NW,,,,,,"$6,449.35",$0.00,1,1,1,1,1,1,20161001,,,,
E0749,HCPCS,ELEC OSTEOGEN STIM IMPLANTED,RR,,28,,NW,,,,,,$686.02,$0.00,1,1,1,1,1,1,20161001,,,,
E0760,HCPCS,OSTEOGEN ULTRASOUND STIMLTOR,,,28,,NW,,,,,,"$8,421.81",$0.00,1,1,1,1,1,1,20161001,,,,
E0760,HCPCS,OSTEOGEN ULTRASOUND STIMLTOR,NU,,28,,NW,,,,,,"$8,421.81",$0.00,1,1,1,1,1,1,20161001,,,,
E0760,HCPCS,OSTEOGEN ULTRASOUND STIMLTOR,RR,,28,,NW,,,,,,$830.42,$0.00,1,1,1,1,1,1,20161001,,,,
E0760,HCPCS,OSTEOGEN ULTRASOUND STIMLTOR,UE,,28,,NW,,,,,,"$6,313.05",$0.00,1,1,1,1,1,1,20161001,,,,
E0762,HCPCS,TRANS ELEC JT STIM DEV SYS,,,28,,NW,,,,,,"$2,848.02",$0.00,1,1,1,1,1,1,20161001,,,,
E0762,HCPCS,TRANS ELEC JT STIM DEV SYS,NU,,28,,NW,,,,,,"$2,848.02",$0.00,1,1,1,1,1,1,20161001,,,,
E0762,HCPCS,TRANS ELEC JT STIM DEV SYS,RR,,28,,NW,,,,,,$255.71,$0.00,1,1,1,1,1,1,20161001,,,,
E0762,HCPCS,TRANS ELEC JT STIM DEV SYS,UE,,28,,NW,,,,,,"$2,132.74",$0.00,1,1,1,1,1,1,20161001,,,,
E0764,HCPCS,FUNCTIONAL NEUROMUSCULARSTIM,,,28,,NW,,,,,,"$28,782.27",$0.00,1,1,1,1,1,1,20161001,,,,
E0764,HCPCS,FUNCTIONAL NEUROMUSCULARSTIM,NU,,28,,NW,,,,,,"$28,782.27",$0.00,1,1,1,1,1,1,20161001,,,,
E0764,HCPCS,FUNCTIONAL NEUROMUSCULARSTIM,RR,,28,,NW,,,,,,"$2,874.10",$0.00,1,1,1,1,1,1,20161001,,,,
E0764,HCPCS,FUNCTIONAL NEUROMUSCULARSTIM,UE,,28,,NW,,,,,,"$21,583.14",$0.00,1,1,1,1,1,1,20161001,,,,
E0765,HCPCS,NERVE STIMULATOR FOR TX N&V,,,28,,NW,,,,,,$206.39,$0.00,1,1,1,1,1,1,20161001,,,,
E0765,HCPCS,NERVE STIMULATOR FOR TX N&V,NU,,28,,NW,,,,,,$206.39,$0.00,1,1,1,1,1,1,20161001,,,,
E0765,HCPCS,NERVE STIMULATOR FOR TX N&V,RR,,28,,NW,,,,,,$15.88,$0.00,1,1,1,1,1,1,20161001,,,,
E0765,HCPCS,NERVE STIMULATOR FOR TX N&V,UE,,28,,NW,,,,,,$151.58,$0.00,1,1,1,1,1,1,20161001,,,,
E0766,HCPCS,ELEC STIM CANCER TREATMENT,,,28,,NW,,,,,,$302.79,$0.00,1,1,1,1,1,1,20161001,,,,
E0769,HCPCS,ELECTRIC WOUND TREATMENT DEV,,,28,,NW,,,,,,$299.21,$0.00,1,1,1,1,1,1,20161001,,,,
E0770,HCPCS,FUNCTIONAL ELECTRIC STIM NOS,,,28,,NW,,,,,,$299.21,$0.00,1,1,1,1,1,1,20161001,,,,
E0776,HCPCS,IV POLE,,,28,,NW,,,,,,$335.39,$0.00,1,1,1,1,1,1,20161001,,,,
E0776,HCPCS,IV POLE,NU,,28,,NW,,,,,,$335.39,$0.00,1,1,1,1,1,1,20161001,,,,
E0776,HCPCS,IV POLE,RR,,28,,NW,,,,,,$32.50,$0.00,1,1,1,1,1,1,20161001,,,,
E0776,HCPCS,IV POLE,UE,,28,,NW,,,,,,$243.88,$0.00,1,1,1,1,1,1,20161001,,,,
E0779,HCPCS,AMB INFUSION PUMP MECHANICAL,,,28,,NW,,,,,,$277.87,$0.00,1,1,1,1,1,1,20161001,,,,
E0779,HCPCS,AMB INFUSION PUMP MECHANICAL,RR,,28,,NW,,,,,,$29.56,$0.00,1,1,1,1,1,1,20161001,,,,
E0780,HCPCS,MECH AMB INFUSION PUMP <8HRS,,,28,,NW,,,,,,$17.47,$0.00,1,1,1,1,1,1,20161001,,,,
E0780,HCPCS,MECH AMB INFUSION PUMP <8HRS,NU,,28,,NW,,,,,,$17.47,$0.00,1,1,1,1,1,1,20161001,,,,
E0781,HCPCS,EXTERNAL AMBULATORY INFUS PU,,,28,,NW,,,,,,"$6,119.43",$0.00,1,1,1,1,1,1,20161001,,,,
E0781,HCPCS,EXTERNAL AMBULATORY INFUS PU,RR,,28,,NW,,,,,,$650.92,$0.00,1,1,1,1,1,1,20161001,,,,
E0782,HCPCS,NON-PROGRAMBLE INFUSION PUMP,,,28,,NW,,,,,,"$10,560.92",$0.00,1,1,1,1,1,1,20161001,,,,
E0782,HCPCS,NON-PROGRAMBLE INFUSION PUMP,NU,,28,,NW,,,,,,"$10,560.92",$0.00,1,1,1,1,1,1,20161001,,,,
E0782,HCPCS,NON-PROGRAMBLE INFUSION PUMP,RR,,28,,NW,,,,,,"$1,044.34",$0.00,1,1,1,1,1,1,20161001,,,,
E0782,HCPCS,NON-PROGRAMBLE INFUSION PUMP,UE,,28,,NW,,,,,,"$7,917.41",$0.00,1,1,1,1,1,1,20161001,,,,
E0783,HCPCS,PROGRAMMABLE INFUSION PUMP,,,28,,NW,,,,,,"$20,817.95",$0.00,1,1,1,1,1,1,20161001,,,,
E0783,HCPCS,PROGRAMMABLE INFUSION PUMP,NU,,28,,NW,,,,,,"$20,817.95",$0.00,1,1,1,1,1,1,20161001,,,,
E0783,HCPCS,PROGRAMMABLE INFUSION PUMP,RR,,28,,NW,,,,,,"$2,070.05",$0.00,1,1,1,1,1,1,20161001,,,,
E0783,HCPCS,PROGRAMMABLE INFUSION PUMP,UE,,28,,NW,,,,,,"$15,610.21",$0.00,1,1,1,1,1,1,20161001,,,,
E0784,HCPCS,EXT AMB INFUSN PUMP INSULIN,,,28,,NW,,,,,,"$10,117.49",$0.00,1,1,1,1,1,1,20161001,,,,
E0784,HCPCS,EXT AMB INFUSN PUMP INSULIN,RR,,28,,NW,,,,,,"$1,076.20",$0.00,1,1,1,1,1,1,20161001,,,,
E0785,HCPCS,REPLACEMENT IMPL PUMP CATHET,,,28,,NW,,,,,,"$1,164.95",$0.00,1,1,1,1,1,1,20161001,,,,
E0785,HCPCS,REPLACEMENT IMPL PUMP CATHET,KF,,28,,NW,,,,,,"$1,164.95",$0.00,1,1,1,1,1,1,20161001,,,,
E0786,HCPCS,IMPLANTABLE PUMP REPLACEMENT,,,28,,NW,,,,,,"$20,286.05",$0.00,1,1,1,1,1,1,20161001,,,,
E0786,HCPCS,IMPLANTABLE PUMP REPLACEMENT,NU,,28,,NW,,,,,,"$20,286.05",$0.00,1,1,1,1,1,1,20161001,,,,
E0786,HCPCS,IMPLANTABLE PUMP REPLACEMENT,RR,,28,,NW,,,,,,"$2,016.79",$0.00,1,1,1,1,1,1,20161001,,,,
E0786,HCPCS,IMPLANTABLE PUMP REPLACEMENT,UE,,28,,NW,,,,,,"$15,211.29",$0.00,1,1,1,1,1,1,20161001,,,,
E0791,HCPCS,PARENTERAL INFUSION PUMP STA,,,28,,NW,,,,,,"$6,423.17",$0.00,1,1,1,1,1,1,20161001,,,,
E0791,HCPCS,PARENTERAL INFUSION PUMP STA,RR,,28,,NW,,,,,,$538.04,$0.00,1,1,1,1,1,1,20161001,,,,
E0791,HCPCS,PARENTERAL INFUSION PUMP STA,UE,,28,,NW,,,,,,"$4,055.40",$0.00,1,1,1,1,1,1,20161001,,,,
E0830,HCPCS,AMBULATORY TRACTION DEVICE,,,28,,NW,,,,,,"$1,610.09",$0.00,1,1,1,1,1,1,20161001,,,,
E0840,HCPCS,TRACT FRAME ATTACH HEADBOARD,,,28,,NW,,,,,,$136.40,$0.00,1,1,1,1,1,1,20161001,,,,
E0840,HCPCS,TRACT FRAME ATTACH HEADBOARD,NU,,28,,NW,,,,,,$136.40,$0.00,1,1,1,1,1,1,20161001,,,,
E0840,HCPCS,TRACT FRAME ATTACH HEADBOARD,RR,,28,,NW,,,,,,$34.00,$0.00,1,1,1,1,1,1,20161001,,,,
E0840,HCPCS,TRACT FRAME ATTACH HEADBOARD,UE,,28,,NW,,,,,,$102.86,$0.00,1,1,1,1,1,1,20161001,,,,
E0849,HCPCS,CERVICAL PNEUM TRAC EQUIP,,,28,,NW,,,,,,"$1,328.19",$0.00,1,1,1,1,1,1,20161001,,,,
E0849,HCPCS,CERVICAL PNEUM TRAC EQUIP,NU,,28,,NW,,,,,,"$1,328.19",$0.00,1,1,1,1,1,1,20161001,,,,
E0849,HCPCS,CERVICAL PNEUM TRAC EQUIP,RR,,28,,NW,,,,,,$121.37,$0.00,1,1,1,1,1,1,20161001,,,,
E0849,HCPCS,CERVICAL PNEUM TRAC EQUIP,UE,,28,,NW,,,,,,$992.59,$0.00,1,1,1,1,1,1,20161001,,,,
E0850,HCPCS,TRACTION STAND FREE STANDING,,,28,,NW,,,,,,$193.64,$0.00,1,1,1,1,1,1,20161001,,,,
E0850,HCPCS,TRACTION STAND FREE STANDING,NU,,28,,NW,,,,,,$193.64,$0.00,1,1,1,1,1,1,20161001,,,,
E0850,HCPCS,TRACTION STAND FREE STANDING,RR,,28,,NW,,,,,,$30.08,$0.00,1,1,1,1,1,1,20161001,,,,
E0850,HCPCS,TRACTION STAND FREE STANDING,UE,,28,,NW,,,,,,$146.89,$0.00,1,1,1,1,1,1,20161001,,,,
E0855,HCPCS,CERVICAL TRACTION EQUIPMENT,,,28,,NW,,,,,,"$1,294.29",$0.00,1,1,1,1,1,1,20161001,,,,
E0855,HCPCS,CERVICAL TRACTION EQUIPMENT,NU,,28,,NW,,,,,,"$1,294.29",$0.00,1,1,1,1,1,1,20161001,,,,
E0855,HCPCS,CERVICAL TRACTION EQUIPMENT,RR,,28,,NW,,,,,,$117.02,$0.00,1,1,1,1,1,1,20161001,,,,
E0855,HCPCS,CERVICAL TRACTION EQUIPMENT,UE,,28,,NW,,,,,,$967.73,$0.00,1,1,1,1,1,1,20161001,,,,
E0856,HCPCS,CERVIC COLLAR W AIR BLADDERS,,,28,,NW,,,,,,$388.05,$0.00,1,1,1,1,1,1,20161001,,,,
E0856,HCPCS,CERVIC COLLAR W AIR BLADDER,NU,,28,,NW,,,,,,$388.05,$0.00,1,1,1,1,1,1,20161001,,,,
E0856,HCPCS,CERVIC COLLAR W AIR BLADDERS,RR,,28,,NW,,,,,,$27.05,$0.00,1,1,1,1,1,1,20161001,,,,
E0856,HCPCS,CERVIC COLLAR W AIR BLADDER,UE,,28,,NW,,,,,,$287.48,$0.00,1,1,1,1,1,1,20161001,,,,
E0860,HCPCS,TRACT EQUIP CERVICAL TRACT,,,28,,NW,,,,,,$72.83,$0.00,1,1,1,1,1,1,20161001,,,,
E0860,HCPCS,TRACT EQUIP CERVICAL TRACT,NU,,28,,NW,,,,,,$72.83,$0.00,1,1,1,1,1,1,20161001,,,,
E0860,HCPCS,TRACT EQUIP CERVICAL TRACT,RR,,28,,NW,,,,,,$15.59,$0.00,1,1,1,1,1,1,20161001,,,,
E0860,HCPCS,TRACT EQUIP CERVICAL TRACT,UE,,28,,NW,,,,,,$56.98,$0.00,1,1,1,1,1,1,20161001,,,,
E0870,HCPCS,TRACT FRAME ATTACH FOOTBOARD,,,28,,NW,,,,,,$210.89,$0.00,1,1,1,1,1,1,20161001,,,,
E0870,HCPCS,TRACT FRAME ATTACH FOOTBOARD,NU,,28,,NW,,,,,,$210.89,$0.00,1,1,1,1,1,1,20161001,,,,
E0870,HCPCS,TRACT FRAME ATTACH FOOTBOARD,RR,,28,,NW,,,,,,$28.94,$0.00,1,1,1,1,1,1,20161001,,,,
E0870,HCPCS,TRACT FRAME ATTACH FOOTBOARD,UE,,28,,NW,,,,,,$159.79,$0.00,1,1,1,1,1,1,20161001,,,,
E0880,HCPCS,TRAC STAND FREE STAND EXTREM,,,28,,NW,,,,,,$224.55,$0.00,1,1,1,1,1,1,20161001,,,,
E0880,HCPCS,TRAC STAND FREE STAND EXTREM,NU,,28,,NW,,,,,,$224.55,$0.00,1,1,1,1,1,1,20161001,,,,
E0880,HCPCS,TRAC STAND FREE STAND EXTREM,RR,,28,,NW,,,,,,$39.36,$0.00,1,1,1,1,1,1,20161001,,,,
E0880,HCPCS,TRAC STAND FREE STAND EXTREM,UE,,28,,NW,,,,,,$171.04,$0.00,1,1,1,1,1,1,20161001,,,,
E0890,HCPCS,TRACTION FRAME ATTACH PELVIC,,,28,,NW,,,,,,$217.28,$0.00,1,1,1,1,1,1,20161001,,,,
E0890,HCPCS,TRACTION FRAME ATTACH PELVIC,NU,,28,,NW,,,,,,$217.28,$0.00,1,1,1,1,1,1,20161001,,,,
E0890,HCPCS,TRACTION FRAME ATTACH PELVIC,RR,,28,,NW,,,,,,$63.83,$0.00,1,1,1,1,1,1,20161001,,,,
E0890,HCPCS,TRACTION FRAME ATTACH PELVIC,UE,,28,,NW,,,,,,$174.45,$0.00,1,1,1,1,1,1,20161001,,,,
E0900,HCPCS,TRAC STAND FREE STAND PELVIC,,,28,,NW,,,,,,$233.16,$0.00,1,1,1,1,1,1,20161001,,,,
E0900,HCPCS,TRAC STAND FREE STAND PELVIC,NU,,28,,NW,,,,,,$233.16,$0.00,1,1,1,1,1,1,20161001,,,,
E0900,HCPCS,TRAC STAND FREE STAND PELVIC,RR,,28,,NW,,,,,,$53.37,$0.00,1,1,1,1,1,1,20161001,,,,
E0900,HCPCS,TRAC STAND FREE STAND PELVIC,UE,,28,,NW,,,,,,$176.72,$0.00,1,1,1,1,1,1,20161001,,,,
E0910,HCPCS,TRAPEZE BAR ATTACHED TO BED,,,28,,NW,,,,,,$332.39,$0.00,1,1,1,1,1,1,20161001,,,,
E0910,HCPCS,TRAPEZE BAR ATTACHED TO BED,RR,,28,,NW,,,,,,$35.36,$0.00,1,1,1,1,1,1,20161001,,,,
E0910,HCPCS,TRAPEZE BAR ATTACHED TO BED,UE,,28,,NW,,,,,,$239.48,$0.00,1,1,1,1,1,1,20161001,,,,
E0911,HCPCS,HD TRAPEZE BAR ATTACH TO BED,,,28,,NW,,,,,,$809.04,$0.00,1,1,1,1,1,1,20161001,,,,
E0911,HCPCS,HD TRAPEZE BAR ATTACH TO BED,RR,,28,,NW,,,,,,$86.06,$0.00,1,1,1,1,1,1,20161001,,,,
E0912,HCPCS,HD TRAPEZE BAR FREE STANDING,,,28,,NW,,,,,,"$1,813.14",$0.00,1,1,1,1,1,1,20161001,,,,
E0912,HCPCS,HD TRAPEZE BAR FREE STANDING,RR,,28,,NW,,,,,,$192.86,$0.00,1,1,1,1,1,1,20161001,,,,
E0920,HCPCS,FRACTURE FRAME ATTACHED TO B,,,28,,NW,,,,,,$817.67,$0.00,1,1,1,1,1,1,20161001,,,,
E0920,HCPCS,FRACTURE FRAME ATTACHED TO B,RR,,28,,NW,,,,,,$86.98,$0.00,1,1,1,1,1,1,20161001,,,,
E0920,HCPCS,FRACTURE FRAME ATTACHED TO B,UE,,28,,NW,,,,,,$582.81,$0.00,1,1,1,1,1,1,20161001,,,,
E0930,HCPCS,FRACTURE FRAME FREE STANDING,,,28,,NW,,,,,,$812.54,$0.00,1,1,1,1,1,1,20161001,,,,
E0930,HCPCS,FRACTURE FRAME FREE STANDING,RR,,28,,NW,,,,,,$86.43,$0.00,1,1,1,1,1,1,20161001,,,,
E0930,HCPCS,FRACTURE FRAME FREE STANDING,UE,,28,,NW,,,,,,$610.88,$0.00,1,1,1,1,1,1,20161001,,,,
E0935,HCPCS,CONT PAS MOTION EXERCISE DEV,,,28,,NW,,,,,,$400.26,$0.00,1,1,1,1,1,1,20161001,,,,
E0935,HCPCS,CONT PAS MOTION EXERCISE DEV,RR,,28,,NW,,,,,,$42.58,$0.00,1,1,1,1,1,1,20161001,,,,
E0936,HCPCS,"CPM DEVICE, OTHER THAN KNEE",,,28,,NW,,,,,,$130.96,$0.00,1,1,1,1,1,1,20161001,,,,
E0936,HCPCS,"CPM DEVICE, OTHER THAN KNEE",RR,,28,,NW,,,,,,$10.77,$0.00,1,1,1,1,1,1,20161001,,,,
E0940,HCPCS,TRAPEZE BAR FREE STANDING,,,28,,NW,,,,,,$547.69,$0.00,1,1,1,1,1,1,20161001,,,,
E0940,HCPCS,TRAPEZE BAR FREE STANDING,RR,,28,,NW,,,,,,$58.26,$0.00,1,1,1,1,1,1,20161001,,,,
E0940,HCPCS,TRAPEZE BAR FREE STANDING,UE,,28,,NW,,,,,,$390.85,$0.00,1,1,1,1,1,1,20161001,,,,
E0941,HCPCS,GRAVITY ASSISTED TRACTION DE,,,28,,NW,,,,,,$792.57,$0.00,1,1,1,1,1,1,20161001,,,,
E0941,HCPCS,GRAVITY ASSISTED TRACTION DE,NU,,28,,NW,,,,,,$792.57,$0.00,1,1,1,1,1,1,20161001,,,,
E0941,HCPCS,GRAVITY ASSISTED TRACTION DE,RR,,28,,NW,,,,,,$84.31,$0.00,1,1,1,1,1,1,20161001,,,,
E0941,HCPCS,GRAVITY ASSISTED TRACTION DE,UE,,28,,NW,,,,,,$595.86,$0.00,1,1,1,1,1,1,20161001,,,,
E0942,HCPCS,CERVICAL HEAD HARNESS/HALTER,,,28,,NW,,,,,,$40.08,$0.00,1,1,1,1,1,1,20161001,,,,
E0942,HCPCS,CERVICAL HEAD HARNESS/HALTER,NU,,28,,NW,,,,,,$40.08,$0.00,1,1,1,1,1,1,20161001,,,,
E0942,HCPCS,CERVICAL HEAD HARNESS/HALTER,RR,,28,,NW,,,,,,$7.98,$0.00,1,1,1,1,1,1,20161001,,,,
E0942,HCPCS,CERVICAL HEAD HARNESS/HALTER,UE,,28,,NW,,,,,,$30.95,$0.00,1,1,1,1,1,1,20161001,,,,
E0944,HCPCS,PELVIC BELT/HARNESS/BOOT,,,28,,NW,,,,,,$83.86,$0.00,1,1,1,1,1,1,20161001,,,,
E0944,HCPCS,PELVIC BELT/HARNESS/BOOT,NU,,28,,NW,,,,,,$83.86,$0.00,1,1,1,1,1,1,20161001,,,,
E0944,HCPCS,PELVIC BELT/HARNESS/BOOT,RR,,28,,NW,,,,,,$11.81,$0.00,1,1,1,1,1,1,20161001,,,,
E0944,HCPCS,PELVIC BELT/HARNESS/BOOT,UE,,28,,NW,,,,,,$63.96,$0.00,1,1,1,1,1,1,20161001,,,,
E0945,HCPCS,BELT/HARNESS EXTREMITY,,,28,,NW,,,,,,$82.95,$0.00,1,1,1,1,1,1,20161001,,,,
E0945,HCPCS,BELT/HARNESS EXTREMITY,NU,,28,,NW,,,,,,$82.95,$0.00,1,1,1,1,1,1,20161001,,,,
E0945,HCPCS,BELT/HARNESS EXTREMITY,RR,,28,,NW,,,,,,$11.67,$0.00,1,1,1,1,1,1,20161001,,,,
E0945,HCPCS,BELT/HARNESS EXTREMITY,UE,,28,,NW,,,,,,$64.72,$0.00,1,1,1,1,1,1,20161001,,,,
E0946,HCPCS,FRACTURE FRAME DUAL W CROSS,,,28,,NW,,,,,,"$1,018.71",$0.00,1,1,1,1,1,1,20161001,,,,
E0946,HCPCS,FRACTURE FRAME DUAL W CROSS,NU,,28,,NW,,,,,,"$1,018.71",$0.00,1,1,1,1,1,1,20161001,,,,
E0946,HCPCS,FRACTURE FRAME DUAL W CROSS,RR,,28,,NW,,,,,,$108.36,$0.00,1,1,1,1,1,1,20161001,,,,
E0946,HCPCS,FRACTURE FRAME DUAL W CROSS,UE,,28,,NW,,,,,,$765.88,$0.00,1,1,1,1,1,1,20161001,,,,
E0947,HCPCS,FRACTURE FRAME ATTACHMNTS PE,,,28,,NW,,,,,,$960.95,$0.00,1,1,1,1,1,1,20161001,,,,
E0947,HCPCS,FRACTURE FRAME ATTACHMNTS PE,NU,,28,,NW,,,,,,$960.95,$0.00,1,1,1,1,1,1,20161001,,,,
E0947,HCPCS,FRACTURE FRAME ATTACHMNTS PE,RR,,28,,NW,,,,,,$115.40,$0.00,1,1,1,1,1,1,20161001,,,,
E0947,HCPCS,FRACTURE FRAME ATTACHMNTS PE,UE,,28,,NW,,,,,,$729.30,$0.00,1,1,1,1,1,1,20161001,,,,
E0948,HCPCS,FRACTURE FRAME ATTACHMNTS CE,,,28,,NW,,,,,,$942.14,$0.00,1,1,1,1,1,1,20161001,,,,
E0948,HCPCS,FRACTURE FRAME ATTACHMNTS CE,NU,,28,,NW,,,,,,$942.14,$0.00,1,1,1,1,1,1,20161001,,,,
E0948,HCPCS,FRACTURE FRAME ATTACHMNTS CE,RR,,28,,NW,,,,,,$108.19,$0.00,1,1,1,1,1,1,20161001,,,,
E0948,HCPCS,FRACTURE FRAME ATTACHMNTS CE,UE,,28,,NW,,,,,,$680.64,$0.00,1,1,1,1,1,1,20161001,,,,
E0950,HCPCS,TRAY,,,28,,NW,,,,,,$335.22,$0.00,1,1,1,1,1,1,20161001,,,,
E0950,HCPCS,TRAY,NU,,28,,NW,,,,,,$335.22,$0.00,1,1,1,1,1,1,20161001,,,,
E0950,HCPCS,TRAY,RR,,28,,NW,,,,,,$38.57,$0.00,1,1,1,1,1,1,20161001,,,,
E0950,HCPCS,TRAY,UE,,28,,NW,,,,,,$259.92,$0.00,1,1,1,1,1,1,20161001,,,,
E0951,HCPCS,LOOP HEEL,,,28,,NW,,,,,,$68.89,$0.00,1,1,1,1,1,1,20161001,,,,
E0951,HCPCS,LOOP HEEL,NU,,28,,NW,,,,,,$68.89,$0.00,1,1,1,1,1,1,20161001,,,,
E0951,HCPCS,LOOP HEEL,RR,,28,,NW,,,,,,$10.41,$0.00,1,1,1,1,1,1,20161001,,,,
E0951,HCPCS,LOOP HEEL,UE,,28,,NW,,,,,,$52.56,$0.00,1,1,1,1,1,1,20161001,,,,
E0952,HCPCS,"TOE LOOP/HOLDER, EACH",,,28,,NW,,,,,,$66.73,$0.00,1,1,1,1,1,1,20161001,,,,
E0952,HCPCS,"TOE LOOP/HOLDER, EACH",NU,,28,,NW,,,,,,$66.73,$0.00,1,1,1,1,1,1,20161001,,,,
E0952,HCPCS,"TOE LOOP/HOLDER, EACH",RR,,28,,NW,,,,,,$10.24,$0.00,1,1,1,1,1,1,20161001,,,,
E0952,HCPCS,"TOE LOOP/HOLDER, EACH",UE,,28,,NW,,,,,,$51.08,$0.00,1,1,1,1,1,1,20161001,,,,
E0955,HCPCS,CUSHIONED HEADREST,,,28,,NW,,,,,,$660.55,$0.00,1,1,1,1,1,1,20161001,,,,
E0955,HCPCS,CUSHIONED HEADREST,NU,,28,,NW,,,,,,$660.55,$0.00,1,1,1,1,1,1,20161001,,,,
E0955,HCPCS,CUSHIONED HEADREST,RR,,28,,NW,,,,,,$75.92,$0.00,1,1,1,1,1,1,20161001,,,,
E0955,HCPCS,CUSHIONED HEADREST,UE,,28,,NW,,,,,,$503.98,$0.00,1,1,1,1,1,1,20161001,,,,
E0956,HCPCS,W/C LATERAL TRUNK/HIP SUPPOR,,,28,,NW,,,,,,$339.71,$0.00,1,1,1,1,1,1,20161001,,,,
E0956,HCPCS,W/C LATERAL TRUNK/HIP SUPPOR,NU,,28,,NW,,,,,,$339.71,$0.00,1,1,1,1,1,1,20161001,,,,
E0956,HCPCS,W/C LATERAL TRUNK/HIP SUPPOR,RR,,28,,NW,,,,,,$38.91,$0.00,1,1,1,1,1,1,20161001,,,,
E0956,HCPCS,W/C LATERAL TRUNK/HIP SUPPOR,UE,,28,,NW,,,,,,$263.39,$0.00,1,1,1,1,1,1,20161001,,,,
E0957,HCPCS,W/C MEDIAL THIGH SUPPORT,,,28,,NW,,,,,,$461.58,$0.00,1,1,1,1,1,1,20161001,,,,
E0957,HCPCS,W/C MEDIAL THIGH SUPPORT,NU,,28,,NW,,,,,,$461.58,$0.00,1,1,1,1,1,1,20161001,,,,
E0957,HCPCS,W/C MEDIAL THIGH SUPPORT,RR,,28,,NW,,,,,,$52.97,$0.00,1,1,1,1,1,1,20161001,,,,
E0957,HCPCS,W/C MEDIAL THIGH SUPPORT,UE,,28,,NW,,,,,,$354.79,$0.00,1,1,1,1,1,1,20161001,,,,
E0958,HCPCS,WHLCHR ATT- CONV 1 ARM DRIVE,,,28,,NW,,,,,,$725.92,$0.00,1,1,1,1,1,1,20161001,,,,
E0958,HCPCS,WHLCHR ATT- CONV 1 ARM DRIVE,NU,,28,,NW,,,,,,$725.92,$0.00,1,1,1,1,1,1,20161001,,,,
E0958,HCPCS,WHLCHR ATT- CONV 1 ARM DRIVE,RR,,28,,NW,,,,,,$83.28,$0.00,1,1,1,1,1,1,20161001,,,,
E0958,HCPCS,WHLCHR ATT- CONV 1 ARM DRIVE,UE,,28,,NW,,,,,,$552.53,$0.00,1,1,1,1,1,1,20161001,,,,
E0959,HCPCS,AMPUTEE ADAPTER,,,28,,NW,,,,,,$84.14,$0.00,1,1,1,1,1,1,20161001,,,,
E0959,HCPCS,AMPUTEE ADAPTER,NU,,28,,NW,,,,,,$84.14,$0.00,1,1,1,1,1,1,20161001,,,,
E0959,HCPCS,AMPUTEE ADAPTER,RR,,28,,NW,,,,,,$11.81,$0.00,1,1,1,1,1,1,20161001,,,,
E0959,HCPCS,AMPUTEE ADAPTER,UE,,28,,NW,,,,,,$64.54,$0.00,1,1,1,1,1,1,20161001,,,,
E0960,HCPCS,W/C SHOULDER HARNESS/STRAPS,,,28,,NW,,,,,,$316.17,$0.00,1,1,1,1,1,1,20161001,,,,
E0960,HCPCS,W/C SHOULDER HARNESS/STRAPS,NU,,28,,NW,,,,,,$316.17,$0.00,1,1,1,1,1,1,20161001,,,,
E0960,HCPCS,W/C SHOULDER HARNESS/STRAPS,RR,,28,,NW,,,,,,$36.23,$0.00,1,1,1,1,1,1,20161001,,,,
E0960,HCPCS,W/C SHOULDER HARNESS/STRAPS,UE,,28,,NW,,,,,,$245.78,$0.00,1,1,1,1,1,1,20161001,,,,
E0961,HCPCS,WHEELCHAIR BRAKE EXTENSION,,,28,,NW,,,,,,$56.14,$0.00,1,1,1,1,1,1,20161001,,,,
E0961,HCPCS,WHEELCHAIR BRAKE EXTENSION,NU,,28,,NW,,,,,,$56.14,$0.00,1,1,1,1,1,1,20161001,,,,
E0961,HCPCS,WHEELCHAIR BRAKE EXTENSION,RR,,28,,NW,,,,,,$9.25,$0.00,1,1,1,1,1,1,20161001,,,,
E0961,HCPCS,WHEELCHAIR BRAKE EXTENSION,UE,,28,,NW,,,,,,$30.20,$0.00,1,1,1,1,1,1,20161001,,,,
E0966,HCPCS,WHEELCHAIR HEAD REST EXTENSI,,,28,,NW,,,,,,$136.01,$0.00,1,1,1,1,1,1,20161001,,,,
E0966,HCPCS,WHEELCHAIR HEAD REST EXTENSI,NU,,28,,NW,,,,,,$136.01,$0.00,1,1,1,1,1,1,20161001,,,,
E0966,HCPCS,WHEELCHAIR HEAD REST EXTENSI,RR,,28,,NW,,,,,,$16.85,$0.00,1,1,1,1,1,1,20161001,,,,
E0966,HCPCS,WHEELCHAIR HEAD REST EXTENSI,UE,,28,,NW,,,,,,$102.94,$0.00,1,1,1,1,1,1,20161001,,,,
E0967,HCPCS,MANUAL WC HAND RIM W PROJECT,,,28,,NW,,,,,,$129.16,$0.00,1,1,1,1,1,1,20161001,,,,
E0967,HCPCS,MANUAL WC HAND RIM W PROJECT,NU,,28,,NW,,,,,,$129.16,$0.00,1,1,1,1,1,1,20161001,,,,
E0967,HCPCS,MANUAL WC HAND RIM W PROJECT,RR,,28,,NW,,,,,,$16.26,$0.00,1,1,1,1,1,1,20161001,,,,
E0967,HCPCS,MANUAL WC HAND RIM W PROJECT,UE,,28,,NW,,,,,,$97.78,$0.00,1,1,1,1,1,1,20161001,,,,
E0968,HCPCS,WHEELCHAIR COMMODE SEAT,,,28,,NW,,,,,,$318.60,$0.00,1,1,1,1,1,1,20161001,,,,
E0968,HCPCS,WHEELCHAIR COMMODE SEAT,NU,,28,,NW,,,,,,$318.60,$0.00,1,1,1,1,1,1,20161001,,,,
E0968,HCPCS,WHEELCHAIR COMMODE SEAT,RR,,28,,NW,,,,,,$36.97,$0.00,1,1,1,1,1,1,20161001,,,,
E0968,HCPCS,WHEELCHAIR COMMODE SEAT,UE,,28,,NW,,,,,,$247.74,$0.00,1,1,1,1,1,1,20161001,,,,
E0969,HCPCS,WHEELCHAIR NARROWING DEVICE,,,28,,NW,,,,,,$285.02,$0.00,1,1,1,1,1,1,20161001,,,,
E0969,HCPCS,WHEELCHAIR NARROWING DEVICE,NU,,28,,NW,,,,,,$285.02,$0.00,1,1,1,1,1,1,20161001,,,,
E0969,HCPCS,WHEELCHAIR NARROWING DEVICE,RR,,28,,NW,,,,,,$32.35,$0.00,1,1,1,1,1,1,20161001,,,,
E0969,HCPCS,WHEELCHAIR NARROWING DEVICE,UE,,28,,NW,,,,,,$221.56,$0.00,1,1,1,1,1,1,20161001,,,,
E0970,HCPCS,WHEELCHAIR NO. 2 FOOTPLATES,,,28,,NW,,,,,,$106.81,$0.00,1,1,1,1,1,1,20161001,,,,
E0970,HCPCS,WHEELCHAIR NO. 2 FOOTPLATES,NU,,28,,NW,,,,,,$106.81,$0.00,1,1,1,1,1,1,20161001,,,,
E0970,HCPCS,WHEELCHAIR NO. 2 FOOTPLATES,RR,,28,,NW,,,,,,$13.23,$0.00,1,1,1,1,1,1,20161001,,,,
E0970,HCPCS,WHEELCHAIR NO. 2 FOOTPLATES,UE,,28,,NW,,,,,,$81.43,$0.00,1,1,1,1,1,1,20161001,,,,
E0971,HCPCS,WHEELCHAIR ANTI-TIPPING DEVI,,,28,,NW,,,,,,$86.87,$0.00,1,1,1,1,1,1,20161001,,,,
E0971,HCPCS,WHEELCHAIR ANTI-TIPPING DEVI,NU,,28,,NW,,,,,,$86.87,$0.00,1,1,1,1,1,1,20161001,,,,
E0971,HCPCS,WHEELCHAIR ANTI-TIPPING DEVI,RR,,28,,NW,,,,,,$12.05,$0.00,1,1,1,1,1,1,20161001,,,,
E0971,HCPCS,WHEELCHAIR ANTI-TIPPING DEVI,UE,,28,,NW,,,,,,$66.13,$0.00,1,1,1,1,1,1,20161001,,,,
E0973,HCPCS,W/CH ACCESS DET ADJ ARMREST,,,28,,NW,,,,,,$359.71,$0.00,1,1,1,1,1,1,20161001,,,,
E0973,HCPCS,W/CH ACCESS DET ADJ ARMREST,NU,,28,,NW,,,,,,$359.71,$0.00,1,1,1,1,1,1,20161001,,,,
E0973,HCPCS,W/CH ACCESS DET ADJ ARMREST,RR,,28,,NW,,,,,,$39.73,$0.00,1,1,1,1,1,1,20161001,,,,
E0973,HCPCS,W/CH ACCESS DET ADJ ARMREST,UE,,28,,NW,,,,,,$279.87,$0.00,1,1,1,1,1,1,20161001,,,,
E0974,HCPCS,W/CH ACCESS ANTI-ROLLBACK,,,28,,NW,,,,,,$146.22,$0.00,1,1,1,1,1,1,20161001,,,,
E0974,HCPCS,W/CH ACCESS ANTI-ROLLBACK,NU,,28,,NW,,,,,,$146.22,$0.00,1,1,1,1,1,1,20161001,,,,
E0974,HCPCS,W/CH ACCESS ANTI-ROLLBACK,RR,,28,,NW,,,,,,$18.83,$0.00,1,1,1,1,1,1,20161001,,,,
E0974,HCPCS,W/CH ACCESS ANTI-ROLLBACK,UE,,28,,NW,,,,,,$112.19,$0.00,1,1,1,1,1,1,20161001,,,,
E0978,HCPCS,"W/C ACC,SAF BELT PELV STRAP",,,28,,NW,,,,,,$147.65,$0.00,1,1,1,1,1,1,20161001,,,,
E0978,HCPCS,"W/C ACC,SAF BELT PELV STRAP",NU,,28,,NW,,,,,,$147.65,$0.00,1,1,1,1,1,1,20161001,,,,
E0978,HCPCS,"W/C ACC,SAF BELT PELV STRAP",RR,,28,,NW,,,,,,$18.05,$0.00,1,1,1,1,1,1,20161001,,,,
E0978,HCPCS,"W/C ACC,SAF BELT PELV STRAP",UE,,28,,NW,,,,,,$110.91,$0.00,1,1,1,1,1,1,20161001,,,,
E0980,HCPCS,WHEELCHAIR SAFETY VEST,,,28,,NW,,,,,,$62.29,$0.00,1,1,1,1,1,1,20161001,,,,
E0980,HCPCS,WHEELCHAIR SAFETY VEST,NU,,28,,NW,,,,,,$62.29,$0.00,1,1,1,1,1,1,20161001,,,,
E0980,HCPCS,WHEELCHAIR SAFETY VEST,RR,,28,,NW,,,,,,$9.56,$0.00,1,1,1,1,1,1,20161001,,,,
E0980,HCPCS,WHEELCHAIR SAFETY VEST,UE,,28,,NW,,,,,,$47.48,$0.00,1,1,1,1,1,1,20161001,,,,
E0981,HCPCS,"SEAT UPHOLSTERY, REPLACEMENT",,,28,,NW,,,,,,$165.05,$0.00,1,1,1,1,1,1,20161001,,,,
E0981,HCPCS,"SEAT UPHOLSTERY, REPLACEMENT",NU,,28,,NW,,,,,,$165.05,$0.00,1,1,1,1,1,1,20161001,,,,
E0981,HCPCS,"SEAT UPHOLSTERY, REPLACEMENT",RR,,28,,NW,,,,,,$19.97,$0.00,1,1,1,1,1,1,20161001,,,,
E0981,HCPCS,"SEAT UPHOLSTERY, REPLACEMENT",UE,,28,,NW,,,,,,$125.57,$0.00,1,1,1,1,1,1,20161001,,,,
E0982,HCPCS,"BACK UPHOLSTERY, REPLACEMENT",,,28,,NW,,,,,,$174.69,$0.00,1,1,1,1,1,1,20161001,,,,
E0982,HCPCS,"BACK UPHOLSTERY, REPLACEMENT",NU,,28,,NW,,,,,,$174.69,$0.00,1,1,1,1,1,1,20161001,,,,
E0982,HCPCS,"BACK UPHOLSTERY, REPLACEMENT",RR,,28,,NW,,,,,,$20.82,$0.00,1,1,1,1,1,1,20161001,,,,
E0982,HCPCS,"BACK UPHOLSTERY, REPLACEMENT",UE,,28,,NW,,,,,,$132.15,$0.00,1,1,1,1,1,1,20161001,,,,
E0983,HCPCS,ADD PWR JOYSTICK,,,28,,NW,,,,,,"$4,131.78",$0.00,1,1,1,1,1,1,20161001,,,,
E0983,HCPCS,ADD PWR JOYSTICK,RR,,28,,NW,,,,,,$439.50,$0.00,1,1,1,1,1,1,20161001,,,,
E0984,HCPCS,ADD PWR TILLER,,,28,,NW,,,,,,"$3,061.09",$0.00,1,1,1,1,1,1,20161001,,,,
E0984,HCPCS,ADD PWR TILLER,NU,,28,,NW,,,,,,"$3,061.09",$0.00,1,1,1,1,1,1,20161001,,,,
E0984,HCPCS,ADD PWR TILLER,RR,,28,,NW,,,,,,$329.45,$0.00,1,1,1,1,1,1,20161001,,,,
E0984,HCPCS,ADD PWR TILLER,UE,,28,,NW,,,,,,"$2,370.31",$0.00,1,1,1,1,1,1,20161001,,,,
E0985,HCPCS,W/C SEAT LIFT MECHANISM,,,28,,NW,,,,,,$371.82,$0.00,1,1,1,1,1,1,20161001,,,,
E0985,HCPCS,W/C SEAT LIFT MECHANISM,NU,,28,,NW,,,,,,$371.82,$0.00,1,1,1,1,1,1,20161001,,,,
E0985,HCPCS,W/C SEAT LIFT MECHANISM,RR,,28,,NW,,,,,,$42.62,$0.00,1,1,1,1,1,1,20161001,,,,
E0985,HCPCS,W/C SEAT LIFT MECHANISM,UE,,28,,NW,,,,,,$287.46,$0.00,1,1,1,1,1,1,20161001,,,,
E0986,HCPCS,MAN W/C PUSH-RIM POWR SYSTEM,,,28,,NW,,,,,,"$7,741.07",$0.00,1,1,1,1,1,1,20161001,,,,
E0986,HCPCS,MAN W/C PUSH-RIM POW ASSIST,NU,,28,,NW,,,,,,"$7,741.07",$0.00,1,1,1,1,1,1,20161001,,,,
E0986,HCPCS,MAN W/C PUSH-RIM POWR SYSTEM,RR,,28,,NW,,,,,,$843.46,$0.00,1,1,1,1,1,1,20161001,,,,
E0986,HCPCS,MAN W/C PUSH-RIM POW ASSIST,UE,,28,,NW,,,,,,"$5,814.58",$0.00,1,1,1,1,1,1,20161001,,,,
E0988,HCPCS,LEVER-ACTIVATED WHEEL DRIVE,,,28,,NW,,,,,,"$4,924.60",$0.00,1,1,1,1,1,1,20161001,,,,
E0988,HCPCS,LEVER-ACTIVATED WHEEL DRIVE,RR,,28,,NW,,,,,,$523.83,$0.00,1,1,1,1,1,1,20161001,,,,
E0990,HCPCS,WHEELCHAIR ELEVATING LEG RES,,,28,,NW,,,,,,$378.24,$0.00,1,1,1,1,1,1,20161001,,,,
E0990,HCPCS,WHEELCHAIR ELEVATING LEG RES,NU,,28,,NW,,,,,,$378.24,$0.00,1,1,1,1,1,1,20161001,,,,
E0990,HCPCS,WHEELCHAIR ELEVATING LEG RES,RR,,28,,NW,,,,,,$48.32,$0.00,1,1,1,1,1,1,20161001,,,,
E0990,HCPCS,WHEELCHAIR ELEVATING LEG RES,UE,,28,,NW,,,,,,$297.96,$0.00,1,1,1,1,1,1,20161001,,,,
E0992,HCPCS,WHEELCHAIR SOLID SEAT INSERT,,,28,,NW,,,,,,$174.97,$0.00,1,1,1,1,1,1,20161001,,,,
E0992,HCPCS,WHEELCHAIR SOLID SEAT INSERT,NU,,28,,NW,,,,,,$174.97,$0.00,1,1,1,1,1,1,20161001,,,,
E0992,HCPCS,WHEELCHAIR SOLID SEAT INSERT,RR,,28,,NW,,,,,,$20.38,$0.00,1,1,1,1,1,1,20161001,,,,
E0992,HCPCS,WHEELCHAIR SOLID SEAT INSERT,UE,,28,,NW,,,,,,$132.17,$0.00,1,1,1,1,1,1,20161001,,,,
E0994,HCPCS,WHEELCHAIR ARM REST,,,28,,NW,,,,,,$35.80,$0.00,1,1,1,1,1,1,20161001,,,,
E0994,HCPCS,WHEELCHAIR ARM REST,NU,,28,,NW,,,,,,$35.80,$0.00,1,1,1,1,1,1,20161001,,,,
E0994,HCPCS,WHEELCHAIR ARM REST,RR,,28,,NW,,,,,,$6.95,$0.00,1,1,1,1,1,1,20161001,,,,
E0994,HCPCS,WHEELCHAIR ARM REST,UE,,28,,NW,,,,,,$27.82,$0.00,1,1,1,1,1,1,20161001,,,,
E0995,HCPCS,WHEELCHAIR CALF REST,,,28,,NW,,,,,,$105.29,$0.00,1,1,1,1,1,1,20161001,,,,
E0995,HCPCS,WHEELCHAIR CALF REST,NU,,28,,NW,,,,,,$105.29,$0.00,1,1,1,1,1,1,20161001,,,,
E0995,HCPCS,WHEELCHAIR CALF REST,RR,,28,,NW,,,,,,$13.92,$0.00,1,1,1,1,1,1,20161001,,,,
E0995,HCPCS,WHEELCHAIR CALF REST,UE,,28,,NW,,,,,,$79.84,$0.00,1,1,1,1,1,1,20161001,,,,
E1002,HCPCS,PWR SEAT TILT,,,28,,NW,,,,,,"$12,123.06",$0.00,1,1,1,1,1,1,20161001,,,,
E1002,HCPCS,PWR SEAT TILT,NU,,28,,NW,,,,,,"$12,123.06",$0.00,1,1,1,1,1,1,20161001,,,,
E1002,HCPCS,PWR SEAT TILT,RR,,28,,NW,,,,,,"$1,289.53",$0.00,1,1,1,1,1,1,20161001,,,,
E1002,HCPCS,PWR SEAT TILT,UE,,28,,NW,,,,,,"$9,100.98",$0.00,1,1,1,1,1,1,20161001,,,,
E1003,HCPCS,PWR SEAT RECLINE,,,28,,NW,,,,,,"$13,107.86",$0.00,1,1,1,1,1,1,20161001,,,,
E1003,HCPCS,PWR SEAT RECLINE,NU,,28,,NW,,,,,,"$13,107.86",$0.00,1,1,1,1,1,1,20161001,,,,
E1003,HCPCS,PWR SEAT RECLINE,RR,,28,,NW,,,,,,"$1,394.28",$0.00,1,1,1,1,1,1,20161001,,,,
E1003,HCPCS,PWR SEAT RECLINE,UE,,28,,NW,,,,,,"$9,839.58",$0.00,1,1,1,1,1,1,20161001,,,,
E1004,HCPCS,PWR SEAT RECLINE MECH,,,28,,NW,,,,,,"$14,498.21",$0.00,1,1,1,1,1,1,20161001,,,,
E1004,HCPCS,PWR SEAT RECLINE MECH,NU,,28,,NW,,,,,,"$14,498.21",$0.00,1,1,1,1,1,1,20161001,,,,
E1004,HCPCS,PWR SEAT RECLINE MECH,RR,,28,,NW,,,,,,"$1,542.18",$0.00,1,1,1,1,1,1,20161001,,,,
E1004,HCPCS,PWR SEAT RECLINE MECH,UE,,28,,NW,,,,,,"$10,882.29",$0.00,1,1,1,1,1,1,20161001,,,,
E1005,HCPCS,PWR SEAT RECLINE PWR,,,28,,NW,,,,,,"$15,666.69",$0.00,1,1,1,1,1,1,20161001,,,,
E1005,HCPCS,PWR SEAT RECLINE PWR,NU,,28,,NW,,,,,,"$15,666.69",$0.00,1,1,1,1,1,1,20161001,,,,
E1005,HCPCS,PWR SEAT RECLINE PWR,RR,,28,,NW,,,,,,"$1,666.47",$0.00,1,1,1,1,1,1,20161001,,,,
E1005,HCPCS,PWR SEAT RECLINE PWR,UE,,28,,NW,,,,,,"$11,758.71",$0.00,1,1,1,1,1,1,20161001,,,,
E1006,HCPCS,PWR SEAT COMBO W/O SHEAR,,,28,,NW,,,,,,"$19,116.92",$0.00,1,1,1,1,1,1,20161001,,,,
E1006,HCPCS,PWR SEAT COMBO W/O SHEAR,NU,,28,,NW,,,,,,"$19,116.92",$0.00,1,1,1,1,1,1,20161001,,,,
E1006,HCPCS,PWR SEAT COMBO W/O SHEAR,RR,,28,,NW,,,,,,"$2,033.47",$0.00,1,1,1,1,1,1,20161001,,,,
E1006,HCPCS,PWR SEAT COMBO W/O SHEAR,UE,,28,,NW,,,,,,"$14,346.35",$0.00,1,1,1,1,1,1,20161001,,,,
E1007,HCPCS,PWR SEAT COMBO W/SHEAR,,,28,,NW,,,,,,"$25,771.30",$0.00,1,1,1,1,1,1,20161001,,,,
E1007,HCPCS,PWR SEAT COMBO W/SHEAR,NU,,28,,NW,,,,,,"$25,771.30",$0.00,1,1,1,1,1,1,20161001,,,,
E1007,HCPCS,PWR SEAT COMBO W/SHEAR,RR,,28,,NW,,,,,,"$2,741.30",$0.00,1,1,1,1,1,1,20161001,,,,
E1007,HCPCS,PWR SEAT COMBO W/SHEAR,UE,,28,,NW,,,,,,"$19,337.07",$0.00,1,1,1,1,1,1,20161001,,,,
E1008,HCPCS,PWR SEAT COMBO PWR SHEAR,,,28,,NW,,,,,,"$25,773.27",$0.00,1,1,1,1,1,1,20161001,,,,
E1008,HCPCS,PWR SEAT COMBO PWR SHEAR,NU,,28,,NW,,,,,,"$25,773.27",$0.00,1,1,1,1,1,1,20161001,,,,
E1008,HCPCS,PWR SEAT COMBO PWR SHEAR,RR,,28,,NW,,,,,,"$2,741.51",$0.00,1,1,1,1,1,1,20161001,,,,
E1008,HCPCS,PWR SEAT COMBO PWR SHEAR,UE,,28,,NW,,,,,,"$19,338.61",$0.00,1,1,1,1,1,1,20161001,,,,
E1009,HCPCS,ADD MECH LEG ELEVATION,,,28,,NW,,,,,,"$2,808.27",$0.00,1,1,1,1,1,1,20161001,,,,
E1009,HCPCS,ADD MECH LEG ELEVATION,NU,,28,,NW,,,,,,"$2,808.27",$0.00,1,1,1,1,1,1,20161001,,,,
E1009,HCPCS,ADD MECH LEG ELEVATION,RR,,28,,NW,,,,,,$305.25,$0.00,1,1,1,1,1,1,20161001,,,,
E1009,HCPCS,ADD MECH LEG ELEVATION,UE,,28,,NW,,,,,,"$2,114.09",$0.00,1,1,1,1,1,1,20161001,,,,
E1010,HCPCS,ADD PWR LEG ELEVATION,,,28,,NW,,,,,,"$3,653.77",$0.00,1,1,1,1,1,1,20161001,,,,
E1010,HCPCS,ADD PWR LEG ELEVATION,NU,,28,,NW,,,,,,"$3,653.77",$0.00,1,1,1,1,1,1,20161001,,,,
E1010,HCPCS,ADD PWR LEG ELEVATION,RR,,28,,NW,,,,,,$388.65,$0.00,1,1,1,1,1,1,20161001,,,,
E1010,HCPCS,ADD PWR LEG ELEVATION,UE,,28,,NW,,,,,,"$2,749.59",$0.00,1,1,1,1,1,1,20161001,,,,
E1014,HCPCS,RECLINING BACK ADD PED W/C,,,28,,NW,,,,,,$613.08,$0.00,1,1,1,1,1,1,20161001,,,,
E1014,HCPCS,RECLINING BACK ADD PED W/C,NU,,28,,NW,,,,,,$613.08,$0.00,1,1,1,1,1,1,20161001,,,,
E1014,HCPCS,RECLINING BACK ADD PED W/C,RR,,28,,NW,,,,,,$73.73,$0.00,1,1,1,1,1,1,20161001,,,,
E1014,HCPCS,RECLINING BACK ADD PED W/C,UE,,28,,NW,,,,,,$468.59,$0.00,1,1,1,1,1,1,20161001,,,,
E1015,HCPCS,SHOCK ABSORBER FOR MAN W/C,,,28,,NW,,,,,,$223.61,$0.00,1,1,1,1,1,1,20161001,,,,
E1015,HCPCS,SHOCK ABSORBER FOR MAN W/C,NU,,28,,NW,,,,,,$223.61,$0.00,1,1,1,1,1,1,20161001,,,,
E1015,HCPCS,SHOCK ABSORBER FOR MAN W/C,RR,,28,,NW,,,,,,$25.68,$0.00,1,1,1,1,1,1,20161001,,,,
E1015,HCPCS,SHOCK ABSORBER FOR MAN W/C,UE,,28,,NW,,,,,,$168.61,$0.00,1,1,1,1,1,1,20161001,,,,
E1016,HCPCS,SHOCK ABSORBER FOR POWER W/C,,,28,,NW,,,,,,$441.08,$0.00,1,1,1,1,1,1,20161001,,,,
E1016,HCPCS,SHOCK ABSORBER FOR POWER W/C,NU,,28,,NW,,,,,,$441.08,$0.00,1,1,1,1,1,1,20161001,,,,
E1016,HCPCS,SHOCK ABSORBER FOR POWER W/C,RR,,28,,NW,,,,,,$50.63,$0.00,1,1,1,1,1,1,20161001,,,,
E1016,HCPCS,SHOCK ABSORBER FOR POWER W/C,UE,,28,,NW,,,,,,$339.41,$0.00,1,1,1,1,1,1,20161001,,,,
E1017,HCPCS,HD SHCK ABSRBR FOR HD MAN WC,,,28,,NW,,,,,,$696.74,$0.00,1,1,1,1,1,1,20161001,,,,
E1017,HCPCS,HD SHCK ABSRBR FOR HD MAN WC,NU,,28,,NW,,,,,,$696.74,$0.00,1,1,1,1,1,1,20161001,,,,
E1017,HCPCS,HD SHCK ABSRBR FOR HD MAN WC,RR,,28,,NW,,,,,,$74.07,$0.00,1,1,1,1,1,1,20161001,,,,
E1017,HCPCS,HD SHCK ABSRBR FOR HD MAN WC,UE,,28,,NW,,,,,,$523.83,$0.00,1,1,1,1,1,1,20161001,,,,
E1018,HCPCS,HD SHCK ABSRBER FOR HD POWWC,,,28,,NW,,,,,,$146.83,$0.00,1,1,1,1,1,1,20161001,,,,
E1018,HCPCS,HD SHCK ABSRBER FOR HD POWWC,NU,,28,,NW,,,,,,$146.83,$0.00,1,1,1,1,1,1,20161001,,,,
E1018,HCPCS,HD SHCK ABSRBER FOR HD POWWC,RR,,28,,NW,,,,,,$15.62,$0.00,1,1,1,1,1,1,20161001,,,,
E1018,HCPCS,HD SHCK ABSRBER FOR HD POWWC,UE,,28,,NW,,,,,,$110.39,$0.00,1,1,1,1,1,1,20161001,,,,
E1020,HCPCS,RESIDUAL LIMB SUPPORT SYSTEM,,,28,,NW,,,,,,$788.18,$0.00,1,1,1,1,1,1,20161001,,,,
E1020,HCPCS,RESIDUAL LIMB SUPPORT SYSTEM,NU,,28,,NW,,,,,,$788.18,$0.00,1,1,1,1,1,1,20161001,,,,
E1020,HCPCS,RESIDUAL LIMB SUPPORT SYSTEM,RR,,28,,NW,,,,,,$90.51,$0.00,1,1,1,1,1,1,20161001,,,,
E1020,HCPCS,RESIDUAL LIMB SUPPORT SYSTEM,UE,,28,,NW,,,,,,$599.73,$0.00,1,1,1,1,1,1,20161001,,,,
E1028,HCPCS,W/C MANUAL SWINGAWAY,,,28,,NW,,,,,,$674.02,$0.00,1,1,1,1,1,1,20161001,,,,
E1028,HCPCS,W/C MANUAL SWINGAWAY,NU,,28,,NW,,,,,,$674.02,$0.00,1,1,1,1,1,1,20161001,,,,
E1028,HCPCS,W/C MANUAL SWINGAWAY,RR,,28,,NW,,,,,,$77.41,$0.00,1,1,1,1,1,1,20161001,,,,
E1028,HCPCS,W/C MANUAL SWINGAWAY,UE,,28,,NW,,,,,,$514.10,$0.00,1,1,1,1,1,1,20161001,,,,
E1029,HCPCS,W/C VENT TRAY FIXED,,,28,,NW,,,,,,"$1,274.72",$0.00,1,1,1,1,1,1,20161001,,,,
E1029,HCPCS,W/C VENT TRAY FIXED,RR,,28,,NW,,,,,,$135.59,$0.00,1,1,1,1,1,1,20161001,,,,
E1030,HCPCS,W/C VENT TRAY GIMBALED,,,28,,NW,,,,,,"$3,716.17",$0.00,1,1,1,1,1,1,20161001,,,,
E1030,HCPCS,W/C VENT TRAY GIMBALED,NU,,28,,NW,,,,,,"$3,716.17",$0.00,1,1,1,1,1,1,20161001,,,,
E1030,HCPCS,W/C VENT TRAY GIMBALED,RR,,28,,NW,,,,,,$395.29,$0.00,1,1,1,1,1,1,20161001,,,,
E1030,HCPCS,W/C VENT TRAY GIMBALED,UE,,28,,NW,,,,,,"$2,796.35",$0.00,1,1,1,1,1,1,20161001,,,,
E1031,HCPCS,ROLLABOUT CHAIR WITH CASTERS,,,28,,NW,,,,,,$834.62,$0.00,1,1,1,1,1,1,20161001,,,,
E1031,HCPCS,ROLLABOUT CHAIR WITH CASTERS,NU,,28,,NW,,,,,,$834.62,$0.00,1,1,1,1,1,1,20161001,,,,
E1031,HCPCS,ROLLABOUT CHAIR WITH CASTERS,RR,,28,,NW,,,,,,$95.55,$0.00,1,1,1,1,1,1,20161001,,,,
E1031,HCPCS,ROLLABOUT CHAIR WITH CASTERS,UE,,28,,NW,,,,,,$634.41,$0.00,1,1,1,1,1,1,20161001,,,,
E1035,HCPCS,PATIENT TRANSFER SYSTEM <300,,,28,,NW,,,,,,"$9,911.60",$0.00,1,1,1,1,1,1,20161001,,,,
E1035,HCPCS,PATIENT TRANSFER SYSTEM <300,RR,,28,,NW,,,,,,"$1,054.30",$0.00,1,1,1,1,1,1,20161001,,,,
E1036,HCPCS,PATIENT TRANSFER SYSTEM >300,,,28,,NW,,,,,,"$13,764.86",$0.00,1,1,1,1,1,1,20161001,,,,
E1036,HCPCS,PATIENT TRANSFER SYSTEM >300,RR,,28,,NW,,,,,,"$1,464.17",$0.00,1,1,1,1,1,1,20161001,,,,
E1037,HCPCS,"TRANSPORT CHAIR, PED SIZE",,,28,,NW,,,,,,"$1,989.96",$0.00,1,1,1,1,1,1,20161001,,,,
E1037,HCPCS,"TRANSPORT CHAIR, PED SIZE",RR,,28,,NW,,,,,,$211.67,$0.00,1,1,1,1,1,1,20161001,,,,
E1038,HCPCS,TRANSPORT CHAIR PT WT<=300LB,,,28,,NW,,,,,,$359.77,$0.00,1,1,1,1,1,1,20161001,,,,
E1038,HCPCS,TRANSPORT CHAIR PT WT<=300LB,RR,,28,,NW,,,,,,$38.27,$0.00,1,1,1,1,1,1,20161001,,,,
E1039,HCPCS,TRANSPORT CHAIR PT WT >300LB,,,28,,NW,,,,,,$651.06,$0.00,1,1,1,1,1,1,20161001,,,,
E1039,HCPCS,TRANSPORT CHAIR PT WT >300LB,RR,,28,,NW,,,,,,$69.25,$0.00,1,1,1,1,1,1,20161001,,,,
E1050,HCPCS,WHELCHR FXD FULL LENGTH ARMS,,,28,,NW,,,,,,"$1,647.88",$0.00,1,1,1,1,1,1,20161001,,,,
E1050,HCPCS,WHELCHR FXD FULL LENGTH ARMS,NU,,28,,NW,,,,,,"$1,647.88",$0.00,1,1,1,1,1,1,20161001,,,,
E1050,HCPCS,WHELCHR FXD FULL LENGTH ARMS,RR,,28,,NW,,,,,,$191.08,$0.00,1,1,1,1,1,1,20161001,,,,
E1050,HCPCS,WHELCHR FXD FULL LENGTH ARMS,UE,,28,,NW,,,,,,"$1,244.69",$0.00,1,1,1,1,1,1,20161001,,,,
E1060,HCPCS,WHEELCHAIR DETACHABLE ARMS,,,28,,NW,,,,,,"$2,031.80",$0.00,1,1,1,1,1,1,20161001,,,,
E1060,HCPCS,WHEELCHAIR DETACHABLE ARMS,NU,,28,,NW,,,,,,"$2,031.80",$0.00,1,1,1,1,1,1,20161001,,,,
E1060,HCPCS,WHEELCHAIR DETACHABLE ARMS,RR,,28,,NW,,,,,,$229.66,$0.00,1,1,1,1,1,1,20161001,,,,
E1060,HCPCS,WHEELCHAIR DETACHABLE ARMS,UE,,28,,NW,,,,,,"$1,532.29",$0.00,1,1,1,1,1,1,20161001,,,,
E1070,HCPCS,WHEELCHAIR DETACHABLE FOOT R,,,28,,NW,,,,,,"$1,769.66",$0.00,1,1,1,1,1,1,20161001,,,,
E1070,HCPCS,WHEELCHAIR DETACHABLE FOOT R,NU,,28,,NW,,,,,,"$1,769.66",$0.00,1,1,1,1,1,1,20161001,,,,
E1070,HCPCS,WHEELCHAIR DETACHABLE FOOT R,RR,,28,,NW,,,,,,$203.93,$0.00,1,1,1,1,1,1,20161001,,,,
E1070,HCPCS,WHEELCHAIR DETACHABLE FOOT R,UE,,28,,NW,,,,,,"$1,336.20",$0.00,1,1,1,1,1,1,20161001,,,,
E1083,HCPCS,HEMI-WHEELCHAIR FIXED ARMS,,,28,,NW,,,,,,"$1,281.84",$0.00,1,1,1,1,1,1,20161001,,,,
E1083,HCPCS,HEMI-WHEELCHAIR FIXED ARMS,NU,,28,,NW,,,,,,"$1,281.84",$0.00,1,1,1,1,1,1,20161001,,,,
E1083,HCPCS,HEMI-WHEELCHAIR FIXED ARMS,RR,,28,,NW,,,,,,$143.47,$0.00,1,1,1,1,1,1,20161001,,,,
E1083,HCPCS,HEMI-WHEELCHAIR FIXED ARMS,UE,,28,,NW,,,,,,$970.17,$0.00,1,1,1,1,1,1,20161001,,,,
E1084,HCPCS,HEMI-WHEELCHAIR DETACHABLE A,,,28,,NW,,,,,,"$1,588.71",$0.00,1,1,1,1,1,1,20161001,,,,
E1084,HCPCS,HEMI-WHEELCHAIR DETACHABLE A,NU,,28,,NW,,,,,,"$1,588.71",$0.00,1,1,1,1,1,1,20161001,,,,
E1084,HCPCS,HEMI-WHEELCHAIR DETACHABLE A,RR,,28,,NW,,,,,,$184.41,$0.00,1,1,1,1,1,1,20161001,,,,
E1084,HCPCS,HEMI-WHEELCHAIR DETACHABLE A,UE,,28,,NW,,,,,,"$1,199.97",$0.00,1,1,1,1,1,1,20161001,,,,
E1085,HCPCS,HEMI-WHEELCHAIR FIXED ARMS,,,28,,NW,,,,,,"$1,418.76",$0.00,1,1,1,1,1,1,20161001,,,,
E1085,HCPCS,HEMI-WHEELCHAIR FIXED ARMS,NU,,28,,NW,,,,,,"$1,418.76",$0.00,1,1,1,1,1,1,20161001,,,,
E1085,HCPCS,HEMI-WHEELCHAIR FIXED ARMS,RR,,28,,NW,,,,,,$163.11,$0.00,1,1,1,1,1,1,20161001,,,,
E1085,HCPCS,HEMI-WHEELCHAIR FIXED ARMS,UE,,28,,NW,,,,,,"$1,028.65",$0.00,1,1,1,1,1,1,20161001,,,,
E1086,HCPCS,HEMI-WHEELCHAIR DETACHABLE A,,,28,,NW,,,,,,"$1,720.81",$0.00,1,1,1,1,1,1,20161001,,,,
E1086,HCPCS,HEMI-WHEELCHAIR DETACHABLE A,NU,,28,,NW,,,,,,"$1,720.81",$0.00,1,1,1,1,1,1,20161001,,,,
E1086,HCPCS,HEMI-WHEELCHAIR DETACHABLE A,RR,,28,,NW,,,,,,$180.56,$0.00,1,1,1,1,1,1,20161001,,,,
E1086,HCPCS,HEMI-WHEELCHAIR DETACHABLE A,UE,,28,,NW,,,,,,"$1,259.14",$0.00,1,1,1,1,1,1,20161001,,,,
E1087,HCPCS,WHEELCHAIR LIGHTWT FIXED ARM,,,28,,NW,,,,,,"$2,038.68",$0.00,1,1,1,1,1,1,20161001,,,,
E1087,HCPCS,WHEELCHAIR LIGHTWT FIXED ARM,NU,,28,,NW,,,,,,"$2,038.68",$0.00,1,1,1,1,1,1,20161001,,,,
E1087,HCPCS,WHEELCHAIR LIGHTWT FIXED ARM,RR,,28,,NW,,,,,,$235.04,$0.00,1,1,1,1,1,1,20161001,,,,
E1087,HCPCS,WHEELCHAIR LIGHTWT FIXED ARM,UE,,28,,NW,,,,,,"$1,537.79",$0.00,1,1,1,1,1,1,20161001,,,,
E1088,HCPCS,WHEELCHAIR LIGHTWEIGHT DET A,,,28,,NW,,,,,,"$2,423.29",$0.00,1,1,1,1,1,1,20161001,,,,
E1088,HCPCS,WHEELCHAIR LIGHTWEIGHT DET A,NU,,28,,NW,,,,,,"$2,423.29",$0.00,1,1,1,1,1,1,20161001,,,,
E1088,HCPCS,WHEELCHAIR LIGHTWEIGHT DET A,RR,,28,,NW,,,,,,$268.36,$0.00,1,1,1,1,1,1,20161001,,,,
E1088,HCPCS,WHEELCHAIR LIGHTWEIGHT DET A,UE,,28,,NW,,,,,,"$1,826.08",$0.00,1,1,1,1,1,1,20161001,,,,
E1089,HCPCS,WHEELCHAIR LIGHTWT FIXED ARM,,,28,,NW,,,,,,"$2,272.61",$0.00,1,1,1,1,1,1,20161001,,,,
E1089,HCPCS,WHEELCHAIR LIGHTWT FIXED ARM,NU,,28,,NW,,,,,,"$2,272.61",$0.00,1,1,1,1,1,1,20161001,,,,
E1089,HCPCS,WHEELCHAIR LIGHTWT FIXED ARM,RR,,28,,NW,,,,,,$258.06,$0.00,1,1,1,1,1,1,20161001,,,,
E1089,HCPCS,WHEELCHAIR LIGHTWT FIXED ARM,UE,,28,,NW,,,,,,"$1,713.24",$0.00,1,1,1,1,1,1,20161001,,,,
E1090,HCPCS,WHEELCHAIR LIGHTWEIGHT DET A,,,28,,NW,,,,,,"$2,342.10",$0.00,1,1,1,1,1,1,20161001,,,,
E1090,HCPCS,WHEELCHAIR LIGHTWEIGHT DET A,NU,,28,,NW,,,,,,"$2,342.10",$0.00,1,1,1,1,1,1,20161001,,,,
E1090,HCPCS,WHEELCHAIR LIGHTWEIGHT DET A,RR,,28,,NW,,,,,,$258.06,$0.00,1,1,1,1,1,1,20161001,,,,
E1090,HCPCS,WHEELCHAIR LIGHTWEIGHT DET A,UE,,28,,NW,,,,,,"$1,720.81",$0.00,1,1,1,1,1,1,20161001,,,,
E1092,HCPCS,WHEELCHAIR WIDE W/ LEG RESTS,,,28,,NW,,,,,,"$2,070.33",$0.00,1,1,1,1,1,1,20161001,,,,
E1092,HCPCS,WHEELCHAIR WIDE W/ LEG RESTS,NU,,28,,NW,,,,,,"$2,070.33",$0.00,1,1,1,1,1,1,20161001,,,,
E1092,HCPCS,WHEELCHAIR WIDE W/ LEG RESTS,RR,,28,,NW,,,,,,$235.53,$0.00,1,1,1,1,1,1,20161001,,,,
E1092,HCPCS,WHEELCHAIR WIDE W/ LEG RESTS,UE,,28,,NW,,,,,,"$1,561.18",$0.00,1,1,1,1,1,1,20161001,,,,
E1093,HCPCS,WHEELCHAIR WIDE W/ FOOT REST,,,28,,NW,,,,,,"$1,785.48",$0.00,1,1,1,1,1,1,20161001,,,,
E1093,HCPCS,WHEELCHAIR WIDE W/ FOOT REST,NU,,28,,NW,,,,,,"$1,785.48",$0.00,1,1,1,1,1,1,20161001,,,,
E1093,HCPCS,WHEELCHAIR WIDE W/ FOOT REST,RR,,28,,NW,,,,,,$204.42,$0.00,1,1,1,1,1,1,20161001,,,,
E1093,HCPCS,WHEELCHAIR WIDE W/ FOOT REST,UE,,28,,NW,,,,,,"$1,347.89",$0.00,1,1,1,1,1,1,20161001,,,,
E1100,HCPCS,WHCHR S-RECL FXD ARM LEG RES,,,28,,NW,,,,,,"$1,678.84",$0.00,1,1,1,1,1,1,20161001,,,,
E1100,HCPCS,WHCHR S-RECL FXD ARM LEG RES,NU,,28,,NW,,,,,,"$1,678.84",$0.00,1,1,1,1,1,1,20161001,,,,
E1100,HCPCS,WHCHR S-RECL FXD ARM LEG RES,RR,,28,,NW,,,,,,$191.82,$0.00,1,1,1,1,1,1,20161001,,,,
E1100,HCPCS,WHCHR S-RECL FXD ARM LEG RES,UE,,28,,NW,,,,,,"$1,268.08",$0.00,1,1,1,1,1,1,20161001,,,,
E1110,HCPCS,WHEELCHAIR SEMI-RECL DETACH,,,28,,NW,,,,,,"$1,645.12",$0.00,1,1,1,1,1,1,20161001,,,,
E1110,HCPCS,WHEELCHAIR SEMI-RECL DETACH,NU,,28,,NW,,,,,,"$1,645.12",$0.00,1,1,1,1,1,1,20161001,,,,
E1110,HCPCS,WHEELCHAIR SEMI-RECL DETACH,RR,,28,,NW,,,,,,$186.60,$0.00,1,1,1,1,1,1,20161001,,,,
E1110,HCPCS,WHEELCHAIR SEMI-RECL DETACH,UE,,28,,NW,,,,,,"$1,242.63",$0.00,1,1,1,1,1,1,20161001,,,,
E1130,HCPCS,WHLCHR STAND FXD ARM FT REST,,,28,,NW,,,,,,$922.00,$0.00,1,1,1,1,1,1,20161001,,,,
E1130,HCPCS,WHLCHR STAND FXD ARM FT REST,NU,,28,,NW,,,,,,$922.00,$0.00,1,1,1,1,1,1,20161001,,,,
E1130,HCPCS,WHLCHR STAND FXD ARM FT REST,RR,,28,,NW,,,,,,$106.01,$0.00,1,1,1,1,1,1,20161001,,,,
E1130,HCPCS,WHLCHR STAND FXD ARM FT REST,UE,,28,,NW,,,,,,$708.72,$0.00,1,1,1,1,1,1,20161001,,,,
E1140,HCPCS,WHEELCHAIR STANDARD DETACH A,,,28,,NW,,,,,,"$1,312.81",$0.00,1,1,1,1,1,1,20161001,,,,
E1140,HCPCS,WHEELCHAIR STANDARD DETACH A,NU,,28,,NW,,,,,,"$1,312.81",$0.00,1,1,1,1,1,1,20161001,,,,
E1140,HCPCS,WHEELCHAIR STANDARD DETACH A,RR,,28,,NW,,,,,,$151.22,$0.00,1,1,1,1,1,1,20161001,,,,
E1140,HCPCS,WHEELCHAIR STANDARD DETACH A,UE,,28,,NW,,,,,,$939.89,$0.00,1,1,1,1,1,1,20161001,,,,
E1150,HCPCS,WHEELCHAIR STANDARD W/ LEG R,,,28,,NW,,,,,,"$1,326.57",$0.00,1,1,1,1,1,1,20161001,,,,
E1150,HCPCS,WHEELCHAIR STANDARD W/ LEG R,NU,,28,,NW,,,,,,"$1,326.57",$0.00,1,1,1,1,1,1,20161001,,,,
E1150,HCPCS,WHEELCHAIR STANDARD W/ LEG R,RR,,28,,NW,,,,,,$152.17,$0.00,1,1,1,1,1,1,20161001,,,,
E1150,HCPCS,WHEELCHAIR STANDARD W/ LEG R,UE,,28,,NW,,,,,,"$1,003.88",$0.00,1,1,1,1,1,1,20161001,,,,
E1160,HCPCS,WHEELCHAIR FIXED ARMS,,,28,,NW,,,,,,"$1,024.52",$0.00,1,1,1,1,1,1,20161001,,,,
E1160,HCPCS,WHEELCHAIR FIXED ARMS,NU,,28,,NW,,,,,,"$1,024.52",$0.00,1,1,1,1,1,1,20161001,,,,
E1160,HCPCS,WHEELCHAIR FIXED ARMS,RR,,28,,NW,,,,,,$118.87,$0.00,1,1,1,1,1,1,20161001,,,,
E1160,HCPCS,WHEELCHAIR FIXED ARMS,UE,,28,,NW,,,,,,$777.52,$0.00,1,1,1,1,1,1,20161001,,,,
E1161,HCPCS,MANUAL ADULT WC W TILTINSPAC,,,28,,NW,,,,,,"$3,782.83",$0.00,1,1,1,1,1,1,20161001,,,,
E1161,HCPCS,MANUAL ADULT WC W TILTINSPAC,NU,,28,,NW,,,,,,"$3,782.83",$0.00,1,1,1,1,1,1,20161001,,,,
E1161,HCPCS,MANUAL ADULT WC W TILTINSPAC,RR,,28,,NW,,,,,,$427.95,$0.00,1,1,1,1,1,1,20161001,,,,
E1161,HCPCS,MANUAL ADULT WC W TILTINSPAC,UE,,28,,NW,,,,,,"$2,845.74",$0.00,1,1,1,1,1,1,20161001,,,,
E1170,HCPCS,WHLCHR AMPU FXD ARM LEG REST,,,28,,NW,,,,,,"$1,449.72",$0.00,1,1,1,1,1,1,20161001,,,,
E1170,HCPCS,WHLCHR AMPU FXD ARM LEG REST,NU,,28,,NW,,,,,,"$1,449.72",$0.00,1,1,1,1,1,1,20161001,,,,
E1170,HCPCS,WHLCHR AMPU FXD ARM LEG REST,RR,,28,,NW,,,,,,$160.92,$0.00,1,1,1,1,1,1,20161001,,,,
E1170,HCPCS,WHLCHR AMPU FXD ARM LEG REST,UE,,28,,NW,,,,,,"$1,095.39",$0.00,1,1,1,1,1,1,20161001,,,,
E1171,HCPCS,WHEELCHAIR AMPUTEE W/O LEG R,,,28,,NW,,,,,,"$1,304.55",$0.00,1,1,1,1,1,1,20161001,,,,
E1171,HCPCS,WHEELCHAIR AMPUTEE W/O LEG R,NU,,28,,NW,,,,,,"$1,304.55",$0.00,1,1,1,1,1,1,20161001,,,,
E1171,HCPCS,WHEELCHAIR AMPUTEE W/O LEG R,RR,,28,,NW,,,,,,$148.58,$0.00,1,1,1,1,1,1,20161001,,,,
E1171,HCPCS,WHEELCHAIR AMPUTEE W/O LEG R,UE,,28,,NW,,,,,,$986.68,$0.00,1,1,1,1,1,1,20161001,,,,
E1172,HCPCS,WHEELCHAIR AMPUTEE DETACH AR,,,28,,NW,,,,,,"$1,585.95",$0.00,1,1,1,1,1,1,20161001,,,,
E1172,HCPCS,WHEELCHAIR AMPUTEE DETACH AR,NU,,28,,NW,,,,,,"$1,585.95",$0.00,1,1,1,1,1,1,20161001,,,,
E1172,HCPCS,WHEELCHAIR AMPUTEE DETACH AR,RR,,28,,NW,,,,,,$182.79,$0.00,1,1,1,1,1,1,20161001,,,,
E1172,HCPCS,WHEELCHAIR AMPUTEE DETACH AR,UE,,28,,NW,,,,,,"$1,198.59",$0.00,1,1,1,1,1,1,20161001,,,,
E1180,HCPCS,WHEELCHAIR AMPUTEE W/ FOOT R,,,28,,NW,,,,,,"$1,640.31",$0.00,1,1,1,1,1,1,20161001,,,,
E1180,HCPCS,WHEELCHAIR AMPUTEE W/ FOOT R,NU,,28,,NW,,,,,,"$1,640.31",$0.00,1,1,1,1,1,1,20161001,,,,
E1180,HCPCS,WHEELCHAIR AMPUTEE W/ FOOT R,RR,,28,,NW,,,,,,$187.44,$0.00,1,1,1,1,1,1,20161001,,,,
E1180,HCPCS,WHEELCHAIR AMPUTEE W/ FOOT R,UE,,28,,NW,,,,,,"$1,238.50",$0.00,1,1,1,1,1,1,20161001,,,,
E1190,HCPCS,WHEELCHAIR AMPUTEE W/ LEG RE,,,28,,NW,,,,,,"$1,889.37",$0.00,1,1,1,1,1,1,20161001,,,,
E1190,HCPCS,WHEELCHAIR AMPUTEE W/ LEG RE,NU,,28,,NW,,,,,,"$1,889.37",$0.00,1,1,1,1,1,1,20161001,,,,
E1190,HCPCS,WHEELCHAIR AMPUTEE W/ LEG RE,RR,,28,,NW,,,,,,$213.08,$0.00,1,1,1,1,1,1,20161001,,,,
E1190,HCPCS,WHEELCHAIR AMPUTEE W/ LEG RE,UE,,28,,NW,,,,,,"$1,425.64",$0.00,1,1,1,1,1,1,20161001,,,,
E1195,HCPCS,WHEELCHAIR AMPUTEE HEAVY DUT,,,28,,NW,,,,,,"$2,024.92",$0.00,1,1,1,1,1,1,20161001,,,,
E1195,HCPCS,WHEELCHAIR AMPUTEE HEAVY DUT,NU,,28,,NW,,,,,,"$2,024.92",$0.00,1,1,1,1,1,1,20161001,,,,
E1195,HCPCS,WHEELCHAIR AMPUTEE HEAVY DUT,RR,,28,,NW,,,,,,$228.54,$0.00,1,1,1,1,1,1,20161001,,,,
E1195,HCPCS,WHEELCHAIR AMPUTEE HEAVY DUT,UE,,28,,NW,,,,,,"$1,527.47",$0.00,1,1,1,1,1,1,20161001,,,,
E1200,HCPCS,WHEELCHAIR AMPUTEE FIXED ARM,,,28,,NW,,,,,,"$1,413.26",$0.00,1,1,1,1,1,1,20161001,,,,
E1200,HCPCS,WHEELCHAIR AMPUTEE FIXED ARM,NU,,28,,NW,,,,,,"$1,413.26",$0.00,1,1,1,1,1,1,20161001,,,,
E1200,HCPCS,WHEELCHAIR AMPUTEE FIXED ARM,RR,,28,,NW,,,,,,$162.57,$0.00,1,1,1,1,1,1,20161001,,,,
E1200,HCPCS,WHEELCHAIR AMPUTEE FIXED ARM,UE,,28,,NW,,,,,,"$1,068.55",$0.00,1,1,1,1,1,1,20161001,,,,
E1220,HCPCS,WHLCHR SPECIAL SIZE/CONSTRC,,,28,,NW,,,,,,"$5,136.73",$0.00,1,1,1,1,1,1,20161001,,,,
E1221,HCPCS,WHEELCHAIR SPEC SIZE W FOOT,,,28,,NW,,,,,,$787.15,$0.00,1,1,1,1,1,1,20161001,,,,
E1221,HCPCS,WHEELCHAIR SPEC SIZE W FOOT,NU,,28,,NW,,,,,,$787.15,$0.00,1,1,1,1,1,1,20161001,,,,
E1221,HCPCS,WHEELCHAIR SPEC SIZE W FOOT,RR,,28,,NW,,,,,,$89.95,$0.00,1,1,1,1,1,1,20161001,,,,
E1221,HCPCS,WHEELCHAIR SPEC SIZE W FOOT,UE,,28,,NW,,,,,,$599.32,$0.00,1,1,1,1,1,1,20161001,,,,
E1222,HCPCS,WHEELCHAIR SPEC SIZE W/ LEG,,,28,,NW,,,,,,"$1,108.46",$0.00,1,1,1,1,1,1,20161001,,,,
E1222,HCPCS,WHEELCHAIR SPEC SIZE W/ LEG,NU,,28,,NW,,,,,,"$1,108.46",$0.00,1,1,1,1,1,1,20161001,,,,
E1222,HCPCS,WHEELCHAIR SPEC SIZE W/ LEG,RR,,28,,NW,,,,,,$129.12,$0.00,1,1,1,1,1,1,20161001,,,,
E1222,HCPCS,WHEELCHAIR SPEC SIZE W/ LEG,UE,,28,,NW,,,,,,$840.13,$0.00,1,1,1,1,1,1,20161001,,,,
E1223,HCPCS,WHEELCHAIR SPEC SIZE W FOOT,,,28,,NW,,,,,,"$1,206.85",$0.00,1,1,1,1,1,1,20161001,,,,
E1223,HCPCS,WHEELCHAIR SPEC SIZE W FOOT,NU,,28,,NW,,,,,,"$1,206.85",$0.00,1,1,1,1,1,1,20161001,,,,
E1223,HCPCS,WHEELCHAIR SPEC SIZE W FOOT,RR,,28,,NW,,,,,,$137.12,$0.00,1,1,1,1,1,1,20161001,,,,
E1223,HCPCS,WHEELCHAIR SPEC SIZE W FOOT,UE,,28,,NW,,,,,,$913.75,$0.00,1,1,1,1,1,1,20161001,,,,
E1224,HCPCS,WHEELCHAIR SPEC SIZE W/ LEG,,,28,,NW,,,,,,"$1,320.37",$0.00,1,1,1,1,1,1,20161001,,,,
E1224,HCPCS,WHEELCHAIR SPEC SIZE W/ LEG,NU,,28,,NW,,,,,,"$1,320.37",$0.00,1,1,1,1,1,1,20161001,,,,
E1224,HCPCS,WHEELCHAIR SPEC SIZE W/ LEG,RR,,28,,NW,,,,,,$149.64,$0.00,1,1,1,1,1,1,20161001,,,,
E1224,HCPCS,WHEELCHAIR SPEC SIZE W/ LEG,UE,,28,,NW,,,,,,$999.06,$0.00,1,1,1,1,1,1,20161001,,,,
E1225,HCPCS,MANUAL SEMI-RECLINING BACK,,,28,,NW,,,,,,$750.68,$0.00,1,1,1,1,1,1,20161001,,,,
E1225,HCPCS,MANUAL SEMI-RECLINING BACK,NU,,28,,NW,,,,,,$750.68,$0.00,1,1,1,1,1,1,20161001,,,,
E1225,HCPCS,MANUAL SEMI-RECLINING BACK,RR,,28,,NW,,,,,,$84.15,$0.00,1,1,1,1,1,1,20161001,,,,
E1225,HCPCS,MANUAL SEMI-RECLINING BACK,UE,,28,,NW,,,,,,$571.80,$0.00,1,1,1,1,1,1,20161001,,,,
E1226,HCPCS,MANUAL FULLY RECLINING BACK,,,28,,NW,,,,,,$873.47,$0.00,1,1,1,1,1,1,20161001,,,,
E1226,HCPCS,MANUAL FULLY RECLINING BACK,NU,,28,,NW,,,,,,$873.47,$0.00,1,1,1,1,1,1,20161001,,,,
E1226,HCPCS,MANUAL FULLY RECLINING BACK,RR,,28,,NW,,,,,,$103.45,$0.00,1,1,1,1,1,1,20161001,,,,
E1226,HCPCS,MANUAL FULLY RECLINING BACK,UE,,28,,NW,,,,,,$663.92,$0.00,1,1,1,1,1,1,20161001,,,,
E1227,HCPCS,WHEELCHAIR SPEC SZ SPEC HT A,,,28,,NW,,,,,,$467.07,$0.00,1,1,1,1,1,1,20161001,,,,
E1227,HCPCS,WHEELCHAIR SPEC SZ SPEC HT A,NU,,28,,NW,,,,,,$467.07,$0.00,1,1,1,1,1,1,20161001,,,,
E1227,HCPCS,WHEELCHAIR SPEC SZ SPEC HT A,RR,,28,,NW,,,,,,$53.59,$0.00,1,1,1,1,1,1,20161001,,,,
E1227,HCPCS,WHEELCHAIR SPEC SZ SPEC HT A,UE,,28,,NW,,,,,,$359.05,$0.00,1,1,1,1,1,1,20161001,,,,
E1228,HCPCS,WHEELCHAIR SPEC SZ SPEC HT B,,,28,,NW,,,,,,$478.23,$0.00,1,1,1,1,1,1,20161001,,,,
E1228,HCPCS,WHEELCHAIR SPEC SZ SPEC HT B,NU,,28,,NW,,,,,,$478.23,$0.00,1,1,1,1,1,1,20161001,,,,
E1228,HCPCS,WHEELCHAIR SPEC SZ SPEC HT B,RR,,28,,NW,,,,,,$52.87,$0.00,1,1,1,1,1,1,20161001,,,,
E1228,HCPCS,WHEELCHAIR SPEC SZ SPEC HT B,UE,,28,,NW,,,,,,$367.45,$0.00,1,1,1,1,1,1,20161001,,,,
E1229,HCPCS,PEDIATRIC WHEELCHAIR NOS,,,28,,NW,,,,,,"$1,657.28",$0.00,1,1,1,1,1,1,20161001,,,,
E1230,HCPCS,POWER OPERATED VEHICLE,,,28,,NW,,,,,,"$3,512.29",$0.00,1,1,1,1,1,1,20161001,,,,
E1230,HCPCS,POWER OPERATED VEHICLE,NU,,28,,NW,,,,,,"$3,512.29",$0.00,1,1,1,1,1,1,20161001,,,,
E1230,HCPCS,POWER OPERATED VEHICLE,RR,,28,,NW,,,,,,$379.34,$0.00,1,1,1,1,1,1,20161001,,,,
E1230,HCPCS,POWER OPERATED VEHICLE,UE,,28,,NW,,,,,,"$2,741.87",$0.00,1,1,1,1,1,1,20161001,,,,
E1231,HCPCS,RIGID PED W/C TILT-IN-SPACE,,,28,,NW,,,,,,"$3,175.71",$0.00,1,1,1,1,1,1,20161001,,,,
E1231,HCPCS,RIGID PED W/C TILT-IN-SPACE,NU,,28,,NW,,,,,,"$3,175.71",$0.00,1,1,1,1,1,1,20161001,,,,
E1231,HCPCS,RIGID PED W/C TILT-IN-SPACE,RR,,28,,NW,,,,,,$347.56,$0.00,1,1,1,1,1,1,20161001,,,,
E1231,HCPCS,RIGID PED W/C TILT-IN-SPACE,UE,,28,,NW,,,,,,"$2,391.51",$0.00,1,1,1,1,1,1,20161001,,,,
E1232,HCPCS,FOLDING PED WC TILT-IN-SPACE,,,28,,NW,,,,,,"$3,422.30",$0.00,1,1,1,1,1,1,20161001,,,,
E1232,HCPCS,FOLDING PED WC TILT-IN-SPACE,NU,,28,,NW,,,,,,"$3,422.30",$0.00,1,1,1,1,1,1,20161001,,,,
E1232,HCPCS,FOLDING PED WC TILT-IN-SPACE,RR,,28,,NW,,,,,,$390.12,$0.00,1,1,1,1,1,1,20161001,,,,
E1232,HCPCS,FOLDING PED WC TILT-IN-SPACE,UE,,28,,NW,,,,,,"$2,575.34",$0.00,1,1,1,1,1,1,20161001,,,,
E1233,HCPCS,RIG PED WC TLTNSPC W/O SEAT,,,28,,NW,,,,,,"$3,544.77",$0.00,1,1,1,1,1,1,20161001,,,,
E1233,HCPCS,RIG PED WC TLTNSPC W/O SEAT,NU,,28,,NW,,,,,,"$3,544.77",$0.00,1,1,1,1,1,1,20161001,,,,
E1233,HCPCS,RIG PED WC TLTNSPC W/O SEAT,RR,,28,,NW,,,,,,$402.95,$0.00,1,1,1,1,1,1,20161001,,,,
E1233,HCPCS,RIG PED WC TLTNSPC W/O SEAT,UE,,28,,NW,,,,,,"$2,667.54",$0.00,1,1,1,1,1,1,20161001,,,,
E1234,HCPCS,FLD PED WC TLTNSPC W/O SEAT,,,28,,NW,,,,,,"$3,090.67",$0.00,1,1,1,1,1,1,20161001,,,,
E1234,HCPCS,FLD PED WC TLTNSPC W/O SEAT,NU,,28,,NW,,,,,,"$3,090.67",$0.00,1,1,1,1,1,1,20161001,,,,
E1234,HCPCS,FLD PED WC TLTNSPC W/O SEAT,RR,,28,,NW,,,,,,$355.28,$0.00,1,1,1,1,1,1,20161001,,,,
E1234,HCPCS,FLD PED WC TLTNSPC W/O SEAT,UE,,28,,NW,,,,,,"$2,326.27",$0.00,1,1,1,1,1,1,20161001,,,,
E1235,HCPCS,RIGID PED WC ADJUSTABLE,,,28,,NW,,,,,,"$2,977.15",$0.00,1,1,1,1,1,1,20161001,,,,
E1235,HCPCS,RIGID PED WC ADJUSTABLE,NU,,28,,NW,,,,,,"$2,977.15",$0.00,1,1,1,1,1,1,20161001,,,,
E1235,HCPCS,RIGID PED WC ADJUSTABLE,RR,,28,,NW,,,,,,$343.38,$0.00,1,1,1,1,1,1,20161001,,,,
E1235,HCPCS,RIGID PED WC ADJUSTABLE,UE,,28,,NW,,,,,,"$2,241.65",$0.00,1,1,1,1,1,1,20161001,,,,
E1236,HCPCS,FOLDING PED WC ADJUSTABLE,,,28,,NW,,,,,,"$2,630.38",$0.00,1,1,1,1,1,1,20161001,,,,
E1236,HCPCS,FOLDING PED WC ADJUSTABLE,NU,,28,,NW,,,,,,"$2,630.38",$0.00,1,1,1,1,1,1,20161001,,,,
E1236,HCPCS,FOLDING PED WC ADJUSTABLE,RR,,28,,NW,,,,,,$306.99,$0.00,1,1,1,1,1,1,20161001,,,,
E1236,HCPCS,FOLDING PED WC ADJUSTABLE,UE,,28,,NW,,,,,,"$1,981.57",$0.00,1,1,1,1,1,1,20161001,,,,
E1237,HCPCS,RGD PED WC ADJSTABL W/O SEAT,,,28,,NW,,,,,,"$2,653.09",$0.00,1,1,1,1,1,1,20161001,,,,
E1237,HCPCS,RGD PED WC ADJSTABL W/O SEAT,NU,,28,,NW,,,,,,"$2,653.09",$0.00,1,1,1,1,1,1,20161001,,,,
E1237,HCPCS,RGD PED WC ADJSTABL W/O SEAT,RR,,28,,NW,,,,,,$309.37,$0.00,1,1,1,1,1,1,20161001,,,,
E1237,HCPCS,RGD PED WC ADJSTABL W/O SEAT,UE,,28,,NW,,,,,,"$1,998.77",$0.00,1,1,1,1,1,1,20161001,,,,
E1238,HCPCS,FLD PED WC ADJSTABL W/O SEAT,,,28,,NW,,,,,,"$2,630.38",$0.00,1,1,1,1,1,1,20161001,,,,
E1238,HCPCS,FLD PED WC ADJSTABL W/O SEAT,NU,,28,,NW,,,,,,"$2,630.38",$0.00,1,1,1,1,1,1,20161001,,,,
E1238,HCPCS,FLD PED WC ADJSTABL W/O SEAT,RR,,28,,NW,,,,,,$306.99,$0.00,1,1,1,1,1,1,20161001,,,,
E1238,HCPCS,FLD PED WC ADJSTABL W/O SEAT,UE,,28,,NW,,,,,,"$1,981.57",$0.00,1,1,1,1,1,1,20161001,,,,
E1239,HCPCS,PED POWER WHEELCHAIR NOS,,,28,,NW,,,,,,"$3,512.29",$0.00,1,1,1,1,1,1,20161001,,,,
E1240,HCPCS,WHCHR LITWT DET ARM LEG REST,,,28,,NW,,,,,,"$1,666.45",$0.00,1,1,1,1,1,1,20161001,,,,
E1240,HCPCS,WHCHR LITWT DET ARM LEG REST,NU,,28,,NW,,,,,,"$1,666.45",$0.00,1,1,1,1,1,1,20161001,,,,
E1240,HCPCS,WHCHR LITWT DET ARM LEG REST,RR,,28,,NW,,,,,,$188.63,$0.00,1,1,1,1,1,1,20161001,,,,
E1240,HCPCS,WHCHR LITWT DET ARM LEG REST,UE,,28,,NW,,,,,,"$1,258.45",$0.00,1,1,1,1,1,1,20161001,,,,
E1250,HCPCS,WHEELCHAIR LIGHTWT FIXED ARM,,,28,,NW,,,,,,"$1,401.56",$0.00,1,1,1,1,1,1,20161001,,,,
E1250,HCPCS,WHEELCHAIR LIGHTWT FIXED ARM,NU,,28,,NW,,,,,,"$1,401.56",$0.00,1,1,1,1,1,1,20161001,,,,
E1250,HCPCS,WHEELCHAIR LIGHTWT FIXED ARM,RR,,28,,NW,,,,,,$147.25,$0.00,1,1,1,1,1,1,20161001,,,,
E1250,HCPCS,WHEELCHAIR LIGHTWT FIXED ARM,UE,,28,,NW,,,,,,"$1,117.40",$0.00,1,1,1,1,1,1,20161001,,,,
E1260,HCPCS,WHEELCHAIR LIGHTWT FOOT REST,,,28,,NW,,,,,,"$1,632.05",$0.00,1,1,1,1,1,1,20161001,,,,
E1260,HCPCS,WHEELCHAIR LIGHTWT FOOT REST,NU,,28,,NW,,,,,,"$1,632.05",$0.00,1,1,1,1,1,1,20161001,,,,
E1260,HCPCS,WHEELCHAIR LIGHTWT FOOT REST,RR,,28,,NW,,,,,,$187.70,$0.00,1,1,1,1,1,1,20161001,,,,
E1260,HCPCS,WHEELCHAIR LIGHTWT FOOT REST,UE,,28,,NW,,,,,,"$1,294.92",$0.00,1,1,1,1,1,1,20161001,,,,
E1270,HCPCS,WHEELCHAIR LIGHTWEIGHT LEG R,,,28,,NW,,,,,,"$1,285.28",$0.00,1,1,1,1,1,1,20161001,,,,
E1270,HCPCS,WHEELCHAIR LIGHTWEIGHT LEG R,NU,,28,,NW,,,,,,"$1,285.28",$0.00,1,1,1,1,1,1,20161001,,,,
E1270,HCPCS,WHEELCHAIR LIGHTWEIGHT LEG R,RR,,28,,NW,,,,,,$145.37,$0.00,1,1,1,1,1,1,20161001,,,,
E1270,HCPCS,WHEELCHAIR LIGHTWEIGHT LEG R,UE,,28,,NW,,,,,,$972.23,$0.00,1,1,1,1,1,1,20161001,,,,
E1280,HCPCS,WHCHR H-DUTY DET ARM LEG RES,,,28,,NW,,,,,,"$2,113.67",$0.00,1,1,1,1,1,1,20161001,,,,
E1280,HCPCS,WHCHR H-DUTY DET ARM LEG RES,NU,,28,,NW,,,,,,"$2,113.67",$0.00,1,1,1,1,1,1,20161001,,,,
E1280,HCPCS,WHCHR H-DUTY DET ARM LEG RES,RR,,28,,NW,,,,,,$238.69,$0.00,1,1,1,1,1,1,20161001,,,,
E1280,HCPCS,WHCHR H-DUTY DET ARM LEG RES,UE,,28,,NW,,,,,,"$1,594.21",$0.00,1,1,1,1,1,1,20161001,,,,
E1285,HCPCS,WHEELCHAIR HEAVY DUTY FIXED,,,28,,NW,,,,,,"$2,093.72",$0.00,1,1,1,1,1,1,20161001,,,,
E1285,HCPCS,WHEELCHAIR HEAVY DUTY FIXED,NU,,28,,NW,,,,,,"$2,093.72",$0.00,1,1,1,1,1,1,20161001,,,,
E1285,HCPCS,WHEELCHAIR HEAVY DUTY FIXED,RR,,28,,NW,,,,,,$240.17,$0.00,1,1,1,1,1,1,20161001,,,,
E1285,HCPCS,WHEELCHAIR HEAVY DUTY FIXED,UE,,28,,NW,,,,,,"$1,543.30",$0.00,1,1,1,1,1,1,20161001,,,,
E1290,HCPCS,WHEELCHAIR HVY DUTY DETACH A,,,28,,NW,,,,,,"$2,164.59",$0.00,1,1,1,1,1,1,20161001,,,,
E1290,HCPCS,WHEELCHAIR HVY DUTY DETACH A,NU,,28,,NW,,,,,,"$2,164.59",$0.00,1,1,1,1,1,1,20161001,,,,
E1290,HCPCS,WHEELCHAIR HVY DUTY DETACH A,RR,,28,,NW,,,,,,$247.74,$0.00,1,1,1,1,1,1,20161001,,,,
E1290,HCPCS,WHEELCHAIR HVY DUTY DETACH A,UE,,28,,NW,,,,,,"$1,588.02",$0.00,1,1,1,1,1,1,20161001,,,,
E1295,HCPCS,WHEELCHAIR HEAVY DUTY FIXED,,,28,,NW,,,,,,"$1,958.87",$0.00,1,1,1,1,1,1,20161001,,,,
E1295,HCPCS,WHEELCHAIR HEAVY DUTY FIXED,NU,,28,,NW,,,,,,"$1,958.87",$0.00,1,1,1,1,1,1,20161001,,,,
E1295,HCPCS,WHEELCHAIR HEAVY DUTY FIXED,RR,,28,,NW,,,,,,$226.45,$0.00,1,1,1,1,1,1,20161001,,,,
E1295,HCPCS,WHEELCHAIR HEAVY DUTY FIXED,UE,,28,,NW,,,,,,"$1,477.93",$0.00,1,1,1,1,1,1,20161001,,,,
E1296,HCPCS,WHEELCHAIR SPECIAL SEAT HEIG,,,28,,NW,,,,,,$784.63,$0.00,1,1,1,1,1,1,20161001,,,,
E1296,HCPCS,WHEELCHAIR SPECIAL SEAT HEIG,NU,,28,,NW,,,,,,$784.63,$0.00,1,1,1,1,1,1,20161001,,,,
E1296,HCPCS,WHEELCHAIR SPECIAL SEAT HEIG,RR,,28,,NW,,,,,,$91.80,$0.00,1,1,1,1,1,1,20161001,,,,
E1296,HCPCS,WHEELCHAIR SPECIAL SEAT HEIG,UE,,28,,NW,,,,,,$597.06,$0.00,1,1,1,1,1,1,20161001,,,,
E1297,HCPCS,WHEELCHAIR SPECIAL SEAT DEPT,,,28,,NW,,,,,,$187.68,$0.00,1,1,1,1,1,1,20161001,,,,
E1297,HCPCS,WHEELCHAIR SPECIAL SEAT DEPT,NU,,28,,NW,,,,,,$187.68,$0.00,1,1,1,1,1,1,20161001,,,,
E1297,HCPCS,WHEELCHAIR SPECIAL SEAT DEPT,RR,,28,,NW,,,,,,$24.75,$0.00,1,1,1,1,1,1,20161001,,,,
E1297,HCPCS,WHEELCHAIR SPECIAL SEAT DEPT,UE,,28,,NW,,,,,,$141.67,$0.00,1,1,1,1,1,1,20161001,,,,
E1298,HCPCS,WHEELCHAIR SPEC SEAT DEPTH/W,,,28,,NW,,,,,,$692.23,$0.00,1,1,1,1,1,1,20161001,,,,
E1298,HCPCS,WHEELCHAIR SPEC SEAT DEPTH/W,NU,,28,,NW,,,,,,$692.23,$0.00,1,1,1,1,1,1,20161001,,,,
E1298,HCPCS,WHEELCHAIR SPEC SEAT DEPTH/W,RR,,28,,NW,,,,,,$80.75,$0.00,1,1,1,1,1,1,20161001,,,,
E1298,HCPCS,WHEELCHAIR SPEC SEAT DEPTH/W,UE,,28,,NW,,,,,,$527.78,$0.00,1,1,1,1,1,1,20161001,,,,
E1300,HCPCS,WHIRLPOOL PORTABLE,,,28,,NW,,,,,,$258.65,$0.00,1,1,1,1,1,1,20161001,,,,
E1300,HCPCS,WHIRLPOOL PORTABLE,NU,,28,,NW,,,,,,$258.65,$0.00,1,1,1,1,1,1,20161001,,,,
E1300,HCPCS,WHIRLPOOL PORTABLE,RR,,28,,NW,,,,,,$27.51,$0.00,1,1,1,1,1,1,20161001,,,,
E1300,HCPCS,WHIRLPOOL PORTABLE,UE,,28,,NW,,,,,,$194.46,$0.00,1,1,1,1,1,1,20161001,,,,
E1310,HCPCS,WHIRLPOOL NON-PORTABLE,,,28,,NW,,,,,,"$5,233.10",$0.00,1,1,1,1,1,1,20161001,,,,
E1310,HCPCS,WHIRLPOOL NON-PORTABLE,NU,,28,,NW,,,,,,"$5,233.10",$0.00,1,1,1,1,1,1,20161001,,,,
E1310,HCPCS,WHIRLPOOL NON-PORTABLE,RR,,28,,NW,,,,,,$438.73,$0.00,1,1,1,1,1,1,20161001,,,,
E1310,HCPCS,WHIRLPOOL NON-PORTABLE,UE,,28,,NW,,,,,,"$3,921.58",$0.00,1,1,1,1,1,1,20161001,,,,
E1352,HCPCS,O2 FLOW REG POS INSPIR PRESS,,,28,,NW,,,,,,$73.09,$0.00,1,1,1,1,1,1,20161001,,,,
E1353,HCPCS,OXYGEN SUPPLIES REGULATOR,,,28,,NW,,,,,,$73.09,$0.00,1,1,1,1,1,1,20161001,,,,
E1353,HCPCS,OXYGEN SUPPLIES REGULATOR,NU,,28,,NW,,,,,,$73.09,$0.00,1,1,1,1,1,1,20161001,,,,
E1353,HCPCS,OXYGEN SUPPLIES REGULATOR,RR,,28,,NW,,,,,,$5.89,$0.00,1,1,1,1,1,1,20161001,,,,
E1353,HCPCS,OXYGEN SUPPLIES REGULATOR,UE,,28,,NW,,,,,,$45.66,$0.00,1,1,1,1,1,1,20161001,,,,
E1354,HCPCS,"WHEELED CART, PORT CYL/CONC",,,28,,NW,,,,,,$22.92,$0.00,1,1,1,1,1,1,20161001,,,,
E1355,HCPCS,OXYGEN SUPPLIES STAND/RACK,,,28,,NW,,,,,,$46.11,$0.00,1,1,1,1,1,1,20161001,,,,
E1355,HCPCS,OXYGEN SUPPLIES STAND/RACK,NU,,28,,NW,,,,,,$46.11,$0.00,1,1,1,1,1,1,20161001,,,,
E1355,HCPCS,OXYGEN SUPPLIES STAND/RACK,RR,,28,,NW,,,,,,$5.82,$0.00,1,1,1,1,1,1,20161001,,,,
E1355,HCPCS,OXYGEN SUPPLIES STAND/RACK,UE,,28,,NW,,,,,,$34.38,$0.00,1,1,1,1,1,1,20161001,,,,
E1356,HCPCS,"BATT PACK/CART, PORT CONC",,,28,,NW,,,,,,$68.98,$0.00,1,1,1,1,1,1,20161001,,,,
E1357,HCPCS,"BATTERY CHARGER, PORT CONC",,,28,,NW,,,,,,$139.87,$0.00,1,1,1,1,1,1,20161001,,,,
E1358,HCPCS,"DC POWER ADAPTER, PORT CONC",,,28,,NW,,,,,,$117.38,$0.00,1,1,1,1,1,1,20161001,,,,
E1372,HCPCS,OXY SUPPL HEATER FOR NEBULIZ,,,28,,NW,,,,,,$384.81,$0.00,1,1,1,1,1,1,20161001,,,,
E1372,HCPCS,OXY SUPPL HEATER FOR NEBULIZ,NU,,28,,NW,,,,,,$384.81,$0.00,1,1,1,1,1,1,20161001,,,,
E1372,HCPCS,OXY SUPPL HEATER FOR NEBULIZ,RR,,28,,NW,,,,,,$45.12,$0.00,1,1,1,1,1,1,20161001,,,,
E1372,HCPCS,OXY SUPPL HEATER FOR NEBULIZ,UE,,28,,NW,,,,,,$280.81,$0.00,1,1,1,1,1,1,20161001,,,,
E1390,HCPCS,OXYGEN CONCENTRATOR,,,28,,NW,,,,,,"$5,573.76",$0.00,1,1,1,1,1,1,20161001,,,,
E1390,HCPCS,OXYGEN CONCENTRATOR,NU,,28,,NW,,,,,,"$5,573.76",$0.00,1,1,1,1,1,1,20161001,,,,
E1390,HCPCS,OXYGEN CONCENTRATOR,RR,,28,,NW,,,,,,$592.88,$0.00,1,1,1,1,1,1,20161001,,,,
E1391,HCPCS,"OXYGEN CONCENTRATOR, DUAL",,,28,,NW,,,,,,"$5,573.76",$0.00,1,1,1,1,1,1,20161001,,,,
E1391,HCPCS,"OXYGEN CONCENTRATOR, DUAL",RR,,28,,NW,,,,,,$592.88,$0.00,1,1,1,1,1,1,20161001,,,,
E1392,HCPCS,PORTABLE OXYGEN CONCENTRATOR,,,28,,NW,,,,,,"$1,347.19",$0.00,1,1,1,1,1,1,20161001,,,,
E1392,HCPCS,PORTABLE OXYGEN CONCENTRATOR,RR,,28,,NW,,,,,,$143.30,$0.00,1,1,1,1,1,1,20161001,,,,
E1399,HCPCS,DURABLE MEDICAL EQUIPMENT MI,,,28,,NW,,,,,,$80.38,$0.00,1,1,1,1,1,1,20161001,,,,
E1405,HCPCS,O2/WATER VAPOR ENRICH W/HEAT,,,28,,NW,,,,,,"$6,788.13",$0.00,1,1,1,1,1,1,20161001,,,,
E1405,HCPCS,O2/WATER VAPOR ENRICH W/HEAT,NU,,28,,NW,,,,,,"$6,788.13",$0.00,1,1,1,1,1,1,20161001,,,,
E1405,HCPCS,O2/WATER VAPOR ENRICH W/HEAT,RR,,28,,NW,,,,,,$722.05,$0.00,1,1,1,1,1,1,20161001,,,,
E1405,HCPCS,O2/WATER VAPOR ENRICH W/HEAT,UE,,28,,NW,,,,,,"$5,103.42",$0.00,1,1,1,1,1,1,20161001,,,,
E1406,HCPCS,O2/WATER VAPOR ENRICH W/O HE,,,28,,NW,,,,,,"$6,158.02",$0.00,1,1,1,1,1,1,20161001,,,,
E1406,HCPCS,O2/WATER VAPOR ENRICH W/O HE,NU,,28,,NW,,,,,,"$6,158.02",$0.00,1,1,1,1,1,1,20161001,,,,
E1406,HCPCS,O2/WATER VAPOR ENRICH W/O HE,RR,,28,,NW,,,,,,$655.03,$0.00,1,1,1,1,1,1,20161001,,,,
E1406,HCPCS,O2/WATER VAPOR ENRICH W/O HE,UE,,28,,NW,,,,,,"$4,629.69",$0.00,1,1,1,1,1,1,20161001,,,,
E1500,HCPCS,CENTRIFUGE,,,28,,NW,,,,,,$296.79,$0.00,1,1,1,1,1,1,20161001,,,,
E1510,HCPCS,KIDNEY DIALYSATE DELIVRY SYS,,,28,,NW,,,,,,"$2,645.67",$0.00,1,1,1,1,1,1,20161001,,,,
E1510,HCPCS,KIDNEY DIALYSATE DELIVRY SYS,NU,,28,,NW,,,,,,"$2,645.67",$0.00,1,1,1,1,1,1,20161001,,,,
E1510,HCPCS,KIDNEY DIALYSATE DELIVRY SYS,RR,,28,,NW,,,,,,$278.69,$0.00,1,1,1,1,1,1,20161001,,,,
E1510,HCPCS,KIDNEY DIALYSATE DELIVRY SYS,UE,,28,,NW,,,,,,"$1,992.36",$0.00,1,1,1,1,1,1,20161001,,,,
E1520,HCPCS,HEPARIN INFUSION PUMP,,,28,,NW,,,,,,"$1,998.05",$0.00,1,1,1,1,1,1,20161001,,,,
E1520,HCPCS,HEPARIN INFUSION PUMP,NU,,28,,NW,,,,,,"$1,998.05",$0.00,1,1,1,1,1,1,20161001,,,,
E1520,HCPCS,HEPARIN INFUSION PUMP,RR,,28,,NW,,,,,,$212.53,$0.00,1,1,1,1,1,1,20161001,,,,
E1520,HCPCS,HEPARIN INFUSION PUMP,UE,,28,,NW,,,,,,"$1,502.17",$0.00,1,1,1,1,1,1,20161001,,,,
E1530,HCPCS,REPLACEMENT AIR BUBBLE DETEC,,,28,,NW,,,,,,"$1,938.78",$0.00,1,1,1,1,1,1,20161001,,,,
E1530,HCPCS,REPLACEMENT AIR BUBBLE DETEC,NU,,28,,NW,,,,,,"$1,938.78",$0.00,1,1,1,1,1,1,20161001,,,,
E1530,HCPCS,REPLACEMENT AIR BUBBLE DETEC,RR,,28,,NW,,,,,,$199.92,$0.00,1,1,1,1,1,1,20161001,,,,
E1530,HCPCS,REPLACEMENT AIR BUBBLE DETEC,UE,,28,,NW,,,,,,"$1,454.49",$0.00,1,1,1,1,1,1,20161001,,,,
E1540,HCPCS,REPLACEMENT PRESSURE ALARM,,,28,,NW,,,,,,$224.94,$0.00,1,1,1,1,1,1,20161001,,,,
E1540,HCPCS,REPLACEMENT PRESSURE ALARM,NU,,28,,NW,,,,,,$224.94,$0.00,1,1,1,1,1,1,20161001,,,,
E1540,HCPCS,REPLACEMENT PRESSURE ALARM,RR,,28,,NW,,,,,,$23.55,$0.00,1,1,1,1,1,1,20161001,,,,
E1540,HCPCS,REPLACEMENT PRESSURE ALARM,UE,,28,,NW,,,,,,$168.61,$0.00,1,1,1,1,1,1,20161001,,,,
E1550,HCPCS,BATH CONDUCTIVITY METER,,,28,,NW,,,,,,$110.22,$0.00,1,1,1,1,1,1,20161001,,,,
E1550,HCPCS,BATH CONDUCTIVITY METER,NU,,28,,NW,,,,,,$110.22,$0.00,1,1,1,1,1,1,20161001,,,,
E1550,HCPCS,BATH CONDUCTIVITY METER,RR,,28,,NW,,,,,,$11.72,$0.00,1,1,1,1,1,1,20161001,,,,
E1550,HCPCS,BATH CONDUCTIVITY METER,UE,,28,,NW,,,,,,$82.87,$0.00,1,1,1,1,1,1,20161001,,,,
E1560,HCPCS,REPLACE BLOOD LEAK DETECTOR,,,28,,NW,,,,,,"$2,243.46",$0.00,1,1,1,1,1,1,20161001,,,,
E1560,HCPCS,REPLACE BLOOD LEAK DETECTOR,NU,,28,,NW,,,,,,"$2,243.46",$0.00,1,1,1,1,1,1,20161001,,,,
E1560,HCPCS,REPLACE BLOOD LEAK DETECTOR,RR,,28,,NW,,,,,,$231.32,$0.00,1,1,1,1,1,1,20161001,,,,
E1560,HCPCS,REPLACE BLOOD LEAK DETECTOR,UE,,28,,NW,,,,,,"$1,660.15",$0.00,1,1,1,1,1,1,20161001,,,,
E1570,HCPCS,ADJUSTABLE CHAIR FOR ESRD PT,,,28,,NW,,,,,,$676.26,$0.00,1,1,1,1,1,1,20161001,,,,
E1570,HCPCS,ADJUSTABLE CHAIR FOR ESRD PT,NU,,28,,NW,,,,,,$676.26,$0.00,1,1,1,1,1,1,20161001,,,,
E1570,HCPCS,ADJUSTABLE CHAIR FOR ESRD PT,RR,,28,,NW,,,,,,$71.93,$0.00,1,1,1,1,1,1,20161001,,,,
E1570,HCPCS,ADJUSTABLE CHAIR FOR ESRD PT,UE,,28,,NW,,,,,,$508.42,$0.00,1,1,1,1,1,1,20161001,,,,
E1575,HCPCS,TRANSDUCER PROTECT/FLD BAR,,,28,,NW,,,,,,$117.68,$0.00,1,1,1,1,1,1,20161001,,,,
E1575,HCPCS,TRANSDUCER PROTECT/FLD BAR,NU,,28,,NW,,,,,,$117.68,$0.00,1,1,1,1,1,1,20161001,,,,
E1575,HCPCS,TRANSDUCER PROTECT/FLD BAR,RR,,28,,NW,,,,,,$12.13,$0.00,1,1,1,1,1,1,20161001,,,,
E1575,HCPCS,TRANSDUCER PROTECT/FLD BAR,UE,,28,,NW,,,,,,$87.09,$0.00,1,1,1,1,1,1,20161001,,,,
E1590,HCPCS,HEMODIALYSIS MACHINE,,,28,,NW,,,,,,"$2,992.85",$0.00,1,1,1,1,1,1,20161001,,,,
E1590,HCPCS,HEMODIALYSIS MACHINE,NU,,28,,NW,,,,,,"$2,992.85",$0.00,1,1,1,1,1,1,20161001,,,,
E1590,HCPCS,HEMODIALYSIS MACHINE,RR,,28,,NW,,,,,,$172.10,$0.00,1,1,1,1,1,1,20161001,,,,
E1590,HCPCS,HEMODIALYSIS MACHINE,UE,,28,,NW,,,,,,"$2,253.80",$0.00,1,1,1,1,1,1,20161001,,,,
E1592,HCPCS,AUTO INTERM PERITONEAL DIALY,,,28,,NW,,,,,,$7.39,$0.00,1,1,1,1,1,1,20161001,,,,
E1594,HCPCS,CYCLER DIALYSIS MACHINE,,,28,,NW,,,,,,"$7,900.21",$0.00,1,1,1,1,1,1,20161001,,,,
E1594,HCPCS,CYCLER DIALYSIS MACHINE,NU,,28,,NW,,,,,,"$7,900.21",$0.00,1,1,1,1,1,1,20161001,,,,
E1594,HCPCS,CYCLER DIALYSIS MACHINE,RR,,28,,NW,,,,,,$864.60,$0.00,1,1,1,1,1,1,20161001,,,,
E1594,HCPCS,CYCLER DIALYSIS MACHINE,UE,,28,,NW,,,,,,"$5,949.36",$0.00,1,1,1,1,1,1,20161001,,,,
E1600,HCPCS,DELI/INSTALL CHRG HEMO EQUIP,,,28,,NW,,,,,,$513.56,$0.00,1,1,1,1,1,1,20161001,,,,
E1610,HCPCS,REVERSE OSMOSIS H2O PURI SYS,,,28,,NW,,,,,,"$5,250.89",$0.00,1,1,1,1,1,1,20161001,,,,
E1610,HCPCS,REVERSE OSMOSIS H2O PURI SYS,NU,,28,,NW,,,,,,"$5,250.89",$0.00,1,1,1,1,1,1,20161001,,,,
E1610,HCPCS,REVERSE OSMOSIS H2O PURI SYS,RR,,28,,NW,,,,,,$548.74,$0.00,1,1,1,1,1,1,20161001,,,,
E1610,HCPCS,REVERSE OSMOSIS H2O PURI SYS,UE,,28,,NW,,,,,,"$3,944.61",$0.00,1,1,1,1,1,1,20161001,,,,
E1615,HCPCS,DEIONIZER H2O PURI SYSTEM,,,28,,NW,,,,,,$316.34,$0.00,1,1,1,1,1,1,20161001,,,,
E1620,HCPCS,REPLACEMENT BLOOD PUMP,,,28,,NW,,,,,,$659.27,$0.00,1,1,1,1,1,1,20161001,,,,
E1625,HCPCS,WATER SOFTENING SYSTEM,,,28,,NW,,,,,,"$1,703.57",$0.00,1,1,1,1,1,1,20161001,,,,
E1630,HCPCS,RECIPROCATING PERITONEAL DIA,,,28,,NW,,,,,,$184.26,$0.00,1,1,1,1,1,1,20161001,,,,
E1634,HCPCS,PERITONEAL DIALYSIS CLAMP,,,28,,NW,,,,,,$13.36,$0.00,1,1,1,1,1,1,20161001,,,,
E1635,HCPCS,COMPACT TRAVEL HEMODIALYZER,,,28,,NW,,,,,,$575.35,$0.00,1,1,1,1,1,1,20161001,,,,
E1636,HCPCS,SORBENT CARTRIDGES PER 10,,,28,,NW,,,,,,$247.86,$0.00,1,1,1,1,1,1,20161001,,,,
E1637,HCPCS,"HEMOSTATS FOR DIALYSIS, EACH",,,28,,NW,,,,,,$48.97,$0.00,1,1,1,1,1,1,20161001,,,,
E1639,HCPCS,DIALYSIS SCALE,,,28,,NW,,,,,,$165.03,$0.00,1,1,1,1,1,1,20161001,,,,
E1699,HCPCS,DIALYSIS EQUIPMENT NOC,,,28,,NW,,,,,,$259.47,$0.00,1,1,1,1,1,1,20161001,,,,
E1700,HCPCS,JAW MOTION REHAB SYSTEM,,,28,,NW,,,,,,$884.11,$0.00,1,1,1,1,1,1,20161001,,,,
E1700,HCPCS,JAW MOTION REHAB SYSTEM,NU,,28,,NW,,,,,,$884.11,$0.00,1,1,1,1,1,1,20161001,,,,
E1700,HCPCS,JAW MOTION REHAB SYSTEM,RR,,28,,NW,,,,,,$71.71,$0.00,1,1,1,1,1,1,20161001,,,,
E1700,HCPCS,JAW MOTION REHAB SYSTEM,UE,,28,,NW,,,,,,$660.37,$0.00,1,1,1,1,1,1,20161001,,,,
E1701,HCPCS,REPL CUSHIONS FOR JAW MOTION,,,28,,NW,,,,,,$17.40,$0.00,1,1,1,1,1,1,20161001,,,,
E1702,HCPCS,REPL MEASR SCALES JAW MOTION,,,28,,NW,,,,,,$42.38,$0.00,1,1,1,1,1,1,20161001,,,,
E1800,HCPCS,ADJUST ELBOW EXT/FLEX DEVICE,,,28,,NW,,,,,,"$2,655.67",$0.00,1,1,1,1,1,1,20161001,,,,
E1800,HCPCS,ADJUST ELBOW EXT/FLEX DEVICE,RR,,28,,NW,,,,,,$282.48,$0.00,1,1,1,1,1,1,20161001,,,,
E1801,HCPCS,SPS ELBOW DEVICE,,,28,,NW,,,,,,"$2,951.54",$0.00,1,1,1,1,1,1,20161001,,,,
E1801,HCPCS,SPS ELBOW DEVICE,RR,,28,,NW,,,,,,$313.96,$0.00,1,1,1,1,1,1,20161001,,,,
E1802,HCPCS,ADJST FOREARM PRO/SUP DEVICE,,,28,,NW,,,,,,"$7,892.42",$0.00,1,1,1,1,1,1,20161001,,,,
E1802,HCPCS,ADJST FOREARM PRO/SUP DEVICE,RR,,28,,NW,,,,,,$839.52,$0.00,1,1,1,1,1,1,20161001,,,,
E1805,HCPCS,ADJUST WRIST EXT/FLEX DEVICE,,,28,,NW,,,,,,"$2,781.69",$0.00,1,1,1,1,1,1,20161001,,,,
E1805,HCPCS,ADJUST WRIST EXT/FLEX DEVICE,RR,,28,,NW,,,,,,$295.89,$0.00,1,1,1,1,1,1,20161001,,,,
E1806,HCPCS,SPS WRIST DEVICE,,,28,,NW,,,,,,"$2,400.92",$0.00,1,1,1,1,1,1,20161001,,,,
E1806,HCPCS,SPS WRIST DEVICE,RR,,28,,NW,,,,,,$255.39,$0.00,1,1,1,1,1,1,20161001,,,,
E1810,HCPCS,ADJUST KNEE EXT/FLEX DEVICE,,,28,,NW,,,,,,"$2,734.16",$0.00,1,1,1,1,1,1,20161001,,,,
E1810,HCPCS,ADJUST KNEE EXT/FLEX DEVICE,RR,,28,,NW,,,,,,$290.83,$0.00,1,1,1,1,1,1,20161001,,,,
E1811,HCPCS,SPS KNEE DEVICE,,,28,,NW,,,,,,"$3,073.56",$0.00,1,1,1,1,1,1,20161001,,,,
E1811,HCPCS,SPS KNEE DEVICE,RR,,28,,NW,,,,,,$326.93,$0.00,1,1,1,1,1,1,20161001,,,,
E1812,HCPCS,KNEE EXT/FLEX W ACT RES CTRL,,,28,,NW,,,,,,"$1,985.82",$0.00,1,1,1,1,1,1,20161001,,,,
E1812,HCPCS,KNEE EXT/FLEX W ACT RES CTRL,RR,,28,,NW,,,,,,$211.23,$0.00,1,1,1,1,1,1,20161001,,,,
E1815,HCPCS,ADJUST ANKLE EXT/FLEX DEVICE,,,28,,NW,,,,,,"$2,782.36",$0.00,1,1,1,1,1,1,20161001,,,,
E1815,HCPCS,ADJUST ANKLE EXT/FLEX DEVICE,RR,,28,,NW,,,,,,$295.96,$0.00,1,1,1,1,1,1,20161001,,,,
E1816,HCPCS,SPS ANKLE DEVICE,,,28,,NW,,,,,,"$3,123.81",$0.00,1,1,1,1,1,1,20161001,,,,
E1816,HCPCS,SPS ANKLE DEVICE,RR,,28,,NW,,,,,,$332.28,$0.00,1,1,1,1,1,1,20161001,,,,
E1818,HCPCS,SPS FOREARM DEVICE,,,28,,NW,,,,,,"$3,191.59",$0.00,1,1,1,1,1,1,20161001,,,,
E1818,HCPCS,SPS FOREARM DEVICE,RR,,28,,NW,,,,,,$339.49,$0.00,1,1,1,1,1,1,20161001,,,,
E1820,HCPCS,SOFT INTERFACE MATERIAL,,,28,,NW,,,,,,$195.52,$0.00,1,1,1,1,1,1,20161001,,,,
E1820,HCPCS,SOFT INTERFACE MATERIAL,NU,,28,,NW,,,,,,$195.52,$0.00,1,1,1,1,1,1,20161001,,,,
E1820,HCPCS,SOFT INTERFACE MATERIAL,RR,,28,,NW,,,,,,$15.53,$0.00,1,1,1,1,1,1,20161001,,,,
E1820,HCPCS,SOFT INTERFACE MATERIAL,UE,,28,,NW,,,,,,$143.40,$0.00,1,1,1,1,1,1,20161001,,,,
E1821,HCPCS,REPLACEMENT INTERFACE SPSD,,,28,,NW,,,,,,$261.49,$0.00,1,1,1,1,1,1,20161001,,,,
E1821,HCPCS,REPLACEMENT INTERFACE SPSD,NU,,28,,NW,,,,,,$261.49,$0.00,1,1,1,1,1,1,20161001,,,,
E1821,HCPCS,REPLACEMENT INTERFACE SPSD,RR,,28,,NW,,,,,,$17.57,$0.00,1,1,1,1,1,1,20161001,,,,
E1821,HCPCS,REPLACEMENT INTERFACE SPSD,UE,,28,,NW,,,,,,$192.90,$0.00,1,1,1,1,1,1,20161001,,,,
E1825,HCPCS,ADJUST FINGER EXT/FLEX DEVC,,,28,,NW,,,,,,"$2,781.69",$0.00,1,1,1,1,1,1,20161001,,,,
E1825,HCPCS,ADJUST FINGER EXT/FLEX DEVC,RR,,28,,NW,,,,,,$295.89,$0.00,1,1,1,1,1,1,20161001,,,,
E1830,HCPCS,ADJUST TOE EXT/FLEX DEVICE,,,28,,NW,,,,,,"$2,781.69",$0.00,1,1,1,1,1,1,20161001,,,,
E1830,HCPCS,ADJUST TOE EXT/FLEX DEVICE,RR,,28,,NW,,,,,,$295.89,$0.00,1,1,1,1,1,1,20161001,,,,
E1831,HCPCS,STATIC STR TOE DEV EXT/FLEX,,,28,,NW,,,,,,"$1,469.99",$0.00,1,1,1,1,1,1,20161001,,,,
E1831,HCPCS,STATIC STR TOE DEV EXT/FLEX,RR,,28,,NW,,,,,,$156.36,$0.00,1,1,1,1,1,1,20161001,,,,
E1840,HCPCS,ADJ SHOULDER EXT/FLEX DEVICE,,,28,,NW,,,,,,"$9,086.79",$0.00,1,1,1,1,1,1,20161001,,,,
E1840,HCPCS,ADJ SHOULDER EXT/FLEX DEVICE,RR,,28,,NW,,,,,,$966.56,$0.00,1,1,1,1,1,1,20161001,,,,
E1841,HCPCS,STATIC STR SHLDR DEV ROM ADJ,,,28,,NW,,,,,,"$10,987.14",$0.00,1,1,1,1,1,1,20161001,,,,
E1841,HCPCS,STATIC STR SHLDR DEV ROM ADJ,RR,,28,,NW,,,,,,"$1,168.70",$0.00,1,1,1,1,1,1,20161001,,,,
E1902,HCPCS,AAC NON-ELECTRONIC BOARD,,,28,,NW,,,,,,"$1,123.36",$0.00,1,1,1,1,1,1,20161001,,,,
E2000,HCPCS,GASTRIC SUCTION PUMP HME MDL,,,28,,NW,,,,,,"$1,111.89",$0.00,1,1,1,1,1,1,20161001,,,,
E2000,HCPCS,GASTRIC SUCTION PUMP HME MDL,RR,,28,,NW,,,,,,$118.27,$0.00,1,1,1,1,1,1,20161001,,,,
E2100,HCPCS,BLD GLUCOSE MONITOR W VOICE,,,28,,NW,,,,,,"$1,522.28",$0.00,1,1,1,1,1,1,20161001,,,,
E2100,HCPCS,BLD GLUCOSE MONITOR W VOICE,NU,,28,,NW,,,,,,"$1,522.28",$0.00,1,1,1,1,1,1,20161001,,,,
E2100,HCPCS,BLD GLUCOSE MONITOR W VOICE,RR,,28,,NW,,,,,,$141.85,$0.00,1,1,1,1,1,1,20161001,,,,
E2100,HCPCS,BLD GLUCOSE MONITOR W VOICE,UE,,28,,NW,,,,,,"$1,142.08",$0.00,1,1,1,1,1,1,20161001,,,,
E2101,HCPCS,BLD GLUCOSE MONITOR W LANCE,,,28,,NW,,,,,,$478.84,$0.00,1,1,1,1,1,1,20161001,,,,
E2101,HCPCS,BLD GLUCOSE MONITOR W LANCE,NU,,28,,NW,,,,,,$478.84,$0.00,1,1,1,1,1,1,20161001,,,,
E2101,HCPCS,BLD GLUCOSE MONITOR W LANCE,RR,,28,,NW,,,,,,$36.07,$0.00,1,1,1,1,1,1,20161001,,,,
E2101,HCPCS,BLD GLUCOSE MONITOR W LANCE,UE,,28,,NW,,,,,,$355.86,$0.00,1,1,1,1,1,1,20161001,,,,
E2120,HCPCS,PULSE GEN SYS TX ENDOLYMP FL,,,28,,NW,,,,,,"$6,830.87",$0.00,1,1,1,1,1,1,20161001,,,,
E2120,HCPCS,PULSE GEN SYS TX ENDOLYMP FL,RR,,28,,NW,,,,,,$726.60,$0.00,1,1,1,1,1,1,20161001,,,,
E2201,HCPCS,MAN W/CH ACC SEAT W>=20<24,,,28,,NW,,,,,,$654.98,$0.00,1,1,1,1,1,1,20161001,,,,
E2201,HCPCS,MAN W/CH ACC SEAT W>=20<24,NU,,28,,NW,,,,,,$654.98,$0.00,1,1,1,1,1,1,20161001,,,,
E2201,HCPCS,MAN W/CH ACC SEAT W>=20<24,RR,,28,,NW,,,,,,$75.23,$0.00,1,1,1,1,1,1,20161001,,,,
E2201,HCPCS,MAN W/CH ACC SEAT W>=20<24,UE,,28,,NW,,,,,,$499.83,$0.00,1,1,1,1,1,1,20161001,,,,
E2202,HCPCS,SEAT WIDTH 24-27 IN,,,28,,NW,,,,,,$822.72,$0.00,1,1,1,1,1,1,20161001,,,,
E2202,HCPCS,SEAT WIDTH 24-27 IN,NU,,28,,NW,,,,,,$822.72,$0.00,1,1,1,1,1,1,20161001,,,,
E2202,HCPCS,SEAT WIDTH 24-27 IN,RR,,28,,NW,,,,,,$94.57,$0.00,1,1,1,1,1,1,20161001,,,,
E2202,HCPCS,SEAT WIDTH 24-27 IN,UE,,28,,NW,,,,,,$625.70,$0.00,1,1,1,1,1,1,20161001,,,,
E2203,HCPCS,FRAME DEPTH LESS THAN 22 IN,,,28,,NW,,,,,,$831.19,$0.00,1,1,1,1,1,1,20161001,,,,
E2203,HCPCS,FRAME DEPTH LESS THAN 22 IN,NU,,28,,NW,,,,,,$831.19,$0.00,1,1,1,1,1,1,20161001,,,,
E2203,HCPCS,FRAME DEPTH LESS THAN 22 IN,RR,,28,,NW,,,,,,$95.52,$0.00,1,1,1,1,1,1,20161001,,,,
E2203,HCPCS,FRAME DEPTH LESS THAN 22 IN,UE,,28,,NW,,,,,,$631.96,$0.00,1,1,1,1,1,1,20161001,,,,
E2204,HCPCS,FRAME DEPTH 22 TO 25 IN,,,28,,NW,,,,,,"$1,387.26",$0.00,1,1,1,1,1,1,20161001,,,,
E2204,HCPCS,FRAME DEPTH 22 TO 25 IN,NU,,28,,NW,,,,,,"$1,387.26",$0.00,1,1,1,1,1,1,20161001,,,,
E2204,HCPCS,FRAME DEPTH 22 TO 25 IN,RR,,28,,NW,,,,,,$159.65,$0.00,1,1,1,1,1,1,20161001,,,,
E2204,HCPCS,FRAME DEPTH 22 TO 25 IN,UE,,28,,NW,,,,,,"$1,049.05",$0.00,1,1,1,1,1,1,20161001,,,,
E2205,HCPCS,"MANUAL WC ACCESSORY, HANDRIM",,,28,,NW,,,,,,$66.11,$0.00,1,1,1,1,1,1,20161001,,,,
E2205,HCPCS,"MANUAL WC ACCESSORY, HANDRIM",NU,,28,,NW,,,,,,$66.11,$0.00,1,1,1,1,1,1,20161001,,,,
E2205,HCPCS,"MANUAL WC ACCESSORY, HANDRIM",RR,,28,,NW,,,,,,$9.92,$0.00,1,1,1,1,1,1,20161001,,,,
E2205,HCPCS,"MANUAL WC ACCESSORY, HANDRIM",UE,,28,,NW,,,,,,$50.55,$0.00,1,1,1,1,1,1,20161001,,,,
E2206,HCPCS,COMPLETE WHEEL LOCK ASSEMBLY,,,28,,NW,,,,,,$81.42,$0.00,1,1,1,1,1,1,20161001,,,,
E2206,HCPCS,COMPLETE WHEEL LOCK ASSEMBLY,NU,,28,,NW,,,,,,$81.42,$0.00,1,1,1,1,1,1,20161001,,,,
E2206,HCPCS,COMPLETE WHEEL LOCK ASSEMBLY,RR,,28,,NW,,,,,,$11.46,$0.00,1,1,1,1,1,1,20161001,,,,
E2206,HCPCS,COMPLETE WHEEL LOCK ASSEMBLY,UE,,28,,NW,,,,,,$61.99,$0.00,1,1,1,1,1,1,20161001,,,,
E2207,HCPCS,CRUTCH AND CANE HOLDER,,,28,,NW,,,,,,$86.51,$0.00,1,1,1,1,1,1,20161001,,,,
E2207,HCPCS,CRUTCH AND CANE HOLDER,NU,,28,,NW,,,,,,$86.51,$0.00,1,1,1,1,1,1,20161001,,,,
E2207,HCPCS,CRUTCH AND CANE HOLDER,RR,,28,,NW,,,,,,$12.02,$0.00,1,1,1,1,1,1,20161001,,,,
E2207,HCPCS,CRUTCH AND CANE HOLDER,UE,,28,,NW,,,,,,$65.82,$0.00,1,1,1,1,1,1,20161001,,,,
E2208,HCPCS,CYLINDER TANK CARRIER,,,28,,NW,,,,,,$400.96,$0.00,1,1,1,1,1,1,20161001,,,,
E2208,HCPCS,CYLINDER TANK CARRIER,NU,,28,,NW,,,,,,$400.96,$0.00,1,1,1,1,1,1,20161001,,,,
E2208,HCPCS,CYLINDER TANK CARRIER,RR,,28,,NW,,,,,,$45.93,$0.00,1,1,1,1,1,1,20161001,,,,
E2208,HCPCS,CYLINDER TANK CARRIER,UE,,28,,NW,,,,,,$309.34,$0.00,1,1,1,1,1,1,20161001,,,,
E2209,HCPCS,ARM TROUGH EACH,,,28,,NW,,,,,,$365.14,$0.00,1,1,1,1,1,1,20161001,,,,
E2209,HCPCS,ARM TROUGH EACH,NU,,28,,NW,,,,,,$365.14,$0.00,1,1,1,1,1,1,20161001,,,,
E2209,HCPCS,ARM TROUGH EACH,RR,,28,,NW,,,,,,$41.88,$0.00,1,1,1,1,1,1,20161001,,,,
E2209,HCPCS,ARM TROUGH EACH,UE,,28,,NW,,,,,,$282.49,$0.00,1,1,1,1,1,1,20161001,,,,
E2210,HCPCS,WHEELCHAIR BEARINGS,,,28,,NW,,,,,,$27.09,$0.00,1,1,1,1,1,1,20161001,,,,
E2210,HCPCS,WHEELCHAIR BEARINGS,NU,,28,,NW,,,,,,$27.09,$0.00,1,1,1,1,1,1,20161001,,,,
E2210,HCPCS,WHEELCHAIR BEARINGS,RR,,28,,NW,,,,,,$6.01,$0.00,1,1,1,1,1,1,20161001,,,,
E2210,HCPCS,WHEELCHAIR BEARINGS,UE,,28,,NW,,,,,,$21.28,$0.00,1,1,1,1,1,1,20161001,,,,
E2211,HCPCS,PNEUMATIC PROPULSION TIRE,,,28,,NW,,,,,,$77.88,$0.00,1,1,1,1,1,1,20161001,,,,
E2211,HCPCS,PNEUMATIC PROPULSION TIRE,NU,,28,,NW,,,,,,$77.88,$0.00,1,1,1,1,1,1,20161001,,,,
E2211,HCPCS,PNEUMATIC PROPULSION TIRE,RR,,28,,NW,,,,,,$11.05,$0.00,1,1,1,1,1,1,20161001,,,,
E2211,HCPCS,PNEUMATIC PROPULSION TIRE,UE,,28,,NW,,,,,,$57.13,$0.00,1,1,1,1,1,1,20161001,,,,
E2212,HCPCS,PNEUMATIC PROP TIRE TUBE,,,28,,NW,,,,,,$14.93,$0.00,1,1,1,1,1,1,20161001,,,,
E2212,HCPCS,PNEUMATIC PROP TIRE TUBE,NU,,28,,NW,,,,,,$14.93,$0.00,1,1,1,1,1,1,20161001,,,,
E2212,HCPCS,PNEUMATIC PROP TIRE TUBE,RR,,28,,NW,,,,,,$4.90,$0.00,1,1,1,1,1,1,20161001,,,,
E2212,HCPCS,PNEUMATIC PROP TIRE TUBE,UE,,28,,NW,,,,,,$12.16,$0.00,1,1,1,1,1,1,20161001,,,,
E2213,HCPCS,PNEUMATIC PROP TIRE INSERT,,,28,,NW,,,,,,$61.81,$0.00,1,1,1,1,1,1,20161001,,,,
E2213,HCPCS,PNEUMATIC PROP TIRE INSERT,NU,,28,,NW,,,,,,$61.81,$0.00,1,1,1,1,1,1,20161001,,,,
E2213,HCPCS,PNEUMATIC PROP TIRE INSERT,RR,,28,,NW,,,,,,$9.55,$0.00,1,1,1,1,1,1,20161001,,,,
E2213,HCPCS,PNEUMATIC PROP TIRE INSERT,UE,,28,,NW,,,,,,$47.24,$0.00,1,1,1,1,1,1,20161001,,,,
E2214,HCPCS,PNEUMATIC CASTER TIRE EACH,,,28,,NW,,,,,,$67.24,$0.00,1,1,1,1,1,1,20161001,,,,
E2214,HCPCS,PNEUMATIC CASTER TIRE EACH,NU,,28,,NW,,,,,,$67.24,$0.00,1,1,1,1,1,1,20161001,,,,
E2214,HCPCS,PNEUMATIC CASTER TIRE EACH,RR,,28,,NW,,,,,,$10.68,$0.00,1,1,1,1,1,1,20161001,,,,
E2214,HCPCS,PNEUMATIC CASTER TIRE EACH,UE,,28,,NW,,,,,,$51.38,$0.00,1,1,1,1,1,1,20161001,,,,
E2215,HCPCS,PNEUMATIC CASTER TIRE TUBE,,,28,,NW,,,,,,$22.03,$0.00,1,1,1,1,1,1,20161001,,,,
E2215,HCPCS,PNEUMATIC CASTER TIRE TUBE,NU,,28,,NW,,,,,,$22.03,$0.00,1,1,1,1,1,1,20161001,,,,
E2215,HCPCS,PNEUMATIC CASTER TIRE TUBE,RR,,28,,NW,,,,,,$5.54,$0.00,1,1,1,1,1,1,20161001,,,,
E2215,HCPCS,PNEUMATIC CASTER TIRE TUBE,UE,,28,,NW,,,,,,$17.43,$0.00,1,1,1,1,1,1,20161001,,,,
E2216,HCPCS,FOAM FILLED PROPULSION TIRE,,,28,,NW,,,,,,$184.63,$0.00,1,1,1,1,1,1,20161001,,,,
E2216,HCPCS,FOAM FILLED PROPULSION TIRE,NU,,28,,NW,,,,,,$184.63,$0.00,1,1,1,1,1,1,20161001,,,,
E2216,HCPCS,FOAM FILLED PROPULSION TIRE,RR,,28,,NW,,,,,,$19.64,$0.00,1,1,1,1,1,1,20161001,,,,
E2216,HCPCS,FOAM FILLED PROPULSION TIRE,UE,,28,,NW,,,,,,$138.80,$0.00,1,1,1,1,1,1,20161001,,,,
E2217,HCPCS,FOAM FILLED CASTER TIRE EACH,,,28,,NW,,,,,,$198.45,$0.00,1,1,1,1,1,1,20161001,,,,
E2217,HCPCS,FOAM FILLED CASTER TIRE EACH,NU,,28,,NW,,,,,,$198.45,$0.00,1,1,1,1,1,1,20161001,,,,
E2217,HCPCS,FOAM FILLED CASTER TIRE EACH,RR,,28,,NW,,,,,,$21.11,$0.00,1,1,1,1,1,1,20161001,,,,
E2217,HCPCS,FOAM FILLED CASTER TIRE EACH,UE,,28,,NW,,,,,,$149.20,$0.00,1,1,1,1,1,1,20161001,,,,
E2218,HCPCS,FOAM PROPULSION TIRE EACH,,,28,,NW,,,,,,$159.78,$0.00,1,1,1,1,1,1,20161001,,,,
E2218,HCPCS,FOAM PROPULSION TIRE EACH,NU,,28,,NW,,,,,,$159.78,$0.00,1,1,1,1,1,1,20161001,,,,
E2218,HCPCS,FOAM PROPULSION TIRE EACH,RR,,28,,NW,,,,,,$17.00,$0.00,1,1,1,1,1,1,20161001,,,,
E2218,HCPCS,FOAM PROPULSION TIRE EACH,UE,,28,,NW,,,,,,$120.12,$0.00,1,1,1,1,1,1,20161001,,,,
E2219,HCPCS,FOAM CASTER TIRE ANY SIZE EA,,,28,,NW,,,,,,$80.02,$0.00,1,1,1,1,1,1,20161001,,,,
E2219,HCPCS,FOAM CASTER TIRE ANY SIZE EA,NU,,28,,NW,,,,,,$80.02,$0.00,1,1,1,1,1,1,20161001,,,,
E2219,HCPCS,FOAM CASTER TIRE ANY SIZE EA,RR,,28,,NW,,,,,,$12.27,$0.00,1,1,1,1,1,1,20161001,,,,
E2219,HCPCS,FOAM CASTER TIRE ANY SIZE EA,UE,,28,,NW,,,,,,$60.95,$0.00,1,1,1,1,1,1,20161001,,,,
E2220,HCPCS,SOLID PROPULSION TIRE EACH,,,28,,NW,,,,,,$55.33,$0.00,1,1,1,1,1,1,20161001,,,,
E2220,HCPCS,SOLID PROPULSION TIRE EACH,NU,,28,,NW,,,,,,$55.33,$0.00,1,1,1,1,1,1,20161001,,,,
E2220,HCPCS,SOLID PROPULSION TIRE EACH,RR,,28,,NW,,,,,,$8.73,$0.00,1,1,1,1,1,1,20161001,,,,
E2220,HCPCS,SOLID PROPULSION TIRE EACH,UE,,28,,NW,,,,,,$43.25,$0.00,1,1,1,1,1,1,20161001,,,,
E2221,HCPCS,SOLID CASTER TIRE EACH,,,28,,NW,,,,,,$52.51,$0.00,1,1,1,1,1,1,20161001,,,,
E2221,HCPCS,SOLID CASTER TIRE EACH,NU,,28,,NW,,,,,,$52.51,$0.00,1,1,1,1,1,1,20161001,,,,
E2221,HCPCS,SOLID CASTER TIRE EACH,RR,,28,,NW,,,,,,$8.63,$0.00,1,1,1,1,1,1,20161001,,,,
E2221,HCPCS,SOLID CASTER TIRE EACH,UE,,28,,NW,,,,,,$40.32,$0.00,1,1,1,1,1,1,20161001,,,,
E2222,HCPCS,SOLID CASTER INTEGRATED WHL,,,28,,NW,,,,,,$44.09,$0.00,1,1,1,1,1,1,20161001,,,,
E2222,HCPCS,SOLID CASTER INTEGRATED WHL,NU,,28,,NW,,,,,,$44.09,$0.00,1,1,1,1,1,1,20161001,,,,
E2222,HCPCS,SOLID CASTER INTEGRATED WHL,RR,,28,,NW,,,,,,$7.70,$0.00,1,1,1,1,1,1,20161001,,,,
E2222,HCPCS,SOLID CASTER INTEGRATED WHL,UE,,28,,NW,,,,,,$34.02,$0.00,1,1,1,1,1,1,20161001,,,,
E2224,HCPCS,PROPULSION WHL EXCLUDES TIRE,,,28,,NW,,,,,,$174.08,$0.00,1,1,1,1,1,1,20161001,,,,
E2224,HCPCS,PROPULSION WHL EXCLUDES TIRE,NU,,28,,NW,,,,,,$174.08,$0.00,1,1,1,1,1,1,20161001,,,,
E2224,HCPCS,PROPULSION WHL EXCLUDES TIRE,RR,,28,,NW,,,,,,$21.59,$0.00,1,1,1,1,1,1,20161001,,,,
E2224,HCPCS,PROPULSION WHL EXCLUDES TIRE,UE,,28,,NW,,,,,,$131.30,$0.00,1,1,1,1,1,1,20161001,,,,
E2225,HCPCS,CASTER WHEEL EXCLUDES TIRE,,,28,,NW,,,,,,$37.08,$0.00,1,1,1,1,1,1,20161001,,,,
E2225,HCPCS,CASTER WHEEL EXCLUDES TIRE,NU,,28,,NW,,,,,,$37.08,$0.00,1,1,1,1,1,1,20161001,,,,
E2225,HCPCS,CASTER WHEEL EXCLUDES TIRE,RR,,28,,NW,,,,,,$7.04,$0.00,1,1,1,1,1,1,20161001,,,,
E2225,HCPCS,CASTER WHEEL EXCLUDES TIRE,UE,,28,,NW,,,,,,$28.70,$0.00,1,1,1,1,1,1,20161001,,,,
E2226,HCPCS,CASTER FORK REPLACEMENT ONLY,,,28,,NW,,,,,,$76.46,$0.00,1,1,1,1,1,1,20161001,,,,
E2226,HCPCS,CASTER FORK REPLACEMENT ONLY,NU,,28,,NW,,,,,,$76.46,$0.00,1,1,1,1,1,1,20161001,,,,
E2226,HCPCS,CASTER FORK REPLACEMENT ONLY,RR,,28,,NW,,,,,,$10.98,$0.00,1,1,1,1,1,1,20161001,,,,
E2226,HCPCS,CASTER FORK REPLACEMENT ONLY,UE,,28,,NW,,,,,,$58.27,$0.00,1,1,1,1,1,1,20161001,,,,
E2227,HCPCS,GEAR REDUCTION DRIVE WHEEL,,,28,,NW,,,,,,"$3,199.00",$0.00,1,1,1,1,1,1,20161001,,,,
E2227,HCPCS,GEAR REDUCTION DRIVE WHEEL,NU,,28,,NW,,,,,,"$3,199.00",$0.00,1,1,1,1,1,1,20161001,,,,
E2227,HCPCS,GEAR REDUCTION DRIVE WHEEL,RR,,28,,NW,,,,,,$340.28,$0.00,1,1,1,1,1,1,20161001,,,,
E2227,HCPCS,GEAR REDUCTION DRIVE WHEEL,UE,,28,,NW,,,,,,"$2,257.47",$0.00,1,1,1,1,1,1,20161001,,,,
E2228,HCPCS,"MWC ACC, WHEELCHAIR BRAKE",,,28,,NW,,,,,,"$1,591.59",$0.00,1,1,1,1,1,1,20161001,,,,
E2228,HCPCS,"MWC ACC, WHEELCHAIR BRAKE",NU,,28,,NW,,,,,,"$1,591.59",$0.00,1,1,1,1,1,1,20161001,,,,
E2228,HCPCS,"MWC ACC, WHEELCHAIR BRAKE",RR,,28,,NW,,,,,,$183.17,$0.00,1,1,1,1,1,1,20161001,,,,
E2228,HCPCS,"MWC ACC, WHEELCHAIR BRAKE",UE,,28,,NW,,,,,,"$1,202.32",$0.00,1,1,1,1,1,1,20161001,,,,
E2230,HCPCS,MANUAL STANDING SYSTEM,,,28,,NW,,,,,,"$1,479.49",$0.00,1,1,1,1,1,1,20161001,,,,
E2231,HCPCS,SOLID SEAT SUPPORT BASE,,,28,,NW,,,,,,$290.03,$0.00,1,1,1,1,1,1,20161001,,,,
E2231,HCPCS,SOLID SEAT SUPPORT BASE,NU,,28,,NW,,,,,,$290.03,$0.00,1,1,1,1,1,1,20161001,,,,
E2231,HCPCS,SOLID SEAT SUPPORT BASE,RR,,28,,NW,,,,,,$33.17,$0.00,1,1,1,1,1,1,20161001,,,,
E2231,HCPCS,SOLID SEAT SUPPORT BASE,UE,,28,,NW,,,,,,$224.64,$0.00,1,1,1,1,1,1,20161001,,,,
E2295,HCPCS,PED DYNAMIC SEATING FRAME,,,28,,NW,,,,,,$86.61,$0.00,1,1,1,1,1,1,20161001,,,,
E2300,HCPCS,PWR SEAT ELEVATION SYS,,,28,,NW,,,,,,$971.92,$0.00,1,1,1,1,1,1,20161001,,,,
E2301,HCPCS,PWR STANDING,,,28,,NW,,,,,,"$1,035.04",$0.00,1,1,1,1,1,1,20161001,,,,
E2310,HCPCS,ELECTRO CONNECT BTW CONTROL,,,28,,NW,,,,,,"$3,730.54",$0.00,1,1,1,1,1,1,20161001,,,,
E2310,HCPCS,ELECTRO CONNECT BTW CONTROL,NU,,28,,NW,,,,,,"$3,730.54",$0.00,1,1,1,1,1,1,20161001,,,,
E2310,HCPCS,ELECTRO CONNECT BTW CONTROL,RR,,28,,NW,,,,,,$396.82,$0.00,1,1,1,1,1,1,20161001,,,,
E2310,HCPCS,ELECTRO CONNECT BTW CONTROL,UE,,28,,NW,,,,,,"$2,807.11",$0.00,1,1,1,1,1,1,20161001,,,,
E2311,HCPCS,ELECTRO CONNECT BTW 2 SYS,,,28,,NW,,,,,,"$7,221.34",$0.00,1,1,1,1,1,1,20161001,,,,
E2311,HCPCS,ELECTRO CONNECT BTW 2 SYS,NU,,28,,NW,,,,,,"$7,221.34",$0.00,1,1,1,1,1,1,20161001,,,,
E2311,HCPCS,ELECTRO CONNECT BTW 2 SYS,RR,,28,,NW,,,,,,$768.13,$0.00,1,1,1,1,1,1,20161001,,,,
E2311,HCPCS,ELECTRO CONNECT BTW 2 SYS,UE,,28,,NW,,,,,,"$5,424.85",$0.00,1,1,1,1,1,1,20161001,,,,
E2312,HCPCS,MINI-PROP REMOTE JOYSTICK,,,28,,NW,,,,,,"$7,376.59",$0.00,1,1,1,1,1,1,20161001,,,,
E2312,HCPCS,MINI-PROP REMOTE JOYSTICK,NU,,28,,NW,,,,,,"$7,376.59",$0.00,1,1,1,1,1,1,20161001,,,,
E2312,HCPCS,MINI-PROP REMOTE JOYSTICK,RR,,28,,NW,,,,,,$784.65,$0.00,1,1,1,1,1,1,20161001,,,,
E2312,HCPCS,MINI-PROP REMOTE JOYSTICK,UE,,28,,NW,,,,,,"$5,541.29",$0.00,1,1,1,1,1,1,20161001,,,,
E2313,HCPCS,"PWC HARNESS, EXPAND CONTROL",,,28,,NW,,,,,,$602.56,$0.00,1,1,1,1,1,1,20161001,,,,
E2313,HCPCS,"PWC HARNESS, EXPAND CONTROL",NU,,28,,NW,,,,,,$602.56,$0.00,1,1,1,1,1,1,20161001,,,,
E2313,HCPCS,"PWC HARNESS, EXPAND CONTROL",RR,,28,,NW,,,,,,$64.09,$0.00,1,1,1,1,1,1,20161001,,,,
E2313,HCPCS,"PWC HARNESS, EXPAND CONTROL",UE,,28,,NW,,,,,,$414.93,$0.00,1,1,1,1,1,1,20161001,,,,
E2321,HCPCS,HAND INTERFACE JOYSTICK,,,28,,NW,,,,,,"$8,438.99",$0.00,1,1,1,1,1,1,20161001,,,,
E2321,HCPCS,HAND INTERFACE JOYSTICK,NU,,28,,NW,,,,,,"$8,438.99",$0.00,1,1,1,1,1,1,20161001,,,,
E2321,HCPCS,HAND INTERFACE JOYSTICK,RR,,28,,NW,,,,,,$897.66,$0.00,1,1,1,1,1,1,20161001,,,,
E2321,HCPCS,HAND INTERFACE JOYSTICK,UE,,28,,NW,,,,,,"$6,338.04",$0.00,1,1,1,1,1,1,20161001,,,,
E2322,HCPCS,MULT MECH SWITCHES,,,28,,NW,,,,,,"$8,123.31",$0.00,1,1,1,1,1,1,20161001,,,,
E2322,HCPCS,MULT MECH SWITCHES,NU,,28,,NW,,,,,,"$8,123.31",$0.00,1,1,1,1,1,1,20161001,,,,
E2322,HCPCS,MULT MECH SWITCHES,RR,,28,,NW,,,,,,$864.08,$0.00,1,1,1,1,1,1,20161001,,,,
E2322,HCPCS,MULT MECH SWITCHES,UE,,28,,NW,,,,,,"$6,101.31",$0.00,1,1,1,1,1,1,20161001,,,,
E2323,HCPCS,SPECIAL JOYSTICK HANDLE,,,28,,NW,,,,,,$248.61,$0.00,1,1,1,1,1,1,20161001,,,,
E2323,HCPCS,SPECIAL JOYSTICK HANDLE,NU,,28,,NW,,,,,,$248.61,$0.00,1,1,1,1,1,1,20161001,,,,
E2323,HCPCS,SPECIAL JOYSTICK HANDLE,RR,,28,,NW,,,,,,$28.37,$0.00,1,1,1,1,1,1,20161001,,,,
E2323,HCPCS,SPECIAL JOYSTICK HANDLE,UE,,28,,NW,,,,,,$188.84,$0.00,1,1,1,1,1,1,20161001,,,,
E2324,HCPCS,CHIN CUP INTERFACE,,,28,,NW,,,,,,$160.10,$0.00,1,1,1,1,1,1,20161001,,,,
E2324,HCPCS,CHIN CUP INTERFACE,NU,,28,,NW,,,,,,$160.10,$0.00,1,1,1,1,1,1,20161001,,,,
E2324,HCPCS,CHIN CUP INTERFACE,RR,,28,,NW,,,,,,$19.30,$0.00,1,1,1,1,1,1,20161001,,,,
E2324,HCPCS,CHIN CUP INTERFACE,UE,,28,,NW,,,,,,$121.03,$0.00,1,1,1,1,1,1,20161001,,,,
E2325,HCPCS,SIP AND PUFF INTERFACE,,,28,,NW,,,,,,"$4,245.26",$0.00,1,1,1,1,1,1,20161001,,,,
E2325,HCPCS,SIP AND PUFF INTERFACE,NU,,28,,NW,,,,,,"$4,245.26",$0.00,1,1,1,1,1,1,20161001,,,,
E2325,HCPCS,SIP AND PUFF INTERFACE,RR,,28,,NW,,,,,,$451.57,$0.00,1,1,1,1,1,1,20161001,,,,
E2325,HCPCS,SIP AND PUFF INTERFACE,UE,,28,,NW,,,,,,"$3,193.11",$0.00,1,1,1,1,1,1,20161001,,,,
E2326,HCPCS,BREATH TUBE KIT,,,28,,NW,,,,,,"$1,200.19",$0.00,1,1,1,1,1,1,20161001,,,,
E2326,HCPCS,BREATH TUBE KIT,NU,,28,,NW,,,,,,"$1,200.19",$0.00,1,1,1,1,1,1,20161001,,,,
E2326,HCPCS,BREATH TUBE KIT,RR,,28,,NW,,,,,,$127.66,$0.00,1,1,1,1,1,1,20161001,,,,
E2326,HCPCS,BREATH TUBE KIT,UE,,28,,NW,,,,,,$909.86,$0.00,1,1,1,1,1,1,20161001,,,,
E2327,HCPCS,HEAD CONTROL INTERFACE MECH,,,28,,NW,,,,,,"$13,277.32",$0.00,1,1,1,1,1,1,20161001,,,,
E2327,HCPCS,HEAD CONTROL INTERFACE MECH,NU,,28,,NW,,,,,,"$13,277.32",$0.00,1,1,1,1,1,1,20161001,,,,
E2327,HCPCS,HEAD CONTROL INTERFACE MECH,RR,,28,,NW,,,,,,"$1,412.31",$0.00,1,1,1,1,1,1,20161001,,,,
E2327,HCPCS,HEAD CONTROL INTERFACE MECH,UE,,28,,NW,,,,,,"$9,966.64",$0.00,1,1,1,1,1,1,20161001,,,,
E2328,HCPCS,HEAD/EXTREMITY CONTROL INTER,,,28,,NW,,,,,,"$14,749.37",$0.00,1,1,1,1,1,1,20161001,,,,
E2328,HCPCS,HEAD/EXTREMITY CONTROL INTER,NU,,28,,NW,,,,,,"$14,749.37",$0.00,1,1,1,1,1,1,20161001,,,,
E2328,HCPCS,HEAD/EXTREMITY CONTROL INTER,RR,,28,,NW,,,,,,"$1,568.89",$0.00,1,1,1,1,1,1,20161001,,,,
E2328,HCPCS,HEAD/EXTREMITY CONTROL INTER,UE,,28,,NW,,,,,,"$11,070.73",$0.00,1,1,1,1,1,1,20161001,,,,
E2329,HCPCS,HEAD CONTROL NONPROPORTIONAL,,,28,,NW,,,,,,"$5,465.30",$0.00,1,1,1,1,1,1,20161001,,,,
E2329,HCPCS,HEAD CONTROL NONPROPORTIONAL,NU,,28,,NW,,,,,,"$5,465.30",$0.00,1,1,1,1,1,1,20161001,,,,
E2329,HCPCS,HEAD CONTROL NONPROPORTIONAL,RR,,28,,NW,,,,,,$581.34,$0.00,1,1,1,1,1,1,20161001,,,,
E2329,HCPCS,HEAD CONTROL NONPROPORTIONAL,UE,,28,,NW,,,,,,"$4,107.95",$0.00,1,1,1,1,1,1,20161001,,,,
E2330,HCPCS,HEAD CONTROL PROXIMITY SWITC,,,28,,NW,,,,,,"$10,285.74",$0.00,1,1,1,1,1,1,20161001,,,,
E2330,HCPCS,HEAD CONTROL PROXIMITY SWITC,NU,,28,,NW,,,,,,"$10,285.74",$0.00,1,1,1,1,1,1,20161001,,,,
E2330,HCPCS,HEAD CONTROL PROXIMITY SWITC,RR,,28,,NW,,,,,,"$1,094.10",$0.00,1,1,1,1,1,1,20161001,,,,
E2330,HCPCS,HEAD CONTROL PROXIMITY SWITC,UE,,28,,NW,,,,,,"$7,723.09",$0.00,1,1,1,1,1,1,20161001,,,,
E2331,HCPCS,ATTENDANT CONTROL,,,28,,NW,,,,,,$858.89,$0.00,1,1,1,1,1,1,20161001,,,,
E2340,HCPCS,W/C WDTH 20-23 IN SEAT FRAME,,,28,,NW,,,,,,$630.45,$0.00,1,1,1,1,1,1,20161001,,,,
E2340,HCPCS,W/C WDTH 20-23 IN SEAT FRAME,NU,,28,,NW,,,,,,$630.45,$0.00,1,1,1,1,1,1,20161001,,,,
E2340,HCPCS,W/C WDTH 20-23 IN SEAT FRAME,RR,,28,,NW,,,,,,$72.43,$0.00,1,1,1,1,1,1,20161001,,,,
E2340,HCPCS,W/C WDTH 20-23 IN SEAT FRAME,UE,,28,,NW,,,,,,$481.49,$0.00,1,1,1,1,1,1,20161001,,,,
E2341,HCPCS,W/C WDTH 24-27 IN SEAT FRAME,,,28,,NW,,,,,,$928.52,$0.00,1,1,1,1,1,1,20161001,,,,
E2341,HCPCS,W/C WDTH 24-27 IN SEAT FRAME,NU,,28,,NW,,,,,,$928.52,$0.00,1,1,1,1,1,1,20161001,,,,
E2341,HCPCS,W/C WDTH 24-27 IN SEAT FRAME,RR,,28,,NW,,,,,,$106.75,$0.00,1,1,1,1,1,1,20161001,,,,
E2341,HCPCS,W/C WDTH 24-27 IN SEAT FRAME,UE,,28,,NW,,,,,,$705.01,$0.00,1,1,1,1,1,1,20161001,,,,
E2342,HCPCS,W/C DPTH 20-21 IN SEAT FRAME,,,28,,NW,,,,,,$779.51,$0.00,1,1,1,1,1,1,20161001,,,,
E2342,HCPCS,W/C DPTH 20-21 IN SEAT FRAME,NU,,28,,NW,,,,,,$779.51,$0.00,1,1,1,1,1,1,20161001,,,,
E2342,HCPCS,W/C DPTH 20-21 IN SEAT FRAME,RR,,28,,NW,,,,,,$89.58,$0.00,1,1,1,1,1,1,20161001,,,,
E2342,HCPCS,W/C DPTH 20-21 IN SEAT FRAME,UE,,28,,NW,,,,,,$593.26,$0.00,1,1,1,1,1,1,20161001,,,,
E2343,HCPCS,W/C DPTH 22-25 IN SEAT FRAME,,,28,,NW,,,,,,"$1,226.55",$0.00,1,1,1,1,1,1,20161001,,,,
E2343,HCPCS,W/C DPTH 22-25 IN SEAT FRAME,NU,,28,,NW,,,,,,"$1,226.55",$0.00,1,1,1,1,1,1,20161001,,,,
E2343,HCPCS,W/C DPTH 22-25 IN SEAT FRAME,RR,,28,,NW,,,,,,$141.10,$0.00,1,1,1,1,1,1,20161001,,,,
E2343,HCPCS,W/C DPTH 22-25 IN SEAT FRAME,UE,,28,,NW,,,,,,$928.52,$0.00,1,1,1,1,1,1,20161001,,,,
E2351,HCPCS,ELECTRONIC SGD INTERFACE,,,28,,NW,,,,,,"$2,197.83",$0.00,1,1,1,1,1,1,20161001,,,,
E2351,HCPCS,ELECTRONIC SGD INTERFACE,NU,,28,,NW,,,,,,"$2,197.83",$0.00,1,1,1,1,1,1,20161001,,,,
E2351,HCPCS,ELECTRONIC SGD INTERFACE,RR,,28,,NW,,,,,,$250.86,$0.00,1,1,1,1,1,1,20161001,,,,
E2351,HCPCS,ELECTRONIC SGD INTERFACE,UE,,28,,NW,,,,,,"$1,657.37",$0.00,1,1,1,1,1,1,20161001,,,,
E2358,HCPCS,GR 34 NONSEALED LEADACID,,,28,,NW,,,,,,$313.90,$0.00,1,1,1,1,1,1,20161001,,,,
E2359,HCPCS,GR34 SEALED LEADACID BATTERY,,,28,,NW,,,,,,$319.12,$0.00,1,1,1,1,1,1,20161001,,,,
E2359,HCPCS,GR34 SEALED LEADACID BATTERY,NU,,28,,NW,,,,,,$319.12,$0.00,1,1,1,1,1,1,20161001,,,,
E2359,HCPCS,GR34 SEALED LEADACID BATTERY,RR,,28,,NW,,,,,,$36.53,$0.00,1,1,1,1,1,1,20161001,,,,
E2359,HCPCS,GR34 SEALED LEADACID BATTERY,UE,,28,,NW,,,,,,$247.95,$0.00,1,1,1,1,1,1,20161001,,,,
E2360,HCPCS,22NF NONSEALED LEADACID,,,28,,NW,,,,,,$206.13,$0.00,1,1,1,1,1,1,20161001,,,,
E2360,HCPCS,22NF NONSEALED LEADACID,NU,,28,,NW,,,,,,$206.13,$0.00,1,1,1,1,1,1,20161001,,,,
E2360,HCPCS,22NF NONSEALED LEADACID,RR,,28,,NW,,,,,,$24.04,$0.00,1,1,1,1,1,1,20161001,,,,
E2360,HCPCS,22NF NONSEALED LEADACID,UE,,28,,NW,,,,,,$155.55,$0.00,1,1,1,1,1,1,20161001,,,,
E2361,HCPCS,22NF SEALED LEADACID BATTERY,,,28,,NW,,,,,,$464.74,$0.00,1,1,1,1,1,1,20161001,,,,
E2361,HCPCS,22NF SEALED LEADACID BATTERY,NU,,28,,NW,,,,,,$464.74,$0.00,1,1,1,1,1,1,20161001,,,,
E2361,HCPCS,22NF SEALED LEADACID BATTERY,RR,,28,,NW,,,,,,$53.33,$0.00,1,1,1,1,1,1,20161001,,,,
E2361,HCPCS,22NF SEALED LEADACID BATTERY,UE,,28,,NW,,,,,,$357.21,$0.00,1,1,1,1,1,1,20161001,,,,
E2362,HCPCS,GR24 NONSEALED LEADACID,,,28,,NW,,,,,,$179.43,$0.00,1,1,1,1,1,1,20161001,,,,
E2362,HCPCS,GR24 NONSEALED LEADACID,NU,,28,,NW,,,,,,$179.43,$0.00,1,1,1,1,1,1,20161001,,,,
E2362,HCPCS,GR24 NONSEALED LEADACID,RR,,28,,NW,,,,,,$21.28,$0.00,1,1,1,1,1,1,20161001,,,,
E2362,HCPCS,GR24 NONSEALED LEADACID,UE,,28,,NW,,,,,,$135.48,$0.00,1,1,1,1,1,1,20161001,,,,
E2363,HCPCS,GR24 SEALED LEADACID BATTERY,,,28,,NW,,,,,,$608.38,$0.00,1,1,1,1,1,1,20161001,,,,
E2363,HCPCS,GR24 SEALED LEADACID BATTERY,NU,,28,,NW,,,,,,$608.38,$0.00,1,1,1,1,1,1,20161001,,,,
E2363,HCPCS,GR24 SEALED LEADACID BATTERY,RR,,28,,NW,,,,,,$69.89,$0.00,1,1,1,1,1,1,20161001,,,,
E2363,HCPCS,GR24 SEALED LEADACID BATTERY,UE,,28,,NW,,,,,,$464.90,$0.00,1,1,1,1,1,1,20161001,,,,
E2364,HCPCS,U1NONSEALED LEADACID BATTERY,,,28,,NW,,,,,,$206.13,$0.00,1,1,1,1,1,1,20161001,,,,
E2364,HCPCS,U1NONSEALED LEADACID BATTERY,NU,,28,,NW,,,,,,$206.13,$0.00,1,1,1,1,1,1,20161001,,,,
E2364,HCPCS,U1NONSEALED LEADACID BATTERY,RR,,28,,NW,,,,,,$24.04,$0.00,1,1,1,1,1,1,20161001,,,,
E2364,HCPCS,U1NONSEALED LEADACID BATTERY,UE,,28,,NW,,,,,,$155.53,$0.00,1,1,1,1,1,1,20161001,,,,
E2365,HCPCS,U1 SEALED LEADACID BATTERY,,,28,,NW,,,,,,$380.56,$0.00,1,1,1,1,1,1,20161001,,,,
E2365,HCPCS,U1 SEALED LEADACID BATTERY,NU,,28,,NW,,,,,,$380.56,$0.00,1,1,1,1,1,1,20161001,,,,
E2365,HCPCS,U1 SEALED LEADACID BATTERY,RR,,28,,NW,,,,,,$43.59,$0.00,1,1,1,1,1,1,20161001,,,,
E2365,HCPCS,U1 SEALED LEADACID BATTERY,UE,,28,,NW,,,,,,$294.20,$0.00,1,1,1,1,1,1,20161001,,,,
E2366,HCPCS,"BATTERY CHARGER, SINGLE MODE",,,28,,NW,,,,,,$801.08,$0.00,1,1,1,1,1,1,20161001,,,,
E2366,HCPCS,"BATTERY CHARGER, SINGLE MODE",NU,,28,,NW,,,,,,$801.08,$0.00,1,1,1,1,1,1,20161001,,,,
E2366,HCPCS,"BATTERY CHARGER, SINGLE MODE",RR,,28,,NW,,,,,,$92.34,$0.00,1,1,1,1,1,1,20161001,,,,
E2366,HCPCS,"BATTERY CHARGER, SINGLE MODE",UE,,28,,NW,,,,,,$609.86,$0.00,1,1,1,1,1,1,20161001,,,,
E2367,HCPCS,"BATTERY CHARGER, DUAL MODE",,,28,,NW,,,,,,"$1,332.15",$0.00,1,1,1,1,1,1,20161001,,,,
E2367,HCPCS,"BATTERY CHARGER, DUAL MODE",NU,,28,,NW,,,,,,"$1,332.15",$0.00,1,1,1,1,1,1,20161001,,,,
E2367,HCPCS,"BATTERY CHARGER, DUAL MODE",RR,,28,,NW,,,,,,$153.31,$0.00,1,1,1,1,1,1,20161001,,,,
E2367,HCPCS,"BATTERY CHARGER, DUAL MODE",UE,,28,,NW,,,,,,"$1,007.74",$0.00,1,1,1,1,1,1,20161001,,,,
E2368,HCPCS,PWR WC DRIVEWHEEL MOTOR REPL,,,28,,NW,,,,,,"$1,634.06",$0.00,1,1,1,1,1,1,20161001,,,,
E2368,HCPCS,PWR WC DRIVEWHEEL MOTOR REPL,NU,,28,,NW,,,,,,"$1,634.06",$0.00,1,1,1,1,1,1,20161001,,,,
E2368,HCPCS,PWR WC DRIVEWHEEL MOTOR REPL,RR,,28,,NW,,,,,,$188.11,$0.00,1,1,1,1,1,1,20161001,,,,
E2368,HCPCS,PWR WC DRIVEWHEEL MOTOR REPL,UE,,28,,NW,,,,,,"$1,234.20",$0.00,1,1,1,1,1,1,20161001,,,,
E2369,HCPCS,PWR WC DRIVEWHEEL GEAR REPL,,,28,,NW,,,,,,"$1,427.74",$0.00,1,1,1,1,1,1,20161001,,,,
E2369,HCPCS,PWR WC DRIVEWHEEL GEAR REPL,NU,,28,,NW,,,,,,"$1,427.74",$0.00,1,1,1,1,1,1,20161001,,,,
E2369,HCPCS,PWR WC DRIVEWHEEL GEAR REPL,RR,,28,,NW,,,,,,$164.35,$0.00,1,1,1,1,1,1,20161001,,,,
E2369,HCPCS,PWR WC DRIVEWHEEL GEAR REPL,UE,,28,,NW,,,,,,"$1,079.40",$0.00,1,1,1,1,1,1,20161001,,,,
E2370,HCPCS,PWR WC DR WH MOTOR/GEAR COMB,,,28,,NW,,,,,,"$2,520.52",$0.00,1,1,1,1,1,1,20161001,,,,
E2370,HCPCS,PWR WC DR WH MOTOR/GEAR COMB,NU,,28,,NW,,,,,,"$2,520.52",$0.00,1,1,1,1,1,1,20161001,,,,
E2370,HCPCS,PWR WC DR WH MOTOR/GEAR COMB,RR,,28,,NW,,,,,,$283.07,$0.00,1,1,1,1,1,1,20161001,,,,
E2370,HCPCS,PWR WC DR WH MOTOR/GEAR COMB,UE,,28,,NW,,,,,,"$1,899.00",$0.00,1,1,1,1,1,1,20161001,,,,
E2371,HCPCS,GR27 SEALED LEADACID BATTERY,,,28,,NW,,,,,,$501.23,$0.00,1,1,1,1,1,1,20161001,,,,
E2371,HCPCS,GR27 SEALED LEADACID BATTERY,NU,,28,,NW,,,,,,$501.23,$0.00,1,1,1,1,1,1,20161001,,,,
E2371,HCPCS,GR27 SEALED LEADACID BATTERY,RR,,28,,NW,,,,,,$57.53,$0.00,1,1,1,1,1,1,20161001,,,,
E2371,HCPCS,GR27 SEALED LEADACID BATTERY,UE,,28,,NW,,,,,,$384.55,$0.00,1,1,1,1,1,1,20161001,,,,
E2372,HCPCS,GR27 NON-SEALED LEADACID,,,28,,NW,,,,,,$189.95,$0.00,1,1,1,1,1,1,20161001,,,,
E2372,HCPCS,GR27 NON-SEALED LEADACID,NU,,28,,NW,,,,,,$189.95,$0.00,1,1,1,1,1,1,20161001,,,,
E2372,HCPCS,GR27 NON-SEALED LEADACID,RR,,28,,NW,,,,,,$20.21,$0.00,1,1,1,1,1,1,20161001,,,,
E2372,HCPCS,GR27 NON-SEALED LEADACID,UE,,28,,NW,,,,,,$142.81,$0.00,1,1,1,1,1,1,20161001,,,,
E2373,HCPCS,HAND/CHIN CTRL SPEC JOYSTICK,,,28,,NW,,,,,,"$5,005.19",$0.00,1,1,1,1,1,1,20161001,,,,
E2373,HCPCS,HAND/CHIN CTRL SPEC JOYSTICK,NU,,28,,NW,,,,,,"$5,005.19",$0.00,1,1,1,1,1,1,20161001,,,,
E2373,HCPCS,HAND/CHIN CTRL SPEC JOYSTICK,RR,,28,,NW,,,,,,$532.40,$0.00,1,1,1,1,1,1,20161001,,,,
E2373,HCPCS,HAND/CHIN CTRL SPEC JOYSTICK,UE,,28,,NW,,,,,,"$3,764.98",$0.00,1,1,1,1,1,1,20161001,,,,
E2374,HCPCS,HAND/CHIN CTRL STD JOYSTICK,,,28,,NW,,,,,,"$1,826.94",$0.00,1,1,1,1,1,1,20161001,,,,
E2374,HCPCS,HAND/CHIN CTRL STD JOYSTICK,NU,,28,,NW,,,,,,"$1,826.94",$0.00,1,1,1,1,1,1,20161001,,,,
E2374,HCPCS,HAND/CHIN CTRL STD JOYSTICK,RR,,28,,NW,,,,,,$194.33,$0.00,1,1,1,1,1,1,20161001,,,,
E2374,HCPCS,HAND/CHIN CTRL STD JOYSTICK,UE,,28,,NW,,,,,,"$1,380.03",$0.00,1,1,1,1,1,1,20161001,,,,
E2375,HCPCS,NON-EXPANDABLE CONTROLLER,,,28,,NW,,,,,,"$2,686.86",$0.00,1,1,1,1,1,1,20161001,,,,
E2375,HCPCS,NON-EXPANDABLE CONTROLLER,NU,,28,,NW,,,,,,"$2,686.86",$0.00,1,1,1,1,1,1,20161001,,,,
E2375,HCPCS,NON-EXPANDABLE CONTROLLER,RR,,28,,NW,,,,,,$299.68,$0.00,1,1,1,1,1,1,20161001,,,,
E2375,HCPCS,NON-EXPANDABLE CONTROLLER,UE,,28,,NW,,,,,,"$2,023.71",$0.00,1,1,1,1,1,1,20161001,,,,
E2376,HCPCS,"EXPANDABLE CONTROLLER, REPL",,,28,,NW,,,,,,"$4,231.32",$0.00,1,1,1,1,1,1,20161001,,,,
E2376,HCPCS,"EXPANDABLE CONTROLLER, REPL",NU,,28,,NW,,,,,,"$4,231.32",$0.00,1,1,1,1,1,1,20161001,,,,
E2376,HCPCS,"EXPANDABLE CONTROLLER, REPL",RR,,28,,NW,,,,,,$450.09,$0.00,1,1,1,1,1,1,20161001,,,,
E2376,HCPCS,"EXPANDABLE CONTROLLER, REPL",UE,,28,,NW,,,,,,"$3,182.67",$0.00,1,1,1,1,1,1,20161001,,,,
E2377,HCPCS,"EXPANDABLE CONTROLLER, INITL",,,28,,NW,,,,,,"$1,664.57",$0.00,1,1,1,1,1,1,20161001,,,,
E2377,HCPCS,"EXPANDABLE CONTROLLER, INITL",NU,,28,,NW,,,,,,"$1,664.57",$0.00,1,1,1,1,1,1,20161001,,,,
E2377,HCPCS,"EXPANDABLE CONTROLLER, INITL",RR,,28,,NW,,,,,,$177.06,$0.00,1,1,1,1,1,1,20161001,,,,
E2377,HCPCS,"EXPANDABLE CONTROLLER, INITL",UE,,28,,NW,,,,,,"$1,258.25",$0.00,1,1,1,1,1,1,20161001,,,,
E2378,HCPCS,PW ACTUATOR REPLACEMENT,,,28,,NW,,,,,,$957.12,$0.00,1,1,1,1,1,1,20161001,,,,
E2378,HCPCS,PW ACTUATOR REPLACEMENT,NU,,28,,NW,,,,,,$957.12,$0.00,1,1,1,1,1,1,20161001,,,,
E2378,HCPCS,PW ACTUATOR REPLACEMENT,RR,,28,,NW,,,,,,$101.81,$0.00,1,1,1,1,1,1,20161001,,,,
E2378,HCPCS,PW ACTUATOR REPLACEMENT,UE,,28,,NW,,,,,,$719.58,$0.00,1,1,1,1,1,1,20161001,,,,
E2381,HCPCS,PNEUM DRIVE WHEEL TIRE,,,28,,NW,,,,,,$269.41,$0.00,1,1,1,1,1,1,20161001,,,,
E2381,HCPCS,PNEUM DRIVE WHEEL TIRE,NU,,28,,NW,,,,,,$269.41,$0.00,1,1,1,1,1,1,20161001,,,,
E2381,HCPCS,PNEUM DRIVE WHEEL TIRE,RR,,28,,NW,,,,,,$30.82,$0.00,1,1,1,1,1,1,20161001,,,,
E2381,HCPCS,PNEUM DRIVE WHEEL TIRE,UE,,28,,NW,,,,,,$206.86,$0.00,1,1,1,1,1,1,20161001,,,,
E2382,HCPCS,"TUBE, PNEUM WHEEL DRIVE TIRE",,,28,,NW,,,,,,$77.55,$0.00,1,1,1,1,1,1,20161001,,,,
E2382,HCPCS,"TUBE, PNEUM WHEEL DRIVE TIRE",NU,,28,,NW,,,,,,$77.55,$0.00,1,1,1,1,1,1,20161001,,,,
E2382,HCPCS,"TUBE, PNEUM WHEEL DRIVE TIRE",RR,,28,,NW,,,,,,$11.05,$0.00,1,1,1,1,1,1,20161001,,,,
E2382,HCPCS,"TUBE, PNEUM WHEEL DRIVE TIRE",UE,,28,,NW,,,,,,$59.11,$0.00,1,1,1,1,1,1,20161001,,,,
E2383,HCPCS,"INSERT, PNEUM WHEEL DRIVE",,,28,,NW,,,,,,$503.09,$0.00,1,1,1,1,1,1,20161001,,,,
E2383,HCPCS,"INSERT, PNEUM WHEEL DRIVE",NU,,28,,NW,,,,,,$503.09,$0.00,1,1,1,1,1,1,20161001,,,,
E2383,HCPCS,"INSERT, PNEUM WHEEL DRIVE",RR,,28,,NW,,,,,,$57.71,$0.00,1,1,1,1,1,1,20161001,,,,
E2383,HCPCS,"INSERT, PNEUM WHEEL DRIVE",UE,,28,,NW,,,,,,$385.95,$0.00,1,1,1,1,1,1,20161001,,,,
E2384,HCPCS,PNEUMATIC CASTER TIRE,,,28,,NW,,,,,,$284.16,$0.00,1,1,1,1,1,1,20161001,,,,
E2384,HCPCS,PNEUMATIC CASTER TIRE,NU,,28,,NW,,,,,,$284.16,$0.00,1,1,1,1,1,1,20161001,,,,
E2384,HCPCS,PNEUMATIC CASTER TIRE,RR,,28,,NW,,,,,,$32.53,$0.00,1,1,1,1,1,1,20161001,,,,
E2384,HCPCS,PNEUMATIC CASTER TIRE,UE,,28,,NW,,,,,,$219.57,$0.00,1,1,1,1,1,1,20161001,,,,
E2385,HCPCS,"TUBE, PNEUMATIC CASTER TIRE",,,28,,NW,,,,,,$180.11,$0.00,1,1,1,1,1,1,20161001,,,,
E2385,HCPCS,"TUBE, PNEUMATIC CASTER TIRE",NU,,28,,NW,,,,,,$180.11,$0.00,1,1,1,1,1,1,20161001,,,,
E2385,HCPCS,"TUBE, PNEUMATIC CASTER TIRE",RR,,28,,NW,,,,,,$21.33,$0.00,1,1,1,1,1,1,20161001,,,,
E2385,HCPCS,"TUBE, PNEUMATIC CASTER TIRE",UE,,28,,NW,,,,,,$135.71,$0.00,1,1,1,1,1,1,20161001,,,,
E2386,HCPCS,FOAM FILLED DRIVE WHEEL TIRE,,,28,,NW,,,,,,$498.86,$0.00,1,1,1,1,1,1,20161001,,,,
E2386,HCPCS,FOAM FILLED DRIVE WHEEL TIRE,NU,,28,,NW,,,,,,$498.86,$0.00,1,1,1,1,1,1,20161001,,,,
E2386,HCPCS,FOAM FILLED DRIVE WHEEL TIRE,RR,,28,,NW,,,,,,$57.23,$0.00,1,1,1,1,1,1,20161001,,,,
E2386,HCPCS,FOAM FILLED DRIVE WHEEL TIRE,UE,,28,,NW,,,,,,$382.74,$0.00,1,1,1,1,1,1,20161001,,,,
E2387,HCPCS,FOAM FILLED CASTER TIRE,,,28,,NW,,,,,,$238.77,$0.00,1,1,1,1,1,1,20161001,,,,
E2387,HCPCS,FOAM FILLED CASTER TIRE,NU,,28,,NW,,,,,,$238.77,$0.00,1,1,1,1,1,1,20161001,,,,
E2387,HCPCS,FOAM FILLED CASTER TIRE,RR,,28,,NW,,,,,,$27.26,$0.00,1,1,1,1,1,1,20161001,,,,
E2387,HCPCS,FOAM FILLED CASTER TIRE,UE,,28,,NW,,,,,,$180.43,$0.00,1,1,1,1,1,1,20161001,,,,
E2388,HCPCS,FOAM DRIVE WHEEL TIRE,,,28,,NW,,,,,,$183.55,$0.00,1,1,1,1,1,1,20161001,,,,
E2388,HCPCS,FOAM DRIVE WHEEL TIRE,NU,,28,,NW,,,,,,$183.55,$0.00,1,1,1,1,1,1,20161001,,,,
E2388,HCPCS,FOAM DRIVE WHEEL TIRE,RR,,28,,NW,,,,,,$21.69,$0.00,1,1,1,1,1,1,20161001,,,,
E2388,HCPCS,FOAM DRIVE WHEEL TIRE,UE,,28,,NW,,,,,,$138.61,$0.00,1,1,1,1,1,1,20161001,,,,
E2389,HCPCS,FOAM CASTER TIRE,,,28,,NW,,,,,,$101.39,$0.00,1,1,1,1,1,1,20161001,,,,
E2389,HCPCS,FOAM CASTER TIRE,NU,,28,,NW,,,,,,$101.39,$0.00,1,1,1,1,1,1,20161001,,,,
E2389,HCPCS,FOAM CASTER TIRE,RR,,28,,NW,,,,,,$13.52,$0.00,1,1,1,1,1,1,20161001,,,,
E2389,HCPCS,FOAM CASTER TIRE,UE,,28,,NW,,,,,,$76.92,$0.00,1,1,1,1,1,1,20161001,,,,
E2390,HCPCS,SOLID DRIVE WHEEL TIRE,,,28,,NW,,,,,,$156.44,$0.00,1,1,1,1,1,1,20161001,,,,
E2390,HCPCS,SOLID DRIVE WHEEL TIRE,NU,,28,,NW,,,,,,$156.44,$0.00,1,1,1,1,1,1,20161001,,,,
E2390,HCPCS,SOLID DRIVE WHEEL TIRE,RR,,28,,NW,,,,,,$18.99,$0.00,1,1,1,1,1,1,20161001,,,,
E2390,HCPCS,SOLID DRIVE WHEEL TIRE,UE,,28,,NW,,,,,,$118.20,$0.00,1,1,1,1,1,1,20161001,,,,
E2391,HCPCS,SOLID CASTER TIRE,,,28,,NW,,,,,,$76.89,$0.00,1,1,1,1,1,1,20161001,,,,
E2391,HCPCS,SOLID CASTER TIRE,NU,,28,,NW,,,,,,$76.89,$0.00,1,1,1,1,1,1,20161001,,,,
E2391,HCPCS,SOLID CASTER TIRE,RR,,28,,NW,,,,,,$11.03,$0.00,1,1,1,1,1,1,20161001,,,,
E2391,HCPCS,SOLID CASTER TIRE,UE,,28,,NW,,,,,,$58.60,$0.00,1,1,1,1,1,1,20161001,,,,
E2392,HCPCS,"SOLID CASTER TIRE, INTEGRATE",,,28,,NW,,,,,,$195.99,$0.00,1,1,1,1,1,1,20161001,,,,
E2392,HCPCS,"SOLID CASTER TIRE, INTEGRATE",NU,,28,,NW,,,,,,$195.99,$0.00,1,1,1,1,1,1,20161001,,,,
E2392,HCPCS,"SOLID CASTER TIRE, INTEGRATE",RR,,28,,NW,,,,,,$23.02,$0.00,1,1,1,1,1,1,20161001,,,,
E2392,HCPCS,"SOLID CASTER TIRE, INTEGRATE",UE,,28,,NW,,,,,,$147.96,$0.00,1,1,1,1,1,1,20161001,,,,
E2394,HCPCS,DRIVE WHEEL EXCLUDES TIRE,,,28,,NW,,,,,,$272.14,$0.00,1,1,1,1,1,1,20161001,,,,
E2394,HCPCS,DRIVE WHEEL EXCLUDES TIRE,NU,,28,,NW,,,,,,$272.14,$0.00,1,1,1,1,1,1,20161001,,,,
E2394,HCPCS,DRIVE WHEEL EXCLUDES TIRE,RR,,28,,NW,,,,,,$31.15,$0.00,1,1,1,1,1,1,20161001,,,,
E2394,HCPCS,DRIVE WHEEL EXCLUDES TIRE,UE,,28,,NW,,,,,,$209.19,$0.00,1,1,1,1,1,1,20161001,,,,
E2395,HCPCS,CASTER WHEEL EXCLUDES TIRE,,,28,,NW,,,,,,$198.39,$0.00,1,1,1,1,1,1,20161001,,,,
E2395,HCPCS,CASTER WHEEL EXCLUDES TIRE,NU,,28,,NW,,,,,,$198.39,$0.00,1,1,1,1,1,1,20161001,,,,
E2395,HCPCS,CASTER WHEEL EXCLUDES TIRE,RR,,28,,NW,,,,,,$23.21,$0.00,1,1,1,1,1,1,20161001,,,,
E2395,HCPCS,CASTER WHEEL EXCLUDES TIRE,UE,,28,,NW,,,,,,$149.79,$0.00,1,1,1,1,1,1,20161001,,,,
E2396,HCPCS,CASTER FORK,,,28,,NW,,,,,,$228.50,$0.00,1,1,1,1,1,1,20161001,,,,
E2396,HCPCS,CASTER FORK,NU,,28,,NW,,,,,,$228.50,$0.00,1,1,1,1,1,1,20161001,,,,
E2396,HCPCS,CASTER FORK,RR,,28,,NW,,,,,,$27.67,$0.00,1,1,1,1,1,1,20161001,,,,
E2396,HCPCS,CASTER FORK,UE,,28,,NW,,,,,,$172.34,$0.00,1,1,1,1,1,1,20161001,,,,
E2397,HCPCS,"PWC ACC, LITH-BASED BATTERY",,,28,,NW,,,,,,$723.21,$0.00,1,1,1,1,1,1,20161001,,,,
E2397,HCPCS,"PWC ACC, LITH-BASED BATTERY",NU,,28,,NW,,,,,,$723.21,$0.00,1,1,1,1,1,1,20161001,,,,
E2397,HCPCS,"PWC ACC, LITH-BASED BATTERY",RR,,28,,NW,,,,,,$83.10,$0.00,1,1,1,1,1,1,20161001,,,,
E2397,HCPCS,"PWC ACC, LITH-BASED BATTERY",UE,,28,,NW,,,,,,$550.98,$0.00,1,1,1,1,1,1,20161001,,,,
E2402,HCPCS,NEG PRESS WOUND THERAPY PUMP,,,28,,NW,,,,,,"$36,162.54",$0.00,1,1,1,1,1,1,20161001,,,,
E2402,HCPCS,NEG PRESS WOUND THERAPY PUMP,RR,,28,,NW,,,,,,"$3,846.61",$0.00,1,1,1,1,1,1,20161001,,,,
E2500,HCPCS,SGD DIGITIZED PRE-REC <=8MIN,,,28,,NW,,,,,,"$1,007.11",$0.00,1,1,1,1,1,1,20161001,,,,
E2500,HCPCS,SGD DIGITIZED PRE-REC <=8MIN,NU,,28,,NW,,,,,,"$1,007.11",$0.00,1,1,1,1,1,1,20161001,,,,
E2500,HCPCS,SGD DIGITIZED PRE-REC <=8MIN,RR,,28,,NW,,,,,,$88.94,$0.00,1,1,1,1,1,1,20161001,,,,
E2500,HCPCS,SGD DIGITIZED PRE-REC <=8MIN,UE,,28,,NW,,,,,,$752.06,$0.00,1,1,1,1,1,1,20161001,,,,
E2502,HCPCS,SGD PREREC MSG >8MIN <=20MIN,,,28,,NW,,,,,,"$3,106.63",$0.00,1,1,1,1,1,1,20161001,,,,
E2502,HCPCS,SGD PREREC MSG >8MIN <=20MIN,NU,,28,,NW,,,,,,"$3,106.63",$0.00,1,1,1,1,1,1,20161001,,,,
E2502,HCPCS,SGD PREREC MSG >8MIN <=20MIN,RR,,28,,NW,,,,,,$298.88,$0.00,1,1,1,1,1,1,20161001,,,,
E2502,HCPCS,SGD PREREC MSG >8MIN <=20MIN,UE,,28,,NW,,,,,,"$2,326.74",$0.00,1,1,1,1,1,1,20161001,,,,
E2504,HCPCS,SGD PREREC MSG>20MIN <=40MIN,,,28,,NW,,,,,,"$4,102.23",$0.00,1,1,1,1,1,1,20161001,,,,
E2504,HCPCS,SGD PREREC MSG>20MIN <=40MIN,NU,,28,,NW,,,,,,"$4,102.23",$0.00,1,1,1,1,1,1,20161001,,,,
E2504,HCPCS,SGD PREREC MSG>20MIN <=40MIN,RR,,28,,NW,,,,,,$398.50,$0.00,1,1,1,1,1,1,20161001,,,,
E2504,HCPCS,SGD PREREC MSG>20MIN <=40MIN,UE,,28,,NW,,,,,,"$3,073.40",$0.00,1,1,1,1,1,1,20161001,,,,
E2506,HCPCS,SGD PREREC MSG > 40 MIN,,,28,,NW,,,,,,"$6,021.24",$0.00,1,1,1,1,1,1,20161001,,,,
E2506,HCPCS,SGD PREREC MSG > 40 MIN,NU,,28,,NW,,,,,,"$6,021.24",$0.00,1,1,1,1,1,1,20161001,,,,
E2506,HCPCS,SGD PREREC MSG > 40 MIN,RR,,28,,NW,,,,,,$590.30,$0.00,1,1,1,1,1,1,20161001,,,,
E2506,HCPCS,SGD PREREC MSG > 40 MIN,UE,,28,,NW,,,,,,"$4,512.55",$0.00,1,1,1,1,1,1,20161001,,,,
E2508,HCPCS,SGD SPELLING PHYS CONTACT,,,28,,NW,,,,,,"$9,317.96",$0.00,1,1,1,1,1,1,20161001,,,,
E2508,HCPCS,SGD SPELLING PHYS CONTACT,NU,,28,,NW,,,,,,"$9,317.96",$0.00,1,1,1,1,1,1,20161001,,,,
E2508,HCPCS,SGD SPELLING PHYS CONTACT,RR,,28,,NW,,,,,,$920.00,$0.00,1,1,1,1,1,1,20161001,,,,
E2508,HCPCS,SGD SPELLING PHYS CONTACT,UE,,28,,NW,,,,,,"$6,985.22",$0.00,1,1,1,1,1,1,20161001,,,,
E2510,HCPCS,SGD W MULTI METHODS MSG/ACCS,,,28,,NW,,,,,,"$17,644.70",$0.00,1,1,1,1,1,1,20161001,,,,
E2510,HCPCS,SGD W MULTI METHODS MSG/ACCS,NU,,28,,NW,,,,,,"$17,644.70",$0.00,1,1,1,1,1,1,20161001,,,,
E2510,HCPCS,SGD W MULTI METHODS MSG/ACCS,RR,,28,,NW,,,,,,"$1,752.68",$0.00,1,1,1,1,1,1,20161001,,,,
E2510,HCPCS,SGD W MULTI METHODS MSG/ACCS,UE,,28,,NW,,,,,,"$13,230.25",$0.00,1,1,1,1,1,1,20161001,,,,
E2511,HCPCS,SGD SFTWRE PRGRM FOR PC/PDA,,,28,,NW,,,,,,$945.74,$0.00,1,1,1,1,1,1,20161001,,,,
E2511,HCPCS,SGD SFTWRE PRGRM FOR PC/PDA,NU,,28,,NW,,,,,,$945.74,$0.00,1,1,1,1,1,1,20161001,,,,
E2511,HCPCS,SGD SFTWRE PRGRM FOR PC/PDA,RR,,28,,NW,,,,,,$100.60,$0.00,1,1,1,1,1,1,20161001,,,,
E2511,HCPCS,SGD SFTWRE PRGRM FOR PC/PDA,UE,,28,,NW,,,,,,$711.03,$0.00,1,1,1,1,1,1,20161001,,,,
E2512,HCPCS,"SGD ACCESSORY, MOUNTING SYS",,,28,,NW,,,,,,"$1,890.81",$0.00,1,1,1,1,1,1,20161001,,,,
E2512,HCPCS,"SGD ACCESSORY, MOUNTING SYS",NU,,28,,NW,,,,,,"$1,890.81",$0.00,1,1,1,1,1,1,20161001,,,,
E2512,HCPCS,"SGD ACCESSORY, MOUNTING SYS",RR,,28,,NW,,,,,,$184.02,$0.00,1,1,1,1,1,1,20161001,,,,
E2512,HCPCS,"SGD ACCESSORY, MOUNTING SYS",UE,,28,,NW,,,,,,"$1,300.61",$0.00,1,1,1,1,1,1,20161001,,,,
E2599,HCPCS,SGD ACCESSORY NOC,,,28,,NW,,,,,,$553.79,$0.00,1,1,1,1,1,1,20161001,,,,
E2601,HCPCS,GEN W/C CUSHION WDTH < 22 IN,,,28,,NW,,,,,,$222.00,$0.00,1,1,1,1,1,1,20161001,,,,
E2601,HCPCS,GEN W/C CUSHION WDTH < 22 IN,NU,,28,,NW,,,,,,$222.00,$0.00,1,1,1,1,1,1,20161001,,,,
E2601,HCPCS,GEN W/C CUSHION WDTH < 22 IN,RR,,28,,NW,,,,,,$25.59,$0.00,1,1,1,1,1,1,20161001,,,,
E2601,HCPCS,GEN W/C CUSHION WDTH < 22 IN,UE,,28,,NW,,,,,,$167.42,$0.00,1,1,1,1,1,1,20161001,,,,
E2602,HCPCS,GEN W/C CUSHION WDTH >=22 IN,,,28,,NW,,,,,,$404.17,$0.00,1,1,1,1,1,1,20161001,,,,
E2602,HCPCS,GEN W/C CUSHION WDTH >=22 IN,NU,,28,,NW,,,,,,$404.17,$0.00,1,1,1,1,1,1,20161001,,,,
E2602,HCPCS,GEN W/C CUSHION WDTH >=22 IN,RR,,28,,NW,,,,,,$46.35,$0.00,1,1,1,1,1,1,20161001,,,,
E2602,HCPCS,GEN W/C CUSHION WDTH >=22 IN,UE,,28,,NW,,,,,,$311.75,$0.00,1,1,1,1,1,1,20161001,,,,
E2603,HCPCS,SKIN PROTECT WC CUS WD <22IN,,,28,,NW,,,,,,$503.85,$0.00,1,1,1,1,1,1,20161001,,,,
E2603,HCPCS,SKIN PROTECT WC CUS WD <22IN,NU,,28,,NW,,,,,,$503.85,$0.00,1,1,1,1,1,1,20161001,,,,
E2603,HCPCS,SKIN PROTECT WC CUS WD <22IN,RR,,28,,NW,,,,,,$57.84,$0.00,1,1,1,1,1,1,20161001,,,,
E2603,HCPCS,SKIN PROTECT WC CUS WD <22IN,UE,,28,,NW,,,,,,$386.49,$0.00,1,1,1,1,1,1,20161001,,,,
E2604,HCPCS,SKIN PROTECT WC CUS WD>=22IN,,,28,,NW,,,,,,$617.88,$0.00,1,1,1,1,1,1,20161001,,,,
E2604,HCPCS,SKIN PROTECT WC CUS WD>=22IN,NU,,28,,NW,,,,,,$617.88,$0.00,1,1,1,1,1,1,20161001,,,,
E2604,HCPCS,SKIN PROTECT WC CUS WD>=22IN,RR,,28,,NW,,,,,,$70.91,$0.00,1,1,1,1,1,1,20161001,,,,
E2604,HCPCS,SKIN PROTECT WC CUS WD>=22IN,UE,,28,,NW,,,,,,$472.10,$0.00,1,1,1,1,1,1,20161001,,,,
E2605,HCPCS,POSITION WC CUSH WDTH <22 IN,,,28,,NW,,,,,,$867.97,$0.00,1,1,1,1,1,1,20161001,,,,
E2605,HCPCS,POSITION WC CUSH WDTH <22 IN,NU,,28,,NW,,,,,,$867.97,$0.00,1,1,1,1,1,1,20161001,,,,
E2605,HCPCS,POSITION WC CUSH WDTH <22 IN,RR,,28,,NW,,,,,,$99.82,$0.00,1,1,1,1,1,1,20161001,,,,
E2605,HCPCS,POSITION WC CUSH WDTH <22 IN,UE,,28,,NW,,,,,,$659.70,$0.00,1,1,1,1,1,1,20161001,,,,
E2606,HCPCS,POSITION WC CUSH WDTH>=22 IN,,,28,,NW,,,,,,"$1,334.83",$0.00,1,1,1,1,1,1,20161001,,,,
E2606,HCPCS,POSITION WC CUSH WDTH>=22 IN,NU,,28,,NW,,,,,,"$1,334.83",$0.00,1,1,1,1,1,1,20161001,,,,
E2606,HCPCS,POSITION WC CUSH WDTH>=22 IN,RR,,28,,NW,,,,,,$153.64,$0.00,1,1,1,1,1,1,20161001,,,,
E2606,HCPCS,POSITION WC CUSH WDTH>=22 IN,UE,,28,,NW,,,,,,"$1,009.69",$0.00,1,1,1,1,1,1,20161001,,,,
E2607,HCPCS,SKIN PRO/POS WC CUS WD <22IN,,,28,,NW,,,,,,$932.00,$0.00,1,1,1,1,1,1,20161001,,,,
E2607,HCPCS,SKIN PRO/POS WC CUS WD <22IN,NU,,28,,NW,,,,,,$932.00,$0.00,1,1,1,1,1,1,20161001,,,,
E2607,HCPCS,SKIN PRO/POS WC CUS WD <22IN,RR,,28,,NW,,,,,,$107.18,$0.00,1,1,1,1,1,1,20161001,,,,
E2607,HCPCS,SKIN PRO/POS WC CUS WD <22IN,UE,,28,,NW,,,,,,$707.61,$0.00,1,1,1,1,1,1,20161001,,,,
E2608,HCPCS,SKIN PRO/POS WC CUS WD>=22IN,,,28,,NW,,,,,,"$1,112.32",$0.00,1,1,1,1,1,1,20161001,,,,
E2608,HCPCS,SKIN PRO/POS WC CUS WD>=22IN,NU,,28,,NW,,,,,,"$1,112.32",$0.00,1,1,1,1,1,1,20161001,,,,
E2608,HCPCS,SKIN PRO/POS WC CUS WD>=22IN,RR,,28,,NW,,,,,,$127.92,$0.00,1,1,1,1,1,1,20161001,,,,
E2608,HCPCS,SKIN PRO/POS WC CUS WD>=22IN,UE,,28,,NW,,,,,,$842.86,$0.00,1,1,1,1,1,1,20161001,,,,
E2609,HCPCS,CUSTOM FABRICATE W/C CUSHION,,,28,,NW,,,,,,$391.05,$0.00,1,1,1,1,1,1,20161001,,,,
E2610,HCPCS,POWERED W/C CUSHION,,,28,,NW,,,,,,$370.11,$0.00,1,1,1,1,1,1,20161001,,,,
E2611,HCPCS,GEN USE BACK CUSH WDTH <22IN,,,28,,NW,,,,,,"$1,001.66",$0.00,1,1,1,1,1,1,20161001,,,,
E2611,HCPCS,GEN USE BACK CUSH WDTH <22IN,NU,,28,,NW,,,,,,"$1,001.66",$0.00,1,1,1,1,1,1,20161001,,,,
E2611,HCPCS,GEN USE BACK CUSH WDTH <22IN,RR,,28,,NW,,,,,,$115.18,$0.00,1,1,1,1,1,1,20161001,,,,
E2611,HCPCS,GEN USE BACK CUSH WDTH <22IN,UE,,28,,NW,,,,,,$759.94,$0.00,1,1,1,1,1,1,20161001,,,,
E2612,HCPCS,GEN USE BACK CUSH WDTH>=22IN,,,28,,NW,,,,,,"$1,342.90",$0.00,1,1,1,1,1,1,20161001,,,,
E2612,HCPCS,GEN USE BACK CUSH WDTH>=22IN,NU,,28,,NW,,,,,,"$1,342.90",$0.00,1,1,1,1,1,1,20161001,,,,
E2612,HCPCS,GEN USE BACK CUSH WDTH>=22IN,RR,,28,,NW,,,,,,$154.50,$0.00,1,1,1,1,1,1,20161001,,,,
E2612,HCPCS,GEN USE BACK CUSH WDTH>=22IN,UE,,28,,NW,,,,,,"$1,015.74",$0.00,1,1,1,1,1,1,20161001,,,,
E2613,HCPCS,POSITION BACK CUSH WD <22IN,,,28,,NW,,,,,,"$1,251.55",$0.00,1,1,1,1,1,1,20161001,,,,
E2613,HCPCS,POSITION BACK CUSH WD <22IN,NU,,28,,NW,,,,,,"$1,251.55",$0.00,1,1,1,1,1,1,20161001,,,,
E2613,HCPCS,POSITION BACK CUSH WD <22IN,RR,,28,,NW,,,,,,$144.05,$0.00,1,1,1,1,1,1,20161001,,,,
E2613,HCPCS,POSITION BACK CUSH WD <22IN,UE,,28,,NW,,,,,,$947.27,$0.00,1,1,1,1,1,1,20161001,,,,
E2614,HCPCS,POSITION BACK CUSH WD>=22IN,,,28,,NW,,,,,,"$1,718.79",$0.00,1,1,1,1,1,1,20161001,,,,
E2614,HCPCS,POSITION BACK CUSH WD>=22IN,NU,,28,,NW,,,,,,"$1,718.79",$0.00,1,1,1,1,1,1,20161001,,,,
E2614,HCPCS,POSITION BACK CUSH WD>=22IN,RR,,28,,NW,,,,,,$197.87,$0.00,1,1,1,1,1,1,20161001,,,,
E2614,HCPCS,POSITION BACK CUSH WD>=22IN,UE,,28,,NW,,,,,,"$1,297.77",$0.00,1,1,1,1,1,1,20161001,,,,
E2615,HCPCS,POS BACK POST/LAT WDTH <22IN,,,28,,NW,,,,,,"$1,435.12",$0.00,1,1,1,1,1,1,20161001,,,,
E2615,HCPCS,POS BACK POST/LAT WDTH <22IN,NU,,28,,NW,,,,,,"$1,435.12",$0.00,1,1,1,1,1,1,20161001,,,,
E2615,HCPCS,POS BACK POST/LAT WDTH <22IN,RR,,28,,NW,,,,,,$165.18,$0.00,1,1,1,1,1,1,20161001,,,,
E2615,HCPCS,POS BACK POST/LAT WDTH <22IN,UE,,28,,NW,,,,,,"$1,084.88",$0.00,1,1,1,1,1,1,20161001,,,,
E2616,HCPCS,POS BACK POST/LAT WDTH>=22IN,,,28,,NW,,,,,,"$1,918.98",$0.00,1,1,1,1,1,1,20161001,,,,
E2616,HCPCS,POS BACK POST/LAT WDTH>=22IN,NU,,28,,NW,,,,,,"$1,918.98",$0.00,1,1,1,1,1,1,20161001,,,,
E2616,HCPCS,POS BACK POST/LAT WDTH>=22IN,RR,,28,,NW,,,,,,$220.93,$0.00,1,1,1,1,1,1,20161001,,,,
E2616,HCPCS,POS BACK POST/LAT WDTH>=22IN,UE,,28,,NW,,,,,,"$1,447.88",$0.00,1,1,1,1,1,1,20161001,,,,
E2617,HCPCS,CUSTOM FAB W/C BACK CUSHION,,,28,,NW,,,,,,$694.04,$0.00,1,1,1,1,1,1,20161001,,,,
E2619,HCPCS,REPLACE COVER W/C SEAT CUSH,,,28,,NW,,,,,,$186.89,$0.00,1,1,1,1,1,1,20161001,,,,
E2619,HCPCS,REPLACE COVER W/C SEAT CUSH,NU,,28,,NW,,,,,,$186.89,$0.00,1,1,1,1,1,1,20161001,,,,
E2619,HCPCS,REPLACE COVER W/C SEAT CUSH,RR,,28,,NW,,,,,,$22.02,$0.00,1,1,1,1,1,1,20161001,,,,
E2619,HCPCS,REPLACE COVER W/C SEAT CUSH,UE,,28,,NW,,,,,,$141.19,$0.00,1,1,1,1,1,1,20161001,,,,
E2620,HCPCS,WC PLANAR BACK CUSH WD <22IN,,,28,,NW,,,,,,"$1,730.45",$0.00,1,1,1,1,1,1,20161001,,,,
E2620,HCPCS,WC PLANAR BACK CUSH WD <22IN,NU,,28,,NW,,,,,,"$1,730.45",$0.00,1,1,1,1,1,1,20161001,,,,
E2620,HCPCS,WC PLANAR BACK CUSH WD <22IN,RR,,28,,NW,,,,,,$199.20,$0.00,1,1,1,1,1,1,20161001,,,,
E2620,HCPCS,WC PLANAR BACK CUSH WD <22IN,UE,,28,,NW,,,,,,"$1,306.49",$0.00,1,1,1,1,1,1,20161001,,,,
E2621,HCPCS,WC PLANAR BACK CUSH WD>=22IN,,,28,,NW,,,,,,"$1,814.27",$0.00,1,1,1,1,1,1,20161001,,,,
E2621,HCPCS,WC PLANAR BACK CUSH WD>=22IN,NU,,28,,NW,,,,,,"$1,814.27",$0.00,1,1,1,1,1,1,20161001,,,,
E2621,HCPCS,WC PLANAR BACK CUSH WD>=22IN,RR,,28,,NW,,,,,,$208.84,$0.00,1,1,1,1,1,1,20161001,,,,
E2621,HCPCS,WC PLANAR BACK CUSH WD>=22IN,UE,,28,,NW,,,,,,"$1,369.31",$0.00,1,1,1,1,1,1,20161001,,,,
E2622,HCPCS,ADJ SKIN PRO W/C CUS WD<22IN,,,28,,NW,,,,,,"$1,060.86",$0.00,1,1,1,1,1,1,20161001,,,,
E2622,HCPCS,ADJ SKIN PRO W/C CUS WD<22IN,NU,,28,,NW,,,,,,"$1,060.86",$0.00,1,1,1,1,1,1,20161001,,,,
E2622,HCPCS,ADJ SKIN PRO W/C CUS WD<22IN,RR,,28,,NW,,,,,,$122.03,$0.00,1,1,1,1,1,1,20161001,,,,
E2622,HCPCS,ADJ SKIN PRO W/C CUS WD<22IN,UE,,28,,NW,,,,,,$804.26,$0.00,1,1,1,1,1,1,20161001,,,,
E2623,HCPCS,ADJ SKIN PRO WC CUS WD>=22IN,,,28,,NW,,,,,,"$1,340.54",$0.00,1,1,1,1,1,1,20161001,,,,
E2623,HCPCS,ADJ SKIN PRO WC CUS WD>=22IN,NU,,28,,NW,,,,,,"$1,340.54",$0.00,1,1,1,1,1,1,20161001,,,,
E2623,HCPCS,ADJ SKIN PRO WC CUS WD>=22IN,RR,,28,,NW,,,,,,$154.30,$0.00,1,1,1,1,1,1,20161001,,,,
E2623,HCPCS,ADJ SKIN PRO WC CUS WD>=22IN,UE,,28,,NW,,,,,,"$1,013.99",$0.00,1,1,1,1,1,1,20161001,,,,
E2624,HCPCS,ADJ SKIN PRO/POS CUS<22IN,,,28,,NW,,,,,,"$1,069.30",$0.00,1,1,1,1,1,1,20161001,,,,
E2624,HCPCS,ADJ SKIN PRO/POS CUS<22IN,NU,,28,,NW,,,,,,"$1,069.30",$0.00,1,1,1,1,1,1,20161001,,,,
E2624,HCPCS,ADJ SKIN PRO/POS CUS<22IN,RR,,28,,NW,,,,,,$123.00,$0.00,1,1,1,1,1,1,20161001,,,,
E2624,HCPCS,ADJ SKIN PRO/POS CUS<22IN,UE,,28,,NW,,,,,,$810.63,$0.00,1,1,1,1,1,1,20161001,,,,
E2625,HCPCS,ADJ SKIN PRO/POS WC CUS>=22,,,28,,NW,,,,,,"$1,344.51",$0.00,1,1,1,1,1,1,20161001,,,,
E2625,HCPCS,ADJ SKIN PRO/POS WC CUS>=22,NU,,28,,NW,,,,,,"$1,344.51",$0.00,1,1,1,1,1,1,20161001,,,,
E2625,HCPCS,ADJ SKIN PRO/POS WC CUS>=22,RR,,28,,NW,,,,,,$154.69,$0.00,1,1,1,1,1,1,20161001,,,,
E2625,HCPCS,ADJ SKIN PRO/POS WC CUS>=22,UE,,28,,NW,,,,,,"$1,016.97",$0.00,1,1,1,1,1,1,20161001,,,,
E2626,HCPCS,SEO MOBILE ARM SUP ATT TO WC,,,28,,NW,,,,,,"$1,046.04",$0.00,1,1,1,1,1,1,20161001,,,,
E2626,HCPCS,SEO MOBILE ARM SUP ATT TO WC,NU,,28,,NW,,,,,,"$1,046.04",$0.00,1,1,1,1,1,1,20161001,,,,
E2626,HCPCS,SEO MOBILE ARM SUP ATT TO WC,RR,,28,,NW,,,,,,$120.29,$0.00,1,1,1,1,1,1,20161001,,,,
E2626,HCPCS,SEO MOBILE ARM SUP ATT TO WC,UE,,28,,NW,,,,,,$793.08,$0.00,1,1,1,1,1,1,20161001,,,,
E2627,HCPCS,ARM SUPP ATT TO WC RANCHO TY,,,28,,NW,,,,,,"$1,603.99",$0.00,1,1,1,1,1,1,20161001,,,,
E2627,HCPCS,ARM SUPP ATT TO WC RANCHO TY,NU,,28,,NW,,,,,,"$1,603.99",$0.00,1,1,1,1,1,1,20161001,,,,
E2627,HCPCS,ARM SUPP ATT TO WC RANCHO TY,RR,,28,,NW,,,,,,$184.67,$0.00,1,1,1,1,1,1,20161001,,,,
E2627,HCPCS,ARM SUPP ATT TO WC RANCHO TY,UE,,28,,NW,,,,,,"$1,211.59",$0.00,1,1,1,1,1,1,20161001,,,,
E2628,HCPCS,MOBILE ARM SUPPORTS RECLININ,,,28,,NW,,,,,,"$1,229.71",$0.00,1,1,1,1,1,1,20161001,,,,
E2628,HCPCS,MOBILE ARM SUPPORTS RECLININ,NU,,28,,NW,,,,,,"$1,229.71",$0.00,1,1,1,1,1,1,20161001,,,,
E2628,HCPCS,MOBILE ARM SUPPORTS RECLININ,RR,,28,,NW,,,,,,$141.48,$0.00,1,1,1,1,1,1,20161001,,,,
E2628,HCPCS,MOBILE ARM SUPPORTS RECLININ,UE,,28,,NW,,,,,,$930.89,$0.00,1,1,1,1,1,1,20161001,,,,
E2629,HCPCS,FRICTION DAMPENING ARM SUPP,,,28,,NW,,,,,,"$1,557.37",$0.00,1,1,1,1,1,1,20161001,,,,
E2629,HCPCS,FRICTION DAMPENING ARM SUPP,NU,,28,,NW,,,,,,"$1,557.37",$0.00,1,1,1,1,1,1,20161001,,,,
E2629,HCPCS,FRICTION DAMPENING ARM SUPP,RR,,28,,NW,,,,,,$179.23,$0.00,1,1,1,1,1,1,20161001,,,,
E2629,HCPCS,FRICTION DAMPENING ARM SUPP,UE,,28,,NW,,,,,,"$1,176.64",$0.00,1,1,1,1,1,1,20161001,,,,
E2630,HCPCS,MONOSUSPENSION ARM/HAND SUPP,,,28,,NW,,,,,,"$1,096.87",$0.00,1,1,1,1,1,1,20161001,,,,
E2630,HCPCS,MONOSUSPENSION ARM/HAND SUPP,NU,,28,,NW,,,,,,"$1,096.87",$0.00,1,1,1,1,1,1,20161001,,,,
E2630,HCPCS,MONOSUSPENSION ARM/HAND SUPP,RR,,28,,NW,,,,,,$126.17,$0.00,1,1,1,1,1,1,20161001,,,,
E2630,HCPCS,MONOSUSPENSION ARM/HAND SUPP,UE,,28,,NW,,,,,,$831.26,$0.00,1,1,1,1,1,1,20161001,,,,
E2631,HCPCS,ELEVAT PROXIMAL ARM SUPPORT,,,28,,NW,,,,,,$460.90,$0.00,1,1,1,1,1,1,20161001,,,,
E2631,HCPCS,ELEVAT PROXIMAL ARM SUPPORT,NU,,28,,NW,,,,,,$460.90,$0.00,1,1,1,1,1,1,20161001,,,,
E2631,HCPCS,ELEVAT PROXIMAL ARM SUPPORT,RR,,28,,NW,,,,,,$52.87,$0.00,1,1,1,1,1,1,20161001,,,,
E2631,HCPCS,ELEVAT PROXIMAL ARM SUPPORT,UE,,28,,NW,,,,,,$354.28,$0.00,1,1,1,1,1,1,20161001,,,,
E2632,HCPCS,OFFSET/LAT ROCKER ARM W/ELA,,,28,,NW,,,,,,$305.61,$0.00,1,1,1,1,1,1,20161001,,,,
E2632,HCPCS,OFFSET/LAT ROCKER ARM W/ELA,NU,,28,,NW,,,,,,$305.61,$0.00,1,1,1,1,1,1,20161001,,,,
E2632,HCPCS,OFFSET/LAT ROCKER ARM W/ELA,RR,,28,,NW,,,,,,$34.96,$0.00,1,1,1,1,1,1,20161001,,,,
E2632,HCPCS,OFFSET/LAT ROCKER ARM W/ELA,UE,,28,,NW,,,,,,$237.81,$0.00,1,1,1,1,1,1,20161001,,,,
E2633,HCPCS,MOBILE ARM SUPPORT SUPINATOR,,,28,,NW,,,,,,$263.81,$0.00,1,1,1,1,1,1,20161001,,,,
E2633,HCPCS,MOBILE ARM SUPPORT SUPINATOR,NU,,28,,NW,,,,,,$263.81,$0.00,1,1,1,1,1,1,20161001,,,,
E2633,HCPCS,MOBILE ARM SUPPORT SUPINATOR,RR,,28,,NW,,,,,,$30.15,$0.00,1,1,1,1,1,1,20161001,,,,
E2633,HCPCS,MOBILE ARM SUPPORT SUPINATOR,UE,,28,,NW,,,,,,$202.00,$0.00,1,1,1,1,1,1,20161001,,,,
G0008,HCPCS,ADMIN INFLUENZA VIRUS VAC,,,9,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0009,HCPCS,ADMIN PNEUMOCOCCAL VACCINE,,,9,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0010,HCPCS,ADMIN HEPATITIS B VACCINE,,,9,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0027,HCPCS,SEMEN ANALYSIS,,,17,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0101,HCPCS,CA SCREEN;PELVIC/BREAST EXAM,,,18,,RBRVS,0.45 ,0.29 ,0.58 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0102,HCPCS,PROSTATE CA SCREENING; DRE,,,18,,RBRVS,0.17 ,0.07 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0103,HCPCS,PSA SCREENING,,,17,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0104,HCPCS,CA SCREEN;FLEXI SIGMOIDSCOPE,,,21,,RBRVS,0.96 ,0.72 ,2.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0105,HCPCS,COLORECTAL SCRN; HI RISK IND,,,21,,RBRVS,3.69 ,1.94 ,6.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0106,HCPCS,COLON CA SCREEN;BARIUM ENEMA,,,20,,RBRVS,0.99 ,4.89 ,4.89 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
G0106,HCPCS,COLON CA SCREEN;BARIUM ENEMA,26,,20,,RBRVS,0.99 ,0.37 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0106,HCPCS,COLON CA SCREEN;BARIUM ENEMA,TC,,20,,RBRVS,,4.52 ,4.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0108,HCPCS,DIAB MANAGE TRN  PER INDIV,,,14,,RBRVS,0.90 ,0.55 ,0.55 ,,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
G0109,HCPCS,DIAB MANAGE TRN IND/GROUP,,,14,,RBRVS,0.25 ,0.14 ,0.14 ,,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
G0117,HCPCS,GLAUCOMA SCRN HGH RISK DIREC,,,14,,RBRVS,0.45 ,1.06 ,1.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0118,HCPCS,GLAUCOMA SCRN HGH RISK DIREC,,,14,,RBRVS,0.17 ,1.09 ,1.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0120,HCPCS,COLON CA SCRN; BARIUM ENEMA,,,20,,RBRVS,0.99 ,4.89 ,4.89 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
G0120,HCPCS,COLON CA SCRN; BARIUM ENEMA,26,,20,,RBRVS,0.99 ,0.37 ,0.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0120,HCPCS,COLON CA SCRN; BARIUM ENEMA,TC,,20,,RBRVS,,4.52 ,4.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0121,HCPCS,COLON CA SCRN NOT HI RSK IND,,,21,,RBRVS,3.69 ,1.94 ,6.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0122,HCPCS,COLON CA SCRN; BARIUM ENEMA,,,20,,RBRVS,0.99 ,6.47 ,6.47 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
G0122,HCPCS,COLON CA SCRN; BARIUM ENEMA,26,,20,,RBRVS,0.99 ,0.38 ,0.38 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0122,HCPCS,COLON CA SCRN; BARIUM ENEMA,TC,,20,,RBRVS,,6.09 ,6.09 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0123,HCPCS,SCREEN CERV/VAG THIN LAYER,,,17,,TotalUnits,,,,0.77 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0124,HCPCS,SCREEN C/V THIN LAYER BY MD,,,17,,RBRVS,0.42 ,0.47 ,0.47 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0127,HCPCS,TRIM NAIL(S),,,21,,RBRVS,0.17 ,0.04 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0128,HCPCS,CORF SKILLED NURSING SERVICE,,TC,14,,RBRVS,,0.21 ,0.21 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0130,HCPCS,SINGLE ENERGY X-RAY STUDY,,,20,,RBRVS,0.22 ,0.73 ,0.73 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
G0130,HCPCS,SINGLE ENERGY X-RAY STUDY,26,,20,,RBRVS,0.22 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0130,HCPCS,SINGLE ENERGY X-RAY STUDY,TC,,20,,RBRVS,,0.64 ,0.64 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0141,HCPCS,"SCR C/V CYTO,AUTOSYS AND MD",,,17,,RBRVS,0.42 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0143,HCPCS,"SCR C/V CYTO,THINLAYER,RESCR",,,17,,TotalUnits,,,,0.77 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0144,HCPCS,"SCR C/V CYTO,THINLAYER,RESCR",,,17,,TotalUnits,,,,0.81 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0145,HCPCS,"SCR C/V CYTO,THINLAYER,RESCR",,,17,,TotalUnits,,,,1.01 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0147,HCPCS,"SCR C/V CYTO, AUTOMATED SYS",,,17,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0148,HCPCS,"SCR C/V CYTO, AUTOSYS, RESCR",,,17,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0151,HCPCS,"HHCP-SERV OF PT,EA 15 MIN",,,14,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
G0152,HCPCS,"HHCP-SERV OF OT,EA 15 MIN",,,14,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
G0153,HCPCS,"HHCP-SVS OF S/L PATH,EA 15MN",,,14,,TotalUnits,,,,0.24 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
G0155,HCPCS,"HHCP-SVS OF CSW,EA 15 MIN",,,14,,TotalUnits,,,,0.77 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
G0156,HCPCS,"HHCP-SVS OF AIDE,EA 15 MIN",,,14,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
G0157,HCPCS,HHC PT ASSISTANT EA 15,,,14,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
G0158,HCPCS,HHC OT ASSISTANT EA 15,,,14,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
G0159,HCPCS,HHC PT MAINT EA 15 MIN,,,14,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
G0160,HCPCS,HHC OCCUP THERAPY EA 15,,,14,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
G0161,HCPCS,HHC SLP EA 15 MIN,,,14,,TotalUnits,,,,0.24 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
G0162,HCPCS,"HHC RN E&M PLAN SVS, 15 MIN",,,14,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
G0163,HCPCS,HHC LPN/RN OBS/ASSES EA 15,,,14,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
G0164,HCPCS,HHC LIS NURSE TRAIN EA 15,,,14,,TotalUnits,,,,0.33 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
G0166,HCPCS,"EXTRNL COUNTERPULSE, PER TX",,,14,,RBRVS,0.07 ,3.76 ,3.76 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
G0168,HCPCS,WOUND CLOSURE BY ADHESIVE,,,21,,RBRVS,0.45 ,0.29 ,2.39 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0175,HCPCS,"OPPS SERVICE,SCHED TEAM CONF",,,14,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0176,HCPCS,OPPS/PHP;ACTIVITY THERAPY,,,16,,TotalUnits,,,,2.15 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0177,HCPCS,OPPS/PHP; TRAIN & EDUC SERV,,,16,,TotalUnits,,,,0.88 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0179,HCPCS,MD RECERTIFICATION HHA PT,,,15,,RBRVS,0.45 ,0.68 ,0.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0180,HCPCS,MD CERTIFICATION HHA PATIENT,,,15,,RBRVS,0.67 ,0.79 ,0.79 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0181,HCPCS,HOME HEALTH CARE SUPERVISION,,,15,,RBRVS,1.73 ,1.19 ,1.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0182,HCPCS,HOSPICE CARE SUPERVISION,,,15,,RBRVS,1.73 ,1.22 ,1.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0186,HCPCS,"DSTRY EYE LESN,FDR VSSL TECH",,,14,,TotalUnits,,,,9.21 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0202,HCPCS,SCREENINGMAMMOGRAPHYDIGITAL,,,20,,RBRVS,0.70 ,3.02 ,3.02 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
G0202,HCPCS,SCREENINGMAMMOGRAPHYDIGITAL,26,,20,,RBRVS,0.70 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0202,HCPCS,SCREENINGMAMMOGRAPHYDIGITAL,TC,,20,,RBRVS,,2.77 ,2.77 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0204,HCPCS,DIAGNOSTICMAMMOGRAPHYDIGITAL,,,20,,RBRVS,0.87 ,3.66 ,3.66 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
G0204,HCPCS,DIAGNOSTICMAMMOGRAPHYDIGITAL,26,,20,,RBRVS,0.87 ,0.32 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0204,HCPCS,DIAGNOSTICMAMMOGRAPHYDIGITAL,TC,,20,,RBRVS,,3.34 ,3.34 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0206,HCPCS,DIAGNOSTICMAMMOGRAPHYDIGITAL,,,20,,RBRVS,0.70 ,2.87 ,2.87 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
G0206,HCPCS,DIAGNOSTICMAMMOGRAPHYDIGITAL,26,,20,,RBRVS,0.70 ,0.25 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0206,HCPCS,DIAGNOSTICMAMMOGRAPHYDIGITAL,TC,,20,,RBRVS,,2.62 ,2.62 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0219,HCPCS,PET IMG WHOLBOD MELANO NONCO,,,20,,TotalUnits,,,,28.08 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
G0219,HCPCS,PET IMG WHOLBOD MELANO NONCO,26,,20,,TotalUnits,,,,1.96 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0219,HCPCS,PET IMG WHOLBOD MELANO NONCO,TC,,20,,TotalUnits,,,,26.12 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0235,HCPCS,PET NOT OTHERWISE SPECIFIED,,,20,,TotalUnits,,,,28.08 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0235,HCPCS,PET NOT OTHERWISE SPECIFIED,26,,20,,TotalUnits,,,,1.96 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0235,HCPCS,PET NOT OTHERWISE SPECIFIED,TC,,20,,TotalUnits,,,,26.12 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0237,HCPCS,THERAPEUTIC PROCD STRG ENDUR,,,14,,RBRVS,,0.28 ,0.28 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
G0238,HCPCS,"OTH RESP PROC, INDIV",,,14,,RBRVS,,0.29 ,0.29 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
G0239,HCPCS,"OTH RESP PROC, GROUP",,,14,,RBRVS,,0.36 ,0.36 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
G0245,HCPCS,INITIAL FOOT EXAM PT LOPS,,,15,,RBRVS,0.88 ,0.28 ,0.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0246,HCPCS,FOLLOWUP EVAL OF FOOT PT LOP,,,15,,RBRVS,0.45 ,0.13 ,0.60 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0247,HCPCS,ROUTINE FOOTCARE PT W LOPS,,,15,,RBRVS,0.50 ,0.13 ,1.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0248,HCPCS,DEMONSTRATE USE HOME INR MON,,TC,14,,RBRVS,,3.12 ,3.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0249,HCPCS,PROVIDE INR TEST MATER/EQUIP,,TC,14,,RBRVS,,3.12 ,3.12 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0250,HCPCS,MD INR TEST REVIE INTER MGMT,,PC,4,,RBRVS,0.18 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0252,HCPCS,PET IMAGING INITIAL DX,,,20,,RBRVS,1.50 ,0.57 ,0.57 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
G0252,HCPCS,PET IMAGING INITIAL DX,26,,20,,RBRVS,1.50 ,0.57 ,0.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0255,HCPCS,CURRENT PERCEP THRESHOLD TST,,,14,,TotalUnits,,,,1.14 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
G0255,HCPCS,CURRENT PERCEP THRESHOLD TST,26,,14,,TotalUnits,,,,0.34 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0255,HCPCS,CURRENT PERCEP THRESHOLD TST,TC,,14,,TotalUnits,,,,0.80 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0257,HCPCS,UNSCHED DIALYSIS ESRD PT HOS,,,14,,TotalUnits,,,,7.20 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0259,HCPCS,INJECT FOR SACROILIAC JOINT,,,21,,TotalUnits,,,,4.77 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0260,HCPCS,INJ FOR SACROILIAC JT ANESTH,,,21,,TotalUnits,,,,16.80 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0268,HCPCS,REMOVAL OF IMPACTED WAX MD,,,14,,RBRVS,0.61 ,0.27 ,0.81 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0269,HCPCS,OCCLUSIVE DEVICE IN VEIN ART,,,21,,TotalUnits,,,,2.80 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0270,HCPCS,MNT SUBS TX FOR CHANGE DX,,,14,,RBRVS,0.45 ,0.31 ,0.38 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0271,HCPCS,GROUP MNT 2 OR MORE 30 MINS,,,14,,RBRVS,0.25 ,0.17 ,0.19 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0276,HCPCS,PILD/PLACEBO CONTROL CLIN TR,,,14,,RBRVS,7.17 ,3.03 ,3.03 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0277,HCPCS,"HBOT, FULL BODY CHAMBER, 30M",,TC,14,,RBRVS,,1.30 ,1.30 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0278,HCPCS,"ILIAC ART ANGIO,CARDIAC CATH",,,20,,RBRVS,0.25 ,0.09 ,0.09 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0279,HCPCS,"TOMOSYNTHESIS, MAMMO",,,20,,RBRVS,0.60 ,0.93 ,0.93 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
G0279,HCPCS,"TOMOSYNTHESIS, MAMMO",26,,20,,RBRVS,0.60 ,0.22 ,0.22 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0279,HCPCS,"TOMOSYNTHESIS, MAMMO",TC,,20,,RBRVS,,0.71 ,0.71 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0281,HCPCS,ELEC STIM UNATTEND FOR PRESS,,,19,,RBRVS,0.18 ,0.20 ,0.20 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
G0282,HCPCS,ELECT STIM WOUND CARE NOT PD,,,19,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
G0283,HCPCS,ELEC STIM OTHER THAN WOUND,,,19,,RBRVS,0.18 ,0.20 ,0.20 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
G0288,HCPCS,"RECON, CTA FOR SURG PLAN",,TC,20,,RBRVS,,0.91 ,0.91 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0289,HCPCS,"ARTHRO, LOOSE BODY + CHONDRO",,,21,,RBRVS,1.48 ,0.75 ,0.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0293,HCPCS,"NON-COV SURG PROC,CLIN TRIAL",,,14,,TotalUnits,,,,0.24 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0295,HCPCS,ELECTROMAGNETIC THERAPY ONC,,,19,,TotalUnits,,,,0.43 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
G0296,HCPCS,VISIT TO DETERM LDCT ELIG,,,20,,RBRVS,1.02 ,0.45 ,0.45 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0297,HCPCS,LDCT FOR LUNG CA SCREEN,,,21,,RBRVS,0.52 ,5.10 ,5.10 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
G0297,HCPCS,LOW-DOSE COMPUTER TOMOGRAPHY,26,,21,,RBRVS,0.52 ,0.20 ,0.20 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0297,HCPCS,LOW-DOSE COMPUTER TOMOGRAPHY,TC,,21,,RBRVS,,4.90 ,4.90 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0299,HCPCS,HHS/HOSPICE OF RN EA 15 MIN,,,21,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
G0300,HCPCS,HHS/HOSPICE OF LPN EA 15 MIN,,,21,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
G0306,HCPCS,CBC/DIFFWBC W/O PLATELET,,,17,,TotalUnits,,,,0.30 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0307,HCPCS,CBC WITHOUT PLATELET,,,17,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0328,HCPCS,FECAL BLOOD SCRN IMMUNOASSAY,,,17,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0329,HCPCS,ELECTROMAGNTIC TX FOR ULCERS,,,19,,RBRVS,0.06 ,0.21 ,0.21 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
G0333,HCPCS,DISPENSE FEE INITIAL 30 DAY,,,28,,NW,,,,,,$74.17,$0.00,1,1,1,0,0,1,20161001,,,,
G0337,HCPCS,HOSPICE EVALUATION PREELECTI,,,15,,RBRVS,1.42 ,0.54 ,0.54 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0339,HCPCS,"ROBOT LIN-RADSURG COM, FIRST",,,21,,TotalUnits,,,,112.02 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0340,HCPCS,ROBT LIN-RADSURG FRACTX 2-5,,,21,,TotalUnits,,,,63.01 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0341,HCPCS,PERCUTANEOUS ISLET CELLTRANS,,,21,,RBRVS,6.98 ,3.12 ,58.83 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
G0342,HCPCS,LAPAROSCOPY ISLET CELL TRANS,,,21,,RBRVS,11.92 ,6.60 ,6.60 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
G0343,HCPCS,LAPAROTOMY ISLET CELL TRANSP,,,21,,RBRVS,19.85 ,11.08 ,11.08 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
G0364,HCPCS,BONE MARROW ASPIRATE &BIOPSY,,,21,,RBRVS,0.16 ,0.08 ,0.18 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0365,HCPCS,VESSEL MAPPING HEMO ACCESS,,,14,,RBRVS,0.25 ,5.31 ,5.31 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
G0365,HCPCS,VESSEL MAPPING HEMO ACCESS,26,,14,,RBRVS,0.25 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0365,HCPCS,VESSEL MAPPING HEMO ACCESS,TC,,14,,RBRVS,,5.24 ,5.24 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0372,HCPCS,MD SERVICE REQUIRED FOR PMD,,,14,,RBRVS,0.17 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0378,HCPCS,HOSPITAL OBSERVATION PER HR,,,10,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0382,HCPCS,LEV 3 HOSP TYPE B ED VISIT,,,7,,TotalUnits,,,,0.70 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0389,HCPCS,ULTRASOUND EXAM AAA SCREEN,,,20,,RBRVS,0.58 ,2.64 ,2.64 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
G0389,HCPCS,ULTRASOUND EXAM AAA SCREEN,26,,20,,RBRVS,0.58 ,0.21 ,0.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0389,HCPCS,ULTRASOUND EXAM AAA SCREEN,TC,,20,,RBRVS,,2.43 ,2.43 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0396,HCPCS,ALCOHOL/SUBS INTERV 15-30MN,,,16,,RBRVS,0.65 ,0.27 ,0.33 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0397,HCPCS,ALCOHOL/SUBS INTERV >30 MIN,,,16,,RBRVS,1.30 ,0.53 ,0.59 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0398,HCPCS,HOME SLEEP TEST/TYPE 2 PORTA,,,14,,TotalUnits,,,,4.17 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
G0398,HCPCS,HOME SLEEP TEST/TYPE 2 PORTA,26,,14,,TotalUnits,,,,1.25 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0398,HCPCS,HOME SLEEP TEST/TYPE 2 PORTA,TC,,14,,TotalUnits,,,,2.91 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0399,HCPCS,HOME SLEEP TEST/TYPE 3 PORTA,,,14,,TotalUnits,,,,3.47 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
G0399,HCPCS,HOME SLEEP TEST/TYPE 3 PORTA,,PC,14,,TotalUnits,,,,1.04 ,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
G0399,HCPCS,HOME SLEEP TEST/TYPE 3 PORTA,,TC,14,,TotalUnits,,,,2.43 ,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
G0400,HCPCS,HOME SLEEP TEST/TYPE 4 PORTA,,,14,,TotalUnits,,,,2.78 ,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
G0400,HCPCS,HOME SLEEP TEST/TYPE 4 PORTA,26,,14,,TotalUnits,,,,0.84 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0400,HCPCS,HOME SLEEP TEST/TYPE 4 PORTA,TC,,14,,TotalUnits,,,,1.94 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0402,HCPCS,INITIAL PREVENTIVE EXAM,,,18,,RBRVS,2.43 ,1.01 ,2.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0403,HCPCS,EKG FOR INITIAL PREVENT EXAM,,,18,,RBRVS,0.17 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
G0404,HCPCS,EKG TRACING FOR INITIAL PREV,,TC,18,,RBRVS,,0.23 ,0.23 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0405,HCPCS,EKG INTERPRET & REPORT PREVE,,PC,18,,RBRVS,0.17 ,0.06 ,0.06 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0406,HCPCS,INPT/TELE FOLLOW UP 15,,,6,,RBRVS,0.76 ,0.29 ,0.29 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0407,HCPCS,INPT/TELE FOLLOW UP 25,,,6,,RBRVS,1.39 ,0.56 ,0.56 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0408,HCPCS,INPT/TELE FOLLOW UP 35,,,6,,RBRVS,2.00 ,0.80 ,0.80 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0409,HCPCS,CORF RELATED SERV 15 MINS EA,,,16,,RBRVS,,0.30 ,0.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0410,HCPCS,GRP PSYCH PARTIAL HOSP 45-50,,,16,,TotalUnits,,,,1.13 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0412,HCPCS,OPEN TX ILIAC SPINE UNI/BIL,,,21,,RBRVS,10.45 ,8.37 ,8.37 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
G0413,HCPCS,PELVIC RING FRACTURE UNI/BIL,,,21,,RBRVS,15.73 ,11.86 ,11.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0414,HCPCS,PELVIC RING FX TREAT INT FIX,,,21,,RBRVS,14.65 ,10.88 ,10.88 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
G0415,HCPCS,OPEN TX POST PELVIC FXCTURE,,,21,,RBRVS,20.93 ,14.38 ,14.38 ,,,$0.00,$0.00,1,0,0,1,1,1,20161001,,,,
G0416,HCPCS,PROSTATE BIOPSY ANY METH ,,,17,,RBRVS,3.09 ,14.92 ,14.92 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
G0416,HCPCS,"PROSTATE BIOPSY, ANY MTHD",,PC,17,,RBRVS,3.09 ,1.95 ,1.95 ,,,$0.00,$0.00,1,0,1,1,1,0,20161001,,,,
G0416,HCPCS,"PROSTATE BIOPSY, ANY MTHD",,TC,17,,RBRVS,,12.97 ,12.97 ,,,$0.00,$0.00,1,1,1,0,1,0,20161001,,,,
G0420,HCPCS,ED SVC CKD IND PER SESSION,,,14,,RBRVS,2.12 ,0.80 ,0.80 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0421,HCPCS,ED SVC CKD GRP PER SESSION,,,14,,RBRVS,0.50 ,0.18 ,0.18 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0422,HCPCS,INTENS CARDIAC REHAB W/EXERC,,,4,,RBRVS,1.56 ,1.25 ,1.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0423,HCPCS,INTENS CARDIAC REHAB NO EXER,,,4,,RBRVS,1.56 ,1.25 ,1.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0424,HCPCS,PULMONARY REHAB W EXER,,,14,,RBRVS,0.28 ,0.09 ,0.55 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0425,HCPCS,INPT/ED TELECONSULT30,,,6,,RBRVS,1.92 ,0.76 ,0.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0426,HCPCS,INPT/ED TELECONSULT50,,,6,,RBRVS,2.61 ,1.05 ,1.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0427,HCPCS,INPT/ED TELECONSULT70,,,6,,RBRVS,3.86 ,1.57 ,1.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0429,HCPCS,DERMAL FILLER INJECTION(S),,,14,,RBRVS,1.19 ,0.70 ,1.47 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
G0432,HCPCS,EIA HIV-1/HIV-2 SCREEN,,,17,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0433,HCPCS,ELISA HIV-1/HIV-2 SCREEN,,,17,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0435,HCPCS,ORAL HIV-1/HIV-2 SCREEN,,,17,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0436,HCPCS,TOBACCO-USE COUNSEL 3-10 MIN,,,14,,RBRVS,0.24 ,0.09 ,0.15 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
G0437,HCPCS,TOBACCO-USE COUNSEL>10MIN,,,14,,RBRVS,0.50 ,0.20 ,0.26 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
G0438,HCPCS,"PPPS, INITIAL VISIT",,,15,,RBRVS,2.43 ,2.26 ,2.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0439,HCPCS,"PPPS, SUBSEQ VISIT",,,15,,RBRVS,1.50 ,1.68 ,1.68 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0442,HCPCS,ANNUAL ALCOHOL SCREEN 15 MIN,,,16,,RBRVS,0.18 ,0.08 ,0.32 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0443,HCPCS,BRIEF ALCOHOL MISUSE COUNSEL,,,16,,RBRVS,0.45 ,0.19 ,0.25 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0444,HCPCS,DEPRESSION SCREEN ANNUAL,,,16,,RBRVS,0.18 ,0.08 ,0.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0445,HCPCS,HIGH INTEN BEH COUNS STD 30M,,,16,,RBRVS,0.45 ,0.18 ,0.27 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0446,HCPCS,INTENS BEHAVE THER CARDIO DX,,,16,,RBRVS,0.45 ,0.19 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0447,HCPCS,BEHAVIOR COUNSEL OBESITY 15M,,,16,,RBRVS,0.45 ,0.19 ,0.25 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0451,HCPCS,DEVLOPMENT TEST INTERPT&REP,,,17,,RBRVS,,0.26 ,0.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0452,HCPCS,MOLECULAR PATHOLOGY INTERPR,,,17,,RBRVS,0.37 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0452,HCPCS,MOLECULAR PATHOLOGY INTERPR,26,,17,,RBRVS,0.37 ,0.14 ,0.14 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0453,HCPCS,CONT INTRAOP NEURO MONITOR,,,14,,RBRVS,0.60 ,0.28 ,0.28 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0454,HCPCS,MD DOCUMENT VISIT BY NPP,,,14,,RBRVS,0.18 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0455,HCPCS,FECAL MICROBIOTA PREP INSTIL,,,21,,RBRVS,1.34 ,0.62 ,2.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0459,HCPCS,TELEHEALTH INPT PHARM MGMT,,,14,,RBRVS,0.95 ,0.17 ,0.17 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0460,HCPCS,AUTOLOGOUS PRP FOR ULCERS,,,14,,TotalUnits,,,,15.54 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0464,HCPCS,"COLOREC CA SCR, STO BAS DNA",,,21,,TotalUnits,,,,7.07 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G0471,HCPCS,VEN BLOOD COLL SNF/HHA,,,17,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0472,HCPCS,HEP C SCREEN HIGH RISK/OTHER,,TC,17,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G0473,HCPCS,GROUP BEHAVE COUNS 2-10,,,16,,RBRVS,0.23 ,0.09 ,0.11 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G6001,HCPCS,ECHO GUIDANCE RADIOTHERAPY,,,20,,RBRVS,0.58 ,0.83 ,0.83 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
G6001,HCPCS,ECHO GUIDANCE RADIOTHERAPY,26,,20,,RBRVS,0.58 ,0.23 ,0.23 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G6001,HCPCS,ECHO GUIDANCE RADIOTHERAPY,TC,,20,,RBRVS,,0.60 ,0.60 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G6002,HCPCS,STEREOSCOPIC X-RAY GUIDANCE,,,20,,RBRVS,0.39 ,1.68 ,1.68 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
G6002,HCPCS,STEREOSCOPIC X-RAY GUIDANCE,26,,20,,RBRVS,0.39 ,0.16 ,0.16 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G6002,HCPCS,STEREOSCOPIC X-RAY GUIDANCE,TC,,20,,RBRVS,,1.52 ,1.52 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G6003,HCPCS,RADIATION TREATMENT DELIVERY,,TC,20,,RBRVS,,4.51 ,4.51 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G6004,HCPCS,RADIATION TREATMENT DELIVERY,,TC,20,,RBRVS,,3.49 ,3.49 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G6005,HCPCS,RADIATION TREATMENT DELIVERY,,TC,20,,RBRVS,,3.90 ,3.90 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G6006,HCPCS,RADIATION TREATMENT DELIVERY,,TC,20,,RBRVS,,3.88 ,3.88 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G6007,HCPCS,RADIATION TREATMENT DELIVERY,,TC,20,,RBRVS,,7.18 ,7.18 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G6008,HCPCS,RADIATION TREATMENT DELIVERY,,TC,20,,RBRVS,,4.83 ,4.83 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G6009,HCPCS,RADIATION TREATMENT DELIVERY,,TC,20,,RBRVS,,5.35 ,5.35 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G6010,HCPCS,RADIATION TREATMENT DELIVERY,,TC,20,,RBRVS,,5.35 ,5.35 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G6011,HCPCS,RADIATION TREATMENT DELIVERY,,TC,20,,RBRVS,,7.68 ,7.68 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G6012,HCPCS,RADIATION TREATMENT DELIVERY,,TC,20,,RBRVS,,6.36 ,6.36 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G6013,HCPCS,RADIATION TREATMENT DELIVERY,,TC,20,,RBRVS,,7.16 ,7.16 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G6014,HCPCS,RADIATION TREATMENT DELIVERY,,TC,20,,RBRVS,,7.16 ,7.16 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G6015,HCPCS,RADIATION TX DELIVERY IMRT,,TC,20,,RBRVS,,11.15 ,11.15 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G6016,HCPCS,DELIVERY COMP IMRT,,TC,20,,RBRVS,,11.15 ,11.15 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G6017,HCPCS,INTRAFRACTION TRACK MOTION,,,20,,TotalUnits,,,,2.18 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G9017,HCPCS,AMANTADINE HCL 100MG ORAL,,,29,,NW,,,,,,$6.74,$0.00,1,1,1,0,0,1,20161001,,,,
G9018,HCPCS,"ZANAMIVIR,INHALATION PWD 10M",,,29,,NW,,,,,,$20.43,$0.00,1,1,1,0,0,1,20161001,,,,
G9019,HCPCS,OSELTAMIVIR PHOSPHATE 75MG,,,29,,NW,,,,,,$21.29,$0.00,1,1,1,0,0,1,20161001,,,,
G9020,HCPCS,RIMANTADINE HCL 100MG ORAL,,,29,,NW,,,,,,$9.03,$0.00,1,1,1,0,0,1,20161001,,,,
G9033,HCPCS,AMANTADINE HCL ORAL BRAND,,,29,,NW,,,,,,$68.86,$0.00,1,1,1,0,0,1,20161001,,,,
G9034,HCPCS,"ZANAMIVIR, INH PWDR, BRAND",,,29,,NW,,,,,,$54.96,$0.00,1,1,1,0,0,1,20161001,,,,
G9036,HCPCS,"RIMANTADINE HCL, BRAND",,,29,,NW,,,,,,$213.16,$0.00,1,1,1,0,0,1,20161001,,,,
G9143,HCPCS,WARFARIN RESPON GENETIC TEST,,,17,,TotalUnits,,,,4.58 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
G9148,HCPCS,MEDICAL HOME LEVEL 1,,,14,,TotalUnits,,,,0.02 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G9149,HCPCS,MEDICAL HOME LEVEL II,,,14,,TotalUnits,,,,0.02 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G9150,HCPCS,MEDICAL HOME LEVEL III,,,14,,TotalUnits,,,,0.02 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G9152,HCPCS,MAPCP DEMO COMMUNITY,,,14,,TotalUnits,,,,0.05 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G9153,HCPCS,MAPCP DEMO PHYSICIAN,,,14,,TotalUnits,,,,0.02 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
G9157,HCPCS,TRANSESOPH DOPPL CARDIAC MON,,PC,4,,RBRVS,2.20 ,0.37 ,0.37 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0001,HCPCS,ALCOHOL AND/OR DRUG ASSESS,,,16,,TotalUnits,,,,1.14 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0002,HCPCS,ALCOHOL AND/OR DRUG SCREENIN,,,16,,TotalUnits,,,,2.71 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0003,HCPCS,ALCOHOL AND/OR DRUG SCREENIN,,,16,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0004,HCPCS,ALCOHOL AND/OR DRUG SERVICES,,,16,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0005,HCPCS,ALCOHOL AND/OR DRUG SERVICES,,,16,,TotalUnits,,,,0.84 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0006,HCPCS,ALCOHOL AND/OR DRUG SERVICES,,,16,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0010,HCPCS,ALCOHOL AND/OR DRUG SERVICES,,,16,,TotalUnits,,,,2.30 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0011,HCPCS,ALCOHOL AND/OR DRUG SERVICES,,,16,,TotalUnits,,,,7.96 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0014,HCPCS,ALCOHOL AND/OR DRUG SERVICES,,,16,,TotalUnits,,,,5.32 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0015,HCPCS,ALCOHOL AND/OR DRUG SERVICES,,,16,,TotalUnits,,,,3.15 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0016,HCPCS,ALCOHOL AND/OR DRUG SERVICES,,,16,,TotalUnits,,,,1.88 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0017,HCPCS,ALCOHOL AND/OR DRUG SERVICES,,,16,,TotalUnits,,,,3.07 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0018,HCPCS,ALCOHOL AND/OR DRUG SERVICES,,,16,,TotalUnits,,,,4.34 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0019,HCPCS,ALCOHOL AND/OR DRUG SERVICES,,,16,,TotalUnits,,,,2.07 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0020,HCPCS,ALCOHOL AND/OR DRUG SERVICES,,,16,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0022,HCPCS,ALCOHOL AND/OR DRUG INTERVEN,,,16,,TotalUnits,,,,0.66 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0024,HCPCS,ALCOHOL AND/OR DRUG PREVENTI,,,16,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0025,HCPCS,ALCOHOL AND/OR DRUG PREVENTI,,,16,,TotalUnits,,,,0.11 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0031,HCPCS,MH HEALTH ASSESS BY NON-MD,,,16,,TotalUnits,,,,1.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0032,HCPCS,MH SVC PLAN DEV BY NON-MD,,,16,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0033,HCPCS,ORAL MED ADM DIRECT OBSERVE,,,16,,TotalUnits,,,,2.18 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0034,HCPCS,MED TRNG & SUPPORT PER 15MIN,,,16,,TotalUnits,,,,0.93 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0035,HCPCS,MH PARTIAL HOSP TX UNDER 24H,,,16,,TotalUnits,,,,2.52 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0036,HCPCS,COMM PSY FACE-FACE PER 15MIN,,,16,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0037,HCPCS,COMM PSY SUP TX PGM PER DIEM,,,16,,TotalUnits,,,,2.21 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0038,HCPCS,SELF-HELP/PEER SVC PER 15MIN,,,16,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0039,HCPCS,ASSER COM TX FACE-FACE/15MIN,,,16,,TotalUnits,,,,0.79 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0040,HCPCS,ASSERT COMM TX PGM PER DIEM,,,16,,TotalUnits,,,,1.35 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0041,HCPCS,FOS C CHLD NON-THER PER DIEM,,,16,,TotalUnits,,,,1.54 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0043,HCPCS,"SUPPORTED HOUSING, PER DIEM",,,16,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0044,HCPCS,"SUPPORTED HOUSING, PER MONTH",,,16,,TotalUnits,,,,9.57 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0045,HCPCS,RESPITE NOT-IN-HOME PER DIEM,,,16,,TotalUnits,,,,2.29 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0046,HCPCS,"MENTAL HEALTH SERVICE, NOS",,,16,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0047,HCPCS,ALCOHOL/DRUG ABUSE SVC NOS,,,16,,TotalUnits,,,,0.90 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0048,HCPCS,SPEC COLL NON-BLOOD:A/D TEST,,,16,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H0050,HCPCS,ALCOHOL/DRUG SERVICE 15 MIN,,,16,,TotalUnits,,,,0.67 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H1000,HCPCS,PRENATAL CARE ATRISK ASSESSM,,,16,,TotalUnits,,,,1.06 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H1001,HCPCS,ANTEPARTUM MANAGEMENT,,,16,,TotalUnits,,,,2.30 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H1002,HCPCS,CARECOORDINATION PRENATAL,,,16,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H1003,HCPCS,PRENATAL AT RISK EDUCATION,,,16,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H1004,HCPCS,FOLLOW UP HOME VISIT/PRENTAL,,,16,,TotalUnits,,,,0.87 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H1005,HCPCS,PRENATALCARE ENHANCED SRV PK,,,16,,TotalUnits,,,,1.96 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H2000,HCPCS,COMP MULTIDISIPLN EVALUATION,,,16,,TotalUnits,,,,1.94 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H2010,HCPCS,COMPREHENSIVE MED SVC 15 MIN,,,16,,TotalUnits,,,,0.79 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H2011,HCPCS,"CRISIS INTERVEN SVC, 15 MIN",,,16,,TotalUnits,,,,1.17 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H2012,HCPCS,"BEHAV HLTH DAY TREAT, PER HR",,,16,,TotalUnits,,,,1.09 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H2013,HCPCS,"PSYCH HLTH FAC SVC, PER DIEM",,,16,,TotalUnits,,,,2.33 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H2014,HCPCS,"SKILLS TRAIN AND DEV, 15 MIN",,,16,,TotalUnits,,,,1.54 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H2015,HCPCS,"COMP COMM SUPP SVC, 15 MIN",,,16,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H2017,HCPCS,"PSYSOC REHAB SVC, PER 15 MIN",,,16,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H2018,HCPCS,"PSYSOC REHAB SVC, PER DIEM",,,16,,TotalUnits,,,,1.76 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H2019,HCPCS,"THER BEHAV SVC, PER 15 MIN",,,16,,TotalUnits,,,,0.23 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H2020,HCPCS,"THER BEHAV SVC, PER DIEM",,,16,,TotalUnits,,,,1.56 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H2021,HCPCS,"COM WRAP-AROUND SV, 15 MIN",,,16,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H2022,HCPCS,"COM WRAP-AROUND SV, PER DIEM",,,16,,TotalUnits,,,,3.13 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H2023,HCPCS,"SUPPORTED EMPLOY, PER 15 MIN",,,16,,TotalUnits,,,,0.09 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H2024,HCPCS,"SUPPORTED EMPLOY, PER DIEM",,,16,,TotalUnits,,,,0.72 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H2026,HCPCS,"SUPP MAINT EMPLOY, PER DIEM",,,16,,TotalUnits,,,,0.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H2029,HCPCS,"SEX OFFEND TX SVC, PER DIEM",,,16,,TotalUnits,,,,1.20 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H2032,HCPCS,"ACTIVITY THERAPY, PER 15 MIN",,,16,,TotalUnits,,,,0.13 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H2033,HCPCS,MULTISYS THER/JUVENILE 15MIN,,,16,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H2035,HCPCS,"A/D TX PROGRAM, PER HOUR",,,16,,TotalUnits,,,,1.10 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
H2036,HCPCS,"A/D TX PROGRAM, PER DIEM",,,16,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
J0120,HCPCS,TETRACYCLIN INJECTION,,,29,,NW,,,,,,$69.25,$0.00,1,1,1,0,0,1,20161001,,,,
J0129,HCPCS,ABATACEPT INJECTION,,,29,,NW,,,,,,$87.02,$0.00,1,1,1,0,0,1,20161001,,,,
J0130,HCPCS,ABCIXIMAB INJECTION,,,29,,NW,,,,,,"$1,952.39",$0.00,1,1,1,0,0,1,20161001,,,,
J0131,HCPCS,ACETAMINOPHEN INJECTION,,,29,,NW,,,,,,$0.73,$0.00,1,1,1,0,0,1,20161001,,,,
J0132,HCPCS,ACETYLCYSTEINE INJECTION,,,29,,NW,,,,,,$10.05,$0.00,1,1,1,0,0,1,20161001,,,,
J0133,HCPCS,ACYCLOVIR INJECTION,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J0135,HCPCS,ADALIMUMAB INJECTION,,,29,,NW,,,,,,"$1,532.10",$0.00,1,1,1,0,0,1,20161001,,,,
J0153,HCPCS,ADENOSINE INJ 1MG,,,29,,NW,,,,,,$8.32,$0.00,1,1,1,0,0,1,20161001,,,,
J0171,HCPCS,ADRENALIN EPINEPHRINE INJECT,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J0178,HCPCS,AFLIBERCEPT INJECTION,,,29,,NW,,,,,,"$2,377.87",$0.00,1,1,1,0,0,1,20161001,,,,
J0180,HCPCS,AGALSIDASE BETA INJECTION,,,29,,NW,,,,,,$375.00,$0.00,1,1,1,0,0,1,20161001,,,,
J0190,HCPCS,INJ BIPERIDEN LACTATE/5 MG,,,29,,NW,,,,,,$4.39,$0.00,1,1,1,0,0,1,20161001,,,,
J0200,HCPCS,ALATROFLOXACIN MESYLATE,,,29,,NW,,,,,,$36.25,$0.00,1,1,1,0,0,1,20161001,,,,
J0202,HCPCS,"INJECTION, ALEMTUZUMAB",,,29,,NW,,,,,,"$1,311.57",$0.00,1,1,1,0,0,1,20161001,,,,
J0205,HCPCS,ALGLUCERASE INJECTION,,,29,,NW,,,,,,$87.02,$0.00,1,1,1,0,0,1,20161001,,,,
J0207,HCPCS,AMIFOSTINE,,,29,,NW,,,,,,"$1,436.97",$0.00,1,1,1,0,0,1,20161001,,,,
J0210,HCPCS,METHYLDOPATE HCL INJECTION,,,29,,NW,,,,,,$109.50,$0.00,1,1,1,0,0,1,20161001,,,,
J0215,HCPCS,ALEFACEPT,,,29,,NW,,,,,,$106.91,$0.00,1,1,1,0,0,1,20161001,,,,
J0220,HCPCS,ALGLUCOSIDASE ALFA INJECTION,,,29,,NW,,,,,,$506.45,$0.00,1,1,1,0,0,1,20161001,,,,
J0221,HCPCS,LUMIZYME INJECTION,,,29,,NW,,,,,,$378.45,$0.00,1,1,1,0,0,1,20161001,,,,
J0256,HCPCS,ALPHA 1 PROTEINASE INHIBITOR,,,29,,NW,,,,,,$16.97,$0.00,1,1,1,0,0,1,20161001,,,,
J0257,HCPCS,GLASSIA INJECTION,,,29,,NW,,,,,,$16.10,$0.00,1,1,1,0,0,1,20161001,,,,
J0270,HCPCS,ALPROSTADIL FOR INJECTION,,,29,,NW,,,,,,$12.64,$0.00,1,1,1,0,0,1,20161001,,,,
J0275,HCPCS,ALPROSTADIL URETHRAL SUPPOS,,,29,,NW,,,,,,$62.23,$0.00,1,1,1,0,0,1,20161001,,,,
J0278,HCPCS,AMIKACIN SULFATE INJECTION,,,29,,NW,,,,,,$7.45,$0.00,1,1,1,0,0,1,20161001,,,,
J0280,HCPCS,AMINOPHYLLIN 250 MG INJ,,,29,,NW,,,,,,$14.37,$0.00,1,1,1,0,0,1,20161001,,,,
J0282,HCPCS,AMIODARONE HCL,,,29,,NW,,,,,,$5.59,$0.00,1,1,1,0,0,1,20161001,,,,
J0285,HCPCS,AMPHOTERICIN B,,,29,,NW,,,,,,$47.24,$0.00,1,1,1,0,0,1,20161001,,,,
J0287,HCPCS,AMPHOTERICIN B LIPID COMPLEX,,,29,,NW,,,,,,$33.40,$0.00,1,1,1,0,0,1,20161001,,,,
J0288,HCPCS,AMPHO B CHOLESTERYL SULFATE,,,29,,NW,,,,,,$195.98,$0.00,1,1,1,0,0,1,20161001,,,,
J0289,HCPCS,AMPHOTERICIN B LIPOSOME INJ,,,29,,NW,,,,,,$48.10,$0.00,1,1,1,0,0,1,20161001,,,,
J0290,HCPCS,AMPICILLIN 500 MG INJ,,,29,,NW,,,,,,$7.45,$0.00,1,1,1,0,0,1,20161001,,,,
J0295,HCPCS,AMPICILLIN SODIUM PER 1.5 GM,,,29,,NW,,,,,,$9.03,$0.00,1,1,1,0,0,1,20161001,,,,
J0300,HCPCS,AMOBARBITAL 125 MG INJ,,,29,,NW,,,,,,$36.86,$0.00,1,1,1,0,0,1,20161001,,,,
J0330,HCPCS,SUCCINYCHOLINE CHLORIDE INJ,,,29,,NW,,,,,,$5.59,$0.00,1,1,1,0,0,1,20161001,,,,
J0348,HCPCS,ANIDULAFUNGIN INJECTION,,,29,,NW,,,,,,$5.59,$0.00,1,1,1,0,0,1,20161001,,,,
J0350,HCPCS,INJECTION ANISTREPLASE 30 U,,,29,,NW,,,,,,$268.42,$0.00,1,1,1,0,0,1,20161001,,,,
J0360,HCPCS,HYDRALAZINE HCL INJECTION,,,29,,NW,,,,,,$12.64,$0.00,1,1,1,0,0,1,20161001,,,,
J0364,HCPCS,APOMORPHINE HYDROCHLORIDE,,,29,,NW,,,,,,$14.37,$0.00,1,1,1,0,0,1,20161001,,,,
J0365,HCPCS,"APROTONIN, 10,000 KIU",,,29,,NW,,,,,,$13.51,$0.00,1,1,1,0,0,1,20161001,,,,
J0380,HCPCS,INJ METARAMINOL BITARTRATE,,,29,,NW,,,,,,$6.74,$0.00,1,1,1,0,0,1,20161001,,,,
J0390,HCPCS,CHLOROQUINE INJECTION,,,29,,NW,,,,,,$227.47,$0.00,1,1,1,0,0,1,20161001,,,,
J0395,HCPCS,ARBUTAMINE HCL INJECTION,,,29,,NW,,,,,,$30.33,$0.00,1,1,1,0,0,1,20161001,,,,
J0400,HCPCS,ARIPIPRAZOLE INJECTION,,,29,,NW,,,,,,$5.59,$0.00,1,1,1,0,0,1,20161001,,,,
J0401,HCPCS,INJ ARIPIPRAZOLE EXT REL 1MG,,,29,,NW,,,,,,$16.10,$0.00,1,1,1,0,0,1,20161001,,,,
J0456,HCPCS,AZITHROMYCIN,,,29,,NW,,,,,,$13.51,$0.00,1,1,1,0,0,1,20161001,,,,
J0461,HCPCS,ATROPINE SULFATE INJECTION,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J0470,HCPCS,DIMECAPROL INJECTION,,,29,,NW,,,,,,$76.64,$0.00,1,1,1,0,0,1,20161001,,,,
J0475,HCPCS,BACLOFEN 10 MG INJECTION,,,29,,NW,,,,,,$393.16,$0.00,1,1,1,0,0,1,20161001,,,,
J0476,HCPCS,BACLOFEN INTRATHECAL TRIAL,,,29,,NW,,,,,,$189.93,$0.00,1,1,1,0,0,1,20161001,,,,
J0480,HCPCS,BASILIXIMAB,,,29,,NW,,,,,,"$6,593.78",$0.00,1,1,1,0,0,1,20161001,,,,
J0485,HCPCS,BELATACEPT INJECTION,,,29,,NW,,,,,,$16.10,$0.00,1,1,1,0,0,1,20161001,,,,
J0490,HCPCS,BELIMUMAB INJECTION,,,29,,NW,,,,,,$103.45,$0.00,1,1,1,0,0,1,20161001,,,,
J0500,HCPCS,DICYCLOMINE INJECTION,,,29,,NW,,,,,,$105.18,$0.00,1,1,1,0,0,1,20161001,,,,
J0515,HCPCS,INJ BENZTROPINE MESYLATE,,,29,,NW,,,,,,$54.15,$0.00,1,1,1,0,0,1,20161001,,,,
J0520,HCPCS,BETHANECHOL CHLORIDE INJECT,,,29,,NW,,,,,,$8.47,$0.00,1,1,1,0,0,1,20161001,,,,
J0558,HCPCS,PENG BENZATHINE/PROCAINE INJ,,,29,,NW,,,,,,$19.56,$0.00,1,1,1,0,0,1,20161001,,,,
J0561,HCPCS,PENICILLIN G BENZATHINE INJ,,,29,,NW,,,,,,$22.16,$0.00,1,1,1,0,0,1,20161001,,,,
J0583,HCPCS,BIVALIRUDIN,,,29,,NW,,,,,,$15.24,$0.00,1,1,1,0,0,1,20161001,,,,
J0585,HCPCS,"INJECTION,ONABOTULINUMTOXINA",,,29,,NW,,,,,,$20.43,$0.00,1,1,1,0,0,1,20161001,,,,
J0586,HCPCS,ABOBOTULINUMTOXINA,,,29,,NW,,,,,,$24.75,$0.00,1,1,1,0,0,1,20161001,,,,
J0587,HCPCS,"INJ, RIMABOTULINUMTOXINB",,,29,,NW,,,,,,$34.26,$0.00,1,1,1,0,0,1,20161001,,,,
J0588,HCPCS,INCOBOTULINUMTOXIN A,,,29,,NW,,,,,,$17.83,$0.00,1,1,1,0,0,1,20161001,,,,
J0592,HCPCS,BUPRENORPHINE HYDROCHLORIDE,,,29,,NW,,,,,,$13.51,$0.00,1,1,1,0,0,1,20161001,,,,
J0594,HCPCS,BUSULFAN INJECTION,,,29,,NW,,,,,,$86.15,$0.00,1,1,1,0,0,1,20161001,,,,
J0595,HCPCS,BUTORPHANOL TARTRATE 1 MG,,,29,,NW,,,,,,$9.03,$0.00,1,1,1,0,0,1,20161001,,,,
J0596,HCPCS,"INJECTION, RUCONEST",,,29,,NW,,,,,,$156.99,$0.00,1,1,1,0,0,1,20161001,,,,
J0597,HCPCS,"C-1 ESTERASE, BERINERT",,,29,,NW,,,,,,$99.99,$0.00,1,1,1,0,0,1,20161001,,,,
J0598,HCPCS,"C-1 ESTERASE, CINRYZE",,,29,,NW,,,,,,$131.99,$0.00,1,1,1,0,0,1,20161001,,,,
J0600,HCPCS,EDETATE CALCIUM DISODIUM INJ,,,29,,NW,,,,,,"$7,417.07",$0.00,1,1,1,0,0,1,20161001,,,,
J0610,HCPCS,CALCIUM GLUCONATE INJECTION,,,29,,NW,,,,,,$8.75,$0.00,1,1,1,0,0,1,20161001,,,,
J0620,HCPCS,CALCIUM GLYCER & LACT/10 ML,,,29,,NW,,,,,,$35.99,$0.00,1,1,1,0,0,1,20161001,,,,
J0630,HCPCS,CALCITONIN SALMON INJECTION,,,29,,NW,,,,,,$873.12,$0.00,1,1,1,0,0,1,20161001,,,,
J0636,HCPCS,INJ CALCITRIOL PER 0.1 MCG,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J0637,HCPCS,CASPOFUNGIN ACETATE,,,29,,NW,,,,,,$35.99,$0.00,1,1,1,0,0,1,20161001,,,,
J0638,HCPCS,CANAKINUMAB INJECTION,,,29,,NW,,,,,,$227.11,$0.00,1,1,1,0,0,1,20161001,,,,
J0640,HCPCS,LEUCOVORIN CALCIUM INJECTION,,,29,,NW,,,,,,$16.10,$0.00,1,1,1,0,0,1,20161001,,,,
J0641,HCPCS,LEVOLEUCOVORIN INJECTION,,,29,,NW,,,,,,$9.03,$0.00,1,1,1,0,0,1,20161001,,,,
J0670,HCPCS,INJ MEPIVACAINE HCL/10 ML,,,29,,NW,,,,,,$12.64,$0.00,1,1,1,0,0,1,20161001,,,,
J0690,HCPCS,CEFAZOLIN SODIUM INJECTION,,,29,,NW,,,,,,$6.02,$0.00,1,1,1,0,0,1,20161001,,,,
J0692,HCPCS,CEFEPIME HCL FOR INJECTION,,,29,,NW,,,,,,$12.64,$0.00,1,1,1,0,0,1,20161001,,,,
J0694,HCPCS,CEFOXITIN SODIUM INJECTION,,,29,,NW,,,,,,$18.70,$0.00,1,1,1,0,0,1,20161001,,,,
J0695,HCPCS,INJ CEFTOLOZANE TAZOBACTAM,,,29,,NW,,,,,,$2.90,$0.00,1,1,1,0,0,1,20161001,,,,
J0696,HCPCS,CEFTRIAXONE SODIUM INJECTION,,,29,,NW,,,,,,$5.59,$0.00,1,1,1,0,0,1,20161001,,,,
J0697,HCPCS,STERILE CEFUROXIME INJECTION,,,29,,NW,,,,,,$13.51,$0.00,1,1,1,0,0,1,20161001,,,,
J0698,HCPCS,CEFOTAXIME SODIUM INJECTION,,,29,,NW,,,,,,$9.03,$0.00,1,1,1,0,0,1,20161001,,,,
J0702,HCPCS,BETAMETHASONE ACET&SOD PHOSP,,,29,,NW,,,,,,$20.43,$0.00,1,1,1,0,0,1,20161001,,,,
J0706,HCPCS,CAFFEINE CITRATE INJECTION,,,29,,NW,,,,,,$14.37,$0.00,1,1,1,0,0,1,20161001,,,,
J0710,HCPCS,CEPHAPIRIN SODIUM INJECTION,,,29,,NW,,,,,,$16.05,$0.00,1,1,1,0,0,1,20161001,,,,
J0712,HCPCS,CEFTAROLINE FOSAMIL INJ,,,29,,NW,,,,,,$6.74,$0.00,1,1,1,0,0,1,20161001,,,,
J0713,HCPCS,INJ CEFTAZIDIME PER 500 MG,,,29,,NW,,,,,,$11.78,$0.00,1,1,1,0,0,1,20161001,,,,
J0715,HCPCS,CEFTIZOXIME SODIUM / 500 MG,,,29,,NW,,,,,,$36.34,$0.00,1,1,1,0,0,1,20161001,,,,
J0716,HCPCS,CENTRUROIDES IMMUNE F(AB),,,29,,NW,,,,,,"$8,718.70",$0.00,1,1,1,0,0,1,20161001,,,,
J0717,HCPCS,CERTOLIZUMAB PEGOL INJ 1MG,,,29,,NW,,,,,,$22.16,$0.00,1,1,1,0,0,1,20161001,,,,
J0720,HCPCS,CHLORAMPHENICOL SODIUM INJEC,,,29,,NW,,,,,,$83.56,$0.00,1,1,1,0,0,1,20161001,,,,
J0725,HCPCS,CHORIONIC GONADOTROPIN/1000U,,,29,,NW,,,,,,$50.70,$0.00,1,1,1,0,0,1,20161001,,,,
J0735,HCPCS,CLONIDINE HYDROCHLORIDE,,,29,,NW,,,,,,$59.34,$0.00,1,1,1,0,0,1,20161001,,,,
J0740,HCPCS,CIDOFOVIR INJECTION,,,29,,NW,,,,,,"$1,420.54",$0.00,1,1,1,0,0,1,20161001,,,,
J0743,HCPCS,CILASTATIN SODIUM INJECTION,,,29,,NW,,,,,,$18.70,$0.00,1,1,1,0,0,1,20161001,,,,
J0744,HCPCS,CIPROFLOXACIN IV,,,29,,NW,,,,,,$6.74,$0.00,1,1,1,0,0,1,20161001,,,,
J0745,HCPCS,INJ CODEINE PHOSPHATE /30 MG,,,29,,NW,,,,,,$6.74,$0.00,1,1,1,0,0,1,20161001,,,,
J0760,HCPCS,COLCHICINE INJECTION,,,29,,NW,,,,,,$21.29,$0.00,1,1,1,0,0,1,20161001,,,,
J0770,HCPCS,COLISTIMETHATE SODIUM INJ,,,29,,NW,,,,,,$34.26,$0.00,1,1,1,0,0,1,20161001,,,,
J0775,HCPCS,"COLLAGENASE, CLOST HIST INJ",,,29,,NW,,,,,,$99.99,$0.00,1,1,1,0,0,1,20161001,,,,
J0780,HCPCS,PROCHLORPERAZINE INJECTION,,,29,,NW,,,,,,$40.32,$0.00,1,1,1,0,0,1,20161001,,,,
J0795,HCPCS,CORTICORELIN OVINE TRIFLUTAL,,,29,,NW,,,,,,$25.62,$0.00,1,1,1,0,0,1,20161001,,,,
J0800,HCPCS,CORTICOTROPIN INJECTION,,,29,,NW,,,,,,"$8,048.37",$0.00,1,1,1,0,0,1,20161001,,,,
J0833,HCPCS,COSYNTROPIN INJECTION NOS,,,29,,NW,,,,,,$250.46,$0.00,1,1,1,0,0,1,20161001,,,,
J0834,HCPCS,COSYNTROPIN CORTROSYN INJ,,,29,,NW,,,,,,$120.74,$0.00,1,1,1,0,0,1,20161001,,,,
J0840,HCPCS,CROTALIDAE POLY IMMUNE FAB,,,29,,NW,,,,,,"$6,036.85",$0.00,1,1,1,0,0,1,20161001,,,,
J0850,HCPCS,CYTOMEGALOVIRUS IMM IV /VIAL,,,29,,NW,,,,,,"$2,459.17",$0.00,1,1,1,0,0,1,20161001,,,,
J0875,HCPCS,"INJECTION, DALBAVANCIN",,,29,,NW,,,,,,$212.83,$0.00,1,1,1,0,0,1,20161001,,,,
J0878,HCPCS,DAPTOMYCIN INJECTION,,,29,,NW,,,,,,$5.59,$0.00,1,1,1,0,0,1,20161001,,,,
J0881,HCPCS,"DARBEPOETIN ALFA, NON-ESRD",,,29,,NW,,,,,,$16.10,$0.00,1,1,1,0,0,1,20161001,,,,
J0882,HCPCS,"DARBEPOETIN ALFA, ESRD USE",,,29,,NW,,,,,,$16.10,$0.00,1,1,1,0,0,1,20161001,,,,
J0885,HCPCS,"EPOETIN ALFA, NON-ESRD",,,29,,NW,,,,,,$35.13,$0.00,1,1,1,0,0,1,20161001,,,,
J0890,HCPCS,PEGINESATIDE INJECTION,,,29,,NW,,,,,,$26.00,$0.00,1,1,1,0,0,1,20161001,,,,
J0894,HCPCS,DECITABINE INJECTION,,,29,,NW,,,,,,$72.32,$0.00,1,1,1,0,0,1,20161001,,,,
J0895,HCPCS,DEFEROXAMINE MESYLATE INJ,,,29,,NW,,,,,,$28.21,$0.00,1,1,1,0,0,1,20161001,,,,
J0897,HCPCS,DENOSUMAB INJECTION,,,29,,NW,,,,,,$42.05,$0.00,1,1,1,0,0,1,20161001,,,,
J0945,HCPCS,BROMPHENIRAMINE MALEATE INJ,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J1000,HCPCS,DEPO-ESTRADIOL CYPIONATE INJ,,,29,,NW,,,,,,$33.40,$0.00,1,1,1,0,0,1,20161001,,,,
J1020,HCPCS,METHYLPREDNISOLONE 20 MG INJ,,,29,,NW,,,,,,$15.24,$0.00,1,1,1,0,0,1,20161001,,,,
J1030,HCPCS,METHYLPREDNISOLONE 40 MG INJ,,,29,,NW,,,,,,$14.37,$0.00,1,1,1,0,0,1,20161001,,,,
J1040,HCPCS,METHYLPREDNISOLONE 80 MG INJ,,,29,,NW,,,,,,$21.29,$0.00,1,1,1,0,0,1,20161001,,,,
J1050,HCPCS,MEDROXYPROGESTERONE ACETATE,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J1071,HCPCS,INJ TESTOSTERONE CYPIONATE,,,29,,NW,,,,,,$3.19,$0.00,1,1,1,0,0,1,20161001,,,,
J1094,HCPCS,INJ DEXAMETHASONE ACETATE,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J1100,HCPCS,DEXAMETHASONE SODIUM PHOS,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J1110,HCPCS,INJ DIHYDROERGOTAMINE MESYLT,,,29,,NW,,,,,,$136.31,$0.00,1,1,1,0,0,1,20161001,,,,
J1120,HCPCS,ACETAZOLAMID SODIUM INJECTIO,,,29,,NW,,,,,,$58.48,$0.00,1,1,1,0,0,1,20161001,,,,
J1160,HCPCS,DIGOXIN INJECTION,,,29,,NW,,,,,,$29.08,$0.00,1,1,1,0,0,1,20161001,,,,
J1162,HCPCS,DIGOXIN IMMUNE FAB (OVINE),,,29,,NW,,,,,,"$4,968.82",$0.00,1,1,1,0,0,1,20161001,,,,
J1165,HCPCS,PHENYTOIN SODIUM INJECTION,,,29,,NW,,,,,,$5.59,$0.00,1,1,1,0,0,1,20161001,,,,
J1170,HCPCS,HYDROMORPHONE INJECTION,,,29,,NW,,,,,,$11.78,$0.00,1,1,1,0,0,1,20161001,,,,
J1180,HCPCS,DYPHYLLINE INJECTION,,,29,,NW,,,,,,$19.26,$0.00,1,1,1,0,0,1,20161001,,,,
J1190,HCPCS,DEXRAZOXANE HCL INJECTION,,,29,,NW,,,,,,$342.13,$0.00,1,1,1,0,0,1,20161001,,,,
J1200,HCPCS,DIPHENHYDRAMINE HCL INJECTIO,,,29,,NW,,,,,,$5.59,$0.00,1,1,1,0,0,1,20161001,,,,
J1205,HCPCS,CHLOROTHIAZIDE SODIUM INJ,,,29,,NW,,,,,,$294.57,$0.00,1,1,1,0,0,1,20161001,,,,
J1212,HCPCS,DIMETHYL SULFOXIDE 50% 50 ML,,,29,,NW,,,,,,$221.06,$0.00,1,1,1,0,0,1,20161001,,,,
J1230,HCPCS,METHADONE INJECTION,,,29,,NW,,,,,,$29.08,$0.00,1,1,1,0,0,1,20161001,,,,
J1240,HCPCS,DIMENHYDRINATE INJECTION,,,29,,NW,,,,,,$19.56,$0.00,1,1,1,0,0,1,20161001,,,,
J1245,HCPCS,DIPYRIDAMOLE INJECTION,,,29,,NW,,,,,,$5.59,$0.00,1,1,1,0,0,1,20161001,,,,
J1250,HCPCS,INJ DOBUTAMINE HCL/250 MG,,,29,,NW,,,,,,$22.16,$0.00,1,1,1,0,0,1,20161001,,,,
J1260,HCPCS,DOLASETRON MESYLATE,,,29,,NW,,,,,,$32.08,$0.00,1,1,1,0,0,1,20161001,,,,
J1265,HCPCS,DOPAMINE INJECTION,,,29,,NW,,,,,,$4.88,$0.00,1,1,1,0,0,1,20161001,,,,
J1267,HCPCS,DORIPENEM INJECTION,,,29,,NW,,,,,,$5.59,$0.00,1,1,1,0,0,1,20161001,,,,
J1270,HCPCS,"INJECTION, DOXERCALCIFEROL",,,29,,NW,,,,,,$10.05,$0.00,1,1,1,0,0,1,20161001,,,,
J1290,HCPCS,ECALLANTIDE INJECTION,,,29,,NW,,,,,,$912.90,$0.00,1,1,1,0,0,1,20161001,,,,
J1300,HCPCS,ECULIZUMAB INJECTION,,,29,,NW,,,,,,$515.09,$0.00,1,1,1,0,0,1,20161001,,,,
J1320,HCPCS,AMITRIPTYLINE INJECTION,,,29,,NW,,,,,,$87.72,$0.00,1,1,1,0,0,1,20161001,,,,
J1322,HCPCS,"ELOSULFASE ALFA, INJECTION",,,29,,NW,,,,,,$314.87,$0.00,1,1,1,0,0,1,20161001,,,,
J1324,HCPCS,ENFUVIRTIDE INJECTION,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J1325,HCPCS,EPOPROSTENOL INJECTION,,,29,,NW,,,,,,$43.78,$0.00,1,1,1,0,0,1,20161001,,,,
J1327,HCPCS,EPTIFIBATIDE INJECTION,,,29,,NW,,,,,,$61.07,$0.00,1,1,1,0,0,1,20161001,,,,
J1330,HCPCS,ERGONOVINE MALEATE INJECTION,,,29,,NW,,,,,,$7.91,$0.00,1,1,1,0,0,1,20161001,,,,
J1335,HCPCS,ERTAPENEM INJECTION,,,29,,NW,,,,,,$94.80,$0.00,1,1,1,0,0,1,20161001,,,,
J1364,HCPCS,ERYTHRO LACTOBIONATE /500 MG,,,29,,NW,,,,,,$112.96,$0.00,1,1,1,0,0,1,20161001,,,,
J1380,HCPCS,ESTRADIOL VALERATE 10 MG INJ,,,29,,NW,,,,,,$29.08,$0.00,1,1,1,0,0,1,20161001,,,,
J1410,HCPCS,INJ ESTROGEN CONJUGATE 25 MG,,,29,,NW,,,,,,$467.53,$0.00,1,1,1,0,0,1,20161001,,,,
J1430,HCPCS,ETHANOLAMINE OLEATE 100 MG,,,29,,NW,,,,,,$758.97,$0.00,1,1,1,0,0,1,20161001,,,,
J1435,HCPCS,INJECTION ESTRONE PER 1 MG,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J1436,HCPCS,ETIDRONATE DISODIUM INJ,,,29,,NW,,,,,,$216.66,$0.00,1,1,1,0,0,1,20161001,,,,
J1438,HCPCS,ETANERCEPT INJECTION,,,29,,NW,,,,,,$730.43,$0.00,1,1,1,0,0,1,20161001,,,,
J1439,HCPCS,INJ FERRIC CARBOXYMALTOS 1MG,,,29,,NW,,,,,,$9.19,$0.00,1,1,1,0,0,1,20161001,,,,
J1442,HCPCS,INJ FILGRASTIM EXCL BIOSIMIL,,,29,,NW,,,,,,$6.74,$0.00,1,1,1,0,0,1,20161001,,,,
J1443,HCPCS,INJ FERRIC PYROPHOSPHATE CIT,,,29,,NW,,,,,,$2.92,$0.00,1,1,1,0,0,1,20161001,,,,
J1450,HCPCS,FLUCONAZOLE,,,29,,NW,,,,,,$16.10,$0.00,1,1,1,0,0,1,20161001,,,,
J1451,HCPCS,"FOMEPIZOLE, 15 MG",,,29,,NW,,,,,,$24.75,$0.00,1,1,1,0,0,1,20161001,,,,
J1452,HCPCS,INTRAOCULAR FOMIVIRSEN NA,,,29,,NW,,,,,,"$2,419.09",$0.00,1,1,1,0,0,1,20161001,,,,
J1453,HCPCS,FOSAPREPITANT INJECTION,,,29,,NW,,,,,,$9.03,$0.00,1,1,1,0,0,1,20161001,,,,
J1455,HCPCS,FOSCARNET SODIUM INJECTION,,,29,,NW,,,,,,$57.61,$0.00,1,1,1,0,0,1,20161001,,,,
J1457,HCPCS,GALLIUM NITRATE INJECTION,,,29,,NW,,,,,,$7.89,$0.00,1,1,1,0,0,1,20161001,,,,
J1458,HCPCS,GALSULFASE INJECTION,,,29,,NW,,,,,,$874.85,$0.00,1,1,1,0,0,1,20161001,,,,
J1459,HCPCS,INJ IVIG PRIVIGEN 500 MG,,,29,,NW,,,,,,$95.67,$0.00,1,1,1,0,0,1,20161001,,,,
J1460,HCPCS,GAMMA GLOBULIN 1 CC INJ,,,29,,NW,,,,,,$76.64,$0.00,1,1,1,0,0,1,20161001,,,,
J1556,HCPCS,"INJ, IMM GLOB BIVIGAM, 500MG",,,29,,NW,,,,,,$99.99,$0.00,1,1,1,0,0,1,20161001,,,,
J1557,HCPCS,GAMMAPLEX INJECTION,,,29,,NW,,,,,,$93.07,$0.00,1,1,1,0,0,1,20161001,,,,
J1559,HCPCS,HIZENTRA INJECTION,,,29,,NW,,,,,,$25.62,$0.00,1,1,1,0,0,1,20161001,,,,
J1560,HCPCS,GAMMA GLOBULIN > 10 CC INJ,,,29,,NW,,,,,,$705.35,$0.00,1,1,1,0,0,1,20161001,,,,
J1561,HCPCS,GAMUNEX-C/GAMMAKED,,,29,,NW,,,,,,$103.45,$0.00,1,1,1,0,0,1,20161001,,,,
J1562,HCPCS,"VIVAGLOBIN, INJ",,,29,,NW,,,,,,$30.81,$0.00,1,1,1,0,0,1,20161001,,,,
J1566,HCPCS,"IMMUNE GLOBULIN, POWDER",,,29,,NW,,,,,,$71.45,$0.00,1,1,1,0,0,1,20161001,,,,
J1568,HCPCS,OCTAGAM INJECTION,,,29,,NW,,,,,,$95.67,$0.00,1,1,1,0,0,1,20161001,,,,
J1569,HCPCS,GAMMAGARD LIQUID INJECTION,,,29,,NW,,,,,,$101.72,$0.00,1,1,1,0,0,1,20161001,,,,
J1570,HCPCS,GANCICLOVIR SODIUM INJECTION,,,29,,NW,,,,,,$189.06,$0.00,1,1,1,0,0,1,20161001,,,,
J1571,HCPCS,HEPAGAM B IM INJECTION,,,29,,NW,,,,,,$132.85,$0.00,1,1,1,0,0,1,20161001,,,,
J1572,HCPCS,FLEBOGAMMA INJECTION,,,29,,NW,,,,,,$93.94,$0.00,1,1,1,0,0,1,20161001,,,,
J1573,HCPCS,"HEPAGAM B INTRAVENOUS, INJ",,,29,,NW,,,,,,$135.31,$0.00,1,1,1,0,0,1,20161001,,,,
J1580,HCPCS,GARAMYCIN GENTAMICIN INJ,,,29,,NW,,,,,,$7.17,$0.00,1,1,1,0,0,1,20161001,,,,
J1590,HCPCS,GATIFLOXACIN INJECTION,,,29,,NW,,,,,,$2.92,$0.00,1,1,1,0,0,1,20161001,,,,
J1595,HCPCS,INJECTION GLATIRAMER ACETATE,,,29,,NW,,,,,,"$4,157.63",$0.00,1,1,1,0,0,1,20161001,,,,
J1599,HCPCS,"IVIG NON-LYOPHILIZED, NOS",,,29,,NW,,,,,,$152.65,$0.00,1,1,1,0,0,1,20161001,,,,
J1600,HCPCS,GOLD SODIUM THIOMALEATE INJ,,,29,,NW,,,,,,$42.05,$0.00,1,1,1,0,0,1,20161001,,,,
J1602,HCPCS,GOLIMUMAB FOR IV USE 1MG,,,29,,NW,,,,,,$64.53,$0.00,1,1,1,0,0,1,20161001,,,,
J1610,HCPCS,GLUCAGON HYDROCHLORIDE/1 MG,,,29,,NW,,,,,,$398.35,$0.00,1,1,1,0,0,1,20161001,,,,
J1620,HCPCS,GONADORELIN HYDROCH/ 100 MCG,,,29,,NW,,,,,,$683.93,$0.00,1,1,1,0,0,1,20161001,,,,
J1626,HCPCS,GRANISETRON HCL INJECTION,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J1630,HCPCS,HALOPERIDOL INJECTION,,,29,,NW,,,,,,$10.33,$0.00,1,1,1,0,0,1,20161001,,,,
J1631,HCPCS,HALOPERIDOL DECANOATE INJ,,,29,,NW,,,,,,$51.56,$0.00,1,1,1,0,0,1,20161001,,,,
J1640,HCPCS,"HEMIN, 1 MG",,,29,,NW,,,,,,$56.75,$0.00,1,1,1,0,0,1,20161001,,,,
J1642,HCPCS,INJ HEPARIN SODIUM PER 10 U,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J1644,HCPCS,INJ HEPARIN SODIUM PER 1000U,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J1645,HCPCS,DALTEPARIN SODIUM,,,29,,NW,,,,,,$37.72,$0.00,1,1,1,0,0,1,20161001,,,,
J1650,HCPCS,INJ ENOXAPARIN SODIUM,,,29,,NW,,,,,,$10.05,$0.00,1,1,1,0,0,1,20161001,,,,
J1652,HCPCS,FONDAPARINUX SODIUM,,,29,,NW,,,,,,$16.10,$0.00,1,1,1,0,0,1,20161001,,,,
J1655,HCPCS,TINZAPARIN SODIUM INJECTION,,,29,,NW,,,,,,$16.10,$0.00,1,1,1,0,0,1,20161001,,,,
J1670,HCPCS,TETANUS IMMUNE GLOBULIN INJ,,,29,,NW,,,,,,$800.48,$0.00,1,1,1,0,0,1,20161001,,,,
J1675,HCPCS,HISTRELIN ACETATE,,,29,,NW,,,,,,$6.74,$0.00,1,1,1,0,0,1,20161001,,,,
J1700,HCPCS,HYDROCORTISONE ACETATE INJ,,,29,,NW,,,,,,$1.24,$0.00,1,1,1,0,0,1,20161001,,,,
J1710,HCPCS,HYDROCORTISONE SODIUM PH INJ,,,29,,NW,,,,,,$21.81,$0.00,1,1,1,0,0,1,20161001,,,,
J1720,HCPCS,HYDROCORTISONE SODIUM SUCC I,,,29,,NW,,,,,,$22.16,$0.00,1,1,1,0,0,1,20161001,,,,
J1725,HCPCS,HYDROXYPROGESTERONE CAPROATE,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J1730,HCPCS,DIAZOXIDE INJECTION,,,29,,NW,,,,,,$269.49,$0.00,1,1,1,0,0,1,20161001,,,,
J1740,HCPCS,IBANDRONATE SODIUM INJECTION,,,29,,NW,,,,,,$305.81,$0.00,1,1,1,0,0,1,20161001,,,,
J1741,HCPCS,IBUPROFEN INJECTION,,,29,,NW,,,,,,$11.53,$0.00,1,1,1,0,0,1,20161001,,,,
J1742,HCPCS,IBUTILIDE FUMARATE INJECTION,,,29,,NW,,,,,,$272.95,$0.00,1,1,1,0,0,1,20161001,,,,
J1743,HCPCS,IDURSULFASE INJECTION,,,29,,NW,,,,,,"$1,174.94",$0.00,1,1,1,0,0,1,20161001,,,,
J1744,HCPCS,ICATIBANT INJECTION,,,29,,NW,,,,,,$563.67,$0.00,1,1,1,0,0,1,20161001,,,,
J1745,HCPCS,INFLIXIMAB INJECTION,,,29,,NW,,,,,,$185.60,$0.00,1,1,1,0,0,1,20161001,,,,
J1750,HCPCS,INJ IRON DEXTRAN,,,29,,NW,,,,,,$35.99,$0.00,1,1,1,0,0,1,20161001,,,,
J1756,HCPCS,IRON SUCROSE INJECTION,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J1786,HCPCS,IMUGLUCERASE INJECTION,,,29,,NW,,,,,,$107.77,$0.00,1,1,1,0,0,1,20161001,,,,
J1790,HCPCS,DROPERIDOL INJECTION,,,29,,NW,,,,,,$11.78,$0.00,1,1,1,0,0,1,20161001,,,,
J1800,HCPCS,PROPRANOLOL INJECTION,,,29,,NW,,,,,,$8.19,$0.00,1,1,1,0,0,1,20161001,,,,
J1810,HCPCS,DROPERIDOL/FENTANYL INJ,,,29,,NW,,,,,,$130.84,$0.00,1,1,1,0,0,1,20161001,,,,
J1815,HCPCS,INSULIN INJECTION,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J1817,HCPCS,INSULIN FOR INSULIN PUMP USE,,,29,,NW,,,,,,$19.56,$0.00,1,1,1,0,0,1,20161001,,,,
J1826,HCPCS,INTERFERON BETA-1A INJ,,,29,,NW,,,,,,"$1,512.21",$0.00,1,1,1,0,0,1,20161001,,,,
J1830,HCPCS,INTERFERON BETA-1B / .25 MG,,,29,,NW,,,,,,$416.30,$0.00,1,1,1,0,0,1,20161001,,,,
J1835,HCPCS,ITRACONAZOLE INJECTION,,,29,,NW,,,,,,"$2,438.41",$0.00,1,1,1,0,0,1,20161001,,,,
J1840,HCPCS,KANAMYCIN SULFATE 500 MG INJ,,,29,,NW,,,,,,$24.75,$0.00,1,1,1,0,0,1,20161001,,,,
J1850,HCPCS,KANAMYCIN SULFATE 75 MG INJ,,,29,,NW,,,,,,$6.74,$0.00,1,1,1,0,0,1,20161001,,,,
J1885,HCPCS,KETOROLAC TROMETHAMINE INJ,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J1890,HCPCS,CEPHALOTHIN SODIUM INJECTION,,,29,,NW,,,,,,$28.39,$0.00,1,1,1,0,0,1,20161001,,,,
J1930,HCPCS,LANREOTIDE INJECTION,,,29,,NW,,,,,,$119.88,$0.00,1,1,1,0,0,1,20161001,,,,
J1931,HCPCS,LARONIDASE INJECTION,,,29,,NW,,,,,,$77.50,$0.00,1,1,1,0,0,1,20161001,,,,
J1940,HCPCS,FUROSEMIDE INJECTION,,,29,,NW,,,,,,$17.83,$0.00,1,1,1,0,0,1,20161001,,,,
J1945,HCPCS,LEPIRUDIN,,,29,,NW,,,,,,$394.89,$0.00,1,1,1,0,0,1,20161001,,,,
J1950,HCPCS,LEUPROLIDE ACETATE /3.75 MG,,,29,,NW,,,,,,"$1,966.23",$0.00,1,1,1,0,0,1,20161001,,,,
J1953,HCPCS,LEVETIRACETAM INJECTION,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J1955,HCPCS,INJ LEVOCARNITINE PER 1 GM,,,29,,NW,,,,,,$27.35,$0.00,1,1,1,0,0,1,20161001,,,,
J1956,HCPCS,LEVOFLOXACIN INJECTION,,,29,,NW,,,,,,$11.78,$0.00,1,1,1,0,0,1,20161001,,,,
J1960,HCPCS,LEVORPHANOL TARTRATE INJ,,,29,,NW,,,,,,$14.37,$0.00,1,1,1,0,0,1,20161001,,,,
J1980,HCPCS,HYOSCYAMINE SULFATE INJ,,,29,,NW,,,,,,$51.56,$0.00,1,1,1,0,0,1,20161001,,,,
J1990,HCPCS,CHLORDIAZEPOXIDE INJECTION,,,29,,NW,,,,,,$60.21,$0.00,1,1,1,0,0,1,20161001,,,,
J2001,HCPCS,LIDOCAINE INJECTION,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J2010,HCPCS,LINCOMYCIN INJECTION,,,29,,NW,,,,,,$29.94,$0.00,1,1,1,0,0,1,20161001,,,,
J2020,HCPCS,LINEZOLID INJECTION,,,29,,NW,,,,,,$122.47,$0.00,1,1,1,0,0,1,20161001,,,,
J2060,HCPCS,LORAZEPAM INJECTION,,,29,,NW,,,,,,$5.59,$0.00,1,1,1,0,0,1,20161001,,,,
J2150,HCPCS,MANNITOL INJECTION,,,29,,NW,,,,,,$10.91,$0.00,1,1,1,0,0,1,20161001,,,,
J2170,HCPCS,MECASERMIN INJECTION,,,29,,NW,,,,,,$24.75,$0.00,1,1,1,0,0,1,20161001,,,,
J2175,HCPCS,MEPERIDINE HYDROCHL /100 MG,,,29,,NW,,,,,,$18.70,$0.00,1,1,1,0,0,1,20161001,,,,
J2180,HCPCS,MEPERIDINE/PROMETHAZINE INJ,,,29,,NW,,,,,,$26.48,$0.00,1,1,1,0,0,1,20161001,,,,
J2185,HCPCS,MEROPENEM,,,29,,NW,,,,,,$6.74,$0.00,1,1,1,0,0,1,20161001,,,,
J2210,HCPCS,METHYLERGONOVIN MALEATE INJ,,,29,,NW,,,,,,$18.70,$0.00,1,1,1,0,0,1,20161001,,,,
J2212,HCPCS,METHYLNALTREXONE INJECTION,,,29,,NW,,,,,,$0.90,$0.00,1,1,1,0,0,1,20161001,,,,
J2248,HCPCS,MICAFUNGIN SODIUM INJECTION,,,29,,NW,,,,,,$6.74,$0.00,1,1,1,0,0,1,20161001,,,,
J2250,HCPCS,INJ MIDAZOLAM HYDROCHLORIDE,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J2260,HCPCS,INJ MILRINONE LACTATE / 5 MG,,,29,,NW,,,,,,$14.37,$0.00,1,1,1,0,0,1,20161001,,,,
J2265,HCPCS,MINOCYCLINE HYDROCHLORIDE,,,29,,NW,,,,,,$1.38,$0.00,1,1,1,0,0,1,20161001,,,,
J2270,HCPCS,MORPHINE SULFATE INJECTION,,,29,,NW,,,,,,$10.91,$0.00,1,1,1,0,0,1,20161001,,,,
J2274,HCPCS,IN MORPHINE PRESERVATIV FREE,,,29,,NW,,,,,,$29.08,$0.00,1,1,1,0,0,1,20161001,,,,
J2278,HCPCS,ZICONOTIDE INJECTION,,,29,,NW,,,,,,$23.02,$0.00,1,1,1,0,0,1,20161001,,,,
J2280,HCPCS,"INJ, MOXIFLOXACIN 100 MG",,,29,,NW,,,,,,$19.56,$0.00,1,1,1,0,0,1,20161001,,,,
J2300,HCPCS,INJ NALBUPHINE HYDROCHLORIDE,,,29,,NW,,,,,,$12.64,$0.00,1,1,1,0,0,1,20161001,,,,
J2310,HCPCS,INJ NALOXONE HYDROCHLORIDE,,,29,,NW,,,,,,$93.07,$0.00,1,1,1,0,0,1,20161001,,,,
J2315,HCPCS,"NALTREXONE, DEPOT FORM",,,29,,NW,,,,,,$13.51,$0.00,1,1,1,0,0,1,20161001,,,,
J2320,HCPCS,NANDROLONE DECANOATE 50 MG,,,29,,NW,,,,,,$16.97,$0.00,1,1,1,0,0,1,20161001,,,,
J2323,HCPCS,NATALIZUMAB INJECTION,,,29,,NW,,,,,,$43.78,$0.00,1,1,1,0,0,1,20161001,,,,
J2325,HCPCS,NESIRITIDE INJECTION,,,29,,NW,,,,,,$84.42,$0.00,1,1,1,0,0,1,20161001,,,,
J2353,HCPCS,"OCTREOTIDE INJECTION, DEPOT",,,29,,NW,,,,,,$353.38,$0.00,1,1,1,0,0,1,20161001,,,,
J2354,HCPCS,"OCTREOTIDE INJ, NON-DEPOT",,,29,,NW,,,,,,$6.74,$0.00,1,1,1,0,0,1,20161001,,,,
J2355,HCPCS,OPRELVEKIN INJECTION,,,29,,NW,,,,,,$787.51,$0.00,1,1,1,0,0,1,20161001,,,,
J2357,HCPCS,OMALIZUMAB INJECTION,,,29,,NW,,,,,,$73.18,$0.00,1,1,1,0,0,1,20161001,,,,
J2358,HCPCS,OLANZAPINE LONG-ACTING INJ,,,29,,NW,,,,,,$13.51,$0.00,1,1,1,0,0,1,20161001,,,,
J2360,HCPCS,ORPHENADRINE INJECTION,,,29,,NW,,,,,,$20.43,$0.00,1,1,1,0,0,1,20161001,,,,
J2370,HCPCS,PHENYLEPHRINE HCL INJECTION,,,29,,NW,,,,,,$14.37,$0.00,1,1,1,0,0,1,20161001,,,,
J2400,HCPCS,CHLOROPROCAINE HCL INJECTION,,,29,,NW,,,,,,$47.24,$0.00,1,1,1,0,0,1,20161001,,,,
J2405,HCPCS,ONDANSETRON HCL INJECTION,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J2407,HCPCS,"INJECTION, ORITAVANCIN",,,29,,NW,,,,,,$172.68,$0.00,1,1,1,0,0,1,20161001,,,,
J2410,HCPCS,OXYMORPHONE HCL INJECTION,,,29,,NW,,,,,,$13.51,$0.00,1,1,1,0,0,1,20161001,,,,
J2425,HCPCS,PALIFERMIN INJECTION,,,29,,NW,,,,,,$43.78,$0.00,1,1,1,0,0,1,20161001,,,,
J2426,HCPCS,PALIPERIDONE PALMITATE INJ,,,29,,NW,,,,,,$26.48,$0.00,1,1,1,0,0,1,20161001,,,,
J2430,HCPCS,PAMIDRONATE DISODIUM /30 MG,,,29,,NW,,,,,,$37.72,$0.00,1,1,1,0,0,1,20161001,,,,
J2440,HCPCS,PAPAVERIN HCL INJECTION,,,29,,NW,,,,,,$13.51,$0.00,1,1,1,0,0,1,20161001,,,,
J2460,HCPCS,OXYTETRACYCLINE INJECTION,,,29,,NW,,,,,,$2.26,$0.00,1,1,1,0,0,1,20161001,,,,
J2469,HCPCS,PALONOSETRON HCL,,,29,,NW,,,,,,$55.02,$0.00,1,1,1,0,0,1,20161001,,,,
J2501,HCPCS,PARICALCITOL,,,29,,NW,,,,,,$10.05,$0.00,1,1,1,0,0,1,20161001,,,,
J2502,HCPCS,"INJ, PASIREOTIDE LONG ACTING",,,29,,NW,,,,,,"$1,267.74",$0.00,1,1,1,0,0,1,20161001,,,,
J2503,HCPCS,PEGAPTANIB SODIUM INJECTION,,,29,,NW,,,,,,"$2,510.19",$0.00,1,1,1,0,0,1,20161001,,,,
J2504,HCPCS,"PEGADEMASE BOVINE, 25 IU",,,29,,NW,,,,,,$687.19,$0.00,1,1,1,0,0,1,20161001,,,,
J2505,HCPCS,"INJECTION, PEGFILGRASTIM 6MG",,,29,,NW,,,,,,"$8,460.88",$0.00,1,1,1,0,0,1,20161001,,,,
J2507,HCPCS,PEGLOTICASE INJECTION,,,29,,NW,,,,,,"$2,441.00",$0.00,1,1,1,0,0,1,20161001,,,,
J2510,HCPCS,PENICILLIN G PROCAINE INJ,,,29,,NW,,,,,,$49.83,$0.00,1,1,1,0,0,1,20161001,,,,
J2513,HCPCS,PENTASTARCH 10% SOLUTION,,,29,,NW,,,,,,$9.79,$0.00,1,1,1,0,0,1,20161001,,,,
J2515,HCPCS,PENTOBARBITAL SODIUM INJ,,,29,,NW,,,,,,$93.07,$0.00,1,1,1,0,0,1,20161001,,,,
J2540,HCPCS,PENICILLIN G POTASSIUM INJ,,,29,,NW,,,,,,$5.59,$0.00,1,1,1,0,0,1,20161001,,,,
J2543,HCPCS,PIPERACILLIN/TAZOBACTAM,,,29,,NW,,,,,,$7.89,$0.00,1,1,1,0,0,1,20161001,,,,
J2545,HCPCS,PENTAMIDINE NON-COMP UNIT,,,29,,NW,,,,,,$241.82,$0.00,1,1,1,0,0,1,20161001,,,,
J2547,HCPCS,"INJECTION, PERAMIVIR",,,29,,NW,,,,,,$11.32,$0.00,1,1,1,0,0,1,20161001,,,,
J2550,HCPCS,PROMETHAZINE HCL INJECTION,,,29,,NW,,,,,,$7.89,$0.00,1,1,1,0,0,1,20161001,,,,
J2560,HCPCS,PHENOBARBITAL SODIUM INJ,,,29,,NW,,,,,,$63.67,$0.00,1,1,1,0,0,1,20161001,,,,
J2562,HCPCS,PLERIXAFOR INJECTION,,,29,,NW,,,,,,$741.67,$0.00,1,1,1,0,0,1,20161001,,,,
J2590,HCPCS,OXYTOCIN INJECTION,,,29,,NW,,,,,,$16.10,$0.00,1,1,1,0,0,1,20161001,,,,
J2597,HCPCS,INJ DESMOPRESSIN ACETATE,,,29,,NW,,,,,,$18.70,$0.00,1,1,1,0,0,1,20161001,,,,
J2650,HCPCS,PREDNISOLONE ACETATE INJ,,,29,,NW,,,,,,$7.53,$0.00,1,1,1,0,0,1,20161001,,,,
J2670,HCPCS,TOTAZOLINE HCL INJECTION,,,29,,NW,,,,,,$12.49,$0.00,1,1,1,0,0,1,20161001,,,,
J2675,HCPCS,INJ PROGESTERONE PER 50 MG,,,29,,NW,,,,,,$7.17,$0.00,1,1,1,0,0,1,20161001,,,,
J2680,HCPCS,FLUPHENAZINE DECANOATE 25 MG,,,29,,NW,,,,,,$62.80,$0.00,1,1,1,0,0,1,20161001,,,,
J2690,HCPCS,PROCAINAMIDE HCL INJECTION,,,29,,NW,,,,,,$144.96,$0.00,1,1,1,0,0,1,20161001,,,,
J2700,HCPCS,OXACILLIN SODIUM INJECITON,,,29,,NW,,,,,,$9.03,$0.00,1,1,1,0,0,1,20161001,,,,
J2704,HCPCS,"INJ, PROPOFOL, 10 MG",,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J2710,HCPCS,NEOSTIGMINE METHYLSLFTE INJ,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J2720,HCPCS,INJ PROTAMINE SULFATE/10 MG,,,29,,NW,,,,,,$6.74,$0.00,1,1,1,0,0,1,20161001,,,,
J2724,HCPCS,PROTEIN C CONCENTRATE,,,29,,NW,,,,,,$42.05,$0.00,1,1,1,0,0,1,20161001,,,,
J2725,HCPCS,INJ PROTIRELIN PER 250 MCG,,,29,,NW,,,,,,$88.98,$0.00,1,1,1,0,0,1,20161001,,,,
J2730,HCPCS,PRALIDOXIME CHLORIDE INJ,,,29,,NW,,,,,,$218.47,$0.00,1,1,1,0,0,1,20161001,,,,
J2760,HCPCS,PHENTOLAINE MESYLATE INJ,,,29,,NW,,,,,,$391.43,$0.00,1,1,1,0,0,1,20161001,,,,
J2765,HCPCS,METOCLOPRAMIDE HCL INJECTION,,,29,,NW,,,,,,$5.59,$0.00,1,1,1,0,0,1,20161001,,,,
J2770,HCPCS,QUINUPRISTIN/DALFOPRISTIN,,,29,,NW,,,,,,$641.35,$0.00,1,1,1,0,0,1,20161001,,,,
J2778,HCPCS,RANIBIZUMAB INJECTION,,,29,,NW,,,,,,$964.79,$0.00,1,1,1,0,0,1,20161001,,,,
J2780,HCPCS,RANITIDINE HYDROCHLORIDE INJ,,,29,,NW,,,,,,$6.74,$0.00,1,1,1,0,0,1,20161001,,,,
J2783,HCPCS,RASBURICASE,,,29,,NW,,,,,,$546.23,$0.00,1,1,1,0,0,1,20161001,,,,
J2785,HCPCS,REGADENOSON INJECTION,,,29,,NW,,,,,,$133.72,$0.00,1,1,1,0,0,1,20161001,,,,
J2788,HCPCS,RHO D IMMUNE GLOBULIN 50 MCG,,,29,,NW,,,,,,$69.72,$0.00,1,1,1,0,0,1,20161001,,,,
J2790,HCPCS,RHO D IMMUNE GLOBULIN INJ,,,29,,NW,,,,,,$207.22,$0.00,1,1,1,0,0,1,20161001,,,,
J2791,HCPCS,RHOPHYLAC INJECTION,,,29,,NW,,,,,,$17.83,$0.00,1,1,1,0,0,1,20161001,,,,
J2792,HCPCS,"RHO(D) IMMUNE GLOBULIN H, SD",,,29,,NW,,,,,,$51.56,$0.00,1,1,1,0,0,1,20161001,,,,
J2793,HCPCS,RILONACEPT INJECTION,,,29,,NW,,,,,,$61.94,$0.00,1,1,1,0,0,1,20161001,,,,
J2794,HCPCS,"RISPERIDONE, LONG ACTING",,,29,,NW,,,,,,$22.16,$0.00,1,1,1,0,0,1,20161001,,,,
J2795,HCPCS,ROPIVACAINE HCL INJECTION,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J2796,HCPCS,ROMIPLOSTIM INJECTION,,,29,,NW,,,,,,$139.77,$0.00,1,1,1,0,0,1,20161001,,,,
J2800,HCPCS,METHOCARBAMOL INJECTION,,,29,,NW,,,,,,$119.01,$0.00,1,1,1,0,0,1,20161001,,,,
J2805,HCPCS,SINCALIDE INJECTION,,,29,,NW,,,,,,$216.74,$0.00,1,1,1,0,0,1,20161001,,,,
J2810,HCPCS,INJ THEOPHYLLINE PER 40 MG,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J2820,HCPCS,SARGRAMOSTIM INJECTION,,,29,,NW,,,,,,$87.02,$0.00,1,1,1,0,0,1,20161001,,,,
J2850,HCPCS,INJ SECRETIN SYNTHETIC HUMAN,,,29,,NW,,,,,,$90.48,$0.00,1,1,1,0,0,1,20161001,,,,
J2860,HCPCS,"INJECTION, SILTUXIMAB",,,29,,NW,,,,,,$58.91,$0.00,1,1,1,0,0,1,20161001,,,,
J2910,HCPCS,AUROTHIOGLUCOSE INJECITON,,,29,,NW,,,,,,$83.47,$0.00,1,1,1,0,0,1,20161001,,,,
J2916,HCPCS,NA FERRIC GLUCONATE COMPLEX,,,29,,NW,,,,,,$13.51,$0.00,1,1,1,0,0,1,20161001,,,,
J2920,HCPCS,METHYLPREDNISOLONE INJECTION,,,29,,NW,,,,,,$9.47,$0.00,1,1,1,0,0,1,20161001,,,,
J2930,HCPCS,METHYLPREDNISOLONE INJECTION,,,29,,NW,,,,,,$13.51,$0.00,1,1,1,0,0,1,20161001,,,,
J2940,HCPCS,SOMATREM INJECTION,,,29,,NW,,,,,,$135.89,$0.00,1,1,1,0,0,1,20161001,,,,
J2941,HCPCS,SOMATROPIN INJECTION,,,29,,NW,,,,,,$122.47,$0.00,1,1,1,0,0,1,20161001,,,,
J2950,HCPCS,PROMAZINE HCL INJECTION,,,29,,NW,,,,,,$35.69,$0.00,1,1,1,0,0,1,20161001,,,,
J2993,HCPCS,RETEPLASE INJECTION,,,29,,NW,,,,,,"$5,574.18",$0.00,1,1,1,0,0,1,20161001,,,,
J2995,HCPCS,INJ STREPTOKINASE /250000 IU,,,29,,NW,,,,,,$196.85,$0.00,1,1,1,0,0,1,20161001,,,,
J2997,HCPCS,ALTEPLASE RECOMBINANT,,,29,,NW,,,,,,$171.77,$0.00,1,1,1,0,0,1,20161001,,,,
J3000,HCPCS,STREPTOMYCIN INJECTION,,,29,,NW,,,,,,$36.86,$0.00,1,1,1,0,0,1,20161001,,,,
J3010,HCPCS,FENTANYL CITRATE INJECITON,,,29,,NW,,,,,,$4.88,$0.00,1,1,1,0,0,1,20161001,,,,
J3030,HCPCS,SUMATRIPTAN SUCCINATE / 6 MG,,,29,,NW,,,,,,$144.96,$0.00,1,1,1,0,0,1,20161001,,,,
J3060,HCPCS,"INJ, TALIGLUCERACE ALFA 10 U",,,29,,NW,,,,,,$92.21,$0.00,1,1,1,0,0,1,20161001,,,,
J3070,HCPCS,PENTAZOCINE INJECTION,,,29,,NW,,,,,,$281.60,$0.00,1,1,1,0,0,1,20161001,,,,
J3095,HCPCS,TELAVANCIN INJECTION,,,29,,NW,,,,,,$17.83,$0.00,1,1,1,0,0,1,20161001,,,,
J3101,HCPCS,TENECTEPLASE INJECTION,,,29,,NW,,,,,,$215.01,$0.00,1,1,1,0,0,1,20161001,,,,
J3105,HCPCS,TERBUTALINE SULFATE INJ,,,29,,NW,,,,,,$17.83,$0.00,1,1,1,0,0,1,20161001,,,,
J3110,HCPCS,TERIPARATIDE INJECTION,,,29,,NW,,,,,,$27.35,$0.00,1,1,1,0,0,1,20161001,,,,
J3121,HCPCS,INJ TESTOSTERO ENANTHATE 1MG,,,29,,NW,,,,,,$3.37,$0.00,1,1,1,0,0,1,20161001,,,,
J3145,HCPCS,TESTOSTERONE UNDECANOATE 1MG,,,29,,NW,,,,,,$1.62,$0.00,1,1,1,0,0,1,20161001,,,,
J3230,HCPCS,CHLORPROMAZINE HCL INJECTION,,,29,,NW,,,,,,$64.53,$0.00,1,1,1,0,0,1,20161001,,,,
J3240,HCPCS,THYROTROPIN INJECTION,,,29,,NW,,,,,,"$3,462.33",$0.00,1,1,1,0,0,1,20161001,,,,
J3243,HCPCS,TIGECYCLINE INJECTION,,,29,,NW,,,,,,$9.47,$0.00,1,1,1,0,0,1,20161001,,,,
J3246,HCPCS,TIROFIBAN HCL,,,29,,NW,,,,,,$28.21,$0.00,1,1,1,0,0,1,20161001,,,,
J3250,HCPCS,TRIMETHOBENZAMIDE HCL INJ,,,29,,NW,,,,,,$56.75,$0.00,1,1,1,0,0,1,20161001,,,,
J3260,HCPCS,TOBRAMYCIN SULFATE INJECTION,,,29,,NW,,,,,,$13.51,$0.00,1,1,1,0,0,1,20161001,,,,
J3262,HCPCS,TOCILIZUMAB INJECTION,,,29,,NW,,,,,,$16.10,$0.00,1,1,1,0,0,1,20161001,,,,
J3265,HCPCS,INJECTION TORSEMIDE 10 MG/ML,,,29,,NW,,,,,,$15.07,$0.00,1,1,1,0,0,1,20161001,,,,
J3280,HCPCS,THIETHYLPERAZINE MALEATE INJ,,,29,,NW,,,,,,$18.70,$0.00,1,1,1,0,0,1,20161001,,,,
J3285,HCPCS,TREPROSTINIL INJECTION,,,29,,NW,,,,,,$154.47,$0.00,1,1,1,0,0,1,20161001,,,,
J3300,HCPCS,TRIAMCINOLONE A INJ PRS-FREE,,,29,,NW,,,,,,$15.24,$0.00,1,1,1,0,0,1,20161001,,,,
J3301,HCPCS,TRIAMCINOLONE ACET INJ NOS,,,29,,NW,,,,,,$9.03,$0.00,1,1,1,0,0,1,20161001,,,,
J3302,HCPCS,TRIAMCINOLONE DIACETATE INJ,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J3303,HCPCS,TRIAMCINOLONE HEXACETONL INJ,,,29,,NW,,,,,,$9.47,$0.00,1,1,1,0,0,1,20161001,,,,
J3305,HCPCS,INJ TRIMETREXATE GLUCORONATE,,,29,,NW,,,,,,$113.73,$0.00,1,1,1,0,0,1,20161001,,,,
J3310,HCPCS,PERPHENAZINE INJECITON,,,29,,NW,,,,,,$50.24,$0.00,1,1,1,0,0,1,20161001,,,,
J3315,HCPCS,TRIPTORELIN PAMOATE,,,29,,NW,,,,,,$416.51,$0.00,1,1,1,0,0,1,20161001,,,,
J3320,HCPCS,SPECTINOMYCN DI-HCL INJ,,,29,,NW,,,,,,$91.72,$0.00,1,1,1,0,0,1,20161001,,,,
J3350,HCPCS,UREA INJECTION,,,29,,NW,,,,,,$31.85,$0.00,1,1,1,0,0,1,20161001,,,,
J3355,HCPCS,"UROFOLLITROPIN, 75 IU",,,29,,NW,,,,,,$164.85,$0.00,1,1,1,0,0,1,20161001,,,,
J3357,HCPCS,USTEKINUMAB INJECTION,,,29,,NW,,,,,,$394.89,$0.00,1,1,1,0,0,1,20161001,,,,
J3360,HCPCS,DIAZEPAM INJECTION,,,29,,NW,,,,,,$17.83,$0.00,1,1,1,0,0,1,20161001,,,,
J3364,HCPCS,UROKINASE 5000 IU INJECTION,,,29,,NW,,,,,,$25.17,$0.00,1,1,1,0,0,1,20161001,,,,
J3365,HCPCS,"UROKINASE 250,000 IU INJ",,,29,,NW,,,,,,"$1,239.30",$0.00,1,1,1,0,0,1,20161001,,,,
J3370,HCPCS,VANCOMYCIN HCL INJECTION,,,29,,NW,,,,,,$11.78,$0.00,1,1,1,0,0,1,20161001,,,,
J3385,HCPCS,VELAGLUCERASE ALFA,,,29,,NW,,,,,,$860.15,$0.00,1,1,1,0,0,1,20161001,,,,
J3396,HCPCS,VERTEPORFIN INJECTION,,,29,,NW,,,,,,$32.53,$0.00,1,1,1,0,0,1,20161001,,,,
J3400,HCPCS,TRIFLUPROMAZINE HCL INJ,,,29,,NW,,,,,,$41.18,$0.00,1,1,1,0,0,1,20161001,,,,
J3410,HCPCS,HYDROXYZINE HCL INJECTION,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J3411,HCPCS,THIAMINE HCL 100 MG,,,29,,NW,,,,,,$15.24,$0.00,1,1,1,0,0,1,20161001,,,,
J3415,HCPCS,PYRIDOXINE HCL 100 MG,,,29,,NW,,,,,,$23.89,$0.00,1,1,1,0,0,1,20161001,,,,
J3420,HCPCS,VITAMIN B12 INJECTION,,,29,,NW,,,,,,$11.48,$0.00,1,1,1,0,0,1,20161001,,,,
J3430,HCPCS,VITAMIN K PHYTONADIONE INJ,,,29,,NW,,,,,,$8.90,$0.00,1,1,1,0,0,1,20161001,,,,
J3465,HCPCS,"INJECTION, VORICONAZOLE",,,29,,NW,,,,,,$15.24,$0.00,1,1,1,0,0,1,20161001,,,,
J3470,HCPCS,HYALURONIDASE INJECTION,,,29,,NW,,,,,,$67.99,$0.00,1,1,1,0,0,1,20161001,,,,
J3471,HCPCS,"OVINE, UP TO 999 USP UNITS",,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J3472,HCPCS,"OVINE, 1000 USP UNITS",,,29,,NW,,,,,,$291.11,$0.00,1,1,1,0,0,1,20161001,,,,
J3473,HCPCS,HYALURONIDASE RECOMBINANT,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J3475,HCPCS,INJ MAGNESIUM SULFATE,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J3480,HCPCS,INJ POTASSIUM CHLORIDE,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J3485,HCPCS,ZIDOVUDINE,,,29,,NW,,,,,,$7.89,$0.00,1,1,1,0,0,1,20161001,,,,
J3486,HCPCS,ZIPRASIDONE MESYLATE,,,29,,NW,,,,,,$36.86,$0.00,1,1,1,0,0,1,20161001,,,,
J3489,HCPCS,ZOLEDRONIC ACID 1MG,,,29,,NW,,,,,,$106.04,$0.00,1,1,1,0,0,1,20161001,,,,
J3490,HCPCS,DRUGS UNCLASSIFIED INJECTION,,,29,,NW,,,,,,$0.69,$0.00,1,1,1,0,0,1,20161001,,,,
J3520,HCPCS,EDETATE DISODIUM PER 150 MG,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J3530,HCPCS,NASAL VACCINE INHALATION,,,29,,NW,,,,,,$55.20,$0.00,1,1,1,0,1,1,20161001,,,,
J3535,HCPCS,METERED DOSE INHALER DRUG,,,29,,NW,,,,,,$12.85,$0.00,1,1,1,0,0,1,20161001,,,,
J3570,HCPCS,LAETRILE AMYGDALIN VIT B17,,,29,,NW,,,,,,$58.63,$0.00,1,1,1,0,0,1,20161001,,,,
J3590,HCPCS,UNCLASSIFIED BIOLOGICS,,,29,,NW,,,,,,$109.03,$0.00,1,1,1,0,0,1,20161001,,,,
J7030,HCPCS,NORMAL SALINE SOLUTION INFUS,,,29,,NW,,,,,,$7.89,$0.00,1,1,1,0,0,1,20161001,,,,
J7040,HCPCS,NORMAL SALINE SOLUTION INFUS,,,29,,NW,,,,,,$5.59,$0.00,1,1,1,0,0,1,20161001,,,,
J7042,HCPCS,5% DEXTROSE/NORMAL SALINE,,,29,,NW,,,,,,$5.59,$0.00,1,1,1,0,0,1,20161001,,,,
J7050,HCPCS,NORMAL SALINE SOLUTION INFUS,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J7060,HCPCS,5% DEXTROSE/WATER,,,29,,NW,,,,,,$7.17,$0.00,1,1,1,0,0,1,20161001,,,,
J7070,HCPCS,D5W INFUSION,,,29,,NW,,,,,,$12.64,$0.00,1,1,1,0,0,1,20161001,,,,
J7100,HCPCS,DEXTRAN 40 INFUSION,,,29,,NW,,,,,,$49.83,$0.00,1,1,1,0,0,1,20161001,,,,
J7110,HCPCS,DEXTRAN 75 INFUSION,,,29,,NW,,,,,,$95.25,$0.00,1,1,1,0,0,1,20161001,,,,
J7120,HCPCS,RINGERS LACTATE INFUSION,,,29,,NW,,,,,,$7.17,$0.00,1,1,1,0,0,1,20161001,,,,
J7131,HCPCS,HYPERTONIC SALINE SOL,,,29,,NW,,,,,,$6.18,$0.00,1,1,1,0,0,1,20161001,,,,
J7178,HCPCS,HUMAN FIBRINOGEN CONC INJ,,,29,,NW,,,,,,$0.99,$0.00,1,1,1,0,0,1,20161001,,,,
J7180,HCPCS,FACTOR XIII ANTI-HEM FACTOR,,,29,,NW,,,,,,$23.89,$0.00,1,1,1,0,0,1,20161001,,,,
J7181,HCPCS,FACTOR XIII RECOMB A-SUBUNIT,,,29,,NW,,,,,,$19.42,$0.00,1,1,1,0,0,1,20161001,,,,
J7183,HCPCS,WILATE INJECTION,,,29,,NW,,,,,,$6.74,$0.00,1,1,1,0,0,1,20161001,,,,
J7185,HCPCS,XYNTHA INJ,,,29,,NW,,,,,,$6.74,$0.00,1,1,1,0,0,1,20161001,,,,
J7186,HCPCS,ANTIHEMOPHILIC VIII/VWF COMP,,,29,,NW,,,,,,$6.74,$0.00,1,1,1,0,0,1,20161001,,,,
J7187,HCPCS,"HUMATE-P, INJ",,,29,,NW,,,,,,$6.74,$0.00,1,1,1,0,0,1,20161001,,,,
J7189,HCPCS,FACTOR VIIA,,,29,,NW,,,,,,$9.03,$0.00,1,1,1,0,0,1,20161001,,,,
J7190,HCPCS,FACTOR VIII,,,29,,NW,,,,,,$6.74,$0.00,1,1,1,0,0,1,20161001,,,,
J7191,HCPCS,FACTOR VIII (PORCINE),,,29,,NW,,,,,,$6.64,$0.00,1,1,1,0,0,1,20161001,,,,
J7192,HCPCS,FACTOR VIII RECOMBINANT NOS,,,29,,NW,,,,,,$6.74,$0.00,1,1,1,0,0,1,20161001,,,,
J7193,HCPCS,FACTOR IX NON-RECOMBINANT,,,29,,NW,,,,,,$6.74,$0.00,1,1,1,0,0,1,20161001,,,,
J7194,HCPCS,FACTOR IX COMPLEX,,,29,,NW,,,,,,$6.74,$0.00,1,1,1,0,0,1,20161001,,,,
J7195,HCPCS,FACTOR IX RECOMBINANT NOS,,,29,,NW,,,,,,$7.89,$0.00,1,1,1,0,0,1,20161001,,,,
J7196,HCPCS,ANTITHROMBIN RECOMBINANT,,,29,,NW,,,,,,$8.77,$0.00,1,1,1,0,0,1,20161001,,,,
J7197,HCPCS,ANTITHROMBIN III INJECTION,,,29,,NW,,,,,,$14.37,$0.00,1,1,1,0,0,1,20161001,,,,
J7198,HCPCS,ANTI-INHIBITOR,,,29,,NW,,,,,,$9.03,$0.00,1,1,1,0,0,1,20161001,,,,
J7199,HCPCS,HEMOPHILIA CLOT FACTOR NOC,,,29,,NW,,,,,,$1.45,$0.00,1,1,1,0,0,1,20161001,,,,
J7200,HCPCS,FACTOR IX RECOMBINAN RIXUBIS,,,29,,NW,,,,,,$7.09,$0.00,1,1,1,0,0,1,20161001,,,,
J7201,HCPCS,FACTOR IX FC FUSION RECOMB,,,29,,NW,,,,,,$13.51,$0.00,1,1,1,0,0,1,20161001,,,,
J7205,HCPCS,FACTOR VIII FC FUSION RECOMB,,,29,,NW,,,,,,$14.16,$0.00,1,1,1,0,0,1,20161001,,,,
J7297,HCPCS,LEVONORGESTREL IU 52MG 3 YR,,,29,,NW,,,,,,"$1,011.49",$0.00,1,1,1,0,0,1,20161001,,,,
J7298,HCPCS,LEVONORGESTREL IU 52MG 5 YR,,,29,,NW,,,,,,"$1,011.49",$0.00,1,1,1,0,0,1,20161001,,,,
J7300,HCPCS,INTRAUT COPPER CONTRACEPTIVE,,,29,,NW,,,,,,$971.71,$0.00,1,1,1,1,1,1,20161001,,,,
J7301,HCPCS,LEVONORGESTREL IU 13.5 MG,,,29,,NW,,,,,,"$1,452.52",$0.00,1,1,1,1,1,1,20161001,,,,
J7303,HCPCS,CONTRACEPTIVE VAGINAL RING,,,29,,NW,,,,,,$99.99,$0.00,1,1,1,1,1,1,20161001,,,,
J7304,HCPCS,CONTRACEPTIVE HORMONE PATCH,,,29,,NW,,,,,,$66.61,$0.00,1,1,1,1,1,1,20161001,,,,
J7306,HCPCS,LEVONORGESTREL IMPLANT SYS,,,29,,NW,,,,,,"$1,011.49",$0.00,1,1,1,1,1,1,20161001,,,,
J7307,HCPCS,ETONOGESTREL IMPLANT SYSTEM,,,29,,NW,,,,,,"$1,373.82",$0.00,1,1,1,1,1,1,20161001,,,,
J7308,HCPCS,AMINOLEVULINIC ACID HCL TOP,,,29,,NW,,,,,,$597.25,$0.00,1,1,1,0,0,1,20161001,,,,
J7309,HCPCS,"METHYL AMINOLEVULINATE, TOP",,,29,,NW,,,,,,$213.31,$0.00,1,1,1,0,0,1,20161001,,,,
J7310,HCPCS,GANCICLOVIR LONG ACT IMPLANT,,,29,,NW,,,,,,"$41,027.54",$0.00,1,1,1,0,0,1,20161001,,,,
J7311,HCPCS,FLUOCINOLONE ACETONIDE IMPLT,,,29,,NW,,,,,,"$47,716.77",$0.00,1,1,1,0,0,1,20161001,,,,
J7312,HCPCS,DEXAMETHASONE INTRA IMPLANT,,,29,,NW,,,,,,$493.47,$0.00,1,1,1,0,0,1,20161001,,,,
J7313,HCPCS,FLUOCINOL ACET INTRAVIT IMP,,,29,,NW,,,,,,"$3,202.23",$0.00,1,1,1,0,0,1,20161001,,,,
J7315,HCPCS,OPHTHALMIC MITOMYCIN,,,29,,NW,,,,,,$553.22,$0.00,1,1,1,0,0,1,20161001,,,,
J7316,HCPCS,"INJ, OCRIPLASMIN, 0.125 MG",,,29,,NW,,,,,,"$2,538.73",$0.00,1,1,1,0,0,1,20161001,,,,
J7321,HCPCS,HYALGAN/SUPARTZ INJ PER DOSE,,,29,,NW,,,,,,$221.93,$0.00,1,1,1,0,0,1,20161001,,,,
J7323,HCPCS,EUFLEXXA INJ PER DOSE,,,29,,NW,,,,,,$380.18,$0.00,1,1,1,0,0,1,20161001,,,,
J7324,HCPCS,ORTHOVISC INJ PER DOSE,,,29,,NW,,,,,,$429.48,$0.00,1,1,1,0,0,1,20161001,,,,
J7325,HCPCS,SYNVISC OR SYNVISC-ONE,,,29,,NW,,,,,,$37.72,$0.00,1,1,1,0,0,1,20161001,,,,
J7326,HCPCS,GEL-ONE,,,29,,NW,,,,,,"$1,370.38",$0.00,1,1,1,0,0,1,20161001,,,,
J7327,HCPCS,MONOVISC INJ PER DOSE,,,29,,NW,,,,,,"$2,396.90",$0.00,1,1,1,0,0,1,20161001,,,,
J7330,HCPCS,CULTURED CHONDROCYTES IMPLNT,,,29,,NW,,,,,,"$75,285.98",$0.00,1,1,1,0,0,1,20161001,,,,
J7336,HCPCS,CAPSAICIN 8% PATCH,,,29,,NW,,,,,,$10.41,$0.00,1,1,1,0,0,1,20161001,,,,
J7500,HCPCS,AZATHIOPRINE ORAL 50MG,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J7501,HCPCS,AZATHIOPRINE PARENTERAL,,,29,,NW,,,,,,$532.39,$0.00,1,1,1,0,0,1,20161001,,,,
J7502,HCPCS,CYCLOSPORINE ORAL 100 MG,,,29,,NW,,,,,,$15.24,$0.00,1,1,1,0,0,1,20161001,,,,
J7504,HCPCS,LYMPHOCYTE IMMUNE GLOBULIN,,,29,,NW,,,,,,"$2,188.48",$0.00,1,1,1,0,0,1,20161001,,,,
J7505,HCPCS,MONOCLONAL ANTIBODIES,,,29,,NW,,,,,,"$2,328.58",$0.00,1,1,1,0,0,1,20161001,,,,
J7507,HCPCS,TACROLIMUS IMME REL ORAL 1MG,,,29,,NW,,,,,,$7.45,$0.00,1,1,1,0,0,1,20161001,,,,
J7508,HCPCS,TACROL ASTAGRAF EX REL ORAL,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J7509,HCPCS,METHYLPREDNISOLONE ORAL,,,29,,NW,,,,,,$4.16,$0.00,1,1,1,0,0,1,20161001,,,,
J7510,HCPCS,PREDNISOLONE ORAL PER 5 MG,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J7511,HCPCS,ANTITHYMOCYTE GLOBULN RABBIT,,,29,,NW,,,,,,"$1,430.92",$0.00,1,1,1,0,0,1,20161001,,,,
J7513,HCPCS,"DACLIZUMAB, PARENTERAL",,,29,,NW,,,,,,"$1,008.89",$0.00,1,1,1,0,0,1,20161001,,,,
J7515,HCPCS,CYCLOSPORINE ORAL 25 MG,,,29,,NW,,,,,,$5.59,$0.00,1,1,1,0,0,1,20161001,,,,
J7516,HCPCS,CYCLOSPORIN PARENTERAL 250MG,,,29,,NW,,,,,,$86.15,$0.00,1,1,1,0,0,1,20161001,,,,
J7517,HCPCS,MYCOPHENOLATE MOFETIL ORAL,,,29,,NW,,,,,,$7.89,$0.00,1,1,1,0,0,1,20161001,,,,
J7518,HCPCS,MYCOPHENOLIC ACID,,,29,,NW,,,,,,$14.37,$0.00,1,1,1,0,0,1,20161001,,,,
J7520,HCPCS,"SIROLIMUS, ORAL",,,29,,NW,,,,,,$48.10,$0.00,1,1,1,0,0,1,20161001,,,,
J7525,HCPCS,TACROLIMUS INJECTION,,,29,,NW,,,,,,$367.21,$0.00,1,1,1,0,0,1,20161001,,,,
J7527,HCPCS,ORAL EVEROLIMUS,,,29,,NW,,,,,,$23.02,$0.00,1,1,1,0,0,1,20161001,,,,
J7599,HCPCS,IMMUNOSUPPRESSIVE DRUG NOC,,,29,,NW,,,,,,$8.39,$0.00,1,1,1,0,0,1,20161001,,,,
J7604,HCPCS,ACETYLCYSTEINE COMP UNIT,,,29,,NW,,,,,,$16.74,$0.00,1,1,1,0,0,1,20161001,,,,
J7605,HCPCS,ARFORMOTEROL NON-COMP UNIT,,,29,,NW,,,,,,$23.89,$0.00,1,1,1,0,0,1,20161001,,,,
J7606,HCPCS,"FORMOTEROL FUMARATE, INH",,,29,,NW,,,,,,$25.62,$0.00,1,1,1,0,0,1,20161001,,,,
J7607,HCPCS,LEVALBUTEROL COMP CON,,,29,,NW,,,,,,$34.89,$0.00,1,1,1,0,0,1,20161001,,,,
J7608,HCPCS,ACETYLCYSTEINE NON-COMP UNIT,,,29,,NW,,,,,,$19.56,$0.00,1,1,1,0,0,1,20161001,,,,
J7609,HCPCS,ALBUTEROL COMP UNIT,,,29,,NW,,,,,,$14.54,$0.00,1,1,1,0,0,1,20161001,,,,
J7610,HCPCS,ALBUTEROL COMP CON,,,29,,NW,,,,,,$14.54,$0.00,1,1,1,0,0,1,20161001,,,,
J7611,HCPCS,ALBUTEROL NON-COMP CON,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J7612,HCPCS,LEVALBUTEROL NON-COMP CON,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J7613,HCPCS,ALBUTEROL NON-COMP UNIT,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J7614,HCPCS,LEVALBUTEROL NON-COMP UNIT,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J7615,HCPCS,LEVALBUTEROL COMP UNIT,,,29,,NW,,,,,,$11.78,$0.00,1,1,1,0,0,1,20161001,,,,
J7620,HCPCS,ALBUTEROL IPRATROP NON-COMP,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J7622,HCPCS,BECLOMETHASONE COMP UNIT,,,29,,NW,,,,,,$15.16,$0.00,1,1,1,0,0,1,20161001,,,,
J7624,HCPCS,BETAMETHASONE COMP UNIT,,,29,,NW,,,,,,$4.39,$0.00,1,1,1,0,0,1,20161001,,,,
J7626,HCPCS,BUDESONIDE NON-COMP UNIT,,,29,,NW,,,,,,$19.56,$0.00,1,1,1,0,0,1,20161001,,,,
J7627,HCPCS,BUDESONIDE COMP UNIT,,,29,,NW,,,,,,$18.70,$0.00,1,1,1,0,0,1,20161001,,,,
J7628,HCPCS,BITOLTEROL MESYLATE COMP CON,,,29,,NW,,,,,,$6.16,$0.00,1,1,1,0,0,1,20161001,,,,
J7629,HCPCS,BITOLTEROL MESYLATE COMP UNT,,,29,,NW,,,,,,$6.16,$0.00,1,1,1,0,0,1,20161001,,,,
J7631,HCPCS,CROMOLYN SODIUM NONCOMP UNIT,,,29,,NW,,,,,,$4.88,$0.00,1,1,1,0,0,1,20161001,,,,
J7632,HCPCS,CROMOLYN SODIUM COMP UNIT,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J7633,HCPCS,BUDESONIDE NON-COMP CON,,,29,,NW,,,,,,$28.36,$0.00,1,1,1,0,0,1,20161001,,,,
J7634,HCPCS,BUDESONIDE COMP CON,,,29,,NW,,,,,,$51.19,$0.00,1,1,1,0,0,1,20161001,,,,
J7635,HCPCS,ATROPINE COMP CON,,,29,,NW,,,,,,$38.33,$0.00,1,1,1,0,0,1,20161001,,,,
J7636,HCPCS,ATROPINE COMP UNIT,,,29,,NW,,,,,,$28.77,$0.00,1,1,1,0,0,1,20161001,,,,
J7637,HCPCS,DEXAMETHASONE COMP CON,,,29,,NW,,,,,,$1.07,$0.00,1,1,1,0,0,1,20161001,,,,
J7638,HCPCS,DEXAMETHASONE COMP UNIT,,,29,,NW,,,,,,$1.07,$0.00,1,1,1,0,0,1,20161001,,,,
J7639,HCPCS,DORNASE ALFA NON-COMP UNIT,,,29,,NW,,,,,,$93.07,$0.00,1,1,1,0,0,1,20161001,,,,
J7640,HCPCS,FORMOTEROL COMP UNIT,,,29,,NW,,,,,,$21.13,$0.00,1,1,1,0,0,1,20161001,,,,
J7641,HCPCS,FLUNISOLIDE COMP UNIT,,,29,,NW,,,,,,$33.40,$0.00,1,1,1,0,0,1,20161001,,,,
J7642,HCPCS,GLYCOPYRROLATE COMP CON,,,29,,NW,,,,,,$0.79,$0.00,1,1,1,0,0,1,20161001,,,,
J7643,HCPCS,GLYCOPYRROLATE COMP UNIT,,,29,,NW,,,,,,$0.79,$0.00,1,1,1,0,0,1,20161001,,,,
J7644,HCPCS,IPRATROPIUM BROMIDE NON-COMP,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J7645,HCPCS,IPRATROPIUM BROMIDE COMP,,,29,,NW,,,,,,$7.27,$0.00,1,1,1,0,0,1,20161001,,,,
J7647,HCPCS,ISOETHARINE COMP CON,,,29,,NW,,,,,,$6.68,$0.00,1,1,1,0,0,1,20161001,,,,
J7648,HCPCS,ISOETHARINE NON-COMP CON,,,29,,NW,,,,,,$2.26,$0.00,1,1,1,0,0,1,20161001,,,,
J7649,HCPCS,ISOETHARINE NON-COMP UNIT,,,29,,NW,,,,,,$2.26,$0.00,1,1,1,0,0,1,20161001,,,,
J7650,HCPCS,ISOETHARINE COMP UNIT,,,29,,NW,,,,,,$6.68,$0.00,1,1,1,0,0,1,20161001,,,,
J7657,HCPCS,ISOPROTERENOL COMP CON,,,29,,NW,,,,,,$9.09,$0.00,1,1,1,0,0,1,20161001,,,,
J7658,HCPCS,ISOPROTERENOL NON-COMP CON,,,29,,NW,,,,,,$12.49,$0.00,1,1,1,0,0,1,20161001,,,,
J7659,HCPCS,ISOPROTERENOL NON-COMP UNIT,,,29,,NW,,,,,,$12.49,$0.00,1,1,1,0,0,1,20161001,,,,
J7660,HCPCS,ISOPROTERENOL COMP UNIT,,,29,,NW,,,,,,$1.51,$0.00,1,1,1,0,0,1,20161001,,,,
J7665,HCPCS,MANNITOL FOR INHALER,,,29,,NW,,,,,,$5.59,$0.00,1,1,1,0,0,1,20161001,,,,
J7667,HCPCS,METAPROTERENOL COMP CON,,,29,,NW,,,,,,$12.12,$0.00,1,1,1,0,0,1,20161001,,,,
J7668,HCPCS,METAPROTERENOL NON-COMP CON,,,29,,NW,,,,,,$0.26,$0.00,1,1,1,0,0,1,20161001,,,,
J7669,HCPCS,METAPROTERENOL NON-COMP UNIT,,,29,,NW,,,,,,$1.24,$0.00,1,1,1,0,0,1,20161001,,,,
J7670,HCPCS,METAPROTERENOL COMP UNIT,,,29,,NW,,,,,,$7.86,$0.00,1,1,1,0,0,1,20161001,,,,
J7674,HCPCS,"METHACHOLINE CHLORIDE, NEB",,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J7676,HCPCS,PENTAMIDINE COMP UNIT DOSE,,,29,,NW,,,,,,$549.78,$0.00,1,1,1,0,0,1,20161001,,,,
J7680,HCPCS,TERBUTALINE SULF COMP CON,,,29,,NW,,,,,,$40.32,$0.00,1,1,1,0,0,1,20161001,,,,
J7681,HCPCS,TERBUTALINE SULF COMP UNIT,,,29,,NW,,,,,,$40.32,$0.00,1,1,1,0,0,1,20161001,,,,
J7682,HCPCS,TOBRAMYCIN NON-COMP UNIT,,,29,,NW,,,,,,$222.79,$0.00,1,1,1,0,0,1,20161001,,,,
J7683,HCPCS,TRIAMCINOLONE COMP CON,,,29,,NW,,,,,,$18.70,$0.00,1,1,1,0,0,1,20161001,,,,
J7684,HCPCS,TRIAMCINOLONE COMP UNIT,,,29,,NW,,,,,,$11.42,$0.00,1,1,1,0,0,1,20161001,,,,
J7685,HCPCS,TOBRAMYCIN COMP UNIT,,,29,,NW,,,,,,$161.39,$0.00,1,1,1,0,0,1,20161001,,,,
J7686,HCPCS,"TREPROSTINIL, NON-COMP UNIT",,,29,,NW,,,,,,"$1,174.94",$0.00,1,1,1,0,0,1,20161001,,,,
J7699,HCPCS,INHALATION SOLUTION FOR DME,,,29,,NW,,,,,,$5.21,$0.00,1,1,1,0,0,1,20161001,,,,
J7799,HCPCS,NON-INHALATION DRUG FOR DME,,,29,,NW,,,,,,$10.18,$0.00,1,1,1,0,0,1,20161001,,,,
J7999,HCPCS,"COMPOUNDED DRUG, NOC",,,29,,NW,,,,,,$2.92,$0.00,1,1,1,0,0,1,20161001,,,,
J8498,HCPCS,ANTIEMETIC RECTAL/SUPP NOS,,,29,,NW,,,,,,$1.45,$0.00,1,1,1,0,0,1,20161001,,,,
J8499,HCPCS,ORAL PRESCRIP DRUG NON CHEMO,,,29,,NW,,,,,,$1.45,$0.00,1,1,1,0,0,1,20161001,,,,
J8501,HCPCS,ORAL APREPITANT,,,29,,NW,,,,,,$24.75,$0.00,1,1,1,0,0,1,20161001,,,,
J8510,HCPCS,ORAL BUSULFAN,,,29,,NW,,,,,,$59.10,$0.00,1,1,1,0,0,1,20161001,,,,
J8515,HCPCS,"CABERGOLINE, ORAL 0.25MG",,,29,,NW,,,,,,$42.91,$0.00,1,1,1,0,0,1,20161001,,,,
J8520,HCPCS,"CAPECITABINE, ORAL, 150 MG",,,29,,NW,,,,,,$38.84,$0.00,1,1,1,0,0,1,20161001,,,,
J8521,HCPCS,"CAPECITABINE, ORAL, 500 MG",,,29,,NW,,,,,,$113.86,$0.00,1,1,1,0,0,1,20161001,,,,
J8530,HCPCS,CYCLOPHOSPHAMIDE ORAL 25 MG,,,29,,NW,,,,,,$13.58,$0.00,1,1,1,0,0,1,20161001,,,,
J8540,HCPCS,ORAL DEXAMETHASONE,,,29,,NW,,,,,,$2.80,$0.00,1,1,1,0,0,1,20161001,,,,
J8560,HCPCS,ETOPOSIDE ORAL 50 MG,,,29,,NW,,,,,,$218.10,$0.00,1,1,1,0,0,1,20161001,,,,
J8562,HCPCS,ORAL FLUDARABINE PHOSPHATE,,,29,,NW,,,,,,$271.13,$0.00,1,1,1,0,0,1,20161001,,,,
J8565,HCPCS,GEFITINIB ORAL,,,29,,NW,,,,,,$144.96,$0.00,1,1,1,0,0,1,20161001,,,,
J8597,HCPCS,ANTIEMETIC DRUG ORAL NOS,,,29,,NW,,,,,,$139.92,$0.00,1,1,1,0,0,1,20161001,,,,
J8600,HCPCS,MELPHALAN ORAL 2 MG,,,29,,NW,,,,,,$45.59,$0.00,1,1,1,0,0,1,20161001,,,,
J8610,HCPCS,METHOTREXATE ORAL 2.5 MG,,,29,,NW,,,,,,$8.44,$0.00,1,1,1,0,0,1,20161001,,,,
J8650,HCPCS,NABILONE ORAL,,,29,,NW,,,,,,$47.24,$0.00,1,1,1,0,0,1,20161001,,,,
J8655,HCPCS,NETUPITANT PALONOSETRON ORAL,,,29,,NW,,,,,,"$3,232.24",$0.00,1,1,1,0,0,1,20161001,,,,
J8700,HCPCS,TEMOZOLOMIDE,,,29,,NW,,,,,,$16.89,$0.00,1,1,1,0,0,1,20161001,,,,
J8705,HCPCS,TOPOTECAN ORAL,,,29,,NW,,,,,,$357.90,$0.00,1,1,1,0,0,1,20161001,,,,
J8999,HCPCS,ORAL PRESCRIPTION DRUG CHEMO,,,29,,NW,,,,,,$50.99,$0.00,1,1,1,0,0,1,20161001,,,,
J9000,HCPCS,DOXORUBICIN HCL INJECTION,,,29,,NW,,,,,,$16.89,$0.00,1,1,1,0,0,1,20161001,,,,
J9015,HCPCS,ALDESLEUKIN INJECTION,,,29,,NW,,,,,,"$1,925.14",$0.00,1,1,1,0,0,1,20161001,,,,
J9017,HCPCS,ARSENIC TRIOXIDE INJECTION,,,29,,NW,,,,,,$207.06,$0.00,1,1,1,0,0,1,20161001,,,,
J9019,HCPCS,ERWINAZE INJECTION,,,29,,NW,,,,,,"$1,260.45",$0.00,1,1,1,0,0,1,20161001,,,,
J9020,HCPCS,"ASPARAGINASE, NOS",,,29,,NW,,,,,,$245.08,$0.00,1,1,1,0,0,1,20161001,,,,
J9025,HCPCS,AZACITIDINE INJECTION,,,29,,NW,,,,,,$16.89,$0.00,1,1,1,0,0,1,20161001,,,,
J9027,HCPCS,CLOFARABINE INJECTION,,,29,,NW,,,,,,$330.89,$0.00,1,1,1,0,0,1,20161001,,,,
J9031,HCPCS,BCG LIVE INTRAVESICAL VAC,,,29,,NW,,,,,,$436.38,$0.00,1,1,1,0,0,1,20161001,,,,
J9032,HCPCS,"INJECTION, BELINOSTAT, 10MG",,,29,,NW,,,,,,$214.24,$0.00,1,1,1,0,0,1,20161001,,,,
J9033,HCPCS,BENDAMUSTINE INJECTION,,,29,,NW,,,,,,$101.60,$0.00,1,1,1,0,0,1,20161001,,,,
J9035,HCPCS,BEVACIZUMAB INJECTION,,,29,,NW,,,,,,$170.90,$0.00,1,1,1,0,0,1,20161001,,,,
J9039,HCPCS,"INJECTION, BLINATUMOMAB",,,29,,NW,,,,,,$645.70,$0.00,1,1,1,0,0,1,20161001,,,,
J9040,HCPCS,BLEOMYCIN SULFATE INJECTION,,,29,,NW,,,,,,$102.83,$0.00,1,1,1,0,0,1,20161001,,,,
J9041,HCPCS,BORTEZOMIB INJECTION,,,29,,NW,,,,,,$119.01,$0.00,1,1,1,0,0,1,20161001,,,,
J9042,HCPCS,BRENTUXIMAB VEDOTIN INJ,,,29,,NW,,,,,,$419.21,$0.00,1,1,1,0,0,1,20161001,,,,
J9043,HCPCS,CABAZITAXEL INJECTION,,,29,,NW,,,,,,$511.18,$0.00,1,1,1,0,0,1,20161001,,,,
J9045,HCPCS,CARBOPLATIN INJECTION,,,29,,NW,,,,,,$16.89,$0.00,1,1,1,0,0,1,20161001,,,,
J9047,HCPCS,"INJECTION, CARFILZOMIB, 1 MG",,,29,,NW,,,,,,$126.13,$0.00,1,1,1,0,0,1,20161001,,,,
J9050,HCPCS,CARMUSTINE INJECTION,,,29,,NW,,,,,,"$3,755.95",$0.00,1,1,1,0,0,1,20161001,,,,
J9055,HCPCS,CETUXIMAB INJECTION,,,29,,NW,,,,,,$136.31,$0.00,1,1,1,0,0,1,20161001,,,,
J9060,HCPCS,CISPLATIN 10 MG INJECTION,,,29,,NW,,,,,,$10.13,$0.00,1,1,1,0,0,1,20161001,,,,
J9065,HCPCS,INJ CLADRIBINE PER 1 MG,,,29,,NW,,,,,,$97.92,$0.00,1,1,1,0,0,1,20161001,,,,
J9070,HCPCS,CYCLOPHOSPHAMIDE 100 MG INJ,,,29,,NW,,,,,,$221.78,$0.00,1,1,1,0,0,1,20161001,,,,
J9098,HCPCS,CYTARABINE LIPOSOME INJ,,,29,,NW,,,,,,"$1,359.14",$0.00,1,1,1,0,0,1,20161001,,,,
J9100,HCPCS,CYTARABINE HCL 100 MG INJ,,,29,,NW,,,,,,$5.07,$0.00,1,1,1,0,0,1,20161001,,,,
J9120,HCPCS,DACTINOMYCIN INJECTION,,,29,,NW,,,,,,"$1,943.35",$0.00,1,1,1,0,0,1,20161001,,,,
J9130,HCPCS,DACARBAZINE 100 MG INJ,,,29,,NW,,,,,,$20.26,$0.00,1,1,1,0,0,1,20161001,,,,
J9150,HCPCS,DAUNORUBICIN INJECTION,,,29,,NW,,,,,,$117.54,$0.00,1,1,1,0,0,1,20161001,,,,
J9151,HCPCS,DAUNORUBICIN CITRATE INJ,,,29,,NW,,,,,,$219.32,$0.00,1,1,1,0,0,1,20161001,,,,
J9155,HCPCS,DEGARELIX INJECTION,,,29,,NW,,,,,,$15.24,$0.00,1,1,1,0,0,1,20161001,,,,
J9160,HCPCS,DENILEUKIN DIFTITOX INJ,,,29,,NW,,,,,,"$3,372.39",$0.00,1,1,1,0,0,1,20161001,,,,
J9165,HCPCS,DIETHYLSTILBESTROL INJECTION,,,29,,NW,,,,,,$62.19,$0.00,1,1,1,0,0,1,20161001,,,,
J9171,HCPCS,DOCETAXEL INJECTION,,,29,,NW,,,,,,$16.10,$0.00,1,1,1,0,0,1,20161001,,,,
J9175,HCPCS,ELLIOTTS B SOLUTION PER ML,,,29,,NW,,,,,,$16.10,$0.00,1,1,1,0,0,1,20161001,,,,
J9178,HCPCS,"INJ, EPIRUBICIN HCL, 2 MG",,,29,,NW,,,,,,$7.89,$0.00,1,1,1,0,0,1,20161001,,,,
J9179,HCPCS,ERIBULIN MESYLATE INJECTION,,,29,,NW,,,,,,$366.48,$0.00,1,1,1,0,0,1,20161001,,,,
J9181,HCPCS,ETOPOSIDE INJECTION,,,29,,NW,,,,,,$3.38,$0.00,1,1,1,0,0,1,20161001,,,,
J9185,HCPCS,FLUDARABINE PHOSPHATE INJ,,,29,,NW,,,,,,$328.47,$0.00,1,1,1,0,0,1,20161001,,,,
J9190,HCPCS,FLUOROURACIL INJECTION,,,29,,NW,,,,,,$10.13,$0.00,1,1,1,0,0,1,20161001,,,,
J9200,HCPCS,FLOXURIDINE INJECTION,,,29,,NW,,,,,,$230.36,$0.00,1,1,1,0,0,1,20161001,,,,
J9201,HCPCS,GEMCITABINE HCL INJECTION,,,29,,NW,,,,,,$33.77,$0.00,1,1,1,0,0,1,20161001,,,,
J9202,HCPCS,GOSERELIN ACETATE IMPLANT,,,29,,NW,,,,,,$811.63,$0.00,1,1,1,0,0,1,20161001,,,,
J9206,HCPCS,IRINOTECAN INJECTION,,,29,,NW,,,,,,$20.26,$0.00,1,1,1,0,0,1,20161001,,,,
J9207,HCPCS,IXABEPILONE INJECTION,,,29,,NW,,,,,,$268.38,$0.00,1,1,1,0,0,1,20161001,,,,
J9208,HCPCS,IFOSFAMIDE INJECTION,,,29,,NW,,,,,,$128.58,$0.00,1,1,1,0,0,1,20161001,,,,
J9209,HCPCS,MESNA INJECTION,,,29,,NW,,,,,,$13.51,$0.00,1,1,1,0,0,1,20161001,,,,
J9211,HCPCS,IDARUBICIN HCL INJECTION,,,29,,NW,,,,,,$167.82,$0.00,1,1,1,0,0,1,20161001,,,,
J9212,HCPCS,INTERFERON ALFACON-1 INJ,,,29,,NW,,,,,,$23.02,$0.00,1,1,1,0,0,1,20161001,,,,
J9213,HCPCS,INTERFERON ALFA-2A INJ,,,29,,NW,,,,,,$151.88,$0.00,1,1,1,0,0,1,20161001,,,,
J9214,HCPCS,INTERFERON ALFA-2B INJ,,,29,,NW,,,,,,$96.69,$0.00,1,1,1,0,0,1,20161001,,,,
J9215,HCPCS,INTERFERON ALFA-N3 INJ,,,29,,NW,,,,,,$85.66,$0.00,1,1,1,0,0,1,20161001,,,,
J9216,HCPCS,INTERFERON GAMMA 1-B INJ,,,29,,NW,,,,,,"$1,120.66",$0.00,1,1,1,0,0,1,20161001,,,,
J9217,HCPCS,LEUPROLIDE ACETATE SUSPNSION,,,29,,NW,,,,,,$836.15,$0.00,1,1,1,0,0,1,20161001,,,,
J9218,HCPCS,LEUPROLIDE ACETATE INJECITON,,,29,,NW,,,,,,$33.77,$0.00,1,1,1,0,0,1,20161001,,,,
J9219,HCPCS,LEUPROLIDE ACETATE IMPLANT,,,29,,NW,,,,,,"$6,913.10",$0.00,1,1,1,0,0,1,20161001,,,,
J9225,HCPCS,VANTAS IMPLANT,,,29,,NW,,,,,,"$5,326.40",$0.00,1,1,1,0,0,1,20161001,,,,
J9226,HCPCS,SUPPRELIN LA IMPLANT,,,29,,NW,,,,,,"$31,731.62",$0.00,1,1,1,0,0,1,20161001,,,,
J9228,HCPCS,IPILIMUMAB INJECTION,,,29,,NW,,,,,,$481.75,$0.00,1,1,1,0,0,1,20161001,,,,
J9230,HCPCS,MECHLORETHAMINE HCL INJ,,,29,,NW,,,,,,$689.00,$0.00,1,1,1,0,0,1,20161001,,,,
J9245,HCPCS,INJ MELPHALAN HYDROCHL 50 MG,,,29,,NW,,,,,,"$2,691.89",$0.00,1,1,1,0,0,1,20161001,,,,
J9250,HCPCS,METHOTREXATE SODIUM INJ,,,29,,NW,,,,,,$1.69,$0.00,1,1,1,0,0,1,20161001,,,,
J9260,HCPCS,METHOTREXATE SODIUM INJ,,,29,,NW,,,,,,$11.82,$0.00,1,1,1,0,0,1,20161001,,,,
J9261,HCPCS,NELARABINE INJECTION,,,29,,NW,,,,,,$352.51,$0.00,1,1,1,0,0,1,20161001,,,,
J9262,HCPCS,"INJ, OMACETAXINE MEP, 0.01MG",,,29,,NW,,,,,,$39.51,$0.00,1,1,1,0,0,1,20161001,,,,
J9263,HCPCS,OXALIPLATIN,,,29,,NW,,,,,,$3.38,$0.00,1,1,1,0,0,1,20161001,,,,
J9264,HCPCS,PACLITAXEL PROTEIN BOUND,,,29,,NW,,,,,,$29.94,$0.00,1,1,1,0,0,1,20161001,,,,
J9266,HCPCS,PEGASPARGASE INJECTION,,,29,,NW,,,,,,"$10,264.45",$0.00,1,1,1,0,0,1,20161001,,,,
J9267,HCPCS,PACLITAXEL INJECTION,,,29,,NW,,,,,,$1.69,$0.00,1,1,1,0,0,1,20161001,,,,
J9268,HCPCS,PENTOSTATIN INJECTION,,,29,,NW,,,,,,"$3,027.82",$0.00,1,1,1,0,0,1,20161001,,,,
J9270,HCPCS,PLICAMYCIN (MITHRAMYCIN) INJ,,,29,,NW,,,,,,$333.83,$0.00,1,1,1,0,0,1,20161001,,,,
J9280,HCPCS,MITOMYCIN INJECTION,,,29,,NW,,,,,,$159.24,$0.00,1,1,1,0,0,1,20161001,,,,
J9293,HCPCS,MITOXANTRONE HYDROCHL / 5 MG,,,29,,NW,,,,,,$142.07,$0.00,1,1,1,0,0,1,20161001,,,,
J9299,HCPCS,"INJECTION, NIVOLUMAB",,,29,,NW,,,,,,$171.20,$0.00,1,1,1,0,0,1,20161001,,,,
J9300,HCPCS,GEMTUZUMAB OZOGAMICIN INJ,,,29,,NW,,,,,,"$4,528.76",$0.00,1,1,1,0,0,1,20161001,,,,
J9301,HCPCS,OBINUTUZUMAB INJ,,,29,,NW,,,,,,$209.51,$0.00,1,1,1,0,0,1,20161001,,,,
J9302,HCPCS,OFATUMUMAB INJECTION,,,29,,NW,,,,,,$188.67,$0.00,1,1,1,0,0,1,20161001,,,,
J9303,HCPCS,PANITUMUMAB INJECTION,,,29,,NW,,,,,,$355.44,$0.00,1,1,1,0,0,1,20161001,,,,
J9305,HCPCS,PEMETREXED INJECTION,,,29,,NW,,,,,,$153.61,$0.00,1,1,1,0,0,1,20161001,,,,
J9306,HCPCS,"INJECTION, PERTUZUMAB, 1 MG",,,29,,NW,,,,,,$48.97,$0.00,1,1,1,0,0,1,20161001,,,,
J9307,HCPCS,PRALATREXATE INJECTION,,,29,,NW,,,,,,$724.56,$0.00,1,1,1,0,0,1,20161001,,,,
J9310,HCPCS,RITUXIMAB INJECTION,,,29,,NW,,,,,,"$1,817.03",$0.00,1,1,1,0,0,1,20161001,,,,
J9315,HCPCS,ROMIDEPSIN INJECTION,,,29,,NW,,,,,,$983.31,$0.00,1,1,1,0,0,1,20161001,,,,
J9320,HCPCS,STREPTOZOCIN INJECTION,,,29,,NW,,,,,,"$1,175.84",$0.00,1,1,1,0,0,1,20161001,,,,
J9328,HCPCS,TEMOZOLOMIDE INJECTION,,,29,,NW,,,,,,$27.02,$0.00,1,1,1,0,0,1,20161001,,,,
J9330,HCPCS,TEMSIROLIMUS INJECTION,,,29,,NW,,,,,,$229.14,$0.00,1,1,1,0,0,1,20161001,,,,
J9340,HCPCS,THIOTEPA INJECTION,,,29,,NW,,,,,,$364.03,$0.00,1,1,1,0,0,1,20161001,,,,
J9351,HCPCS,TOPOTECAN INJECTION,,,29,,NW,,,,,,$6.75,$0.00,1,1,1,0,0,1,20161001,,,,
J9354,HCPCS,"INJ, ADO-TRASTUZUMAB EMT 1MG",,,29,,NW,,,,,,$123.67,$0.00,1,1,1,0,0,1,20161001,,,,
J9355,HCPCS,TRASTUZUMAB INJECTION,,,29,,NW,,,,,,$210.68,$0.00,1,1,1,0,0,1,20161001,,,,
J9357,HCPCS,VALRUBICIN INJECTION,,,29,,NW,,,,,,"$2,664.12",$0.00,1,1,1,0,0,1,20161001,,,,
J9360,HCPCS,VINBLASTINE SULFATE INJ,,,29,,NW,,,,,,$11.82,$0.00,1,1,1,0,0,1,20161001,,,,
J9370,HCPCS,VINCRISTINE SULFATE 1 MG INJ,,,29,,NW,,,,,,$23.64,$0.00,1,1,1,0,0,1,20161001,,,,
J9371,HCPCS,"INJ, VINCRISTINE SUL LIP 1MG",,,29,,NW,,,,,,"$4,003.08",$0.00,1,1,1,0,0,1,20161001,,,,
J9390,HCPCS,VINORELBINE TARTRATE INJ,,,29,,NW,,,,,,$48.97,$0.00,1,1,1,0,0,1,20161001,,,,
J9395,HCPCS,"INJECTION, FULVESTRANT",,,29,,NW,,,,,,$227.11,$0.00,1,1,1,0,0,1,20161001,,,,
J9400,HCPCS,"INJ, ZIV-AFLIBERCEPT, 1MG",,,29,,NW,,,,,,$24.75,$0.00,1,1,1,0,0,1,20161001,,,,
J9600,HCPCS,PORFIMER SODIUM INJECTION,,,29,,NW,,,,,,"$4,449.33",$0.00,1,1,1,0,0,1,20161001,,,,
J9999,HCPCS,CHEMOTHERAPY DRUG,,,29,,NW,,,,,,$106.33,$0.00,1,1,1,0,0,1,20161001,,,,
K0001,HCPCS,STANDARD WHEELCHAIR,,,28,,NW,,,,,,$966.69,$0.00,1,1,1,1,1,1,20161001,,,,
K0001,HCPCS,STANDARD WHEELCHAIR,NU,,28,,NW,,,,,,$966.69,$0.00,1,1,1,1,1,1,20161001,,,,
K0001,HCPCS,STANDARD WHEELCHAIR,RR,,28,,NW,,,,,,$102.83,$0.00,1,1,1,1,1,1,20161001,,,,
K0001,HCPCS,STANDARD WHEELCHAIR,UE,,28,,NW,,,,,,$726.77,$0.00,1,1,1,1,1,1,20161001,,,,
K0002,HCPCS,STND HEMI (LOW SEAT) WHLCHR,,,28,,NW,,,,,,$959.16,$0.00,1,1,1,1,1,1,20161001,,,,
K0002,HCPCS,STND HEMI (LOW SEAT) WHLCHR,NU,,28,,NW,,,,,,$959.16,$0.00,1,1,1,1,1,1,20161001,,,,
K0002,HCPCS,STND HEMI (LOW SEAT) WHLCHR,RR,,28,,NW,,,,,,$152.54,$0.00,1,1,1,1,1,1,20161001,,,,
K0002,HCPCS,STND HEMI (LOW SEAT) WHLCHR,UE,,28,,NW,,,,,,$727.98,$0.00,1,1,1,1,1,1,20161001,,,,
K0003,HCPCS,LIGHTWEIGHT WHEELCHAIR,,,28,,NW,,,,,,"$1,046.54",$0.00,1,1,1,1,1,1,20161001,,,,
K0003,HCPCS,LIGHTWEIGHT WHEELCHAIR,NU,,28,,NW,,,,,,"$1,046.54",$0.00,1,1,1,1,1,1,20161001,,,,
K0003,HCPCS,LIGHTWEIGHT WHEELCHAIR,RR,,28,,NW,,,,,,$166.24,$0.00,1,1,1,1,1,1,20161001,,,,
K0003,HCPCS,LIGHTWEIGHT WHEELCHAIR,UE,,28,,NW,,,,,,$793.34,$0.00,1,1,1,1,1,1,20161001,,,,
K0004,HCPCS,HIGH STRENGTH LTWT WHLCHR,,,28,,NW,,,,,,"$1,544.67",$0.00,1,1,1,1,1,1,20161001,,,,
K0004,HCPCS,HIGH STRENGTH LTWT WHLCHR,NU,,28,,NW,,,,,,"$1,544.67",$0.00,1,1,1,1,1,1,20161001,,,,
K0004,HCPCS,HIGH STRENGTH LTWT WHLCHR,RR,,28,,NW,,,,,,$241.28,$0.00,1,1,1,1,1,1,20161001,,,,
K0004,HCPCS,HIGH STRENGTH LTWT WHLCHR,UE,,28,,NW,,,,,,"$1,166.94",$0.00,1,1,1,1,1,1,20161001,,,,
K0005,HCPCS,ULTRALIGHTWEIGHT WHEELCHAIR,,,28,,NW,,,,,,"$3,099.48",$0.00,1,1,1,1,1,1,20161001,,,,
K0005,HCPCS,ULTRALIGHTWEIGHT WHEELCHAIR,NU,,28,,NW,,,,,,"$3,099.48",$0.00,1,1,1,1,1,1,20161001,,,,
K0005,HCPCS,ULTRALIGHTWEIGHT WHEELCHAIR,RR,,28,,NW,,,,,,$340.81,$0.00,1,1,1,1,1,1,20161001,,,,
K0005,HCPCS,ULTRALIGHTWEIGHT WHEELCHAIR,UE,,28,,NW,,,,,,"$2,333.18",$0.00,1,1,1,1,1,1,20161001,,,,
K0006,HCPCS,HEAVY DUTY WHEELCHAIR,,,28,,NW,,,,,,"$1,451.79",$0.00,1,1,1,1,1,1,20161001,,,,
K0006,HCPCS,HEAVY DUTY WHEELCHAIR,NU,,28,,NW,,,,,,"$1,451.79",$0.00,1,1,1,1,1,1,20161001,,,,
K0006,HCPCS,HEAVY DUTY WHEELCHAIR,RR,,28,,NW,,,,,,$228.16,$0.00,1,1,1,1,1,1,20161001,,,,
K0006,HCPCS,HEAVY DUTY WHEELCHAIR,UE,,28,,NW,,,,,,"$1,097.45",$0.00,1,1,1,1,1,1,20161001,,,,
K0007,HCPCS,EXTRA HEAVY DUTY WHEELCHAIR,,,28,,NW,,,,,,"$2,051.06",$0.00,1,1,1,1,1,1,20161001,,,,
K0007,HCPCS,EXTRA HEAVY DUTY WHEELCHAIR,NU,,28,,NW,,,,,,"$2,051.06",$0.00,1,1,1,1,1,1,20161001,,,,
K0007,HCPCS,EXTRA HEAVY DUTY WHEELCHAIR,RR,,28,,NW,,,,,,$324.55,$0.00,1,1,1,1,1,1,20161001,,,,
K0007,HCPCS,EXTRA HEAVY DUTY WHEELCHAIR,UE,,28,,NW,,,,,,"$1,547.42",$0.00,1,1,1,1,1,1,20161001,,,,
K0008,HCPCS,CSTM MANUAL WHEELCHAIR/BASE,,,28,,NW,,,,,,$722.76,$0.00,1,1,1,1,1,1,20161001,,,,
K0009,HCPCS,OTHER MANUAL WHEELCHAIR/BASE,,,28,,NW,,,,,,"$1,351.80",$0.00,1,1,1,1,1,1,20161001,,,,
K0009,HCPCS,OTHER MANUAL WHEELCHAIR/BASE,RR,,28,,NW,,,,,,$143.79,$0.00,1,1,1,1,1,1,20161001,,,,
K0010,HCPCS,STND WT FRAME POWER WHLCHR,,,28,,NW,,,,,,"$4,847.90",$0.00,1,1,1,1,1,1,20161001,,,,
K0010,HCPCS,STND WT FRAME POWER WHLCHR,NU,,28,,NW,,,,,,"$4,847.90",$0.00,1,1,1,1,1,1,20161001,,,,
K0010,HCPCS,STND WT FRAME POWER WHLCHR,RR,,28,,NW,,,,,,$689.66,$0.00,1,1,1,1,1,1,20161001,,,,
K0010,HCPCS,STND WT FRAME POWER WHLCHR,UE,,28,,NW,,,,,,"$3,644.54",$0.00,1,1,1,1,1,1,20161001,,,,
K0011,HCPCS,STND WT PWR WHLCHR W CONTROL,,,28,,NW,,,,,,"$17,034.80",$0.00,1,1,1,1,1,1,20161001,,,,
K0011,HCPCS,STND WT PWR WHLCHR W CONTROL,NU,,28,,NW,,,,,,"$17,034.80",$0.00,1,1,1,1,1,1,20161001,,,,
K0011,HCPCS,STND WT PWR WHLCHR W CONTROL,RR,,28,,NW,,,,,,"$1,811.99",$0.00,1,1,1,1,1,1,20161001,,,,
K0012,HCPCS,LTWT PORTBL POWER WHLCHR,,,28,,NW,,,,,,"$5,262.02",$0.00,1,1,1,1,1,1,20161001,,,,
K0012,HCPCS,LTWT PORTBL POWER WHLCHR,RR,,28,,NW,,,,,,$559.72,$0.00,1,1,1,1,1,1,20161001,,,,
K0013,HCPCS,CUSTOM POWER WHLCHR BASE,,,28,,NW,,,,,,"$1,476.62",$0.00,1,1,1,1,1,1,20161001,,,,
K0014,HCPCS,OTHER POWER WHLCHR BASE,,,28,,NW,,,,,,$403.43,$0.00,1,1,1,1,1,1,20161001,,,,
K0015,HCPCS,DETACH NON-ADJUS HGHT ARMRST,,,28,,NW,,,,,,$594.93,$0.00,1,1,1,1,1,1,20161001,,,,
K0015,HCPCS,DETACH NON-ADJUS HGHT ARMRST,NU,,28,,NW,,,,,,$594.93,$0.00,1,1,1,1,1,1,20161001,,,,
K0015,HCPCS,DETACH NON-ADJUS HGHT ARMRST,RR,,28,,NW,,,,,,$68.29,$0.00,1,1,1,1,1,1,20161001,,,,
K0015,HCPCS,DETACH NON-ADJUS HGHT ARMRST,UE,,28,,NW,,,,,,$454.80,$0.00,1,1,1,1,1,1,20161001,,,,
K0017,HCPCS,DETACH ADJUST ARMREST BASE,,,28,,NW,,,,,,$185.49,$0.00,1,1,1,1,1,1,20161001,,,,
K0017,HCPCS,DETACH ADJUST ARMREST BASE,NU,,28,,NW,,,,,,$185.49,$0.00,1,1,1,1,1,1,20161001,,,,
K0017,HCPCS,DETACH ADJUST ARMREST BASE,RR,,28,,NW,,,,,,$21.89,$0.00,1,1,1,1,1,1,20161001,,,,
K0017,HCPCS,DETACH ADJUST ARMREST BASE,UE,,28,,NW,,,,,,$140.05,$0.00,1,1,1,1,1,1,20161001,,,,
K0018,HCPCS,DETACH ADJUST ARMRST UPPER,,,28,,NW,,,,,,$105.27,$0.00,1,1,1,1,1,1,20161001,,,,
K0018,HCPCS,DETACH ADJUST ARMRST UPPER,NU,,28,,NW,,,,,,$105.27,$0.00,1,1,1,1,1,1,20161001,,,,
K0018,HCPCS,DETACH ADJUST ARMRST UPPER,RR,,28,,NW,,,,,,$13.82,$0.00,1,1,1,1,1,1,20161001,,,,
K0018,HCPCS,DETACH ADJUST ARMRST UPPER,UE,,28,,NW,,,,,,$79.90,$0.00,1,1,1,1,1,1,20161001,,,,
K0019,HCPCS,ARM PAD EACH,,,28,,NW,,,,,,$64.00,$0.00,1,1,1,1,1,1,20161001,,,,
K0019,HCPCS,ARM PAD EACH,NU,,28,,NW,,,,,,$64.00,$0.00,1,1,1,1,1,1,20161001,,,,
K0019,HCPCS,ARM PAD EACH,RR,,28,,NW,,,,,,$9.74,$0.00,1,1,1,1,1,1,20161001,,,,
K0019,HCPCS,ARM PAD EACH,UE,,28,,NW,,,,,,$48.92,$0.00,1,1,1,1,1,1,20161001,,,,
K0020,HCPCS,FIXED ADJUST ARMREST PAIR,,,28,,NW,,,,,,$168.94,$0.00,1,1,1,1,1,1,20161001,,,,
K0020,HCPCS,FIXED ADJUST ARMREST PAIR,NU,,28,,NW,,,,,,$168.94,$0.00,1,1,1,1,1,1,20161001,,,,
K0020,HCPCS,FIXED ADJUST ARMREST PAIR,RR,,28,,NW,,,,,,$20.25,$0.00,1,1,1,1,1,1,20161001,,,,
K0020,HCPCS,FIXED ADJUST ARMREST PAIR,UE,,28,,NW,,,,,,$127.60,$0.00,1,1,1,1,1,1,20161001,,,,
K0037,HCPCS,HIGH MOUNT FLIP-UP FOOTREST,,,28,,NW,,,,,,$169.65,$0.00,1,1,1,1,1,1,20161001,,,,
K0037,HCPCS,HIGH MOUNT FLIP-UP FOOTREST,NU,,28,,NW,,,,,,$169.65,$0.00,1,1,1,1,1,1,20161001,,,,
K0037,HCPCS,HIGH MOUNT FLIP-UP FOOTREST,RR,,28,,NW,,,,,,$18.63,$0.00,1,1,1,1,1,1,20161001,,,,
K0037,HCPCS,HIGH MOUNT FLIP-UP FOOTREST,UE,,28,,NW,,,,,,$128.21,$0.00,1,1,1,1,1,1,20161001,,,,
K0038,HCPCS,LEG STRAP EACH,,,28,,NW,,,,,,$89.99,$0.00,1,1,1,1,1,1,20161001,,,,
K0038,HCPCS,LEG STRAP EACH,NU,,28,,NW,,,,,,$89.99,$0.00,1,1,1,1,1,1,20161001,,,,
K0038,HCPCS,LEG STRAP EACH,RR,,28,,NW,,,,,,$12.34,$0.00,1,1,1,1,1,1,20161001,,,,
K0038,HCPCS,LEG STRAP EACH,UE,,28,,NW,,,,,,$68.42,$0.00,1,1,1,1,1,1,20161001,,,,
K0039,HCPCS,LEG STRAP H STYLE EACH,,,28,,NW,,,,,,$195.32,$0.00,1,1,1,1,1,1,20161001,,,,
K0039,HCPCS,LEG STRAP H STYLE EACH,NU,,28,,NW,,,,,,$195.32,$0.00,1,1,1,1,1,1,20161001,,,,
K0039,HCPCS,LEG STRAP H STYLE EACH,RR,,28,,NW,,,,,,$22.96,$0.00,1,1,1,1,1,1,20161001,,,,
K0039,HCPCS,LEG STRAP H STYLE EACH,UE,,28,,NW,,,,,,$147.44,$0.00,1,1,1,1,1,1,20161001,,,,
K0040,HCPCS,ADJUSTABLE ANGLE FOOTPLATE,,,28,,NW,,,,,,$264.84,$0.00,1,1,1,1,1,1,20161001,,,,
K0040,HCPCS,ADJUSTABLE ANGLE FOOTPLATE,NU,,28,,NW,,,,,,$264.84,$0.00,1,1,1,1,1,1,20161001,,,,
K0040,HCPCS,ADJUSTABLE ANGLE FOOTPLATE,RR,,28,,NW,,,,,,$30.21,$0.00,1,1,1,1,1,1,20161001,,,,
K0040,HCPCS,ADJUSTABLE ANGLE FOOTPLATE,UE,,28,,NW,,,,,,$202.84,$0.00,1,1,1,1,1,1,20161001,,,,
K0041,HCPCS,LARGE SIZE FOOTPLATE EACH,,,28,,NW,,,,,,$191.93,$0.00,1,1,1,1,1,1,20161001,,,,
K0041,HCPCS,LARGE SIZE FOOTPLATE EACH,NU,,28,,NW,,,,,,$191.93,$0.00,1,1,1,1,1,1,20161001,,,,
K0041,HCPCS,LARGE SIZE FOOTPLATE EACH,RR,,28,,NW,,,,,,$22.61,$0.00,1,1,1,1,1,1,20161001,,,,
K0041,HCPCS,LARGE SIZE FOOTPLATE EACH,UE,,28,,NW,,,,,,$144.85,$0.00,1,1,1,1,1,1,20161001,,,,
K0042,HCPCS,STANDARD SIZE FOOTPLATE EACH,,,28,,NW,,,,,,$126.45,$0.00,1,1,1,1,1,1,20161001,,,,
K0042,HCPCS,STANDARD SIZE FOOTPLATE EACH,NU,,28,,NW,,,,,,$126.45,$0.00,1,1,1,1,1,1,20161001,,,,
K0042,HCPCS,STANDARD SIZE FOOTPLATE EACH,RR,,28,,NW,,,,,,$15.96,$0.00,1,1,1,1,1,1,20161001,,,,
K0042,HCPCS,STANDARD SIZE FOOTPLATE EACH,UE,,28,,NW,,,,,,$95.75,$0.00,1,1,1,1,1,1,20161001,,,,
K0043,HCPCS,FTRST LOWER EXTENSION TUBE,,,28,,NW,,,,,,$73.15,$0.00,1,1,1,1,1,1,20161001,,,,
K0043,HCPCS,FTRST LOWER EXTENSION TUBE,NU,,28,,NW,,,,,,$73.15,$0.00,1,1,1,1,1,1,20161001,,,,
K0043,HCPCS,FTRST LOWER EXTENSION TUBE,RR,,28,,NW,,,,,,$10.65,$0.00,1,1,1,1,1,1,20161001,,,,
K0043,HCPCS,FTRST LOWER EXTENSION TUBE,UE,,28,,NW,,,,,,$55.85,$0.00,1,1,1,1,1,1,20161001,,,,
K0044,HCPCS,FTRST UPPER HANGER BRACKET,,,28,,NW,,,,,,$62.89,$0.00,1,1,1,1,1,1,20161001,,,,
K0044,HCPCS,FTRST UPPER HANGER BRACKET,NU,,28,,NW,,,,,,$62.89,$0.00,1,1,1,1,1,1,20161001,,,,
K0044,HCPCS,FTRST UPPER HANGER BRACKET,RR,,28,,NW,,,,,,$9.65,$0.00,1,1,1,1,1,1,20161001,,,,
K0044,HCPCS,FTRST UPPER HANGER BRACKET,UE,,28,,NW,,,,,,$48.08,$0.00,1,1,1,1,1,1,20161001,,,,
K0045,HCPCS,FOOTREST COMPLETE ASSEMBLY,,,28,,NW,,,,,,$205.83,$0.00,1,1,1,1,1,1,20161001,,,,
K0045,HCPCS,FOOTREST COMPLETE ASSEMBLY,NU,,28,,NW,,,,,,$205.83,$0.00,1,1,1,1,1,1,20161001,,,,
K0045,HCPCS,FOOTREST COMPLETE ASSEMBLY,RR,,28,,NW,,,,,,$24.31,$0.00,1,1,1,1,1,1,20161001,,,,
K0045,HCPCS,FOOTREST COMPLETE ASSEMBLY,UE,,28,,NW,,,,,,$155.31,$0.00,1,1,1,1,1,1,20161001,,,,
K0046,HCPCS,ELEVAT LEGRST LOW EXTENSION,,,28,,NW,,,,,,$73.15,$0.00,1,1,1,1,1,1,20161001,,,,
K0046,HCPCS,ELEVAT LEGRST LOW EXTENSION,NU,,28,,NW,,,,,,$73.15,$0.00,1,1,1,1,1,1,20161001,,,,
K0046,HCPCS,ELEVAT LEGRST LOW EXTENSION,RR,,28,,NW,,,,,,$10.65,$0.00,1,1,1,1,1,1,20161001,,,,
K0046,HCPCS,ELEVAT LEGRST LOW EXTENSION,UE,,28,,NW,,,,,,$55.86,$0.00,1,1,1,1,1,1,20161001,,,,
K0047,HCPCS,ELEVAT LEGRST UP HANGR BRACK,,,28,,NW,,,,,,$270.42,$0.00,1,1,1,1,1,1,20161001,,,,
K0047,HCPCS,ELEVAT LEGRST UP HANGR BRACK,NU,,28,,NW,,,,,,$270.42,$0.00,1,1,1,1,1,1,20161001,,,,
K0047,HCPCS,ELEVAT LEGRST UP HANGR BRACK,RR,,28,,NW,,,,,,$30.97,$0.00,1,1,1,1,1,1,20161001,,,,
K0047,HCPCS,ELEVAT LEGRST UP HANGR BRACK,UE,,28,,NW,,,,,,$207.65,$0.00,1,1,1,1,1,1,20161001,,,,
K0050,HCPCS,RATCHET ASSEMBLY,,,28,,NW,,,,,,$119.31,$0.00,1,1,1,1,1,1,20161001,,,,
K0050,HCPCS,RATCHET ASSEMBLY,NU,,28,,NW,,,,,,$119.31,$0.00,1,1,1,1,1,1,20161001,,,,
K0050,HCPCS,RATCHET ASSEMBLY,RR,,28,,NW,,,,,,$15.24,$0.00,1,1,1,1,1,1,20161001,,,,
K0050,HCPCS,RATCHET ASSEMBLY,UE,,28,,NW,,,,,,$90.43,$0.00,1,1,1,1,1,1,20161001,,,,
K0051,HCPCS,CAM RELESE ASSEM FTRST/LGRST,,,28,,NW,,,,,,$190.78,$0.00,1,1,1,1,1,1,20161001,,,,
K0051,HCPCS,CAM RELESE ASSEM FTRST/LGRST,NU,,28,,NW,,,,,,$190.78,$0.00,1,1,1,1,1,1,20161001,,,,
K0051,HCPCS,CAM RELESE ASSEM FTRST/LGRST,RR,,28,,NW,,,,,,$22.49,$0.00,1,1,1,1,1,1,20161001,,,,
K0051,HCPCS,CAM RELESE ASSEM FTRST/LGRST,UE,,28,,NW,,,,,,$143.99,$0.00,1,1,1,1,1,1,20161001,,,,
K0052,HCPCS,SWINGAWAY DETACH FOOTREST,,,28,,NW,,,,,,$319.69,$0.00,1,1,1,1,1,1,20161001,,,,
K0052,HCPCS,SWINGAWAY DETACH FOOTREST,NU,,28,,NW,,,,,,$319.69,$0.00,1,1,1,1,1,1,20161001,,,,
K0052,HCPCS,SWINGAWAY DETACH FOOTREST,RR,,28,,NW,,,,,,$36.58,$0.00,1,1,1,1,1,1,20161001,,,,
K0052,HCPCS,SWINGAWAY DETACH FOOTREST,UE,,28,,NW,,,,,,$248.36,$0.00,1,1,1,1,1,1,20161001,,,,
K0053,HCPCS,ELEVATE FOOTREST ARTICULATE,,,28,,NW,,,,,,$349.22,$0.00,1,1,1,1,1,1,20161001,,,,
K0053,HCPCS,ELEVATE FOOTREST ARTICULATE,NU,,28,,NW,,,,,,$349.22,$0.00,1,1,1,1,1,1,20161001,,,,
K0053,HCPCS,ELEVATE FOOTREST ARTICULATE,RR,,28,,NW,,,,,,$39.98,$0.00,1,1,1,1,1,1,20161001,,,,
K0053,HCPCS,ELEVATE FOOTREST ARTICULATE,UE,,28,,NW,,,,,,$270.53,$0.00,1,1,1,1,1,1,20161001,,,,
K0056,HCPCS,SEAT HT <17 OR >=21 LTWT WC,,,28,,NW,,,,,,$185.31,$0.00,1,1,1,1,1,1,20161001,,,,
K0056,HCPCS,SEAT HT <17 OR >=21 LTWT WC,NU,,28,,NW,,,,,,$185.31,$0.00,1,1,1,1,1,1,20161001,,,,
K0056,HCPCS,SEAT HT <17 OR >=21 LTWT WC,RR,,28,,NW,,,,,,$21.88,$0.00,1,1,1,1,1,1,20161001,,,,
K0056,HCPCS,SEAT HT <17 OR >=21 LTWT WC,UE,,28,,NW,,,,,,$139.95,$0.00,1,1,1,1,1,1,20161001,,,,
K0065,HCPCS,SPOKE PROTECTORS,,,28,,NW,,,,,,$88.63,$0.00,1,1,1,1,1,1,20161001,,,,
K0065,HCPCS,SPOKE PROTECTORS,NU,,28,,NW,,,,,,$88.63,$0.00,1,1,1,1,1,1,20161001,,,,
K0065,HCPCS,SPOKE PROTECTORS,RR,,28,,NW,,,,,,$12.21,$0.00,1,1,1,1,1,1,20161001,,,,
K0065,HCPCS,SPOKE PROTECTORS,UE,,28,,NW,,,,,,$67.41,$0.00,1,1,1,1,1,1,20161001,,,,
K0069,HCPCS,REAR WHL COMPLETE SOLID TIRE,,,28,,NW,,,,,,$194.52,$0.00,1,1,1,1,1,1,20161001,,,,
K0069,HCPCS,REAR WHL COMPLETE SOLID TIRE,NU,,28,,NW,,,,,,$194.52,$0.00,1,1,1,1,1,1,20161001,,,,
K0069,HCPCS,REAR WHL COMPLETE SOLID TIRE,RR,,28,,NW,,,,,,$23.16,$0.00,1,1,1,1,1,1,20161001,,,,
K0069,HCPCS,REAR WHL COMPLETE SOLID TIRE,UE,,28,,NW,,,,,,$146.80,$0.00,1,1,1,1,1,1,20161001,,,,
K0070,HCPCS,REAR WHL COMPL PNEUM TIRE,,,28,,NW,,,,,,$337.87,$0.00,1,1,1,1,1,1,20161001,,,,
K0070,HCPCS,REAR WHL COMPL PNEUM TIRE,NU,,28,,NW,,,,,,$337.87,$0.00,1,1,1,1,1,1,20161001,,,,
K0070,HCPCS,REAR WHL COMPL PNEUM TIRE,RR,,28,,NW,,,,,,$38.70,$0.00,1,1,1,1,1,1,20161001,,,,
K0070,HCPCS,REAR WHL COMPL PNEUM TIRE,UE,,28,,NW,,,,,,$261.96,$0.00,1,1,1,1,1,1,20161001,,,,
K0071,HCPCS,FRONT CASTR COMPL PNEUM TIRE,,,28,,NW,,,,,,$212.39,$0.00,1,1,1,1,1,1,20161001,,,,
K0071,HCPCS,FRONT CASTR COMPL PNEUM TIRE,NU,,28,,NW,,,,,,$212.39,$0.00,1,1,1,1,1,1,20161001,,,,
K0071,HCPCS,FRONT CASTR COMPL PNEUM TIRE,RR,,28,,NW,,,,,,$24.61,$0.00,1,1,1,1,1,1,20161001,,,,
K0071,HCPCS,FRONT CASTR COMPL PNEUM TIRE,UE,,28,,NW,,,,,,$160.19,$0.00,1,1,1,1,1,1,20161001,,,,
K0072,HCPCS,FRNT CSTR CMPL SEM-PNEUM TIR,,,28,,NW,,,,,,$128.69,$0.00,1,1,1,1,1,1,20161001,,,,
K0072,HCPCS,FRNT CSTR CMPL SEM-PNEUM TIR,NU,,28,,NW,,,,,,$128.69,$0.00,1,1,1,1,1,1,20161001,,,,
K0072,HCPCS,FRNT CSTR CMPL SEM-PNEUM TIR,RR,,28,,NW,,,,,,$16.21,$0.00,1,1,1,1,1,1,20161001,,,,
K0072,HCPCS,FRNT CSTR CMPL SEM-PNEUM TIR,UE,,28,,NW,,,,,,$97.43,$0.00,1,1,1,1,1,1,20161001,,,,
K0073,HCPCS,CASTER PIN LOCK EACH,,,28,,NW,,,,,,$68.92,$0.00,1,1,1,1,1,1,20161001,,,,
K0073,HCPCS,CASTER PIN LOCK EACH,NU,,28,,NW,,,,,,$68.92,$0.00,1,1,1,1,1,1,20161001,,,,
K0073,HCPCS,CASTER PIN LOCK EACH,RR,,28,,NW,,,,,,$10.25,$0.00,1,1,1,1,1,1,20161001,,,,
K0073,HCPCS,CASTER PIN LOCK EACH,UE,,28,,NW,,,,,,$52.60,$0.00,1,1,1,1,1,1,20161001,,,,
K0077,HCPCS,FRONT CASTER ASSEM COMPLETE,,,28,,NW,,,,,,$116.13,$0.00,1,1,1,1,1,1,20161001,,,,
K0077,HCPCS,FRONT CASTER ASSEM COMPLETE,NU,,28,,NW,,,,,,$116.13,$0.00,1,1,1,1,1,1,20161001,,,,
K0077,HCPCS,FRONT CASTER ASSEM COMPLETE,RR,,28,,NW,,,,,,$14.93,$0.00,1,1,1,1,1,1,20161001,,,,
K0077,HCPCS,FRONT CASTER ASSEM COMPLETE,UE,,28,,NW,,,,,,$88.00,$0.00,1,1,1,1,1,1,20161001,,,,
K0098,HCPCS,DRIVE BELT POWER WHEELCHAIR,,,28,,NW,,,,,,$99.04,$0.00,1,1,1,1,1,1,20161001,,,,
K0098,HCPCS,DRIVE BELT POWER WHEELCHAIR,NU,,28,,NW,,,,,,$99.04,$0.00,1,1,1,1,1,1,20161001,,,,
K0098,HCPCS,DRIVE BELT POWER WHEELCHAIR,RR,,28,,NW,,,,,,$13.27,$0.00,1,1,1,1,1,1,20161001,,,,
K0098,HCPCS,DRIVE BELT POWER WHEELCHAIR,UE,,28,,NW,,,,,,$75.19,$0.00,1,1,1,1,1,1,20161001,,,,
K0105,HCPCS,IV HANGER,,,28,,NW,,,,,,$193.64,$0.00,1,1,1,1,1,1,20161001,,,,
K0105,HCPCS,IV HANGER,NU,,28,,NW,,,,,,$193.64,$0.00,1,1,1,1,1,1,20161001,,,,
K0105,HCPCS,IV HANGER,RR,,28,,NW,,,,,,$22.69,$0.00,1,1,1,1,1,1,20161001,,,,
K0105,HCPCS,IV HANGER,UE,,28,,NW,,,,,,$146.16,$0.00,1,1,1,1,1,1,20161001,,,,
K0108,HCPCS,W/C COMPONENT-ACCESSORY NOS,,,28,,NW,,,,,,$66.27,$0.00,1,1,1,1,1,1,20161001,,,,
K0195,HCPCS,ELEVATING WHLCHAIR LEG RESTS,,,28,,NW,,,,,,$716.24,$0.00,1,1,1,1,1,1,20161001,,,,
K0195,HCPCS,ELEVATING WHLCHAIR LEG RESTS,RR,,28,,NW,,,,,,$76.19,$0.00,1,1,1,1,1,1,20161001,,,,
K0455,HCPCS,PUMP UNINTERRUPTED INFUSION,,,28,,NW,,,,,,"$6,119.43",$0.00,1,1,1,1,1,1,20161001,,,,
K0455,HCPCS,PUMP UNINTERRUPTED INFUSION,RR,,28,,NW,,,,,,$650.92,$0.00,1,1,1,1,1,1,20161001,,,,
K0462,HCPCS,TEMPORARY REPLACEMENT EQPMNT,,,28,,NW,,,,,,$650.66,$0.00,1,1,1,1,1,1,20161001,,,,
K0552,HCPCS,SUPPLY/EXT INF PUMP SYR TYPE,,,28,,NW,,,,,,$7.41,$0.00,1,1,1,1,1,1,20161001,,,,
K0601,HCPCS,REPL BATT SILVER OXIDE 1.5 V,,,28,,NW,,,,,,$3.12,$0.00,1,1,1,1,1,1,20161001,,,,
K0601,HCPCS,REPL BATT SILVER OXIDE 1.5 V,NU,,28,,NW,,,,,,$3.12,$0.00,1,1,1,1,1,1,20161001,,,,
K0602,HCPCS,REPL BATT SILVER OXIDE 3 V,,,28,,NW,,,,,,$14.19,$0.00,1,1,1,1,1,1,20161001,,,,
K0602,HCPCS,REPL BATT SILVER OXIDE 3 V,NU,,28,,NW,,,,,,$14.19,$0.00,1,1,1,1,1,1,20161001,,,,
K0603,HCPCS,REPL BATT ALKALINE 1.5 V,,,28,,NW,,,,,,$1.60,$0.00,1,1,1,1,1,1,20161001,,,,
K0603,HCPCS,REPL BATT ALKALINE 1.5 V,NU,,28,,NW,,,,,,$1.60,$0.00,1,1,1,1,1,1,20161001,,,,
K0604,HCPCS,REPL BATT LITHIUM 3.6 V,,,28,,NW,,,,,,$13.97,$0.00,1,1,1,1,1,1,20161001,,,,
K0604,HCPCS,REPL BATT LITHIUM 3.6 V,NU,,28,,NW,,,,,,$13.97,$0.00,1,1,1,1,1,1,20161001,,,,
K0605,HCPCS,REPL BATT LITHIUM 4.5 V,,,28,,NW,,,,,,$25.00,$0.00,1,1,1,1,1,1,20161001,,,,
K0605,HCPCS,REPL BATT LITHIUM 4.5 V,NU,,28,,NW,,,,,,$25.00,$0.00,1,1,1,1,1,1,20161001,,,,
K0606,HCPCS,AED GARMENT W ELEC ANALYSIS,,,28,,NW,,,,,,"$61,642.22",$0.00,1,1,1,1,1,1,20161001,,,,
K0606,HCPCS,AED GARMENT W ELEC ANALYSIS,KF,,28,,NW,,,,,,"$61,642.22",$0.00,1,1,1,1,1,1,20161001,,,,
K0606,HCPCS,AED GARMENT W ELEC ANALYSIS,RR,,28,,NW,,,,,,"$6,556.89",$0.00,1,1,1,1,1,1,20161001,,,,
K0607,HCPCS,REPL BATT FOR AED,,,28,,NW,,,,,,"$1,226.76",$0.00,1,1,1,1,1,1,20161001,,,,
K0607,HCPCS,REPL BATT FOR AED,NU,,28,,NW,,,,,,"$1,226.76",$0.00,1,1,1,1,1,1,20161001,,,,
K0607,HCPCS,REPL BATT FOR AED,RR,,28,,NW,,,,,,$93.87,$0.00,1,1,1,1,1,1,20161001,,,,
K0607,HCPCS,REPL BATT FOR AED,UE,,28,,NW,,,,,,$909.49,$0.00,1,1,1,1,1,1,20161001,,,,
K0608,HCPCS,REPL GARMENT FOR AED,,,28,,NW,,,,,,$654.25,$0.00,1,1,1,1,1,1,20161001,,,,
K0608,HCPCS,REPL GARMENT FOR AED,NU,,28,,NW,,,,,,$654.25,$0.00,1,1,1,1,1,1,20161001,,,,
K0608,HCPCS,REPL GARMENT FOR AED,RR,,28,,NW,,,,,,$53.75,$0.00,1,1,1,1,1,1,20161001,,,,
K0608,HCPCS,REPL GARMENT FOR AED,UE,,28,,NW,,,,,,$487.39,$0.00,1,1,1,1,1,1,20161001,,,,
K0609,HCPCS,REPL ELECTRODE FOR AED,,,28,,NW,,,,,,"$2,321.78",$0.00,1,1,1,1,1,1,20161001,,,,
K0609,HCPCS,REPL ELECTRODE FOR AED,KF,,28,,NW,,,,,,"$2,321.78",$0.00,1,1,1,1,1,1,20161001,,,,
K0669,HCPCS,SEAT/BACK CUS NO DMEPDAC VER,,,28,,NW,,,,,,$710.45,$0.00,1,1,1,1,1,1,20161001,,,,
K0669,HCPCS,SEAT/BACK CUS NO DMEPDAC VER,NU,,28,,NW,,,,,,$710.45,$0.00,1,1,1,1,1,1,20161001,,,,
K0672,HCPCS,REMOVABLE SOFT INTERFACE LE,,,28,,NW,,,,,,$176.34,$0.00,1,1,1,1,1,1,20161001,,,,
K0730,HCPCS,CTRL DOSE INH DRUG DELIV SYS,,,28,,NW,,,,,,"$3,185.88",$0.00,1,1,1,1,1,1,20161001,,,,
K0730,HCPCS,CTRL DOSE INH DRUG DELIV SYS,NU,,28,,NW,,,,,,"$3,185.88",$0.00,1,1,1,1,1,1,20161001,,,,
K0730,HCPCS,CTRL DOSE INH DRUG DELIV SYS,RR,,28,,NW,,,,,,$436.69,$0.00,1,1,1,1,1,1,20161001,,,,
K0730,HCPCS,CTRL DOSE INH DRUG DELIV SYS,UE,,28,,NW,,,,,,"$2,385.86",$0.00,1,1,1,1,1,1,20161001,,,,
K0733,HCPCS,12-24HR SEALED LEAD ACID,,,28,,NW,,,,,,$111.55,$0.00,1,1,1,1,1,1,20161001,,,,
K0733,HCPCS,12-24HR SEALED LEAD ACID,NU,,28,,NW,,,,,,$111.55,$0.00,1,1,1,1,1,1,20161001,,,,
K0733,HCPCS,12-24HR SEALED LEAD ACID,RR,,28,,NW,,,,,,$14.57,$0.00,1,1,1,1,1,1,20161001,,,,
K0733,HCPCS,12-24HR SEALED LEAD ACID,UE,,28,,NW,,,,,,$84.62,$0.00,1,1,1,1,1,1,20161001,,,,
K0738,HCPCS,PORTABLE GAS OXYGEN SYSTEM,,,28,,NW,,,,,,"$1,347.19",$0.00,1,1,1,1,1,1,20161001,,,,
K0738,HCPCS,PORTABLE GAS OXYGEN SYSTEM,RR,,28,,NW,,,,,,$143.30,$0.00,1,1,1,1,1,1,20161001,,,,
K0739,HCPCS,REPAIR/SVC DME NON-OXYGEN EQ,,,28,,NW,,,,,,$32.99,$0.00,1,1,1,1,1,1,20161001,,,,
K0740,HCPCS,REPAIR/SVC OXYGEN EQUIPMENT,,,28,,NW,,,,,,$96.91,$0.00,1,1,1,1,1,1,20161001,,,,
K0743,HCPCS,PORTABLE HOME SUCTION PUMP,,,28,,NW,,,,,,$264.87,$0.00,1,1,1,1,1,1,20161001,,,,
K0744,HCPCS,ABSORP DRG <= 16 SUC PUMP,,,28,,NW,,,,,,$3.76,$0.00,1,1,1,1,1,1,20161001,,,,
K0745,HCPCS,ABSORP DRG >16<=48 SUC PUMP,,,28,,NW,,,,,,$6.14,$0.00,1,1,1,1,1,1,20161001,,,,
K0746,HCPCS,ABSORP DRG >48 SUC PUMP,,,28,,NW,,,,,,$15.17,$0.00,1,1,1,1,1,1,20161001,,,,
K0800,HCPCS,POV GROUP 1 STD UP TO 300LBS,,,28,,NW,,,,,,"$1,887.59",$0.00,1,1,1,1,1,1,20161001,,,,
K0800,HCPCS,POV GROUP 1 STD UP TO 300LBS,NU,,28,,NW,,,,,,"$1,887.59",$0.00,1,1,1,1,1,1,20161001,,,,
K0800,HCPCS,POV GROUP 1 STD UP TO 300LBS,RR,,28,,NW,,,,,,$217.34,$0.00,1,1,1,1,1,1,20161001,,,,
K0800,HCPCS,POV GROUP 1 STD UP TO 300LBS,UE,,28,,NW,,,,,,"$1,424.31",$0.00,1,1,1,1,1,1,20161001,,,,
K0801,HCPCS,POV GROUP 1 HD 301-450 LBS,,,28,,NW,,,,,,"$3,022.11",$0.00,1,1,1,1,1,1,20161001,,,,
K0801,HCPCS,POV GROUP 1 HD 301-450 LBS,NU,,28,,NW,,,,,,"$3,022.11",$0.00,1,1,1,1,1,1,20161001,,,,
K0801,HCPCS,POV GROUP 1 HD 301-450 LBS,RR,,28,,NW,,,,,,$333.17,$0.00,1,1,1,1,1,1,20161001,,,,
K0801,HCPCS,POV GROUP 1 HD 301-450 LBS,UE,,28,,NW,,,,,,"$2,275.19",$0.00,1,1,1,1,1,1,20161001,,,,
K0802,HCPCS,POV GROUP 1 VHD 451-600 LBS,,,28,,NW,,,,,,"$3,415.53",$0.00,1,1,1,1,1,1,20161001,,,,
K0802,HCPCS,POV GROUP 1 VHD 451-600 LBS,NU,,28,,NW,,,,,,"$3,415.53",$0.00,1,1,1,1,1,1,20161001,,,,
K0802,HCPCS,POV GROUP 1 VHD 451-600 LBS,RR,,28,,NW,,,,,,$372.54,$0.00,1,1,1,1,1,1,20161001,,,,
K0802,HCPCS,POV GROUP 1 VHD 451-600 LBS,UE,,28,,NW,,,,,,"$2,570.25",$0.00,1,1,1,1,1,1,20161001,,,,
K0806,HCPCS,POV GROUP 2 STD UP TO 300LBS,,,28,,NW,,,,,,"$2,276.24",$0.00,1,1,1,1,1,1,20161001,,,,
K0806,HCPCS,POV GROUP 2 STD UP TO 300LBS,NU,,28,,NW,,,,,,"$2,276.24",$0.00,1,1,1,1,1,1,20161001,,,,
K0806,HCPCS,POV GROUP 2 STD UP TO 300LBS,RR,,28,,NW,,,,,,$258.62,$0.00,1,1,1,1,1,1,20161001,,,,
K0806,HCPCS,POV GROUP 2 STD UP TO 300LBS,UE,,28,,NW,,,,,,"$1,715.81",$0.00,1,1,1,1,1,1,20161001,,,,
K0807,HCPCS,POV GROUP 2 HD 301-450 LBS,,,28,,NW,,,,,,"$3,436.15",$0.00,1,1,1,1,1,1,20161001,,,,
K0807,HCPCS,POV GROUP 2 HD 301-450 LBS,NU,,28,,NW,,,,,,"$3,436.15",$0.00,1,1,1,1,1,1,20161001,,,,
K0807,HCPCS,POV GROUP 2 HD 301-450 LBS,RR,,28,,NW,,,,,,$374.63,$0.00,1,1,1,1,1,1,20161001,,,,
K0807,HCPCS,POV GROUP 2 HD 301-450 LBS,UE,,28,,NW,,,,,,"$2,585.73",$0.00,1,1,1,1,1,1,20161001,,,,
K0808,HCPCS,POV GROUP 2 VHD 451-600 LBS,,,28,,NW,,,,,,"$5,297.57",$0.00,1,1,1,1,1,1,20161001,,,,
K0808,HCPCS,POV GROUP 2 VHD 451-600 LBS,NU,,28,,NW,,,,,,"$5,297.57",$0.00,1,1,1,1,1,1,20161001,,,,
K0808,HCPCS,POV GROUP 2 VHD 451-600 LBS,RR,,28,,NW,,,,,,$560.76,$0.00,1,1,1,1,1,1,20161001,,,,
K0808,HCPCS,POV GROUP 2 VHD 451-600 LBS,UE,,28,,NW,,,,,,"$3,981.77",$0.00,1,1,1,1,1,1,20161001,,,,
K0812,HCPCS,POWER OPERATED VEHICLE NOC,,,28,,NW,,,,,,"$1,046.54",$0.00,1,1,1,1,1,1,20161001,,,,
K0813,HCPCS,PWC GP 1 STD PORT SEAT/BACK,,,28,,NW,,,,,,"$5,200.33",$0.00,1,1,1,1,1,1,20161001,,,,
K0813,HCPCS,PWC GP 1 STD PORT SEAT/BACK,RR,,28,,NW,,,,,,$553.16,$0.00,1,1,1,1,1,1,20161001,,,,
K0814,HCPCS,PWC GP 1 STD PORT CAP CHAIR,,,28,,NW,,,,,,"$6,566.17",$0.00,1,1,1,1,1,1,20161001,,,,
K0814,HCPCS,PWC GP 1 STD PORT CAP CHAIR,RR,,28,,NW,,,,,,$698.44,$0.00,1,1,1,1,1,1,20161001,,,,
K0815,HCPCS,PWC GP 1 STD SEAT/BACK,,,28,,NW,,,,,,"$7,431.51",$0.00,1,1,1,1,1,1,20161001,,,,
K0815,HCPCS,PWC GP 1 STD SEAT/BACK,RR,,28,,NW,,,,,,$790.49,$0.00,1,1,1,1,1,1,20161001,,,,
K0816,HCPCS,PWC GP 1 STD CAP CHAIR,,,28,,NW,,,,,,"$7,130.91",$0.00,1,1,1,1,1,1,20161001,,,,
K0816,HCPCS,PWC GP 1 STD CAP CHAIR,RR,,28,,NW,,,,,,$758.52,$0.00,1,1,1,1,1,1,20161001,,,,
K0820,HCPCS,PWC GP 2 STD PORT SEAT/BACK,,,28,,NW,,,,,,"$5,532.50",$0.00,1,1,1,1,1,1,20161001,,,,
K0820,HCPCS,PWC GP 2 STD PORT SEAT/BACK,RR,,28,,NW,,,,,,$588.49,$0.00,1,1,1,1,1,1,20161001,,,,
K0821,HCPCS,PWC GP 2 STD PORT CAP CHAIR,,,28,,NW,,,,,,"$7,010.04",$0.00,1,1,1,1,1,1,20161001,,,,
K0821,HCPCS,PWC GP 2 STD PORT CAP CHAIR,RR,,28,,NW,,,,,,$745.66,$0.00,1,1,1,1,1,1,20161001,,,,
K0822,HCPCS,PWC GP 2 STD SEAT/BACK,,,28,,NW,,,,,,"$8,404.62",$0.00,1,1,1,1,1,1,20161001,,,,
K0822,HCPCS,PWC GP 2 STD SEAT/BACK,RR,,28,,NW,,,,,,$894.00,$0.00,1,1,1,1,1,1,20161001,,,,
K0823,HCPCS,PWC GP 2 STD CAP CHAIR,,,28,,NW,,,,,,"$8,457.72",$0.00,1,1,1,1,1,1,20161001,,,,
K0823,HCPCS,PWC GP 2 STD CAP CHAIR,RR,,28,,NW,,,,,,$899.65,$0.00,1,1,1,1,1,1,20161001,,,,
K0824,HCPCS,PWC GP 2 HD SEAT/BACK,,,28,,NW,,,,,,"$10,112.90",$0.00,1,1,1,1,1,1,20161001,,,,
K0824,HCPCS,PWC GP 2 HD SEAT/BACK,RR,,28,,NW,,,,,,"$1,075.71",$0.00,1,1,1,1,1,1,20161001,,,,
K0825,HCPCS,PWC GP 2 HD CAP CHAIR,,,28,,NW,,,,,,"$9,285.73",$0.00,1,1,1,1,1,1,20161001,,,,
K0825,HCPCS,PWC GP 2 HD CAP CHAIR,RR,,28,,NW,,,,,,$987.72,$0.00,1,1,1,1,1,1,20161001,,,,
K0826,HCPCS,PWC GP 2 VHD SEAT/BACK,,,28,,NW,,,,,,"$12,997.28",$0.00,1,1,1,1,1,1,20161001,,,,
K0826,HCPCS,PWC GP 2 VHD SEAT/BACK,RR,,28,,NW,,,,,,"$1,382.52",$0.00,1,1,1,1,1,1,20161001,,,,
K0827,HCPCS,PWC GP VHD CAP CHAIR,,,28,,NW,,,,,,"$11,099.81",$0.00,1,1,1,1,1,1,20161001,,,,
K0827,HCPCS,PWC GP VHD CAP CHAIR,RR,,28,,NW,,,,,,"$1,180.69",$0.00,1,1,1,1,1,1,20161001,,,,
K0828,HCPCS,PWC GP 2 XTRA HD SEAT/BACK,,,28,,NW,,,,,,"$14,288.31",$0.00,1,1,1,1,1,1,20161001,,,,
K0828,HCPCS,PWC GP 2 XTRA HD SEAT/BACK,RR,,28,,NW,,,,,,"$1,519.85",$0.00,1,1,1,1,1,1,20161001,,,,
K0829,HCPCS,PWC GP 2 XTRA HD CAP CHAIR,,,28,,NW,,,,,,"$13,147.44",$0.00,1,1,1,1,1,1,20161001,,,,
K0829,HCPCS,PWC GP 2 XTRA HD CAP CHAIR,RR,,28,,NW,,,,,,"$1,398.49",$0.00,1,1,1,1,1,1,20161001,,,,
K0830,HCPCS,PWC GP2 STD SEAT ELEVATE S/B,,,28,,NW,,,,,,$399.07,$0.00,1,1,1,1,1,1,20161001,,,,
K0831,HCPCS,PWC GP2 STD SEAT ELEVATE CAP,,,28,,NW,,,,,,$955.20,$0.00,1,1,1,1,1,1,20161001,,,,
K0835,HCPCS,PWC GP2 STD SING POW OPT S/B,,,28,,NW,,,,,,"$8,525.62",$0.00,1,1,1,1,1,1,20161001,,,,
K0835,HCPCS,PWC GP2 STD SING POW OPT S/B,RR,,28,,NW,,,,,,$906.87,$0.00,1,1,1,1,1,1,20161001,,,,
K0836,HCPCS,PWC GP2 STD SING POW OPT CAP,,,28,,NW,,,,,,"$8,829.47",$0.00,1,1,1,1,1,1,20161001,,,,
K0836,HCPCS,PWC GP2 STD SING POW OPT CAP,RR,,28,,NW,,,,,,$939.19,$0.00,1,1,1,1,1,1,20161001,,,,
K0837,HCPCS,PWC GP 2 HD SING POW OPT S/B,,,28,,NW,,,,,,"$10,112.90",$0.00,1,1,1,1,1,1,20161001,,,,
K0837,HCPCS,PWC GP 2 HD SING POW OPT S/B,RR,,28,,NW,,,,,,"$1,075.71",$0.00,1,1,1,1,1,1,20161001,,,,
K0838,HCPCS,PWC GP 2 HD SING POW OPT CAP,,,28,,NW,,,,,,"$9,081.06",$0.00,1,1,1,1,1,1,20161001,,,,
K0838,HCPCS,PWC GP 2 HD SING POW OPT CAP,RR,,28,,NW,,,,,,$965.95,$0.00,1,1,1,1,1,1,20161001,,,,
K0839,HCPCS,PWC GP2 VHD SING POW OPT S/B,,,28,,NW,,,,,,"$12,997.28",$0.00,1,1,1,1,1,1,20161001,,,,
K0839,HCPCS,PWC GP2 VHD SING POW OPT S/B,RR,,28,,NW,,,,,,"$1,382.52",$0.00,1,1,1,1,1,1,20161001,,,,
K0840,HCPCS,PWC GP2 XHD SING POW OPT S/B,,,28,,NW,,,,,,"$19,523.60",$0.00,1,1,1,1,1,1,20161001,,,,
K0840,HCPCS,PWC GP2 XHD SING POW OPT S/B,RR,,28,,NW,,,,,,"$2,076.73",$0.00,1,1,1,1,1,1,20161001,,,,
K0841,HCPCS,PWC GP2 STD MULT POW OPT S/B,,,28,,NW,,,,,,"$9,053.87",$0.00,1,1,1,1,1,1,20161001,,,,
K0841,HCPCS,PWC GP2 STD MULT POW OPT S/B,RR,,28,,NW,,,,,,$963.06,$0.00,1,1,1,1,1,1,20161001,,,,
K0842,HCPCS,PWC GP2 STD MULT POW OPT CAP,,,28,,NW,,,,,,"$9,053.87",$0.00,1,1,1,1,1,1,20161001,,,,
K0842,HCPCS,PWC GP2 STD MULT POW OPT CAP,RR,,28,,NW,,,,,,$963.06,$0.00,1,1,1,1,1,1,20161001,,,,
K0843,HCPCS,PWC GP2 HD MULT POW OPT S/B,,,28,,NW,,,,,,"$10,834.56",$0.00,1,1,1,1,1,1,20161001,,,,
K0843,HCPCS,PWC GP2 HD MULT POW OPT S/B,RR,,28,,NW,,,,,,"$1,152.47",$0.00,1,1,1,1,1,1,20161001,,,,
K0848,HCPCS,PWC GP 3 STD SEAT/BACK,,,28,,NW,,,,,,"$11,005.85",$0.00,1,1,1,1,1,1,20161001,,,,
K0848,HCPCS,PWC GP 3 STD SEAT/BACK,RR,,28,,NW,,,,,,"$1,170.69",$0.00,1,1,1,1,1,1,20161001,,,,
K0849,HCPCS,PWC GP 3 STD CAP CHAIR,,,28,,NW,,,,,,"$10,594.10",$0.00,1,1,1,1,1,1,20161001,,,,
K0849,HCPCS,PWC GP 3 STD CAP CHAIR,RR,,28,,NW,,,,,,"$1,126.90",$0.00,1,1,1,1,1,1,20161001,,,,
K0850,HCPCS,PWC GP 3 HD SEAT/BACK,,,28,,NW,,,,,,"$12,714.70",$0.00,1,1,1,1,1,1,20161001,,,,
K0850,HCPCS,PWC GP 3 HD SEAT/BACK,RR,,28,,NW,,,,,,"$1,352.46",$0.00,1,1,1,1,1,1,20161001,,,,
K0851,HCPCS,PWC GP 3 HD CAP CHAIR,,,28,,NW,,,,,,"$12,237.59",$0.00,1,1,1,1,1,1,20161001,,,,
K0851,HCPCS,PWC GP 3 HD CAP CHAIR,RR,,28,,NW,,,,,,"$1,301.71",$0.00,1,1,1,1,1,1,20161001,,,,
K0852,HCPCS,PWC GP 3 VHD SEAT/BACK,,,28,,NW,,,,,,"$14,640.62",$0.00,1,1,1,1,1,1,20161001,,,,
K0852,HCPCS,PWC GP 3 VHD SEAT/BACK,RR,,28,,NW,,,,,,"$1,557.32",$0.00,1,1,1,1,1,1,20161001,,,,
K0853,HCPCS,PWC GP 3 VHD CAP CHAIR,,,28,,NW,,,,,,"$15,030.82",$0.00,1,1,1,1,1,1,20161001,,,,
K0853,HCPCS,PWC GP 3 VHD CAP CHAIR,RR,,28,,NW,,,,,,"$1,598.83",$0.00,1,1,1,1,1,1,20161001,,,,
K0854,HCPCS,PWC GP 3 XHD SEAT/BACK,,,28,,NW,,,,,,"$19,807.31",$0.00,1,1,1,1,1,1,20161001,,,,
K0854,HCPCS,PWC GP 3 XHD SEAT/BACK,RR,,28,,NW,,,,,,"$2,106.91",$0.00,1,1,1,1,1,1,20161001,,,,
K0855,HCPCS,PWC GP 3 XHD CAP CHAIR,,,28,,NW,,,,,,"$18,728.98",$0.00,1,1,1,1,1,1,20161001,,,,
K0855,HCPCS,PWC GP 3 XHD CAP CHAIR,RR,,28,,NW,,,,,,"$1,992.20",$0.00,1,1,1,1,1,1,20161001,,,,
K0856,HCPCS,PWC GP3 STD SING POW OPT S/B,,,28,,NW,,,,,,"$11,789.91",$0.00,1,1,1,1,1,1,20161001,,,,
K0856,HCPCS,PWC GP3 STD SING POW OPT S/B,RR,,28,,NW,,,,,,"$1,254.09",$0.00,1,1,1,1,1,1,20161001,,,,
K0857,HCPCS,PWC GP3 STD SING POW OPT CAP,,,28,,NW,,,,,,"$12,019.67",$0.00,1,1,1,1,1,1,20161001,,,,
K0857,HCPCS,PWC GP3 STD SING POW OPT CAP,RR,,28,,NW,,,,,,"$1,278.53",$0.00,1,1,1,1,1,1,20161001,,,,
K0858,HCPCS,PWC GP3 HD SING POW OPT S/B,,,28,,NW,,,,,,"$14,549.90",$0.00,1,1,1,1,1,1,20161001,,,,
K0858,HCPCS,PWC GP3 HD SING POW OPT S/B,RR,,28,,NW,,,,,,"$1,547.67",$0.00,1,1,1,1,1,1,20161001,,,,
K0859,HCPCS,PWC GP3 HD SING POW OPT CAP,,,28,,NW,,,,,,"$13,891.07",$0.00,1,1,1,1,1,1,20161001,,,,
K0859,HCPCS,PWC GP3 HD SING POW OPT CAP,RR,,28,,NW,,,,,,"$1,477.59",$0.00,1,1,1,1,1,1,20161001,,,,
K0860,HCPCS,PWC GP3 VHD SING POW OPT S/B,,,28,,NW,,,,,,"$20,647.44",$0.00,1,1,1,1,1,1,20161001,,,,
K0860,HCPCS,PWC GP3 VHD SING POW OPT S/B,RR,,28,,NW,,,,,,"$2,196.27",$0.00,1,1,1,1,1,1,20161001,,,,
K0861,HCPCS,PWC GP3 STD MULT POW OPT S/B,,,28,,NW,,,,,,"$26,601.71",$0.00,1,1,1,1,1,1,20161001,,,,
K0861,HCPCS,PWC GP3 STD MULT POW OPT S/B,RR,,28,,NW,,,,,,"$2,829.63",$0.00,1,1,1,1,1,1,20161001,,,,
K0862,HCPCS,PWC GP3 HD MULT POW OPT S/B,,,28,,NW,,,,,,"$14,549.90",$0.00,1,1,1,1,1,1,20161001,,,,
K0862,HCPCS,PWC GP3 HD MULT POW OPT S/B,RR,,28,,NW,,,,,,"$1,547.67",$0.00,1,1,1,1,1,1,20161001,,,,
K0863,HCPCS,PWC GP3 VHD MULT POW OPT S/B,,,28,,NW,,,,,,"$20,647.44",$0.00,1,1,1,1,1,1,20161001,,,,
K0863,HCPCS,PWC GP3 VHD MULT POW OPT S/B,RR,,28,,NW,,,,,,"$2,196.27",$0.00,1,1,1,1,1,1,20161001,,,,
K0864,HCPCS,PWC GP3 XHD MULT POW OPT S/B,,,28,,NW,,,,,,"$24,509.14",$0.00,1,1,1,1,1,1,20161001,,,,
K0864,HCPCS,PWC GP3 XHD MULT POW OPT S/B,RR,,28,,NW,,,,,,"$2,607.04",$0.00,1,1,1,1,1,1,20161001,,,,
K0868,HCPCS,PWC GP 4 STD SEAT/BACK,,,28,,NW,,,,,,"$1,160.01",$0.00,1,1,1,1,1,1,20161001,,,,
K0869,HCPCS,PWC GP 4 STD CAP CHAIR,,,28,,NW,,,,,,"$2,519.71",$0.00,1,1,1,1,1,1,20161001,,,,
K0870,HCPCS,PWC GP 4 HD SEAT/BACK,,,28,,NW,,,,,,"$2,651.91",$0.00,1,1,1,1,1,1,20161001,,,,
K0871,HCPCS,PWC GP 4 VHD SEAT/BACK,,,28,,NW,,,,,,"$6,895.98",$0.00,1,1,1,1,1,1,20161001,,,,
K0877,HCPCS,PWC GP4 STD SING POW OPT S/B,,,28,,NW,,,,,,"$1,321.73",$0.00,1,1,1,1,1,1,20161001,,,,
K0878,HCPCS,PWC GP4 STD SING POW OPT CAP,,,28,,NW,,,,,,"$1,816.37",$0.00,1,1,1,1,1,1,20161001,,,,
K0879,HCPCS,PWC GP4 HD SING POW OPT S/B,,,28,,NW,,,,,,"$2,197.02",$0.00,1,1,1,1,1,1,20161001,,,,
K0880,HCPCS,PWC GP4 VHD SING POW OPT S/B,,,28,,NW,,,,,,"$2,351.38",$0.00,1,1,1,1,1,1,20161001,,,,
K0884,HCPCS,PWC GP4 STD MULT POW OPT S/B,,,28,,NW,,,,,,"$1,400.51",$0.00,1,1,1,1,1,1,20161001,,,,
K0885,HCPCS,PWC GP4 STD MULT POW OPT CAP,,,28,,NW,,,,,,"$3,355.69",$0.00,1,1,1,1,1,1,20161001,,,,
K0886,HCPCS,PWC GP4 HD MULT POW S/B,,,28,,NW,,,,,,"$2,809.91",$0.00,1,1,1,1,1,1,20161001,,,,
K0890,HCPCS,PWC GP5 PED SING POW OPT S/B,,,28,,NW,,,,,,"$2,146.32",$0.00,1,1,1,1,1,1,20161001,,,,
K0891,HCPCS,PWC GP5 PED MULT POW OPT S/B,,,28,,NW,,,,,,"$1,360.08",$0.00,1,1,1,1,1,1,20161001,,,,
K0898,HCPCS,POWER WHEELCHAIR NOC,,,28,,NW,,,,,,"$1,046.54",$0.00,1,1,1,1,1,1,20161001,,,,
K0899,HCPCS,POW MOBIL DEV NO DMEPDAC,,,28,,NW,,,,,,"$1,990.50",$0.00,1,1,1,1,1,1,20161001,,,,
K0901,HCPCS,KO SINGLE UPRIGHT PRE OTS,,,28,,NW,,,,,,"$1,484.26",$0.00,1,1,1,1,1,1,20161001,,,,
K0902,HCPCS,KO DOUBLE UPRIGHT PRE OTS,,,28,,NW,,,,,,"$1,434.96",$0.00,1,1,1,1,1,1,20161001,,,,
L0112,HCPCS,CRANIAL CERVICAL ORTHOSIS,,,28,,NW,,,,,,"$2,361.39",$0.00,1,1,1,1,1,1,20161001,,,,
L0113,HCPCS,CRANIAL CERVICAL TORTICOLLIS,,,28,,NW,,,,,,$416.30,$0.00,1,1,1,1,1,1,20161001,,,,
L0120,HCPCS,CERV FLEX N/ADJ FOAM PRE OTS,,,28,,NW,,,,,,$29.96,$0.00,1,1,1,1,1,1,20161001,,,,
L0130,HCPCS,FLEX THERMOPLASTIC COLLAR MO,,,28,,NW,,,,,,$223.69,$0.00,1,1,1,1,1,1,20161001,,,,
L0140,HCPCS,CERVICAL SEMI-RIGID ADJUSTAB,,,28,,NW,,,,,,$59.52,$0.00,1,1,1,1,1,1,20161001,,,,
L0150,HCPCS,CERV SEMI-RIG ADJ MOLDED CHN,,,28,,NW,,,,,,$120.54,$0.00,1,1,1,1,1,1,20161001,,,,
L0160,HCPCS,CERV SR WIRE OCC/MAN PRE OTS,,,28,,NW,,,,,,$208.49,$0.00,1,1,1,1,1,1,20161001,,,,
L0170,HCPCS,CERVICAL COLLAR MOLDED TO PT,,,28,,NW,,,,,,"$1,158.55",$0.00,1,1,1,1,1,1,20161001,,,,
L0172,HCPCS,CERV COL SR FOAM 2PC PRE OTS,,,28,,NW,,,,,,$159.19,$0.00,1,1,1,1,1,1,20161001,,,,
L0174,HCPCS,CERV SR 2PC THOR EXT PRE OTS,,,28,,NW,,,,,,$413.05,$0.00,1,1,1,1,1,1,20161001,,,,
L0180,HCPCS,CER POST COL OCC/MAN SUP ADJ,,,28,,NW,,,,,,$615.36,$0.00,1,1,1,1,1,1,20161001,,,,
L0190,HCPCS,CERV COLLAR SUPP ADJ CERV BA,,,28,,NW,,,,,,$851.66,$0.00,1,1,1,1,1,1,20161001,,,,
L0200,HCPCS,CERV COL SUPP ADJ BAR & THOR,,,28,,NW,,,,,,$895.55,$0.00,1,1,1,1,1,1,20161001,,,,
L0220,HCPCS,THOR RIB BELT CUSTOM FABRICA,,,28,,NW,,,,,,$141.80,$0.00,1,1,1,1,1,1,20161001,,,,
L0450,HCPCS,TLSO FLEX TRUNK/THOR PRE OTS,,,28,,NW,,,,,,$242.91,$0.00,1,1,1,1,1,1,20161001,,,,
L0452,HCPCS,TLSO FLEX CUSTOM FAB THORACI,,,28,,NW,,,,,,$733.87,$0.00,1,1,1,1,1,1,20161001,,,,
L0454,HCPCS,TLSO TRNK SJ-T9 PRE CST,,,28,,NW,,,,,,$523.18,$0.00,1,1,1,1,1,1,20161001,,,,
L0455,HCPCS,TLSO FLEX TRNK SJ-T9 PRE OTS,,,28,,NW,,,,,,$523.18,$0.00,1,1,1,1,1,1,20161001,,,,
L0456,HCPCS,TLSO FLEX TRNK SJ-SS PRE CST,,,28,,NW,,,,,,"$1,654.18",$0.00,1,1,1,1,1,1,20161001,,,,
L0457,HCPCS,TLSO FLEX TRNK SJ-SS PRE OTS,,,28,,NW,,,,,,"$1,654.18",$0.00,1,1,1,1,1,1,20161001,,,,
L0458,HCPCS,TLSO 2MOD SYMPHIS-XIPHO PRE,,,28,,NW,,,,,,"$1,474.79",$0.00,1,1,1,1,1,1,20161001,,,,
L0460,HCPCS,TLSO 2 SHL SYMPHYS-STERN CST,,,28,,NW,,,,,,"$1,670.33",$0.00,1,1,1,1,1,1,20161001,,,,
L0462,HCPCS,TLSO 3MOD SACRO-SCAP PRE,,,28,,NW,,,,,,"$2,097.70",$0.00,1,1,1,1,1,1,20161001,,,,
L0464,HCPCS,TLSO 4MOD SACRO-SCAP PRE,,,28,,NW,,,,,,"$2,512.97",$0.00,1,1,1,1,1,1,20161001,,,,
L0466,HCPCS,TLSO R FRAM SOFT ANT PRE CST,,,28,,NW,,,,,,$611.46,$0.00,1,1,1,1,1,1,20161001,,,,
L0467,HCPCS,TLSO R FRAM SOFT PRE OTS,,,28,,NW,,,,,,$611.46,$0.00,1,1,1,1,1,1,20161001,,,,
L0468,HCPCS,TLSO RIG FRAM PELVIC PRE CST,,,28,,NW,,,,,,$773.98,$0.00,1,1,1,1,1,1,20161001,,,,
L0469,HCPCS,TLSO RIG FRAM PELVIC PRE OTS,,,28,,NW,,,,,,$773.98,$0.00,1,1,1,1,1,1,20161001,,,,
L0470,HCPCS,TLSO RIGID FRAME PRE SUBCLAV,,,28,,NW,,,,,,"$1,108.88",$0.00,1,1,1,1,1,1,20161001,,,,
L0472,HCPCS,TLSO RIGID FRAME HYPEREX PRE,,,28,,NW,,,,,,$678.67,$0.00,1,1,1,1,1,1,20161001,,,,
L0480,HCPCS,TLSO RIGID PLASTIC CUSTOM FA,,,28,,NW,,,,,,"$2,518.24",$0.00,1,1,1,1,1,1,20161001,,,,
L0482,HCPCS,TLSO RIGID LINED CUSTOM FAB,,,28,,NW,,,,,,"$2,776.80",$0.00,1,1,1,1,1,1,20161001,,,,
L0484,HCPCS,TLSO RIGID PLASTIC CUST FAB,,,28,,NW,,,,,,"$3,097.25",$0.00,1,1,1,1,1,1,20161001,,,,
L0486,HCPCS,TLSO RIGIDLINED CUST FAB TWO,,,28,,NW,,,,,,"$3,294.11",$0.00,1,1,1,1,1,1,20161001,,,,
L0488,HCPCS,TLSO RIGID LINED PRE ONE PIE,,,28,,NW,,,,,,"$1,670.33",$0.00,1,1,1,1,1,1,20161001,,,,
L0490,HCPCS,TLSO RIGID PLASTIC PRE ONE,,,28,,NW,,,,,,$411.54,$0.00,1,1,1,1,1,1,20161001,,,,
L0491,HCPCS,TLSO 2 PIECE RIGID SHELL,,,28,,NW,,,,,,"$1,258.56",$0.00,1,1,1,1,1,1,20161001,,,,
L0492,HCPCS,TLSO 3 PIECE RIGID SHELL,,,28,,NW,,,,,,$796.64,$0.00,1,1,1,1,1,1,20161001,,,,
L0621,HCPCS,SIO FLEX PELVIC/SACR PRE OTS,,,28,,NW,,,,,,$87.36,$0.00,1,1,1,1,1,1,20161001,,,,
L0622,HCPCS,SIO FLEX PELVISACRAL CUSTOM,,,28,,NW,,,,,,$395.55,$0.00,1,1,1,1,1,1,20161001,,,,
L0623,HCPCS,SIO RIG PNL PELV/SAC PRE OTS,,,28,,NW,,,,,,$85.77,$0.00,1,1,1,1,1,1,20161001,,,,
L0624,HCPCS,SIO PANEL CUSTOM,,,28,,NW,,,,,,$107.69,$0.00,1,1,1,1,1,1,20161001,,,,
L0625,HCPCS,LO FLEX L1-BELOW L5 PRE OTS,,,28,,NW,,,,,,$51.32,$0.00,1,1,1,1,1,1,20161001,,,,
L0626,HCPCS,LO SAG RIG PNL STAYS PRE CST,,,28,,NW,,,,,,$69.48,$0.00,1,1,1,1,1,1,20161001,,,,
L0627,HCPCS,LO SAG RI AN/POS PNL PRE CST,,,28,,NW,,,,,,$635.38,$0.00,1,1,1,1,1,1,20161001,,,,
L0628,HCPCS,LSO FLEX NO RI STAYS PRE OTS,,,28,,NW,,,,,,$74.20,$0.00,1,1,1,1,1,1,20161001,,,,
L0629,HCPCS,LSO FLEX W/RIGID STAYS CUST,,,28,,NW,,,,,,$93.83,$0.00,1,1,1,1,1,1,20161001,,,,
L0630,HCPCS,LSO R POST PNL SJ-T9 PRE CST,,,28,,NW,,,,,,$200.41,$0.00,1,1,1,1,1,1,20161001,,,,
L0631,HCPCS,LSO SAG R AN/POS PNL PRE CST,,,28,,NW,,,,,,"$1,710.18",$0.00,1,1,1,1,1,1,20161001,,,,
L0632,HCPCS,LSO SAG RIGID FRAME CUST,,,28,,NW,,,,,,"$2,465.47",$0.00,1,1,1,1,1,1,20161001,,,,
L0633,HCPCS,LSO SC R POS/LAT PNL PRE CST,,,28,,NW,,,,,,$418.34,$0.00,1,1,1,1,1,1,20161001,,,,
L0634,HCPCS,LSO FLEXION CONTROL CUSTOM,,,28,,NW,,,,,,$613.30,$0.00,1,1,1,1,1,1,20161001,,,,
L0635,HCPCS,LSO SAGIT RIGID PANEL PREFAB,,,28,,NW,,,,,,"$1,724.38",$0.00,1,1,1,1,1,1,20161001,,,,
L0636,HCPCS,LSO SAGITTAL RIGID PANEL CUS,,,28,,NW,,,,,,"$2,547.06",$0.00,1,1,1,1,1,1,20161001,,,,
L0637,HCPCS,LSO SC R ANT/POS PNL PRE CST,,,28,,NW,,,,,,"$2,044.98",$0.00,1,1,1,1,1,1,20161001,,,,
L0638,HCPCS,LSO SAG-CORONAL PANEL CUSTOM,,,28,,NW,,,,,,"$2,220.48",$0.00,1,1,1,1,1,1,20161001,,,,
L0639,HCPCS,LSO S/C SHELL/PANEL PREFAB,,,28,,NW,,,,,,"$2,044.98",$0.00,1,1,1,1,1,1,20161001,,,,
L0640,HCPCS,LSO S/C SHELL/PANEL CUSTOM,,,28,,NW,,,,,,"$1,744.66",$0.00,1,1,1,1,1,1,20161001,,,,
L0641,HCPCS,LO RIG POS PNL L1-L5 PRE OTS,,,28,,NW,,,,,,$69.48,$0.00,1,1,1,1,1,1,20161001,,,,
L0642,HCPCS,LO SAG RI AN/POS PNL PRE OTS,,,28,,NW,,,,,,$635.38,$0.00,1,1,1,1,1,1,20161001,,,,
L0643,HCPCS,LSO SAG CTR RIGI POS PRE OTS,,,28,,NW,,,,,,$200.41,$0.00,1,1,1,1,1,1,20161001,,,,
L0648,HCPCS,LSO SAG R AN/POS PNL PRE OTS,,,28,,NW,,,,,,"$1,710.18",$0.00,1,1,1,1,1,1,20161001,,,,
L0649,HCPCS,LSO SC R POS/LAT PNL PRE OTS,,,28,,NW,,,,,,$418.34,$0.00,1,1,1,1,1,1,20161001,,,,
L0650,HCPCS,LSO SC R ANT/POS PNL PRE OTS,,,28,,NW,,,,,,"$2,044.98",$0.00,1,1,1,1,1,1,20161001,,,,
L0651,HCPCS,LSO SAG-CO SHELL PNL PRE OTS,,,28,,NW,,,,,,"$2,044.98",$0.00,1,1,1,1,1,1,20161001,,,,
L0700,HCPCS,CTLSO A-P-L CONTROL MOLDED,,,28,,NW,,,,,,"$3,626.21",$0.00,1,1,1,1,1,1,20161001,,,,
L0710,HCPCS,CTLSO A-P-L CONTROL W/ INTER,,,28,,NW,,,,,,"$3,844.49",$0.00,1,1,1,1,1,1,20161001,,,,
L0810,HCPCS,HALO CERVICAL INTO JCKT VEST,,,28,,NW,,,,,,"$4,642.37",$0.00,1,1,1,1,1,1,20161001,,,,
L0820,HCPCS,HALO CERVICAL INTO BODY JACK,,,28,,NW,,,,,,"$3,810.42",$0.00,1,1,1,1,1,1,20161001,,,,
L0830,HCPCS,HALO CERV INTO MILWAUKEE TYP,,,28,,NW,,,,,,"$5,698.46",$0.00,1,1,1,1,1,1,20161001,,,,
L0859,HCPCS,MRI COMPATIBLE SYSTEM,,,28,,NW,,,,,,"$2,062.02",$0.00,1,1,1,1,1,1,20161001,,,,
L0861,HCPCS,HALO REPL LINER/INTERFACE,,,28,,NW,,,,,,$293.95,$0.00,1,1,1,1,1,1,20161001,,,,
L0970,HCPCS,TLSO CORSET FRONT,,,28,,NW,,,,,,$128.68,$0.00,1,1,1,1,1,1,20161001,,,,
L0972,HCPCS,LSO CORSET FRONT,,,28,,NW,,,,,,$112.51,$0.00,1,1,1,1,1,1,20161001,,,,
L0974,HCPCS,TLSO FULL CORSET,,,28,,NW,,,,,,$256.84,$0.00,1,1,1,1,1,1,20161001,,,,
L0976,HCPCS,LSO FULL CORSET,,,28,,NW,,,,,,$211.76,$0.00,1,1,1,1,1,1,20161001,,,,
L0978,HCPCS,AXILLARY CRUTCH EXTENSION,,,28,,NW,,,,,,$267.84,$0.00,1,1,1,1,1,1,20161001,,,,
L0980,HCPCS,PERONEAL STRAPS PAIR PRE OTS,,,28,,NW,,,,,,$21.92,$0.00,1,1,1,1,1,1,20161001,,,,
L0982,HCPCS,STOCKING SUP GRIPS 4 PRE OTS,,,28,,NW,,,,,,$21.15,$0.00,1,1,1,1,1,1,20161001,,,,
L0984,HCPCS,PROTECT BODY SOCK EA PRE OTS,,,28,,NW,,,,,,$57.23,$0.00,1,1,1,1,1,1,20161001,,,,
L0999,HCPCS,ADD TO SPINAL ORTHOSIS NOS,,,28,,NW,,,,,,$112.51,$0.00,1,1,1,1,1,1,20161001,,,,
L1000,HCPCS,CTLSO MILWAUKE INITIAL MODEL,,,28,,NW,,,,,,"$3,617.18",$0.00,1,1,1,1,1,1,20161001,,,,
L1001,HCPCS,CTLSO INFANT IMMOBILIZER,,,28,,NW,,,,,,$65.31,$0.00,1,1,1,1,1,1,20161001,,,,
L1005,HCPCS,TENSION BASED SCOLIOSIS ORTH,,,28,,NW,,,,,,"$5,506.04",$0.00,1,1,1,1,1,1,20161001,,,,
L1010,HCPCS,CTLSO AXILLA SLING,,,28,,NW,,,,,,$65.54,$0.00,1,1,1,1,1,1,20161001,,,,
L1020,HCPCS,KYPHOSIS PAD,,,28,,NW,,,,,,$89.84,$0.00,1,1,1,1,1,1,20161001,,,,
L1025,HCPCS,KYPHOSIS PAD FLOATING,,,28,,NW,,,,,,$156.39,$0.00,1,1,1,1,1,1,20161001,,,,
L1030,HCPCS,LUMBAR BOLSTER PAD,,,28,,NW,,,,,,$63.27,$0.00,1,1,1,1,1,1,20161001,,,,
L1040,HCPCS,LUMBAR OR LUMBAR RIB PAD,,,28,,NW,,,,,,$76.87,$0.00,1,1,1,1,1,1,20161001,,,,
L1050,HCPCS,STERNAL PAD,,,28,,NW,,,,,,$81.13,$0.00,1,1,1,1,1,1,20161001,,,,
L1060,HCPCS,THORACIC PAD,,,28,,NW,,,,,,$97.75,$0.00,1,1,1,1,1,1,20161001,,,,
L1070,HCPCS,TRAPEZIUS SLING,,,28,,NW,,,,,,$93.34,$0.00,1,1,1,1,1,1,20161001,,,,
L1080,HCPCS,OUTRIGGER,,,28,,NW,,,,,,$54.11,$0.00,1,1,1,1,1,1,20161001,,,,
L1085,HCPCS,OUTRIGGER BIL W/ VERT EXTENS,,,28,,NW,,,,,,$216.46,$0.00,1,1,1,1,1,1,20161001,,,,
L1090,HCPCS,LUMBAR SLING,,,28,,NW,,,,,,$89.95,$0.00,1,1,1,1,1,1,20161001,,,,
L1100,HCPCS,RING FLANGE PLASTIC/LEATHER,,,28,,NW,,,,,,$220.71,$0.00,1,1,1,1,1,1,20161001,,,,
L1110,HCPCS,RING FLANGE PLAS/LEATHER MOL,,,28,,NW,,,,,,$402.60,$0.00,1,1,1,1,1,1,20161001,,,,
L1120,HCPCS,COVERS FOR UPRIGHT EACH,,,28,,NW,,,,,,$41.09,$0.00,1,1,1,1,1,1,20161001,,,,
L1200,HCPCS,FURNSH INITIAL ORTHOSIS ONLY,,,28,,NW,,,,,,"$2,935.36",$0.00,1,1,1,1,1,1,20161001,,,,
L1210,HCPCS,LATERAL THORACIC EXTENSION,,,28,,NW,,,,,,$390.07,$0.00,1,1,1,1,1,1,20161001,,,,
L1220,HCPCS,ANTERIOR THORACIC EXTENSION,,,28,,NW,,,,,,$337.93,$0.00,1,1,1,1,1,1,20161001,,,,
L1230,HCPCS,MILWAUKEE TYPE SUPERSTRUCTUR,,,28,,NW,,,,,,$956.15,$0.00,1,1,1,1,1,1,20161001,,,,
L1240,HCPCS,LUMBAR DEROTATION PAD,,,28,,NW,,,,,,$76.00,$0.00,1,1,1,1,1,1,20161001,,,,
L1250,HCPCS,ANTERIOR ASIS PAD,,,28,,NW,,,,,,$70.41,$0.00,1,1,1,1,1,1,20161001,,,,
L1260,HCPCS,ANTERIOR THORACIC DEROTATION,,,28,,NW,,,,,,$74.50,$0.00,1,1,1,1,1,1,20161001,,,,
L1270,HCPCS,ABDOMINAL PAD,,,28,,NW,,,,,,$74.64,$0.00,1,1,1,1,1,1,20161001,,,,
L1280,HCPCS,RIB GUSSET (ELASTIC) EACH,,,28,,NW,,,,,,$79.68,$0.00,1,1,1,1,1,1,20161001,,,,
L1290,HCPCS,LATERAL TROCHANTERIC PAD,,,28,,NW,,,,,,$74.20,$0.00,1,1,1,1,1,1,20161001,,,,
L1300,HCPCS,BODY JACKET MOLD TO PATIENT,,,28,,NW,,,,,,"$3,070.97",$0.00,1,1,1,1,1,1,20161001,,,,
L1310,HCPCS,POST-OPERATIVE BODY JACKET,,,28,,NW,,,,,,"$3,101.47",$0.00,1,1,1,1,1,1,20161001,,,,
L1499,HCPCS,SPINAL ORTHOSIS NOS,,,28,,NW,,,,,,"$3,086.22",$0.00,1,1,1,1,1,1,20161001,,,,
L1600,HCPCS,HO FLEX FREJKA W/COV PRE CST,,,28,,NW,,,,,,$152.58,$0.00,1,1,1,1,1,1,20161001,,,,
L1610,HCPCS,HO FREJKA COV ONLY PRE CST,,,28,,NW,,,,,,$45.78,$0.00,1,1,1,1,1,1,20161001,,,,
L1620,HCPCS,HO FLEX PAVLIK HARNS PRE CST,,,28,,NW,,,,,,$168.47,$0.00,1,1,1,1,1,1,20161001,,,,
L1630,HCPCS,ABDUCT CONTROL HIP SEMI-FLEX,,,28,,NW,,,,,,$223.48,$0.00,1,1,1,1,1,1,20161001,,,,
L1640,HCPCS,PELV BAND/SPREAD BAR THIGH C,,,28,,NW,,,,,,$747.51,$0.00,1,1,1,1,1,1,20161001,,,,
L1650,HCPCS,HO ABDUCTION HIP ADJUSTABLE,,,28,,NW,,,,,,$337.62,$0.00,1,1,1,1,1,1,20161001,,,,
L1652,HCPCS,HO BI THIGHCUFFS W SPRDR BAR,,,28,,NW,,,,,,$540.02,$0.00,1,1,1,1,1,1,20161001,,,,
L1660,HCPCS,HO ABDUCTION STATIC PLASTIC,,,28,,NW,,,,,,$221.23,$0.00,1,1,1,1,1,1,20161001,,,,
L1680,HCPCS,PELVIC & HIP CONTROL THIGH C,,,28,,NW,,,,,,"$2,195.00",$0.00,1,1,1,1,1,1,20161001,,,,
L1685,HCPCS,POST-OP HIP ABDUCT CUSTOM FA,,,28,,NW,,,,,,"$2,121.83",$0.00,1,1,1,1,1,1,20161001,,,,
L1686,HCPCS,HO POST-OP HIP ABDUCTION,,,28,,NW,,,,,,"$1,651.08",$0.00,1,1,1,1,1,1,20161001,,,,
L1690,HCPCS,COMBINATION BILATERAL HO,,,28,,NW,,,,,,"$3,294.00",$0.00,1,1,1,1,1,1,20161001,,,,
L1700,HCPCS,LEG PERTHES ORTH TORONTO TYP,,,28,,NW,,,,,,"$2,765.87",$0.00,1,1,1,1,1,1,20161001,,,,
L1710,HCPCS,LEGG PERTHES ORTH NEWINGTON,,,28,,NW,,,,,,"$3,341.26",$0.00,1,1,1,1,1,1,20161001,,,,
L1720,HCPCS,LEGG PERTHES ORTHOSIS TRILAT,,,28,,NW,,,,,,"$2,434.32",$0.00,1,1,1,1,1,1,20161001,,,,
L1730,HCPCS,LEGG PERTHES ORTH SCOTTISH R,,,28,,NW,,,,,,"$2,013.31",$0.00,1,1,1,1,1,1,20161001,,,,
L1755,HCPCS,LEGG PERTHES PATTEN BOTTOM T,,,28,,NW,,,,,,"$2,856.97",$0.00,1,1,1,1,1,1,20161001,,,,
L1810,HCPCS,KO ELASTIC WITH JOINTS,,,28,,NW,,,,,,$106.26,$0.00,1,1,1,1,1,1,20161001,,,,
L1812,HCPCS,KO ELASTIC W/JOINTS PRE OTS,,,28,,NW,,,,,,$106.26,$0.00,1,1,1,1,1,1,20161001,,,,
L1820,HCPCS,KO ELAS W/ CONDYLE PADS & JO,,,28,,NW,,,,,,$157.59,$0.00,1,1,1,1,1,1,20161001,,,,
L1830,HCPCS,KO IMMOB CANVAS LONG PRE OTS,,,28,,NW,,,,,,$82.65,$0.00,1,1,1,1,1,1,20161001,,,,
L1831,HCPCS,KNEE ORTH POS LOCKING JOINT,,,28,,NW,,,,,,$431.49,$0.00,1,1,1,1,1,1,20161001,,,,
L1832,HCPCS,KO ADJ JNT POS R SUP PRE CST,,,28,,NW,,,,,,"$1,110.33",$0.00,1,1,1,1,1,1,20161001,,,,
L1833,HCPCS,KO ADJ JNT POS R SUP PRE OTS,,,28,,NW,,,,,,"$1,110.33",$0.00,1,1,1,1,1,1,20161001,,,,
L1834,HCPCS,KO W/0 JOINT RIGID MOLDED TO,,,28,,NW,,,,,,"$1,348.54",$0.00,1,1,1,1,1,1,20161001,,,,
L1836,HCPCS,KO RIGID W/O JOINTS PRE OTS,,,28,,NW,,,,,,$150.58,$0.00,1,1,1,1,1,1,20161001,,,,
L1840,HCPCS,KO DEROT ANT CRUCIATE CUSTOM,,,28,,NW,,,,,,"$1,658.19",$0.00,1,1,1,1,1,1,20161001,,,,
L1843,HCPCS,KO SINGLE UPRIGHT PRE CST,,,28,,NW,,,,,,"$1,484.26",$0.00,1,1,1,1,1,1,20161001,,,,
L1844,HCPCS,KO W/ADJ JT ROT CNTRL MOLDED,,,28,,NW,,,,,,"$2,821.97",$0.00,1,1,1,1,1,1,20161001,,,,
L1845,HCPCS,KO DOUBLE UPRIGHT PRE CST,,,28,,NW,,,,,,"$1,434.96",$0.00,1,1,1,1,1,1,20161001,,,,
L1846,HCPCS,KO W ADJ FLEX/EXT ROTAT MOLD,,,28,,NW,,,,,,"$2,027.51",$0.00,1,1,1,1,1,1,20161001,,,,
L1847,HCPCS,KO DBL UPRIGHT W/AIR PRE CST,,,28,,NW,,,,,,$921.88,$0.00,1,1,1,1,1,1,20161001,,,,
L1848,HCPCS,KO DBL UPRIGHT W/AIR PRE OTS,,,28,,NW,,,,,,$921.88,$0.00,1,1,1,1,1,1,20161001,,,,
L1850,HCPCS,KO SWEDISH TYPE PRE OTS,,,28,,NW,,,,,,$448.86,$0.00,1,1,1,1,1,1,20161001,,,,
L1860,HCPCS,KO SUPRACONDYLAR SOCKET MOLD,,,28,,NW,,,,,,"$1,946.95",$0.00,1,1,1,1,1,1,20161001,,,,
L1900,HCPCS,AFO SPRNG WIR DRSFLX CALF BD,,,28,,NW,,,,,,$415.08,$0.00,1,1,1,1,1,1,20161001,,,,
L1902,HCPCS,AFO ANKLE GAUNTLET PRE OTS,,,28,,NW,,,,,,$75.38,$0.00,1,1,1,1,1,1,20161001,,,,
L1904,HCPCS,AFO MOLDED ANKLE GAUNTLET,,,28,,NW,,,,,,$767.49,$0.00,1,1,1,1,1,1,20161001,,,,
L1906,HCPCS,AFO MULTILIG ANK SUP PRE OTS,,,28,,NW,,,,,,$136.50,$0.00,1,1,1,1,1,1,20161001,,,,
L1907,HCPCS,AFO SUPRAMALLEOLAR CUSTOM,,,28,,NW,,,,,,$900.09,$0.00,1,1,1,1,1,1,20161001,,,,
L1910,HCPCS,AFO SING BAR CLASP ATTACH SH,,,28,,NW,,,,,,$417.46,$0.00,1,1,1,1,1,1,20161001,,,,
L1920,HCPCS,AFO SING UPRIGHT W/ ADJUST S,,,28,,NW,,,,,,$548.21,$0.00,1,1,1,1,1,1,20161001,,,,
L1930,HCPCS,AFO PLASTIC,,,28,,NW,,,,,,$363.62,$0.00,1,1,1,1,1,1,20161001,,,,
L1932,HCPCS,AFO RIG ANT TIB PREFAB TCF/=,,,28,,NW,,,,,,"$1,475.70",$0.00,1,1,1,1,1,1,20161001,,,,
L1940,HCPCS,AFO MOLDED TO PATIENT PLASTI,,,28,,NW,,,,,,$836.56,$0.00,1,1,1,1,1,1,20161001,,,,
L1945,HCPCS,AFO MOLDED PLAS RIG ANT TIB,,,28,,NW,,,,,,"$1,690.64",$0.00,1,1,1,1,1,1,20161001,,,,
L1950,HCPCS,AFO SPIRAL MOLDED TO PT PLAS,,,28,,NW,,,,,,"$1,313.68",$0.00,1,1,1,1,1,1,20161001,,,,
L1951,HCPCS,AFO SPIRAL PREFABRICATED,,,28,,NW,,,,,,"$1,383.98",$0.00,1,1,1,1,1,1,20161001,,,,
L1960,HCPCS,AFO POS SOLID ANK PLASTIC MO,,,28,,NW,,,,,,$956.99,$0.00,1,1,1,1,1,1,20161001,,,,
L1970,HCPCS,AFO PLASTIC MOLDED W/ANKLE J,,,28,,NW,,,,,,"$1,214.77",$0.00,1,1,1,1,1,1,20161001,,,,
L1971,HCPCS,"AFO W/ANKLE JOINT, PREFAB",,,28,,NW,,,,,,$736.03,$0.00,1,1,1,1,1,1,20161001,,,,
L1980,HCPCS,AFO SING SOLID STIRRUP CALF,,,28,,NW,,,,,,$603.44,$0.00,1,1,1,1,1,1,20161001,,,,
L1990,HCPCS,AFO DOUB SOLID STIRRUP CALF,,,28,,NW,,,,,,$750.56,$0.00,1,1,1,1,1,1,20161001,,,,
L2000,HCPCS,KAFO SING FRE STIRR THI/CALF,,,28,,NW,,,,,,"$1,795.97",$0.00,1,1,1,1,1,1,20161001,,,,
L2005,HCPCS,KAFO SNG/DBL MECHANICAL ACT,,,28,,NW,,,,,,"$7,072.89",$0.00,1,1,1,1,1,1,20161001,,,,
L2010,HCPCS,KAFO SNG SOLID STIRRUP W/O J,,,28,,NW,,,,,,"$1,638.06",$0.00,1,1,1,1,1,1,20161001,,,,
L2020,HCPCS,KAFO DBL SOLID STIRRUP BAND/,,,28,,NW,,,,,,"$2,034.08",$0.00,1,1,1,1,1,1,20161001,,,,
L2030,HCPCS,KAFO DBL SOLID STIRRUP W/O J,,,28,,NW,,,,,,"$1,821.04",$0.00,1,1,1,1,1,1,20161001,,,,
L2034,HCPCS,KAFO PLA SIN UP W/WO K/A CUS,,,28,,NW,,,,,,"$3,494.17",$0.00,1,1,1,1,1,1,20161001,,,,
L2035,HCPCS,KAFO PLASTIC PEDIATRIC SIZE,,,28,,NW,,,,,,$221.63,$0.00,1,1,1,1,1,1,20161001,,,,
L2036,HCPCS,KAFO PLAS DOUB FREE KNEE MOL,,,28,,NW,,,,,,"$3,319.27",$0.00,1,1,1,1,1,1,20161001,,,,
L2037,HCPCS,KAFO PLAS SING FREE KNEE MOL,,,28,,NW,,,,,,"$3,011.87",$0.00,1,1,1,1,1,1,20161001,,,,
L2038,HCPCS,KAFO W/O JOINT MULTI-AXIS AN,,,28,,NW,,,,,,"$2,505.01",$0.00,1,1,1,1,1,1,20161001,,,,
L2040,HCPCS,HKAFO TORSION BIL ROT STRAPS,,,28,,NW,,,,,,$239.20,$0.00,1,1,1,1,1,1,20161001,,,,
L2050,HCPCS,HKAFO TORSION CABLE HIP PELV,,,28,,NW,,,,,,$797.51,$0.00,1,1,1,1,1,1,20161001,,,,
L2060,HCPCS,HKAFO TORSION BALL BEARING J,,,28,,NW,,,,,,$995.39,$0.00,1,1,1,1,1,1,20161001,,,,
L2070,HCPCS,HKAFO TORSION UNILAT ROT STR,,,28,,NW,,,,,,$170.47,$0.00,1,1,1,1,1,1,20161001,,,,
L2080,HCPCS,HKAFO UNILAT TORSION CABLE,,,28,,NW,,,,,,$583.67,$0.00,1,1,1,1,1,1,20161001,,,,
L2090,HCPCS,HKAFO UNILAT TORSION BALL BR,,,28,,NW,,,,,,$739.17,$0.00,1,1,1,1,1,1,20161001,,,,
L2106,HCPCS,AFO TIB FX CAST PLASTER MOLD,,,28,,NW,,,,,,"$1,225.20",$0.00,1,1,1,1,1,1,20161001,,,,
L2108,HCPCS,AFO TIB FX CAST MOLDED TO PT,,,28,,NW,,,,,,"$1,899.93",$0.00,1,1,1,1,1,1,20161001,,,,
L2112,HCPCS,AFO TIBIAL FRACTURE SOFT,,,28,,NW,,,,,,$808.00,$0.00,1,1,1,1,1,1,20161001,,,,
L2114,HCPCS,AFO TIB FX SEMI-RIGID,,,28,,NW,,,,,,"$1,024.20",$0.00,1,1,1,1,1,1,20161001,,,,
L2116,HCPCS,AFO TIBIAL FRACTURE RIGID,,,28,,NW,,,,,,"$1,265.85",$0.00,1,1,1,1,1,1,20161001,,,,
L2126,HCPCS,KAFO FEM FX CAST THERMOPLAS,,,28,,NW,,,,,,"$2,140.01",$0.00,1,1,1,1,1,1,20161001,,,,
L2128,HCPCS,KAFO FEM FX CAST MOLDED TO P,,,28,,NW,,,,,,"$3,013.89",$0.00,1,1,1,1,1,1,20161001,,,,
L2132,HCPCS,KAFO FEMORAL FX CAST SOFT,,,28,,NW,,,,,,"$1,427.91",$0.00,1,1,1,1,1,1,20161001,,,,
L2134,HCPCS,KAFO FEM FX CAST SEMI-RIGID,,,28,,NW,,,,,,"$1,789.76",$0.00,1,1,1,1,1,1,20161001,,,,
L2136,HCPCS,KAFO FEMORAL FX CAST RIGID,,,28,,NW,,,,,,"$2,135.28",$0.00,1,1,1,1,1,1,20161001,,,,
L2180,HCPCS,PLAS SHOE INSERT W ANK JOINT,,,28,,NW,,,,,,$140.14,$0.00,1,1,1,1,1,1,20161001,,,,
L2182,HCPCS,DROP LOCK KNEE,,,28,,NW,,,,,,$92.03,$0.00,1,1,1,1,1,1,20161001,,,,
L2184,HCPCS,LIMITED MOTION KNEE JOINT,,,28,,NW,,,,,,$142.76,$0.00,1,1,1,1,1,1,20161001,,,,
L2186,HCPCS,ADJ MOTION KNEE JNT LERMAN T,,,28,,NW,,,,,,$192.04,$0.00,1,1,1,1,1,1,20161001,,,,
L2188,HCPCS,QUADRILATERAL BRIM,,,28,,NW,,,,,,$483.20,$0.00,1,1,1,1,1,1,20161001,,,,
L2190,HCPCS,WAIST BELT,,,28,,NW,,,,,,$79.12,$0.00,1,1,1,1,1,1,20161001,,,,
L2192,HCPCS,PELVIC BAND & BELT THIGH FLA,,,28,,NW,,,,,,$580.96,$0.00,1,1,1,1,1,1,20161001,,,,
L2200,HCPCS,LIMITED ANKLE MOTION EA JNT,,,28,,NW,,,,,,$48.60,$0.00,1,1,1,1,1,1,20161001,,,,
L2210,HCPCS,DORSIFLEXION ASSIST EACH JOI,,,28,,NW,,,,,,$63.53,$0.00,1,1,1,1,1,1,20161001,,,,
L2220,HCPCS,DORSI & PLANTAR FLEX ASS/RES,,,28,,NW,,,,,,$76.44,$0.00,1,1,1,1,1,1,20161001,,,,
L2230,HCPCS,SPLIT FLAT CALIPER STIRR & P,,,28,,NW,,,,,,$72.88,$0.00,1,1,1,1,1,1,20161001,,,,
L2232,HCPCS,"ROCKER BOTTOM, CONTACT AFO",,,28,,NW,,,,,,$88.65,$0.00,1,1,1,1,1,1,20161001,,,,
L2240,HCPCS,ROUND CALIPER AND PLATE ATTA,,,28,,NW,,,,,,$77.84,$0.00,1,1,1,1,1,1,20161001,,,,
L2250,HCPCS,FOOT PLATE MOLDED STIRRUP AT,,,28,,NW,,,,,,$558.92,$0.00,1,1,1,1,1,1,20161001,,,,
L2260,HCPCS,REINFORCED SOLID STIRRUP,,,28,,NW,,,,,,$283.17,$0.00,1,1,1,1,1,1,20161001,,,,
L2265,HCPCS,LONG TONGUE STIRRUP,,,28,,NW,,,,,,$141.89,$0.00,1,1,1,1,1,1,20161001,,,,
L2270,HCPCS,VARUS/VALGUS STRAP PADDED/LI,,,28,,NW,,,,,,$52.83,$0.00,1,1,1,1,1,1,20161001,,,,
L2275,HCPCS,PLASTIC MOD LOW EXT PAD/LINE,,,28,,NW,,,,,,$146.36,$0.00,1,1,1,1,1,1,20161001,,,,
L2280,HCPCS,MOLDED INNER BOOT,,,28,,NW,,,,,,$770.51,$0.00,1,1,1,1,1,1,20161001,,,,
L2300,HCPCS,ABDUCTION BAR JOINTED ADJUST,,,28,,NW,,,,,,$427.81,$0.00,1,1,1,1,1,1,20161001,,,,
L2310,HCPCS,ABDUCTION BAR-STRAIGHT,,,28,,NW,,,,,,$147.28,$0.00,1,1,1,1,1,1,20161001,,,,
L2320,HCPCS,NON-MOLDED LACER,,,28,,NW,,,,,,$296.10,$0.00,1,1,1,1,1,1,20161001,,,,
L2330,HCPCS,LACER MOLDED TO PATIENT MODE,,,28,,NW,,,,,,$643.87,$0.00,1,1,1,1,1,1,20161001,,,,
L2335,HCPCS,ANTERIOR SWING BAND,,,28,,NW,,,,,,$353.12,$0.00,1,1,1,1,1,1,20161001,,,,
L2340,HCPCS,PRE-TIBIAL SHELL MOLDED TO P,,,28,,NW,,,,,,$780.20,$0.00,1,1,1,1,1,1,20161001,,,,
L2350,HCPCS,PROSTHETIC TYPE SOCKET MOLDE,,,28,,NW,,,,,,"$1,567.82",$0.00,1,1,1,1,1,1,20161001,,,,
L2360,HCPCS,EXTENDED STEEL SHANK,,,28,,NW,,,,,,$52.31,$0.00,1,1,1,1,1,1,20161001,,,,
L2370,HCPCS,PATTEN BOTTOM,,,28,,NW,,,,,,$429.39,$0.00,1,1,1,1,1,1,20161001,,,,
L2375,HCPCS,TORSION ANK & HALF SOLID STI,,,28,,NW,,,,,,$132.53,$0.00,1,1,1,1,1,1,20161001,,,,
L2380,HCPCS,TORSION STRAIGHT KNEE JOINT,,,28,,NW,,,,,,$148.63,$0.00,1,1,1,1,1,1,20161001,,,,
L2385,HCPCS,STRAIGHT KNEE JOINT HEAVY DU,,,28,,NW,,,,,,$170.11,$0.00,1,1,1,1,1,1,20161001,,,,
L2387,HCPCS,ADD LE POLY KNEE CUSTOM KAFO,,,28,,NW,,,,,,$231.69,$0.00,1,1,1,1,1,1,20161001,,,,
L2390,HCPCS,OFFSET KNEE JOINT EACH,,,28,,NW,,,,,,$114.37,$0.00,1,1,1,1,1,1,20161001,,,,
L2395,HCPCS,OFFSET KNEE JOINT HEAVY DUTY,,,28,,NW,,,,,,$205.18,$0.00,1,1,1,1,1,1,20161001,,,,
L2397,HCPCS,SUSPENSION SLEEVE LOWER EXT,,,28,,NW,,,,,,$122.35,$0.00,1,1,1,1,1,1,20161001,,,,
L2405,HCPCS,KNEE JOINT DROP LOCK EA JNT,,,28,,NW,,,,,,$76.82,$0.00,1,1,1,1,1,1,20161001,,,,
L2415,HCPCS,KNEE JOINT CAM LOCK EACH JOI,,,28,,NW,,,,,,$129.71,$0.00,1,1,1,1,1,1,20161001,,,,
L2425,HCPCS,KNEE DISC/DIAL LOCK/ADJ FLEX,,,28,,NW,,,,,,$167.90,$0.00,1,1,1,1,1,1,20161001,,,,
L2430,HCPCS,KNEE JNT RATCHET LOCK EA JNT,,,28,,NW,,,,,,$167.90,$0.00,1,1,1,1,1,1,20161001,,,,
L2492,HCPCS,KNEE LIFT LOOP DROP LOCK RIN,,,28,,NW,,,,,,$109.27,$0.00,1,1,1,1,1,1,20161001,,,,
L2500,HCPCS,THI/GLUT/ISCHIA WGT BEARING,,,28,,NW,,,,,,$492.51,$0.00,1,1,1,1,1,1,20161001,,,,
L2510,HCPCS,TH/WGHT BEAR QUAD-LAT BRIM M,,,28,,NW,,,,,,"$1,310.99",$0.00,1,1,1,1,1,1,20161001,,,,
L2520,HCPCS,TH/WGHT BEAR QUAD-LAT BRIM C,,,28,,NW,,,,,,$794.96,$0.00,1,1,1,1,1,1,20161001,,,,
L2525,HCPCS,TH/WGHT BEAR NAR M-L BRIM MO,,,28,,NW,,,,,,"$2,213.32",$0.00,1,1,1,1,1,1,20161001,,,,
L2526,HCPCS,TH/WGHT BEAR NAR M-L BRIM CU,,,28,,NW,,,,,,"$1,192.41",$0.00,1,1,1,1,1,1,20161001,,,,
L2530,HCPCS,THIGH/WGHT BEAR LACER NON-MO,,,28,,NW,,,,,,$353.04,$0.00,1,1,1,1,1,1,20161001,,,,
L2540,HCPCS,THIGH/WGHT BEAR LACER MOLDED,,,28,,NW,,,,,,$698.32,$0.00,1,1,1,1,1,1,20161001,,,,
L2550,HCPCS,THIGH/WGHT BEAR HIGH ROLL CU,,,28,,NW,,,,,,$454.72,$0.00,1,1,1,1,1,1,20161001,,,,
L2570,HCPCS,HIP CLEVIS TYPE 2 POSIT JNT,,,28,,NW,,,,,,$838.14,$0.00,1,1,1,1,1,1,20161001,,,,
L2580,HCPCS,PELVIC CONTROL PELVIC SLING,,,28,,NW,,,,,,$796.53,$0.00,1,1,1,1,1,1,20161001,,,,
L2600,HCPCS,HIP CLEVIS/THRUST BEARING FR,,,28,,NW,,,,,,$307.03,$0.00,1,1,1,1,1,1,20161001,,,,
L2610,HCPCS,HIP CLEVIS/THRUST BEARING LO,,,28,,NW,,,,,,$373.78,$0.00,1,1,1,1,1,1,20161001,,,,
L2620,HCPCS,PELVIC CONTROL HIP HEAVY DUT,,,28,,NW,,,,,,$425.80,$0.00,1,1,1,1,1,1,20161001,,,,
L2622,HCPCS,HIP JOINT ADJUSTABLE FLEXION,,,28,,NW,,,,,,$496.62,$0.00,1,1,1,1,1,1,20161001,,,,
L2624,HCPCS,HIP ADJ FLEX EXT ABDUCT CONT,,,28,,NW,,,,,,$559.31,$0.00,1,1,1,1,1,1,20161001,,,,
L2627,HCPCS,PLASTIC MOLD RECIPRO HIP & C,,,28,,NW,,,,,,"$3,041.54",$0.00,1,1,1,1,1,1,20161001,,,,
L2628,HCPCS,METAL FRAME RECIPRO HIP & CA,,,28,,NW,,,,,,"$2,965.48",$0.00,1,1,1,1,1,1,20161001,,,,
L2630,HCPCS,PELVIC CONTROL BAND & BELT U,,,28,,NW,,,,,,$375.40,$0.00,1,1,1,1,1,1,20161001,,,,
L2640,HCPCS,PELVIC CONTROL BAND & BELT B,,,28,,NW,,,,,,$543.85,$0.00,1,1,1,1,1,1,20161001,,,,
L2650,HCPCS,PELV & THOR CONTROL GLUTEAL,,,28,,NW,,,,,,$140.54,$0.00,1,1,1,1,1,1,20161001,,,,
L2660,HCPCS,THORACIC CONTROL THORACIC BA,,,28,,NW,,,,,,$258.79,$0.00,1,1,1,1,1,1,20161001,,,,
L2670,HCPCS,THORAC CONT PARASPINAL UPRIG,,,28,,NW,,,,,,$230.81,$0.00,1,1,1,1,1,1,20161001,,,,
L2680,HCPCS,THORAC CONT LAT SUPPORT UPRI,,,28,,NW,,,,,,$206.87,$0.00,1,1,1,1,1,1,20161001,,,,
L2750,HCPCS,PLATING CHROME/NICKEL PR BAR,,,28,,NW,,,,,,$75.34,$0.00,1,1,1,1,1,1,20161001,,,,
L2755,HCPCS,CARBON GRAPHITE LAMINATION,,,28,,NW,,,,,,$145.84,$0.00,1,1,1,1,1,1,20161001,,,,
L2760,HCPCS,EXTENSION PER EXTENSION PER,,,28,,NW,,,,,,$59.22,$0.00,1,1,1,1,1,1,20161001,,,,
L2768,HCPCS,ORTHO SIDEBAR DISCONNECT,,,28,,NW,,,,,,$145.10,$0.00,1,1,1,1,1,1,20161001,,,,
L2780,HCPCS,NON-CORROSIVE FINISH,,,28,,NW,,,,,,$64.02,$0.00,1,1,1,1,1,1,20161001,,,,
L2785,HCPCS,DROP LOCK RETAINER EACH,,,28,,NW,,,,,,$34.85,$0.00,1,1,1,1,1,1,20161001,,,,
L2795,HCPCS,KNEE CONTROL FULL KNEECAP,,,28,,NW,,,,,,$78.73,$0.00,1,1,1,1,1,1,20161001,,,,
L2800,HCPCS,KNEE CAP MEDIAL OR LATERAL P,,,28,,NW,,,,,,$111.71,$0.00,1,1,1,1,1,1,20161001,,,,
L2810,HCPCS,KNEE CONTROL CONDYLAR PAD,,,28,,NW,,,,,,$74.15,$0.00,1,1,1,1,1,1,20161001,,,,
L2820,HCPCS,SOFT INTERFACE BELOW KNEE SE,,,28,,NW,,,,,,$79.23,$0.00,1,1,1,1,1,1,20161001,,,,
L2830,HCPCS,SOFT INTERFACE ABOVE KNEE SE,,,28,,NW,,,,,,$89.84,$0.00,1,1,1,1,1,1,20161001,,,,
L2840,HCPCS,TIBIAL LENGTH SOCK FX OR EQU,,,28,,NW,,,,,,$45.02,$0.00,1,1,1,1,1,1,20161001,,,,
L2850,HCPCS,FEMORAL LGTH SOCK FX OR EQUA,,,28,,NW,,,,,,$58.35,$0.00,1,1,1,1,1,1,20161001,,,,
L2861,HCPCS,TORSION MECHANISM KNEE/ANKLE,,,28,,NW,,,,,,"$1,077.20",$0.00,1,1,1,1,1,1,20161001,,,,
L2999,HCPCS,LOWER EXTREMITY ORTHOSIS NOS,,,28,,NW,,,,,,$79.23,$0.00,1,1,1,1,1,1,20161001,,,,
L3000,HCPCS,FT INSERT UCB BERKELEY SHELL,,,28,,NW,,,,,,$466.09,$0.00,1,1,1,1,1,1,20161001,,,,
L3001,HCPCS,FOOT INSERT REMOV MOLDED SPE,,,28,,NW,,,,,,$148.55,$0.00,1,1,1,1,1,1,20161001,,,,
L3002,HCPCS,FOOT INSERT PLASTAZOTE OR EQ,,,28,,NW,,,,,,$199.61,$0.00,1,1,1,1,1,1,20161001,,,,
L3003,HCPCS,FOOT INSERT SILICONE GEL EAC,,,28,,NW,,,,,,$221.85,$0.00,1,1,1,1,1,1,20161001,,,,
L3010,HCPCS,FOOT LONGITUDINAL ARCH SUPPO,,,28,,NW,,,,,,$221.85,$0.00,1,1,1,1,1,1,20161001,,,,
L3020,HCPCS,FOOT LONGITUD/METATARSAL SUP,,,28,,NW,,,,,,$264.03,$0.00,1,1,1,1,1,1,20161001,,,,
L3030,HCPCS,FOOT ARCH SUPPORT REMOV PREM,,,28,,NW,,,,,,$68.19,$0.00,1,1,1,1,1,1,20161001,,,,
L3031,HCPCS,FOOT LAMIN/PREPREG COMPOSITE,,,28,,NW,,,,,,$131.79,$0.00,1,1,1,1,1,1,20161001,,,,
L3040,HCPCS,FT ARCH SUPRT PREMOLD LONGIT,,,28,,NW,,,,,,$44.95,$0.00,1,1,1,1,1,1,20161001,,,,
L3050,HCPCS,FOOT ARCH SUPP PREMOLD METAT,,,28,,NW,,,,,,$44.95,$0.00,1,1,1,1,1,1,20161001,,,,
L3060,HCPCS,FOOT ARCH SUPP LONGITUD/META,,,28,,NW,,,,,,$66.15,$0.00,1,1,1,1,1,1,20161001,,,,
L3070,HCPCS,ARCH SUPRT ATT TO SHO LONGIT,,,28,,NW,,,,,,$32.80,$0.00,1,1,1,1,1,1,20161001,,,,
L3080,HCPCS,ARCH SUPP ATT TO SHOE METATA,,,28,,NW,,,,,,$32.80,$0.00,1,1,1,1,1,1,20161001,,,,
L3090,HCPCS,ARCH SUPP ATT TO SHOE LONG/M,,,28,,NW,,,,,,$39.90,$0.00,1,1,1,1,1,1,20161001,,,,
L3100,HCPCS,HALLUS-VALGUS NT DYN PRE OTS,,,28,,NW,,,,,,$41.90,$0.00,1,1,1,1,1,1,20161001,,,,
L3140,HCPCS,ABDUCTION ROTATION BAR SHOE,,,28,,NW,,,,,,$78.29,$0.00,1,1,1,1,1,1,20161001,,,,
L3150,HCPCS,ABDUCT ROTATION BAR W/O SHOE,,,28,,NW,,,,,,$72.22,$0.00,1,1,1,1,1,1,20161001,,,,
L3160,HCPCS,SHOE STYLED POSITIONING DEV,,,28,,NW,,,,,,$22.43,$0.00,1,1,1,1,1,1,20161001,,,,
L3170,HCPCS,FOOT PLAS HEEL STABI PRE OTS,,,28,,NW,,,,,,$47.98,$0.00,1,1,1,1,1,1,20161001,,,,
L3201,HCPCS,OXFORD W SUPINAT/PRONAT INF,,,28,,NW,,,,,,$63.87,$0.00,1,1,1,1,1,1,20161001,,,,
L3202,HCPCS,OXFORD W/ SUPINAT/PRONATOR C,,,28,,NW,,,,,,$62.80,$0.00,1,1,1,1,1,1,20161001,,,,
L3203,HCPCS,OXFORD W/ SUPINATOR/PRONATOR,,,28,,NW,,,,,,$61.21,$0.00,1,1,1,1,1,1,20161001,,,,
L3204,HCPCS,HIGHTOP W/ SUPP/PRONATOR INF,,,28,,NW,,,,,,$61.21,$0.00,1,1,1,1,1,1,20161001,,,,
L3206,HCPCS,HIGHTOP W/ SUPP/PRONATOR CHI,,,28,,NW,,,,,,$63.34,$0.00,1,1,1,1,1,1,20161001,,,,
L3207,HCPCS,HIGHTOP W/ SUPP/PRONATOR JUN,,,28,,NW,,,,,,$64.40,$0.00,1,1,1,1,1,1,20161001,,,,
L3208,HCPCS,SURGICAL BOOT EACH INFANT,,,28,,NW,,,,,,$37.31,$0.00,1,1,1,1,1,1,20161001,,,,
L3209,HCPCS,SURGICAL BOOT EACH CHILD,,,28,,NW,,,,,,$50.06,$0.00,1,1,1,1,1,1,20161001,,,,
L3211,HCPCS,SURGICAL BOOT EACH JUNIOR,,,28,,NW,,,,,,$52.71,$0.00,1,1,1,1,1,1,20161001,,,,
L3212,HCPCS,BENESCH BOOT PAIR INFANT,,,28,,NW,,,,,,$70.24,$0.00,1,1,1,1,1,1,20161001,,,,
L3213,HCPCS,BENESCH BOOT PAIR CHILD,,,28,,NW,,,,,,$84.57,$0.00,1,1,1,1,1,1,20161001,,,,
L3214,HCPCS,BENESCH BOOT PAIR JUNIOR,,,28,,NW,,,,,,$95.08,$0.00,1,1,1,1,1,1,20161001,,,,
L3215,HCPCS,ORTHOPEDIC FTWEAR LADIES OXF,,,28,,NW,,,,,,$142.95,$0.00,1,1,1,1,1,1,20161001,,,,
L3216,HCPCS,ORTHOPED LADIES SHOES DPTH I,,,28,,NW,,,,,,$190.82,$0.00,1,1,1,1,1,1,20161001,,,,
L3217,HCPCS,LADIES SHOES HIGHTOP DEPTH I,,,28,,NW,,,,,,$213.00,$0.00,1,1,1,1,1,1,20161001,,,,
L3219,HCPCS,ORTHOPEDIC MENS SHOES OXFORD,,,28,,NW,,,,,,$170.97,$0.00,1,1,1,1,1,1,20161001,,,,
L3221,HCPCS,ORTHOPEDIC MENS SHOES DPTH I,,,28,,NW,,,,,,$221.17,$0.00,1,1,1,1,1,1,20161001,,,,
L3222,HCPCS,MENS SHOES HIGHTOP DEPTH INL,,,28,,NW,,,,,,$253.87,$0.00,1,1,1,1,1,1,20161001,,,,
L3224,HCPCS,WOMAN'S SHOE OXFORD BRACE,,,28,,NW,,,,,,$57.76,$0.00,1,1,1,1,1,1,20161001,,,,
L3225,HCPCS,MAN'S SHOE OXFORD BRACE,,,28,,NW,,,,,,$64.68,$0.00,1,1,1,1,1,1,20161001,,,,
L3230,HCPCS,CUSTOM SHOES DEPTH INLAY,,,28,,NW,,,,,,$313.41,$0.00,1,1,1,1,1,1,20161001,,,,
L3250,HCPCS,CUSTOM MOLD SHOE REMOV PROST,,,28,,NW,,,,,,$687.02,$0.00,1,1,1,1,1,1,20161001,,,,
L3251,HCPCS,SHOE MOLDED TO PT SILICONE S,,,28,,NW,,,,,,$55.90,$0.00,1,1,1,1,1,1,20161001,,,,
L3252,HCPCS,SHOE MOLDED PLASTAZOTE CUST,,,28,,NW,,,,,,$339.10,$0.00,1,1,1,1,1,1,20161001,,,,
L3253,HCPCS,SHOE MOLDED PLASTAZOTE CUST,,,28,,NW,,,,,,$55.37,$0.00,1,1,1,1,1,1,20161001,,,,
L3254,HCPCS,ORTH FOOT NON-STNDARD SIZE/W,,,28,,NW,,,,,,$36.59,$0.00,1,1,1,1,1,1,20161001,,,,
L3255,HCPCS,ORTH FOOT NON-STANDARD SIZE/,,,28,,NW,,,,,,$223.47,$0.00,1,1,1,1,1,1,20161001,,,,
L3257,HCPCS,ORTH FOOT ADD CHARGE SPLIT S,,,28,,NW,,,,,,$42.09,$0.00,1,1,1,1,1,1,20161001,,,,
L3260,HCPCS,AMBULATORY SURGICAL BOOT EAC,,,28,,NW,,,,,,$27.21,$0.00,1,1,1,1,1,1,20161001,,,,
L3265,HCPCS,PLASTAZOTE SANDAL EACH,,,28,,NW,,,,,,$28.81,$0.00,1,1,1,1,1,1,20161001,,,,
L3300,HCPCS,SHO LIFT TAPER TO METATARSAL,,,28,,NW,,,,,,$48.98,$0.00,1,1,1,1,1,1,20161001,,,,
L3310,HCPCS,SHOE LIFT ELEV HEEL/SOLE NEO,,,28,,NW,,,,,,$72.22,$0.00,1,1,1,1,1,1,20161001,,,,
L3320,HCPCS,SHOE LIFT ELEV HEEL/SOLE COR,,,28,,NW,,,,,,$202.49,$0.00,1,1,1,1,1,1,20161001,,,,
L3330,HCPCS,LIFTS ELEVATION METAL EXTENS,,,28,,NW,,,,,,$905.76,$0.00,1,1,1,1,1,1,20161001,,,,
L3332,HCPCS,SHOE LIFTS TAPERED TO ONE-HA,,,28,,NW,,,,,,$66.15,$0.00,1,1,1,1,1,1,20161001,,,,
L3334,HCPCS,SHOE LIFTS ELEVATION HEEL /I,,,28,,NW,,,,,,$37.87,$0.00,1,1,1,1,1,1,20161001,,,,
L3340,HCPCS,SHOE WEDGE SACH,,,28,,NW,,,,,,$75.27,$0.00,1,1,1,1,1,1,20161001,,,,
L3350,HCPCS,SHOE HEEL WEDGE,,,28,,NW,,,,,,$25.75,$0.00,1,1,1,1,1,1,20161001,,,,
L3360,HCPCS,SHOE SOLE WEDGE OUTSIDE SOLE,,,28,,NW,,,,,,$35.85,$0.00,1,1,1,1,1,1,20161001,,,,
L3370,HCPCS,SHOE SOLE WEDGE BETWEEN SOLE,,,28,,NW,,,,,,$46.95,$0.00,1,1,1,1,1,1,20161001,,,,
L3380,HCPCS,SHOE CLUBFOOT WEDGE,,,28,,NW,,,,,,$46.95,$0.00,1,1,1,1,1,1,20161001,,,,
L3390,HCPCS,SHOE OUTFLARE WEDGE,,,28,,NW,,,,,,$46.95,$0.00,1,1,1,1,1,1,20161001,,,,
L3400,HCPCS,SHOE METATARSAL BAR WEDGE RO,,,28,,NW,,,,,,$39.90,$0.00,1,1,1,1,1,1,20161001,,,,
L3410,HCPCS,SHOE METATARSAL BAR BETWEEN,,,28,,NW,,,,,,$81.32,$0.00,1,1,1,1,1,1,20161001,,,,
L3420,HCPCS,FULL SOLE/HEEL WEDGE BTWEEN,,,28,,NW,,,,,,$51.00,$0.00,1,1,1,1,1,1,20161001,,,,
L3430,HCPCS,SHO HEEL COUNT PLAST REINFOR,,,28,,NW,,,,,,$197.42,$0.00,1,1,1,1,1,1,20161001,,,,
L3440,HCPCS,HEEL LEATHER REINFORCED,,,28,,NW,,,,,,$68.19,$0.00,1,1,1,1,1,1,20161001,,,,
L3450,HCPCS,SHOE HEEL SACH CUSHION TYPE,,,28,,NW,,,,,,$101.91,$0.00,1,1,1,1,1,1,20161001,,,,
L3455,HCPCS,SHOE HEEL NEW LEATHER STANDA,,,28,,NW,,,,,,$39.90,$0.00,1,1,1,1,1,1,20161001,,,,
L3460,HCPCS,SHOE HEEL NEW RUBBER STANDAR,,,28,,NW,,,,,,$34.83,$0.00,1,1,1,1,1,1,20161001,,,,
L3465,HCPCS,SHOE HEEL THOMAS WITH WEDGE,,,28,,NW,,,,,,$54.04,$0.00,1,1,1,1,1,1,20161001,,,,
L3470,HCPCS,SHOE HEEL THOMAS EXTEND TO B,,,28,,NW,,,,,,$57.06,$0.00,1,1,1,1,1,1,20161001,,,,
L3480,HCPCS,SHOE HEEL PAD & DEPRESS FOR,,,28,,NW,,,,,,$57.06,$0.00,1,1,1,1,1,1,20161001,,,,
L3485,HCPCS,SHOE HEEL PAD REMOVABLE FOR,,,28,,NW,,,,,,$27.21,$0.00,1,1,1,1,1,1,20161001,,,,
L3500,HCPCS,ORTHO SHOE ADD LEATHER INSOL,,,28,,NW,,,,,,$30.80,$0.00,1,1,1,1,1,1,20161001,,,,
L3510,HCPCS,ORTHOPEDIC SHOE ADD RUB INSL,,,28,,NW,,,,,,$30.80,$0.00,1,1,1,1,1,1,20161001,,,,
L3520,HCPCS,O SHOE ADD FELT W LEATH INSL,,,28,,NW,,,,,,$32.80,$0.00,1,1,1,1,1,1,20161001,,,,
L3530,HCPCS,ORTHO SHOE ADD HALF SOLE,,,28,,NW,,,,,,$32.80,$0.00,1,1,1,1,1,1,20161001,,,,
L3540,HCPCS,ORTHO SHOE ADD FULL SOLE,,,28,,NW,,,,,,$47.98,$0.00,1,1,1,1,1,1,20161001,,,,
L3550,HCPCS,O SHOE ADD STANDARD TOE TAP,,,28,,NW,,,,,,$14.63,$0.00,1,1,1,1,1,1,20161001,,,,
L3560,HCPCS,O SHOE ADD HORSESHOE TOE TAP,,,28,,NW,,,,,,$25.75,$0.00,1,1,1,1,1,1,20161001,,,,
L3570,HCPCS,O SHOE ADD INSTEP EXTENSION,,,28,,NW,,,,,,$75.27,$0.00,1,1,1,1,1,1,20161001,,,,
L3580,HCPCS,O SHOE ADD INSTEP VELCRO CLO,,,28,,NW,,,,,,$59.08,$0.00,1,1,1,1,1,1,20161001,,,,
L3590,HCPCS,O SHOE CONVERT TO SOF COUNTE,,,28,,NW,,,,,,$49.99,$0.00,1,1,1,1,1,1,20161001,,,,
L3595,HCPCS,ORTHO SHOE ADD MARCH BAR,,,28,,NW,,,,,,$40.89,$0.00,1,1,1,1,1,1,20161001,,,,
L3600,HCPCS,TRANS SHOE CALIP PLATE EXIST,,,28,,NW,,,,,,$68.19,$0.00,1,1,1,1,1,1,20161001,,,,
L3610,HCPCS,TRANS SHOE CALIPER PLATE NEW,,,28,,NW,,,,,,$93.04,$0.00,1,1,1,1,1,1,20161001,,,,
L3620,HCPCS,TRANS SHOE SOLID STIRRUP EXI,,,28,,NW,,,,,,$68.19,$0.00,1,1,1,1,1,1,20161001,,,,
L3630,HCPCS,TRANS SHOE SOLID STIRRUP NEW,,,28,,NW,,,,,,$93.04,$0.00,1,1,1,1,1,1,20161001,,,,
L3640,HCPCS,SHOE DENNIS BROWNE SPLINT BO,,,28,,NW,,,,,,$41.90,$0.00,1,1,1,1,1,1,20161001,,,,
L3649,HCPCS,ORTHOPEDIC SHOE MODIFICA NOS,,,28,,NW,,,,,,$60.99,$0.00,1,1,1,1,1,1,20161001,,,,
L3650,HCPCS,SO 8 ABD RESTRAINT PRE OTS,,,28,,NW,,,,,,$57.67,$0.00,1,1,1,1,1,1,20161001,,,,
L3660,HCPCS,SO 8 AB RSTR CAN/WEB PRE OTS,,,28,,NW,,,,,,$94.64,$0.00,1,1,1,1,1,1,20161001,,,,
L3670,HCPCS,SO ACRO/CLAV CAN WEB PRE OTS,,,28,,NW,,,,,,$129.77,$0.00,1,1,1,1,1,1,20161001,,,,
L3671,HCPCS,SO CAP DESIGN W/O JNTS CF,,,28,,NW,,,,,,"$1,349.45",$0.00,1,1,1,1,1,1,20161001,,,,
L3674,HCPCS,SO AIRPLANE W/WO JOINT CF,,,28,,NW,,,,,,"$1,795.93",$0.00,1,1,1,1,1,1,20161001,,,,
L3675,HCPCS,SO VEST CANVAS/WEB PRE OTS,,,28,,NW,,,,,,$196.48,$0.00,1,1,1,1,1,1,20161001,,,,
L3677,HCPCS,SO HARD PLAS STABILI PRE CST,,,28,,NW,,,,,,$229.35,$0.00,1,1,1,1,1,1,20161001,,,,
L3678,HCPCS,SO HARD PLAS STABILI PRE OTS,,,28,,NW,,,,,,$187.45,$0.00,1,1,1,1,1,1,20161001,,,,
L3702,HCPCS,EO W/O JOINTS CF,,,28,,NW,,,,,,$376.46,$0.00,1,1,1,1,1,1,20161001,,,,
L3710,HCPCS,EO ELAS W/METAL JNTS PRE OTS,,,28,,NW,,,,,,$145.63,$0.00,1,1,1,1,1,1,20161001,,,,
L3720,HCPCS,FOREARM/ARM CUFFS FREE MOTIO,,,28,,NW,,,,,,"$1,131.11",$0.00,1,1,1,1,1,1,20161001,,,,
L3730,HCPCS,FOREARM/ARM CUFFS EXT/FLEX A,,,28,,NW,,,,,,"$1,592.16",$0.00,1,1,1,1,1,1,20161001,,,,
L3740,HCPCS,CUFFS ADJ LOCK W/ ACTIVE CON,,,28,,NW,,,,,,"$1,880.00",$0.00,1,1,1,1,1,1,20161001,,,,
L3760,HCPCS,"EO WITHJOINT, PREFABRICATED",,,28,,NW,,,,,,$712.28,$0.00,1,1,1,1,1,1,20161001,,,,
L3762,HCPCS,EO RIGID W/O JOINTS PRE OTS,,,28,,NW,,,,,,$88.48,$0.00,1,1,1,1,1,1,20161001,,,,
L3763,HCPCS,EWHO RIGID W/O JNTS CF,,,28,,NW,,,,,,"$1,122.23",$0.00,1,1,1,1,1,1,20161001,,,,
L3764,HCPCS,EWHO W/JOINT(S) CF,,,28,,NW,,,,,,"$1,264.95",$0.00,1,1,1,1,1,1,20161001,,,,
L3765,HCPCS,EWHFO RIGID W/O JNTS CF,,,28,,NW,,,,,,"$1,955.15",$0.00,1,1,1,1,1,1,20161001,,,,
L3766,HCPCS,EWHFO W/JOINT(S) CF,,,28,,NW,,,,,,"$2,075.23",$0.00,1,1,1,1,1,1,20161001,,,,
L3806,HCPCS,WHFO W/JOINT(S) CUSTOM FAB,,,28,,NW,,,,,,$639.42,$0.00,1,1,1,1,1,1,20161001,,,,
L3807,HCPCS,WHFO W/O JOINTS PRE CST,,,28,,NW,,,,,,$314.96,$0.00,1,1,1,1,1,1,20161001,,,,
L3808,HCPCS,"WHFO, RIGID W/O JOINTS",,,28,,NW,,,,,,$512.09,$0.00,1,1,1,1,1,1,20161001,,,,
L3809,HCPCS,WHFO W/O JOINTS PRE OTS,,,28,,NW,,,,,,$314.96,$0.00,1,1,1,1,1,1,20161001,,,,
L3891,HCPCS,TORSION MECHANISM WRIST/ELBO,,,28,,NW,,,,,,$216.08,$0.00,1,1,1,1,1,1,20161001,,,,
L3900,HCPCS,HINGE EXTENSION/FLEX WRIST/F,,,28,,NW,,,,,,"$2,302.98",$0.00,1,1,1,1,1,1,20161001,,,,
L3901,HCPCS,HINGE EXT/FLEX WRIST FINGER,,,28,,NW,,,,,,"$2,859.84",$0.00,1,1,1,1,1,1,20161001,,,,
L3904,HCPCS,WHFO ELECTRIC CUSTOM FITTED,,,28,,NW,,,,,,"$5,287.63",$0.00,1,1,1,1,1,1,20161001,,,,
L3905,HCPCS,WHO W/NONTORSION JNT(S) CF,,,28,,NW,,,,,,"$1,493.47",$0.00,1,1,1,1,1,1,20161001,,,,
L3906,HCPCS,WHO W/O JOINTS CF,,,28,,NW,,,,,,$640.90,$0.00,1,1,1,1,1,1,20161001,,,,
L3908,HCPCS,WHO COCK-UP NONMOLDE PRE OTS,,,28,,NW,,,,,,$58.67,$0.00,1,1,1,1,1,1,20161001,,,,
L3912,HCPCS,HFO FLEXION GLOVE PRE OTS,,,28,,NW,,,,,,$94.89,$0.00,1,1,1,1,1,1,20161001,,,,
L3913,HCPCS,HFO W/O JOINTS CF,,,28,,NW,,,,,,$347.99,$0.00,1,1,1,1,1,1,20161001,,,,
L3915,HCPCS,WHO NONTORSION JNTS PRE CST,,,28,,NW,,,,,,$762.30,$0.00,1,1,1,1,1,1,20161001,,,,
L3916,HCPCS,WHO NONTORSION JNTS PRE OTS,,,28,,NW,,,,,,$762.30,$0.00,1,1,1,1,1,1,20161001,,,,
L3917,HCPCS,METACARP FX ORTHOSIS PRE CST,,,28,,NW,,,,,,$85.48,$0.00,1,1,1,1,1,1,20161001,,,,
L3918,HCPCS,METACARP FX ORTHOSIS PRE OTS,,,28,,NW,,,,,,$85.48,$0.00,1,1,1,1,1,1,20161001,,,,
L3919,HCPCS,HO W/O JOINTS CF,,,28,,NW,,,,,,$347.99,$0.00,1,1,1,1,1,1,20161001,,,,
L3921,HCPCS,HFO W/JOINT(S) CF,,,28,,NW,,,,,,$428.02,$0.00,1,1,1,1,1,1,20161001,,,,
L3923,HCPCS,HFO WITHOUT JOINTS PRE CST,,,28,,NW,,,,,,$74.17,$0.00,1,1,1,1,1,1,20161001,,,,
L3924,HCPCS,HFO WITHOUT JOINTS PRE OTS,,,28,,NW,,,,,,$74.17,$0.00,1,1,1,1,1,1,20161001,,,,
L3925,HCPCS,FO PIP DIP JNT/SPRNG PRE OTS,,,28,,NW,,,,,,$49.28,$0.00,1,1,1,1,1,1,20161001,,,,
L3927,HCPCS,FO PIP DIP NO JT SPR PRE OTS,,,28,,NW,,,,,,$32.85,$0.00,1,1,1,1,1,1,20161001,,,,
L3929,HCPCS,HFO NONTORSION JNTS PRE CST,,,28,,NW,,,,,,$73.61,$0.00,1,1,1,1,1,1,20161001,,,,
L3930,HCPCS,HFO NONTORSION JNTS PRE OTS,,,28,,NW,,,,,,$73.61,$0.00,1,1,1,1,1,1,20161001,,,,
L3931,HCPCS,WHFO NONTORSION JOINT PREFAB,,,28,,NW,,,,,,$249.51,$0.00,1,1,1,1,1,1,20161001,,,,
L3933,HCPCS,FO W/O JOINTS CF,,,28,,NW,,,,,,$256.66,$0.00,1,1,1,1,1,1,20161001,,,,
L3935,HCPCS,FO NONTORSION JOINT CF,,,28,,NW,,,,,,$268.68,$0.00,1,1,1,1,1,1,20161001,,,,
L3956,HCPCS,ADD JOINT UPPER EXT ORTHOSIS,,,28,,NW,,,,,,$93.84,$0.00,1,1,1,1,1,1,20161001,,,,
L3960,HCPCS,SEWHO AIRPLAN DESIG ABDU POS,,,28,,NW,,,,,,"$1,266.67",$0.00,1,1,1,1,1,1,20161001,,,,
L3961,HCPCS,SEWHO CAP DESIGN W/O JNTS CF,,,28,,NW,,,,,,"$2,587.40",$0.00,1,1,1,1,1,1,20161001,,,,
L3962,HCPCS,SEWHO ERBS PALSEY DESIGN ABD,,,28,,NW,,,,,,"$1,217.28",$0.00,1,1,1,1,1,1,20161001,,,,
L3967,HCPCS,SEWHO AIRPLANE W/O JNTS CF,,,28,,NW,,,,,,"$3,069.73",$0.00,1,1,1,1,1,1,20161001,,,,
L3971,HCPCS,SEWHO CAP DESIGN W/JNT(S) CF,,,28,,NW,,,,,,"$2,909.69",$0.00,1,1,1,1,1,1,20161001,,,,
L3973,HCPCS,SEWHO AIRPLANE W/JNT(S) CF,,,28,,NW,,,,,,"$3,069.73",$0.00,1,1,1,1,1,1,20161001,,,,
L3975,HCPCS,SEWHFO CAP DESIGN W/O JNT CF,,,28,,NW,,,,,,"$2,587.40",$0.00,1,1,1,1,1,1,20161001,,,,
L3976,HCPCS,SEWHFO AIRPLANE W/O JNTS CF,,,28,,NW,,,,,,"$2,587.40",$0.00,1,1,1,1,1,1,20161001,,,,
L3977,HCPCS,SEWHFO CAP DESGN W/JNT(S) CF,,,28,,NW,,,,,,"$2,909.69",$0.00,1,1,1,1,1,1,20161001,,,,
L3978,HCPCS,SEWHFO AIRPLANE W/JNT(S) CF,,,28,,NW,,,,,,"$3,069.73",$0.00,1,1,1,1,1,1,20161001,,,,
L3980,HCPCS,UP EXT FX ORTHOS HUMERAL NOS,,,28,,NW,,,,,,$495.65,$0.00,1,1,1,1,1,1,20161001,,,,
L3981,HCPCS,UE FX ORTH SHOUL CAP FOREARM,,,28,,NW,,,,,,"$1,517.21",$0.00,1,1,1,1,1,1,20161001,,,,
L3982,HCPCS,UPPER EXT FX ORTHOSIS RAD/UL,,,28,,NW,,,,,,$594.57,$0.00,1,1,1,1,1,1,20161001,,,,
L3984,HCPCS,UPPER EXT FX ORTHOSIS WRIST,,,28,,NW,,,,,,$544.55,$0.00,1,1,1,1,1,1,20161001,,,,
L3995,HCPCS,SOCK FRACTURE OR EQUAL EACH,,,28,,NW,,,,,,$35.72,$0.00,1,1,1,1,1,1,20161001,,,,
L3999,HCPCS,UPPER LIMB ORTHOSIS NOS,,,28,,NW,,,,,,$35.72,$0.00,1,1,1,1,1,1,20161001,,,,
L4000,HCPCS,REPL GIRDLE MILWAUKEE ORTH,,,28,,NW,,,,,,"$2,259.73",$0.00,1,1,1,1,1,1,20161001,,,,
L4002,HCPCS,"REPLACE STRAP, ANY ORTHOSIS",,,28,,NW,,,,,,$36.59,$0.00,1,1,1,1,1,1,20161001,,,,
L4010,HCPCS,REPLACE TRILATERAL SOCKET BR,,,28,,NW,,,,,,"$1,194.53",$0.00,1,1,1,1,1,1,20161001,,,,
L4020,HCPCS,REPLACE QUADLAT SOCKET BRIM,,,28,,NW,,,,,,"$1,569.26",$0.00,1,1,1,1,1,1,20161001,,,,
L4030,HCPCS,REPLACE SOCKET BRIM CUST FIT,,,28,,NW,,,,,,$904.17,$0.00,1,1,1,1,1,1,20161001,,,,
L4040,HCPCS,REPLACE MOLDED THIGH LACER,,,28,,NW,,,,,,$667.59,$0.00,1,1,1,1,1,1,20161001,,,,
L4045,HCPCS,REPLACE NON-MOLDED THIGH LAC,,,28,,NW,,,,,,$502.73,$0.00,1,1,1,1,1,1,20161001,,,,
L4050,HCPCS,REPLACE MOLDED CALF LACER,,,28,,NW,,,,,,$681.65,$0.00,1,1,1,1,1,1,20161001,,,,
L4055,HCPCS,REPLACE NON-MOLDED CALF LACE,,,28,,NW,,,,,,$393.04,$0.00,1,1,1,1,1,1,20161001,,,,
L4060,HCPCS,REPLACE HIGH ROLL CUFF,,,28,,NW,,,,,,$492.25,$0.00,1,1,1,1,1,1,20161001,,,,
L4070,HCPCS,REPLACE PROX & DIST UPRIGHT,,,28,,NW,,,,,,$441.28,$0.00,1,1,1,1,1,1,20161001,,,,
L4080,HCPCS,REPL MET BAND KAFO-AFO PROX,,,28,,NW,,,,,,$99.09,$0.00,1,1,1,1,1,1,20161001,,,,
L4090,HCPCS,REPL MET BAND KAFO-AFO CALF/,,,28,,NW,,,,,,$85.49,$0.00,1,1,1,1,1,1,20161001,,,,
L4100,HCPCS,REPL LEATH CUFF KAFO PROX TH,,,28,,NW,,,,,,$113.08,$0.00,1,1,1,1,1,1,20161001,,,,
L4110,HCPCS,REPL LEATH CUFF KAFO-AFO CAL,,,28,,NW,,,,,,$79.29,$0.00,1,1,1,1,1,1,20161001,,,,
L4130,HCPCS,REPLACE PRETIBIAL SHELL,,,28,,NW,,,,,,$848.19,$0.00,1,1,1,1,1,1,20161001,,,,
L4205,HCPCS,ORTHO DVC REPAIR PER 15 MIN,,,28,,NW,,,,,,$43.04,$0.00,1,1,1,1,1,1,20161001,,,,
L4210,HCPCS,ORTH DEV REPAIR/REPL MINOR P,,,28,,NW,,,,,,$30.49,$0.00,1,1,1,1,1,1,20161001,,,,
L4350,HCPCS,ANKLE CONTROL ORTHO PRE OTS,,,28,,NW,,,,,,$86.08,$0.00,1,1,1,1,1,1,20161001,,,,
L4360,HCPCS,PNEUMAT WALKING BOOT PRE CST,,,28,,NW,,,,,,$412.05,$0.00,1,1,1,1,1,1,20161001,,,,
L4361,HCPCS,PNEUMA/VAC WALK BOOT PRE OTS,,,28,,NW,,,,,,$412.05,$0.00,1,1,1,1,1,1,20161001,,,,
L4370,HCPCS,PNEUM FULL LEG SPLNT PRE OTS,,,28,,NW,,,,,,$257.97,$0.00,1,1,1,1,1,1,20161001,,,,
L4386,HCPCS,NON-PNEUM WALK BOOT PRE CST,,,28,,NW,,,,,,$194.45,$0.00,1,1,1,1,1,1,20161001,,,,
L4387,HCPCS,NON-PNEUM WALK BOOT PRE OTS,,,28,,NW,,,,,,$194.45,$0.00,1,1,1,1,1,1,20161001,,,,
L4392,HCPCS,REPLACE AFO SOFT INTERFACE,,,28,,NW,,,,,,$26.19,$0.00,1,1,1,1,1,1,20161001,,,,
L4394,HCPCS,REPLACE FOOT DROP SPINT,,,28,,NW,,,,,,$21.15,$0.00,1,1,1,1,1,1,20161001,,,,
L4396,HCPCS,STATIC OR DYNAMI AFO PRE CST,,,28,,NW,,,,,,$209.62,$0.00,1,1,1,1,1,1,20161001,,,,
L4397,HCPCS,STATIC OR DYNAMI AFO PRE OTS,,,28,,NW,,,,,,$209.62,$0.00,1,1,1,1,1,1,20161001,,,,
L4398,HCPCS,FOOT DROP SPLINT PRE OTS,,,28,,NW,,,,,,$68.72,$0.00,1,1,1,1,1,1,20161001,,,,
L4631,HCPCS,"AFO, WALK BOOT TYPE, CUS FAB",,,28,,NW,,,,,,"$2,691.63",$0.00,1,1,1,1,1,1,20161001,,,,
L5000,HCPCS,SHO INSERT W ARCH TOE FILLER,,,28,,NW,,,,,,$907.77,$0.00,1,1,1,1,1,1,20161001,,,,
L5010,HCPCS,MOLD SOCKET ANK HGT W/ TOE F,,,28,,NW,,,,,,"$2,370.79",$0.00,1,1,1,1,1,1,20161001,,,,
L5020,HCPCS,TIBIAL TUBERCLE HGT W/ TOE F,,,28,,NW,,,,,,"$3,924.92",$0.00,1,1,1,1,1,1,20161001,,,,
L5050,HCPCS,ANK SYMES MOLD SCKT SACH FT,,,28,,NW,,,,,,"$4,451.68",$0.00,1,1,1,1,1,1,20161001,,,,
L5060,HCPCS,SYMES MET FR LEATH SOCKET AR,,,28,,NW,,,,,,"$5,582.80",$0.00,1,1,1,1,1,1,20161001,,,,
L5100,HCPCS,MOLDED SOCKET SHIN SACH FOOT,,,28,,NW,,,,,,"$4,501.97",$0.00,1,1,1,1,1,1,20161001,,,,
L5105,HCPCS,PLAST SOCKET JTS/THGH LACER,,,28,,NW,,,,,,"$6,770.81",$0.00,1,1,1,1,1,1,20161001,,,,
L5150,HCPCS,MOLD SCKT EXT KNEE SHIN SACH,,,28,,NW,,,,,,"$6,960.04",$0.00,1,1,1,1,1,1,20161001,,,,
L5160,HCPCS,MOLD SOCKET BENT KNEE SHIN S,,,28,,NW,,,,,,"$7,550.65",$0.00,1,1,1,1,1,1,20161001,,,,
L5200,HCPCS,KNE SING AXIS FRIC SHIN SACH,,,28,,NW,,,,,,"$6,389.92",$0.00,1,1,1,1,1,1,20161001,,,,
L5210,HCPCS,NO KNEE/ANKLE JOINTS W/ FT B,,,28,,NW,,,,,,"$4,776.35",$0.00,1,1,1,1,1,1,20161001,,,,
L5220,HCPCS,NO KNEE JOINT WITH ARTIC ALI,,,28,,NW,,,,,,"$5,458.00",$0.00,1,1,1,1,1,1,20161001,,,,
L5230,HCPCS,FEM FOCAL DEFIC CONSTANT FRI,,,28,,NW,,,,,,"$7,514.05",$0.00,1,1,1,1,1,1,20161001,,,,
L5250,HCPCS,HIP CANAD SING AXI CONS FRIC,,,28,,NW,,,,,,"$10,059.07",$0.00,1,1,1,1,1,1,20161001,,,,
L5270,HCPCS,TILT TABLE LOCKING HIP SING,,,28,,NW,,,,,,"$10,142.05",$0.00,1,1,1,1,1,1,20161001,,,,
L5280,HCPCS,HEMIPELVECT CANAD SING AXIS,,,28,,NW,,,,,,"$10,198.54",$0.00,1,1,1,1,1,1,20161001,,,,
L5301,HCPCS,BK MOLD SOCKET SACH FT ENDO,,,28,,NW,,,,,,"$4,607.27",$0.00,1,1,1,1,1,1,20161001,,,,
L5312,HCPCS,"KNEE DISART, SACH FT, ENDO",,,28,,NW,,,,,,"$6,621.36",$0.00,1,1,1,1,1,1,20161001,,,,
L5321,HCPCS,AK OPEN END SACH,,,28,,NW,,,,,,"$6,540.52",$0.00,1,1,1,1,1,1,20161001,,,,
L5331,HCPCS,HIP DISART CANADIAN SACH FT,,,28,,NW,,,,,,"$9,256.91",$0.00,1,1,1,1,1,1,20161001,,,,
L5341,HCPCS,HEMIPELVECTOMY CANADIAN SACH,,,28,,NW,,,,,,"$9,965.66",$0.00,1,1,1,1,1,1,20161001,,,,
L5400,HCPCS,POSTOP DRESS & 1 CAST CHG BK,,,28,,NW,,,,,,"$2,380.80",$0.00,1,1,1,1,1,1,20161001,,,,
L5410,HCPCS,POSTOP DSG BK EA ADD CAST CH,,,28,,NW,,,,,,$723.03,$0.00,1,1,1,1,1,1,20161001,,,,
L5420,HCPCS,POSTOP DSG & 1 CAST CHG AK/D,,,28,,NW,,,,,,"$3,036.17",$0.00,1,1,1,1,1,1,20161001,,,,
L5430,HCPCS,POSTOP DSG AK EA ADD CAST CH,,,28,,NW,,,,,,$933.14,$0.00,1,1,1,1,1,1,20161001,,,,
L5450,HCPCS,POSTOP APP NON-WGT BEAR DSG,,,28,,NW,,,,,,$707.31,$0.00,1,1,1,1,1,1,20161001,,,,
L5460,HCPCS,POSTOP APP NON-WGT BEAR DSG,,,28,,NW,,,,,,$966.94,$0.00,1,1,1,1,1,1,20161001,,,,
L5500,HCPCS,INIT BK PTB PLASTER DIRECT,,,28,,NW,,,,,,"$2,451.52",$0.00,1,1,1,1,1,1,20161001,,,,
L5505,HCPCS,INIT AK ISCHAL PLSTR DIRECT,,,28,,NW,,,,,,"$3,431.81",$0.00,1,1,1,1,1,1,20161001,,,,
L5510,HCPCS,PREP BK PTB PLASTER MOLDED,,,28,,NW,,,,,,"$2,778.64",$0.00,1,1,1,1,1,1,20161001,,,,
L5520,HCPCS,PERP BK PTB THERMOPLS DIRECT,,,28,,NW,,,,,,"$2,837.79",$0.00,1,1,1,1,1,1,20161001,,,,
L5530,HCPCS,PREP BK PTB THERMOPLS MOLDED,,,28,,NW,,,,,,"$3,356.09",$0.00,1,1,1,1,1,1,20161001,,,,
L5535,HCPCS,PREP BK PTB OPEN END SOCKET,,,28,,NW,,,,,,"$3,333.68",$0.00,1,1,1,1,1,1,20161001,,,,
L5540,HCPCS,PREP BK PTB LAMINATED SOCKET,,,28,,NW,,,,,,"$3,516.74",$0.00,1,1,1,1,1,1,20161001,,,,
L5560,HCPCS,PREP AK ISCHIAL PLAST MOLDED,,,28,,NW,,,,,,"$3,811.12",$0.00,1,1,1,1,1,1,20161001,,,,
L5570,HCPCS,PREP AK ISCHIAL DIRECT FORM,,,28,,NW,,,,,,"$3,959.94",$0.00,1,1,1,1,1,1,20161001,,,,
L5580,HCPCS,PREP AK ISCHIAL THERMO MOLD,,,28,,NW,,,,,,"$4,627.43",$0.00,1,1,1,1,1,1,20161001,,,,
L5585,HCPCS,PREP AK ISCHIAL OPEN END,,,28,,NW,,,,,,"$4,942.97",$0.00,1,1,1,1,1,1,20161001,,,,
L5590,HCPCS,PREP AK ISCHIAL LAMINATED,,,28,,NW,,,,,,"$4,756.14",$0.00,1,1,1,1,1,1,20161001,,,,
L5595,HCPCS,HIP DISARTIC SACH THERMOPLS,,,28,,NW,,,,,,"$7,851.62",$0.00,1,1,1,1,1,1,20161001,,,,
L5600,HCPCS,HIP DISART SACH LAMINAT MOLD,,,28,,NW,,,,,,"$8,735.30",$0.00,1,1,1,1,1,1,20161001,,,,
L5610,HCPCS,ABOVE KNEE HYDRACADENCE,,,28,,NW,,,,,,"$4,029.61",$0.00,1,1,1,1,1,1,20161001,,,,
L5611,HCPCS,AK 4 BAR LINK W/FRIC SWING,,,28,,NW,,,,,,"$2,955.68",$0.00,1,1,1,1,1,1,20161001,,,,
L5613,HCPCS,AK 4 BAR LING W/HYDRAUL SWIG,,,28,,NW,,,,,,"$4,625.41",$0.00,1,1,1,1,1,1,20161001,,,,
L5614,HCPCS,4-BAR LINK ABOVE KNEE W/SWNG,,,28,,NW,,,,,,"$2,870.80",$0.00,1,1,1,1,1,1,20161001,,,,
L5616,HCPCS,AK UNIV MULTIPLEX SYS FRICT,,,28,,NW,,,,,,"$2,511.15",$0.00,1,1,1,1,1,1,20161001,,,,
L5617,HCPCS,AK/BK SELF-ALIGNING UNIT EA,,,28,,NW,,,,,,$900.64,$0.00,1,1,1,1,1,1,20161001,,,,
L5618,HCPCS,TEST SOCKET SYMES,,,28,,NW,,,,,,$459.35,$0.00,1,1,1,1,1,1,20161001,,,,
L5620,HCPCS,TEST SOCKET BELOW KNEE,,,28,,NW,,,,,,$453.29,$0.00,1,1,1,1,1,1,20161001,,,,
L5622,HCPCS,TEST SOCKET KNEE DISARTICULA,,,28,,NW,,,,,,$637.64,$0.00,1,1,1,1,1,1,20161001,,,,
L5624,HCPCS,TEST SOCKET ABOVE KNEE,,,28,,NW,,,,,,$635.12,$0.00,1,1,1,1,1,1,20161001,,,,
L5626,HCPCS,TEST SOCKET HIP DISARTICULAT,,,28,,NW,,,,,,$861.90,$0.00,1,1,1,1,1,1,20161001,,,,
L5628,HCPCS,TEST SOCKET HEMIPELVECTOMY,,,28,,NW,,,,,,$868.86,$0.00,1,1,1,1,1,1,20161001,,,,
L5629,HCPCS,BELOW KNEE ACRYLIC SOCKET,,,28,,NW,,,,,,$539.09,$0.00,1,1,1,1,1,1,20161001,,,,
L5630,HCPCS,SYME TYP EXPANDABL WALL SCKT,,,28,,NW,,,,,,$801.51,$0.00,1,1,1,1,1,1,20161001,,,,
L5631,HCPCS,AK/KNEE DISARTIC ACRYLIC SOC,,,28,,NW,,,,,,$772.61,$0.00,1,1,1,1,1,1,20161001,,,,
L5632,HCPCS,SYMES TYPE PTB BRIM DESIGN S,,,28,,NW,,,,,,$349.82,$0.00,1,1,1,1,1,1,20161001,,,,
L5634,HCPCS,SYMES TYPE POSTER OPENING SO,,,28,,NW,,,,,,$518.36,$0.00,1,1,1,1,1,1,20161001,,,,
L5636,HCPCS,SYMES TYPE MEDIAL OPENING SO,,,28,,NW,,,,,,$395.96,$0.00,1,1,1,1,1,1,20161001,,,,
L5637,HCPCS,BELOW KNEE TOTAL CONTACT,,,28,,NW,,,,,,$525.99,$0.00,1,1,1,1,1,1,20161001,,,,
L5638,HCPCS,BELOW KNEE LEATHER SOCKET,,,28,,NW,,,,,,$905.36,$0.00,1,1,1,1,1,1,20161001,,,,
L5639,HCPCS,BELOW KNEE WOOD SOCKET,,,28,,NW,,,,,,"$2,110.50",$0.00,1,1,1,1,1,1,20161001,,,,
L5640,HCPCS,KNEE DISARTICULAT LEATHER SO,,,28,,NW,,,,,,"$1,179.12",$0.00,1,1,1,1,1,1,20161001,,,,
L5642,HCPCS,ABOVE KNEE LEATHER SOCKET,,,28,,NW,,,,,,"$1,074.09",$0.00,1,1,1,1,1,1,20161001,,,,
L5643,HCPCS,HIP FLEX INNER SOCKET EXT FR,,,28,,NW,,,,,,"$2,899.42",$0.00,1,1,1,1,1,1,20161001,,,,
L5644,HCPCS,ABOVE KNEE WOOD SOCKET,,,28,,NW,,,,,,"$1,015.00",$0.00,1,1,1,1,1,1,20161001,,,,
L5645,HCPCS,BK FLEX INNER SOCKET EXT FRA,,,28,,NW,,,,,,"$1,425.46",$0.00,1,1,1,1,1,1,20161001,,,,
L5646,HCPCS,BELOW KNEE CUSHION SOCKET,,,28,,NW,,,,,,$968.15,$0.00,1,1,1,1,1,1,20161001,,,,
L5647,HCPCS,BELOW KNEE SUCTION SOCKET,,,28,,NW,,,,,,"$1,448.28",$0.00,1,1,1,1,1,1,20161001,,,,
L5648,HCPCS,ABOVE KNEE CUSHION SOCKET,,,28,,NW,,,,,,"$1,148.23",$0.00,1,1,1,1,1,1,20161001,,,,
L5649,HCPCS,ISCH CONTAINMT/NARROW M-L SO,,,28,,NW,,,,,,"$3,745.53",$0.00,1,1,1,1,1,1,20161001,,,,
L5650,HCPCS,TOT CONTACT AK/KNEE DISART S,,,28,,NW,,,,,,$880.84,$0.00,1,1,1,1,1,1,20161001,,,,
L5651,HCPCS,AK FLEX INNER SOCKET EXT FRA,,,28,,NW,,,,,,"$2,236.80",$0.00,1,1,1,1,1,1,20161001,,,,
L5652,HCPCS,SUCTION SUSP AK/KNEE DISART,,,28,,NW,,,,,,$713.46,$0.00,1,1,1,1,1,1,20161001,,,,
L5653,HCPCS,KNEE DISART EXPAND WALL SOCK,,,28,,NW,,,,,,"$1,020.62",$0.00,1,1,1,1,1,1,20161001,,,,
L5654,HCPCS,SOCKET INSERT SYMES,,,28,,NW,,,,,,$570.74,$0.00,1,1,1,1,1,1,20161001,,,,
L5655,HCPCS,SOCKET INSERT BELOW KNEE,,,28,,NW,,,,,,$452.51,$0.00,1,1,1,1,1,1,20161001,,,,
L5656,HCPCS,SOCKET INSERT KNEE ARTICULAT,,,28,,NW,,,,,,$661.05,$0.00,1,1,1,1,1,1,20161001,,,,
L5658,HCPCS,SOCKET INSERT ABOVE KNEE,,,28,,NW,,,,,,$616.50,$0.00,1,1,1,1,1,1,20161001,,,,
L5661,HCPCS,MULTI-DUROMETER SYMES,,,28,,NW,,,,,,"$1,072.10",$0.00,1,1,1,1,1,1,20161001,,,,
L5665,HCPCS,MULTI-DUROMETER BELOW KNEE,,,28,,NW,,,,,,$920.04,$0.00,1,1,1,1,1,1,20161001,,,,
L5666,HCPCS,BELOW KNEE CUFF SUSPENSION,,,28,,NW,,,,,,$71.62,$0.00,1,1,1,1,1,1,20161001,,,,
L5668,HCPCS,BK MOLDED DISTAL CUSHION,,,28,,NW,,,,,,$123.46,$0.00,1,1,1,1,1,1,20161001,,,,
L5670,HCPCS,BK MOLDED SUPRACONDYLAR SUSP,,,28,,NW,,,,,,$455.97,$0.00,1,1,1,1,1,1,20161001,,,,
L5671,HCPCS,BK/AK LOCKING MECHANISM,,,28,,NW,,,,,,$916.81,$0.00,1,1,1,1,1,1,20161001,,,,
L5672,HCPCS,BK REMOVABLE MEDIAL BRIM SUS,,,28,,NW,,,,,,$489.60,$0.00,1,1,1,1,1,1,20161001,,,,
L5673,HCPCS,SOCKET INSERT W LOCK MECH,,,28,,NW,,,,,,"$1,219.19",$0.00,1,1,1,1,1,1,20161001,,,,
L5676,HCPCS,BK KNEE JOINTS SINGLE AXIS P,,,28,,NW,,,,,,$630.46,$0.00,1,1,1,1,1,1,20161001,,,,
L5677,HCPCS,BK KNEE JOINTS POLYCENTRIC P,,,28,,NW,,,,,,$904.79,$0.00,1,1,1,1,1,1,20161001,,,,
L5678,HCPCS,BK JOINT COVERS PAIR,,,28,,NW,,,,,,$43.20,$0.00,1,1,1,1,1,1,20161001,,,,
L5679,HCPCS,SOCKET INSERT W/O LOCK MECH,,,28,,NW,,,,,,"$1,002.24",$0.00,1,1,1,1,1,1,20161001,,,,
L5680,HCPCS,BK THIGH LACER NON-MOLDED,,,28,,NW,,,,,,$503.64,$0.00,1,1,1,1,1,1,20161001,,,,
L5681,HCPCS,INTL CUSTM CONG/LATYP INSERT,,,28,,NW,,,,,,"$2,218.99",$0.00,1,1,1,1,1,1,20161001,,,,
L5682,HCPCS,BK THIGH LACER GLUT/ISCHIA M,,,28,,NW,,,,,,"$1,102.76",$0.00,1,1,1,1,1,1,20161001,,,,
L5683,HCPCS,INITIAL CUSTOM SOCKET INSERT,,,28,,NW,,,,,,"$2,218.99",$0.00,1,1,1,1,1,1,20161001,,,,
L5684,HCPCS,BK FORK STRAP,,,28,,NW,,,,,,$50.10,$0.00,1,1,1,1,1,1,20161001,,,,
L5685,HCPCS,BELOW KNEE SUS/SEAL SLEEVE,,,28,,NW,,,,,,$141.69,$0.00,1,1,1,1,1,1,20161001,,,,
L5686,HCPCS,BK BACK CHECK,,,28,,NW,,,,,,$54.37,$0.00,1,1,1,1,1,1,20161001,,,,
L5688,HCPCS,BK WAIST BELT WEBBING,,,28,,NW,,,,,,$63.17,$0.00,1,1,1,1,1,1,20161001,,,,
L5690,HCPCS,BK WAIST BELT PADDED AND LIN,,,28,,NW,,,,,,$116.49,$0.00,1,1,1,1,1,1,20161001,,,,
L5692,HCPCS,AK PELVIC CONTROL BELT LIGHT,,,28,,NW,,,,,,$180.22,$0.00,1,1,1,1,1,1,20161001,,,,
L5694,HCPCS,AK PELVIC CONTROL BELT PAD/L,,,28,,NW,,,,,,$277.18,$0.00,1,1,1,1,1,1,20161001,,,,
L5695,HCPCS,AK SLEEVE SUSP NEOPRENE/EQUA,,,28,,NW,,,,,,$245.17,$0.00,1,1,1,1,1,1,20161001,,,,
L5696,HCPCS,AK/KNEE DISARTIC PELVIC JOIN,,,28,,NW,,,,,,$287.46,$0.00,1,1,1,1,1,1,20161001,,,,
L5697,HCPCS,AK/KNEE DISARTIC PELVIC BAND,,,28,,NW,,,,,,$79.25,$0.00,1,1,1,1,1,1,20161001,,,,
L5698,HCPCS,AK/KNEE DISARTIC SILESIAN BA,,,28,,NW,,,,,,$135.08,$0.00,1,1,1,1,1,1,20161001,,,,
L5699,HCPCS,SHOULDER HARNESS,,,28,,NW,,,,,,$294.84,$0.00,1,1,1,1,1,1,20161001,,,,
L5700,HCPCS,REPLACE SOCKET BELOW KNEE,,,28,,NW,,,,,,"$5,307.30",$0.00,1,1,1,1,1,1,20161001,,,,
L5701,HCPCS,REPLACE SOCKET ABOVE KNEE,,,28,,NW,,,,,,"$6,538.71",$0.00,1,1,1,1,1,1,20161001,,,,
L5702,HCPCS,REPLACE SOCKET HIP,,,28,,NW,,,,,,"$8,375.19",$0.00,1,1,1,1,1,1,20161001,,,,
L5703,HCPCS,SYMES ANKLE W/O (SACH) FOOT,,,28,,NW,,,,,,"$4,084.92",$0.00,1,1,1,1,1,1,20161001,,,,
L5704,HCPCS,CUSTOM SHAPE COVER BK,,,28,,NW,,,,,,$939.89,$0.00,1,1,1,1,1,1,20161001,,,,
L5705,HCPCS,CUSTOM SHAPE COVER AK,,,28,,NW,,,,,,"$1,722.40",$0.00,1,1,1,1,1,1,20161001,,,,
L5706,HCPCS,CUSTOM SHAPE CVR KNEE DISART,,,28,,NW,,,,,,"$1,688.02",$0.00,1,1,1,1,1,1,20161001,,,,
L5707,HCPCS,CUSTOM SHAPE CVR HIP DISART,,,28,,NW,,,,,,"$2,317.10",$0.00,1,1,1,1,1,1,20161001,,,,
L5710,HCPCS,KNE-SHIN EXO SNG AXI MNL LOC,,,28,,NW,,,,,,$625.42,$0.00,1,1,1,1,1,1,20161001,,,,
L5711,HCPCS,KNEE-SHIN EXO MNL LOCK ULTRA,,,28,,NW,,,,,,$946.19,$0.00,1,1,1,1,1,1,20161001,,,,
L5712,HCPCS,KNEE-SHIN EXO FRICT SWG & ST,,,28,,NW,,,,,,$776.34,$0.00,1,1,1,1,1,1,20161001,,,,
L5714,HCPCS,KNEE-SHIN EXO VARIABLE FRICT,,,28,,NW,,,,,,$726.95,$0.00,1,1,1,1,1,1,20161001,,,,
L5716,HCPCS,KNEE-SHIN EXO MECH STANCE PH,,,28,,NW,,,,,,"$1,367.90",$0.00,1,1,1,1,1,1,20161001,,,,
L5718,HCPCS,KNEE-SHIN EXO FRCT SWG & STA,,,28,,NW,,,,,,"$1,665.64",$0.00,1,1,1,1,1,1,20161001,,,,
L5722,HCPCS,KNEE-SHIN PNEUM SWG FRCT EXO,,,28,,NW,,,,,,"$1,686.24",$0.00,1,1,1,1,1,1,20161001,,,,
L5724,HCPCS,KNEE-SHIN EXO FLUID SWING PH,,,28,,NW,,,,,,"$2,981.59",$0.00,1,1,1,1,1,1,20161001,,,,
L5726,HCPCS,KNEE-SHIN EXT JNTS FLD SWG E,,,28,,NW,,,,,,"$3,379.08",$0.00,1,1,1,1,1,1,20161001,,,,
L5728,HCPCS,KNEE-SHIN FLUID SWG & STANCE,,,28,,NW,,,,,,"$4,533.29",$0.00,1,1,1,1,1,1,20161001,,,,
L5780,HCPCS,KNEE-SHIN PNEUM/HYDRA PNEUM,,,28,,NW,,,,,,"$2,174.33",$0.00,1,1,1,1,1,1,20161001,,,,
L5781,HCPCS,LOWER LIMB PROS VACUUM PUMP,,,28,,NW,,,,,,"$6,917.43",$0.00,1,1,1,1,1,1,20161001,,,,
L5782,HCPCS,HD LOW LIMB PROS VACUUM PUMP,,,28,,NW,,,,,,"$7,296.99",$0.00,1,1,1,1,1,1,20161001,,,,
L5785,HCPCS,EXOSKELETAL BK ULTRALT MATER,,,28,,NW,,,,,,$914.43,$0.00,1,1,1,1,1,1,20161001,,,,
L5790,HCPCS,EXOSKELETAL AK ULTRA-LIGHT M,,,28,,NW,,,,,,"$1,310.80",$0.00,1,1,1,1,1,1,20161001,,,,
L5795,HCPCS,EXOSKEL HIP ULTRA-LIGHT MATE,,,28,,NW,,,,,,"$2,045.06",$0.00,1,1,1,1,1,1,20161001,,,,
L5810,HCPCS,ENDOSKEL KNEE-SHIN MNL LOCK,,,28,,NW,,,,,,$882.13,$0.00,1,1,1,1,1,1,20161001,,,,
L5811,HCPCS,ENDO KNEE-SHIN MNL LCK ULTRA,,,28,,NW,,,,,,"$1,337.46",$0.00,1,1,1,1,1,1,20161001,,,,
L5812,HCPCS,ENDO KNEE-SHIN FRCT SWG & ST,,,28,,NW,,,,,,"$1,011.23",$0.00,1,1,1,1,1,1,20161001,,,,
L5814,HCPCS,ENDO KNEE-SHIN HYDRAL SWG PH,,,28,,NW,,,,,,"$6,417.18",$0.00,1,1,1,1,1,1,20161001,,,,
L5816,HCPCS,ENDO KNEE-SHIN POLYC MCH STA,,,28,,NW,,,,,,"$1,545.57",$0.00,1,1,1,1,1,1,20161001,,,,
L5818,HCPCS,ENDO KNEE-SHIN FRCT SWG & ST,,,28,,NW,,,,,,"$1,768.47",$0.00,1,1,1,1,1,1,20161001,,,,
L5822,HCPCS,ENDO KNEE-SHIN PNEUM SWG FRC,,,28,,NW,,,,,,"$3,069.97",$0.00,1,1,1,1,1,1,20161001,,,,
L5824,HCPCS,ENDO KNEE-SHIN FLUID SWING P,,,28,,NW,,,,,,"$2,977.98",$0.00,1,1,1,1,1,1,20161001,,,,
L5826,HCPCS,MINIATURE KNEE JOINT,,,28,,NW,,,,,,"$5,408.83",$0.00,1,1,1,1,1,1,20161001,,,,
L5828,HCPCS,ENDO KNEE-SHIN FLUID SWG/STA,,,28,,NW,,,,,,"$5,387.28",$0.00,1,1,1,1,1,1,20161001,,,,
L5830,HCPCS,ENDO KNEE-SHIN PNEUM/SWG PHA,,,28,,NW,,,,,,"$3,659.44",$0.00,1,1,1,1,1,1,20161001,,,,
L5840,HCPCS,MULTI-AXIAL KNEE/SHIN SYSTEM,,,28,,NW,,,,,,"$6,494.89",$0.00,1,1,1,1,1,1,20161001,,,,
L5845,HCPCS,KNEE-SHIN SYS STANCE FLEXION,,,28,,NW,,,,,,"$3,053.26",$0.00,1,1,1,1,1,1,20161001,,,,
L5848,HCPCS,KNEE-SHIN SYS HYDRAUL STANCE,,,28,,NW,,,,,,"$1,798.83",$0.00,1,1,1,1,1,1,20161001,,,,
L5850,HCPCS,ENDO AK/HIP KNEE EXTENS ASSI,,,28,,NW,,,,,,$155.93,$0.00,1,1,1,1,1,1,20161001,,,,
L5855,HCPCS,MECH HIP EXTENSION ASSIST,,,28,,NW,,,,,,$528.75,$0.00,1,1,1,1,1,1,20161001,,,,
L5856,HCPCS,ELEC KNEE-SHIN SWING/STANCE,,,28,,NW,,,,,,"$41,955.15",$0.00,1,1,1,1,1,1,20161001,,,,
L5857,HCPCS,ELEC KNEE-SHIN SWING ONLY,,,28,,NW,,,,,,"$14,860.40",$0.00,1,1,1,1,1,1,20161001,,,,
L5858,HCPCS,STANCE PHASE ONLY,,,28,,NW,,,,,,"$32,431.32",$0.00,1,1,1,1,1,1,20161001,,,,
L5859,HCPCS,KNEE-SHIN PRO FLEX/EXT CONT,,,28,,NW,,,,,,"$25,359.51",$0.00,1,1,1,1,1,1,20161001,,,,
L5910,HCPCS,ENDO BELOW KNEE ALIGNABLE SY,,,28,,NW,,,,,,$602.51,$0.00,1,1,1,1,1,1,20161001,,,,
L5920,HCPCS,ENDO AK/HIP ALIGNABLE SYSTEM,,,28,,NW,,,,,,$912.69,$0.00,1,1,1,1,1,1,20161001,,,,
L5925,HCPCS,ABOVE KNEE MANUAL LOCK,,,28,,NW,,,,,,$620.85,$0.00,1,1,1,1,1,1,20161001,,,,
L5930,HCPCS,HIGH ACTIVITY KNEE FRAME,,,28,,NW,,,,,,"$5,831.36",$0.00,1,1,1,1,1,1,20161001,,,,
L5940,HCPCS,ENDO BK ULTRA-LIGHT MATERIAL,,,28,,NW,,,,,,$882.22,$0.00,1,1,1,1,1,1,20161001,,,,
L5950,HCPCS,ENDO AK ULTRA-LIGHT MATERIAL,,,28,,NW,,,,,,"$1,401.53",$0.00,1,1,1,1,1,1,20161001,,,,
L5960,HCPCS,ENDO HIP ULTRA-LIGHT MATERIA,,,28,,NW,,,,,,"$1,818.59",$0.00,1,1,1,1,1,1,20161001,,,,
L5961,HCPCS,"ENDO POLY HIP, PNEU/HYD/ROT",,,28,,NW,,,,,,"$8,249.51",$0.00,1,1,1,1,1,1,20161001,,,,
L5962,HCPCS,BELOW KNEE FLEX COVER SYSTEM,,,28,,NW,,,,,,"$1,067.77",$0.00,1,1,1,1,1,1,20161001,,,,
L5964,HCPCS,ABOVE KNEE FLEX COVER SYSTEM,,,28,,NW,,,,,,"$1,750.52",$0.00,1,1,1,1,1,1,20161001,,,,
L5966,HCPCS,HIP FLEXIBLE COVER SYSTEM,,,28,,NW,,,,,,"$2,274.06",$0.00,1,1,1,1,1,1,20161001,,,,
L5968,HCPCS,MULTIAXIAL ANKLE W DORSIFLEX,,,28,,NW,,,,,,"$6,274.94",$0.00,1,1,1,1,1,1,20161001,,,,
L5969,HCPCS,AK/FT POWER ASST INCL MOTORS,,,28,,NW,,,,,,"$17,195.94",$0.00,1,1,1,1,1,1,20161001,,,,
L5970,HCPCS,FOOT EXTERNAL KEEL SACH FOOT,,,28,,NW,,,,,,$311.89,$0.00,1,1,1,1,1,1,20161001,,,,
L5971,HCPCS,"SACH FOOT, REPLACEMENT",,,28,,NW,,,,,,$311.89,$0.00,1,1,1,1,1,1,20161001,,,,
L5972,HCPCS,FLEXIBLE KEEL FOOT,,,28,,NW,,,,,,$625.34,$0.00,1,1,1,1,1,1,20161001,,,,
L5973,HCPCS,ANK-FOOT SYS DORS-PLANT FLEX,,,28,,NW,,,,,,"$30,428.71",$0.00,1,1,1,1,1,1,20161001,,,,
L5974,HCPCS,FOOT SINGLE AXIS ANKLE/FOOT,,,28,,NW,,,,,,$380.21,$0.00,1,1,1,1,1,1,20161001,,,,
L5975,HCPCS,COMBO ANKLE/FOOT PROSTHESIS,,,28,,NW,,,,,,$728.65,$0.00,1,1,1,1,1,1,20161001,,,,
L5976,HCPCS,ENERGY STORING FOOT,,,28,,NW,,,,,,"$1,020.59",$0.00,1,1,1,1,1,1,20161001,,,,
L5978,HCPCS,FT PROSTH MULTIAXIAL ANKL/FT,,,28,,NW,,,,,,$493.51,$0.00,1,1,1,1,1,1,20161001,,,,
L5979,HCPCS,MULTI-AXIAL ANKLE/FT PROSTH,,,28,,NW,,,,,,"$4,344.06",$0.00,1,1,1,1,1,1,20161001,,,,
L5980,HCPCS,FLEX FOOT SYSTEM,,,28,,NW,,,,,,"$7,020.88",$0.00,1,1,1,1,1,1,20161001,,,,
L5981,HCPCS,FLEX-WALK SYS LOW EXT PROSTH,,,28,,NW,,,,,,"$5,510.55",$0.00,1,1,1,1,1,1,20161001,,,,
L5982,HCPCS,EXOSKELETAL AXIAL ROTATION U,,,28,,NW,,,,,,"$1,064.29",$0.00,1,1,1,1,1,1,20161001,,,,
L5984,HCPCS,ENDOSKELETAL AXIAL ROTATION,,,28,,NW,,,,,,"$1,048.07",$0.00,1,1,1,1,1,1,20161001,,,,
L5985,HCPCS,LWR EXT DYNAMIC PROSTH PYLON,,,28,,NW,,,,,,$413.75,$0.00,1,1,1,1,1,1,20161001,,,,
L5986,HCPCS,MULTI-AXIAL ROTATION UNIT,,,28,,NW,,,,,,"$1,172.15",$0.00,1,1,1,1,1,1,20161001,,,,
L5987,HCPCS,SHANK FT W VERT LOAD PYLON,,,28,,NW,,,,,,"$12,507.24",$0.00,1,1,1,1,1,1,20161001,,,,
L5988,HCPCS,VERTICAL SHOCK REDUCING PYLO,,,28,,NW,,,,,,"$3,412.47",$0.00,1,1,1,1,1,1,20161001,,,,
L5990,HCPCS,USER ADJUSTABLE HEEL HEIGHT,,,28,,NW,,,,,,"$3,091.46",$0.00,1,1,1,1,1,1,20161001,,,,
L5999,HCPCS,LOWR EXTREMITY PROSTHES NOS,,,28,,NW,,,,,,"$1,067.77",$0.00,1,1,1,1,1,1,20161001,,,,
L6000,HCPCS,PART HAND THUMB REM,,,28,,NW,,,,,,"$2,611.59",$0.00,1,1,1,1,1,1,20161001,,,,
L6010,HCPCS,PART HAND LITTLE/RING,,,28,,NW,,,,,,"$2,893.49",$0.00,1,1,1,1,1,1,20161001,,,,
L6020,HCPCS,PART HAND NO FINGERS,,,28,,NW,,,,,,"$2,700.83",$0.00,1,1,1,1,1,1,20161001,,,,
L6026,HCPCS,PART HAND MYO EXCLU TERM DEV,,,28,,NW,,,,,,"$7,679.89",$0.00,1,1,1,1,1,1,20161001,,,,
L6050,HCPCS,WRST MLD SCK FLX HNG TRI PAD,,,28,,NW,,,,,,"$3,815.81",$0.00,1,1,1,1,1,1,20161001,,,,
L6055,HCPCS,WRST MOLD SOCK W/EXP INTERFA,,,28,,NW,,,,,,"$5,149.25",$0.00,1,1,1,1,1,1,20161001,,,,
L6100,HCPCS,ELB MOLD SOCK FLEX HINGE PAD,,,28,,NW,,,,,,"$3,804.26",$0.00,1,1,1,1,1,1,20161001,,,,
L6110,HCPCS,ELBOW MOLD SOCK SUSPENSION T,,,28,,NW,,,,,,"$4,160.62",$0.00,1,1,1,1,1,1,20161001,,,,
L6120,HCPCS,ELBOW MOLD DOUB SPLT SOC STE,,,28,,NW,,,,,,"$4,790.26",$0.00,1,1,1,1,1,1,20161001,,,,
L6130,HCPCS,ELBOW STUMP ACTIVATED LOCK H,,,28,,NW,,,,,,"$5,121.64",$0.00,1,1,1,1,1,1,20161001,,,,
L6200,HCPCS,ELBOW MOLD OUTSID LOCK HINGE,,,28,,NW,,,,,,"$5,393.13",$0.00,1,1,1,1,1,1,20161001,,,,
L6205,HCPCS,ELBOW MOLDED W/ EXPAND INTER,,,28,,NW,,,,,,"$7,166.23",$0.00,1,1,1,1,1,1,20161001,,,,
L6250,HCPCS,ELBOW INTER LOC ELBOW FORARM,,,28,,NW,,,,,,"$5,353.87",$0.00,1,1,1,1,1,1,20161001,,,,
L6300,HCPCS,SHLDER DISART INT LOCK ELBOW,,,28,,NW,,,,,,"$7,421.35",$0.00,1,1,1,1,1,1,20161001,,,,
L6310,HCPCS,SHOULDER PASSIVE RESTOR COMP,,,28,,NW,,,,,,"$6,065.88",$0.00,1,1,1,1,1,1,20161001,,,,
L6320,HCPCS,SHOULDER PASSIVE RESTOR CAP,,,28,,NW,,,,,,"$3,313.67",$0.00,1,1,1,1,1,1,20161001,,,,
L6350,HCPCS,THORACIC INTERN LOCK ELBOW,,,28,,NW,,,,,,"$7,832.30",$0.00,1,1,1,1,1,1,20161001,,,,
L6360,HCPCS,THORACIC PASSIVE RESTOR COMP,,,28,,NW,,,,,,"$6,328.56",$0.00,1,1,1,1,1,1,20161001,,,,
L6370,HCPCS,THORACIC PASSIVE RESTOR CAP,,,28,,NW,,,,,,"$4,064.75",$0.00,1,1,1,1,1,1,20161001,,,,
L6380,HCPCS,POSTOP DSG CAST CHG WRST/ELB,,,28,,NW,,,,,,"$2,209.11",$0.00,1,1,1,1,1,1,20161001,,,,
L6382,HCPCS,POSTOP DSG CAST CHG ELB DIS/,,,28,,NW,,,,,,"$2,873.68",$0.00,1,1,1,1,1,1,20161001,,,,
L6384,HCPCS,POSTOP DSG CAST CHG SHLDER/T,,,28,,NW,,,,,,"$3,743.12",$0.00,1,1,1,1,1,1,20161001,,,,
L6386,HCPCS,POSTOP EA CAST CHG & REALIGN,,,28,,NW,,,,,,$733.20,$0.00,1,1,1,1,1,1,20161001,,,,
L6388,HCPCS,POSTOP APPLICAT RIGID DSG ON,,,28,,NW,,,,,,$778.39,$0.00,1,1,1,1,1,1,20161001,,,,
L6400,HCPCS,BELOW ELBOW PROSTH TISS SHAP,,,28,,NW,,,,,,"$4,514.39",$0.00,1,1,1,1,1,1,20161001,,,,
L6450,HCPCS,ELB DISART PROSTH TISS SHAP,,,28,,NW,,,,,,"$5,876.11",$0.00,1,1,1,1,1,1,20161001,,,,
L6500,HCPCS,ABOVE ELBOW PROSTH TISS SHAP,,,28,,NW,,,,,,"$5,806.80",$0.00,1,1,1,1,1,1,20161001,,,,
L6550,HCPCS,SHLDR DISAR PROSTH TISS SHAP,,,28,,NW,,,,,,"$7,404.13",$0.00,1,1,1,1,1,1,20161001,,,,
L6570,HCPCS,SCAP THORAC PROSTH TISS SHAP,,,28,,NW,,,,,,"$8,529.45",$0.00,1,1,1,1,1,1,20161001,,,,
L6580,HCPCS,WRIST/ELBOW BOWDEN CABLE MOL,,,28,,NW,,,,,,"$2,975.13",$0.00,1,1,1,1,1,1,20161001,,,,
L6582,HCPCS,WRIST/ELBOW BOWDEN CBL DIR F,,,28,,NW,,,,,,"$2,552.03",$0.00,1,1,1,1,1,1,20161001,,,,
L6584,HCPCS,ELBOW FAIR LEAD CABLE MOLDED,,,28,,NW,,,,,,"$3,948.67",$0.00,1,1,1,1,1,1,20161001,,,,
L6586,HCPCS,ELBOW FAIR LEAD CABLE DIR FO,,,28,,NW,,,,,,"$3,577.44",$0.00,1,1,1,1,1,1,20161001,,,,
L6588,HCPCS,SHDR FAIR LEAD CABLE MOLDED,,,28,,NW,,,,,,"$5,480.34",$0.00,1,1,1,1,1,1,20161001,,,,
L6590,HCPCS,SHDR FAIR LEAD CABLE DIRECT,,,28,,NW,,,,,,"$5,015.77",$0.00,1,1,1,1,1,1,20161001,,,,
L6600,HCPCS,POLYCENTRIC HINGE PAIR,,,28,,NW,,,,,,$303.78,$0.00,1,1,1,1,1,1,20161001,,,,
L6605,HCPCS,SINGLE PIVOT HINGE PAIR,,,28,,NW,,,,,,$299.41,$0.00,1,1,1,1,1,1,20161001,,,,
L6610,HCPCS,FLEXIBLE METAL HINGE PAIR,,,28,,NW,,,,,,$256.18,$0.00,1,1,1,1,1,1,20161001,,,,
L6611,HCPCS,"ADDITIONAL SWITCH, EXT POWER",,,28,,NW,,,,,,$637.90,$0.00,1,1,1,1,1,1,20161001,,,,
L6615,HCPCS,DISCONNECT LOCKING WRIST UNI,,,28,,NW,,,,,,$260.28,$0.00,1,1,1,1,1,1,20161001,,,,
L6616,HCPCS,DISCONNECT INSERT LOCKING WR,,,28,,NW,,,,,,$65.17,$0.00,1,1,1,1,1,1,20161001,,,,
L6620,HCPCS,FLEXION/EXTENSION WRIST UNIT,,,28,,NW,,,,,,$516.81,$0.00,1,1,1,1,1,1,20161001,,,,
L6621,HCPCS,FLEX/EXT WRIST W/WO FRICTION,,,28,,NW,,,,,,"$3,919.10",$0.00,1,1,1,1,1,1,20161001,,,,
L6623,HCPCS,SPRING-ASS ROT WRST W/ LATCH,,,28,,NW,,,,,,"$1,178.09",$0.00,1,1,1,1,1,1,20161001,,,,
L6624,HCPCS,FLEX/EXT/ROTATION WRIST UNIT,,,28,,NW,,,,,,"$6,506.17",$0.00,1,1,1,1,1,1,20161001,,,,
L6625,HCPCS,ROTATION WRST W/ CABLE LOCK,,,28,,NW,,,,,,$989.25,$0.00,1,1,1,1,1,1,20161001,,,,
L6628,HCPCS,QUICK DISCONN HOOK ADAPTER O,,,28,,NW,,,,,,$836.83,$0.00,1,1,1,1,1,1,20161001,,,,
L6629,HCPCS,LAMINATION COLLAR W/ COUPLIN,,,28,,NW,,,,,,$211.32,$0.00,1,1,1,1,1,1,20161001,,,,
L6630,HCPCS,STAINLESS STEEL ANY WRIST,,,28,,NW,,,,,,$338.37,$0.00,1,1,1,1,1,1,20161001,,,,
L6632,HCPCS,LATEX SUSPENSION SLEEVE EACH,,,28,,NW,,,,,,$62.47,$0.00,1,1,1,1,1,1,20161001,,,,
L6635,HCPCS,LIFT ASSIST FOR ELBOW,,,28,,NW,,,,,,$275.46,$0.00,1,1,1,1,1,1,20161001,,,,
L6637,HCPCS,NUDGE CONTROL ELBOW LOCK,,,28,,NW,,,,,,$632.05,$0.00,1,1,1,1,1,1,20161001,,,,
L6638,HCPCS,ELEC LOCK ON MANUAL PW ELBOW,,,28,,NW,,,,,,"$4,292.50",$0.00,1,1,1,1,1,1,20161001,,,,
L6640,HCPCS,SHOULDER ABDUCTION JOINT PAI,,,28,,NW,,,,,,$483.66,$0.00,1,1,1,1,1,1,20161001,,,,
L6641,HCPCS,EXCURSION AMPLIFIER PULLEY T,,,28,,NW,,,,,,$247.98,$0.00,1,1,1,1,1,1,20161001,,,,
L6642,HCPCS,EXCURSION AMPLIFIER LEVER TY,,,28,,NW,,,,,,$364.49,$0.00,1,1,1,1,1,1,20161001,,,,
L6645,HCPCS,SHOULDER FLEXION-ABDUCTION J,,,28,,NW,,,,,,$576.69,$0.00,1,1,1,1,1,1,20161001,,,,
L6646,HCPCS,MULTIPO LOCKING SHOULDER JNT,,,28,,NW,,,,,,"$5,435.34",$0.00,1,1,1,1,1,1,20161001,,,,
L6647,HCPCS,SHOULDER LOCK ACTUATOR,,,28,,NW,,,,,,$825.99,$0.00,1,1,1,1,1,1,20161001,,,,
L6648,HCPCS,EXT PWRD SHLDER LOCK/UNLOCK,,,28,,NW,,,,,,"$5,608.35",$0.00,1,1,1,1,1,1,20161001,,,,
L6650,HCPCS,SHOULDER UNIVERSAL JOINT,,,28,,NW,,,,,,$616.71,$0.00,1,1,1,1,1,1,20161001,,,,
L6655,HCPCS,STANDARD CONTROL CABLE EXTRA,,,28,,NW,,,,,,$75.82,$0.00,1,1,1,1,1,1,20161001,,,,
L6660,HCPCS,HEAVY DUTY CONTROL CABLE,,,28,,NW,,,,,,$98.39,$0.00,1,1,1,1,1,1,20161001,,,,
L6665,HCPCS,TEFLON OR EQUAL CABLE LINING,,,28,,NW,,,,,,$47.81,$0.00,1,1,1,1,1,1,20161001,,,,
L6670,HCPCS,HOOK TO HAND CABLE ADAPTER,,,28,,NW,,,,,,$51.62,$0.00,1,1,1,1,1,1,20161001,,,,
L6672,HCPCS,HARNESS CHEST/SHLDER SADDLE,,,28,,NW,,,,,,$267.77,$0.00,1,1,1,1,1,1,20161001,,,,
L6675,HCPCS,HARNESS FIGURE OF 8 SING CON,,,28,,NW,,,,,,$144.28,$0.00,1,1,1,1,1,1,20161001,,,,
L6676,HCPCS,HARNESS FIGURE OF 8 DUAL CON,,,28,,NW,,,,,,$159.69,$0.00,1,1,1,1,1,1,20161001,,,,
L6677,HCPCS,UE TRIPLE CONTROL HARNESS,,,28,,NW,,,,,,$436.59,$0.00,1,1,1,1,1,1,20161001,,,,
L6680,HCPCS,TEST SOCK WRIST DISART/BEL E,,,28,,NW,,,,,,$398.53,$0.00,1,1,1,1,1,1,20161001,,,,
L6682,HCPCS,TEST SOCK ELBW DISART/ABOVE,,,28,,NW,,,,,,$433.89,$0.00,1,1,1,1,1,1,20161001,,,,
L6684,HCPCS,TEST SOCKET SHLDR DISART/THO,,,28,,NW,,,,,,$629.17,$0.00,1,1,1,1,1,1,20161001,,,,
L6686,HCPCS,SUCTION SOCKET,,,28,,NW,,,,,,"$1,150.44",$0.00,1,1,1,1,1,1,20161001,,,,
L6687,HCPCS,FRAME TYP SOCKET BEL ELBOW/W,,,28,,NW,,,,,,$945.39,$0.00,1,1,1,1,1,1,20161001,,,,
L6688,HCPCS,FRAME TYP SOCK ABOVE ELB/DIS,,,28,,NW,,,,,,$980.49,$0.00,1,1,1,1,1,1,20161001,,,,
L6689,HCPCS,FRAME TYP SOCKET SHOULDER DI,,,28,,NW,,,,,,"$1,217.79",$0.00,1,1,1,1,1,1,20161001,,,,
L6690,HCPCS,FRAME TYP SOCK INTERSCAP-THO,,,28,,NW,,,,,,"$1,309.03",$0.00,1,1,1,1,1,1,20161001,,,,
L6691,HCPCS,REMOVABLE INSERT EACH,,,28,,NW,,,,,,$595.20,$0.00,1,1,1,1,1,1,20161001,,,,
L6692,HCPCS,SILICONE GEL INSERT OR EQUAL,,,28,,NW,,,,,,"$1,026.07",$0.00,1,1,1,1,1,1,20161001,,,,
L6693,HCPCS,LOCKINGELBOW FOREARM CNTRBAL,,,28,,NW,,,,,,"$4,884.27",$0.00,1,1,1,1,1,1,20161001,,,,
L6694,HCPCS,ELBOW SOCKET INS USE W/LOCK,,,28,,NW,,,,,,"$1,219.19",$0.00,1,1,1,1,1,1,20161001,,,,
L6695,HCPCS,ELBOW SOCKET INS USE W/O LCK,,,28,,NW,,,,,,"$1,002.24",$0.00,1,1,1,1,1,1,20161001,,,,
L6696,HCPCS,CUS ELBO SKT IN FOR CON/ATYP,,,28,,NW,,,,,,"$2,218.99",$0.00,1,1,1,1,1,1,20161001,,,,
L6697,HCPCS,CUS ELBO SKT IN NOT CON/ATYP,,,28,,NW,,,,,,"$2,218.99",$0.00,1,1,1,1,1,1,20161001,,,,
L6698,HCPCS,BELOW/ABOVE ELBOW LOCK MECH,,,28,,NW,,,,,,$916.81,$0.00,1,1,1,1,1,1,20161001,,,,
L6703,HCPCS,"TERM DEV, PASSIVE HAND MITT",,,28,,NW,,,,,,$551.26,$0.00,1,1,1,1,1,1,20161001,,,,
L6704,HCPCS,"TERM DEV, SPORT/REC/WORK ATT",,,28,,NW,,,,,,"$1,087.98",$0.00,1,1,1,1,1,1,20161001,,,,
L6706,HCPCS,TERM DEV MECH HOOK VOL OPEN,,,28,,NW,,,,,,$605.40,$0.00,1,1,1,1,1,1,20161001,,,,
L6707,HCPCS,TERM DEV MECH HOOK VOL CLOSE,,,28,,NW,,,,,,"$2,456.79",$0.00,1,1,1,1,1,1,20161001,,,,
L6708,HCPCS,TERM DEV MECH HAND VOL OPEN,,,28,,NW,,,,,,"$1,584.27",$0.00,1,1,1,1,1,1,20161001,,,,
L6709,HCPCS,TERM DEV MECH HAND VOL CLOSE,,,28,,NW,,,,,,"$2,332.50",$0.00,1,1,1,1,1,1,20161001,,,,
L6711,HCPCS,"PED TERM DEV, HOOK, VOL OPEN",,,28,,NW,,,,,,"$1,093.77",$0.00,1,1,1,1,1,1,20161001,,,,
L6712,HCPCS,"PED TERM DEV, HOOK, VOL CLOS",,,28,,NW,,,,,,"$2,083.18",$0.00,1,1,1,1,1,1,20161001,,,,
L6713,HCPCS,"PED TERM DEV, HAND, VOL OPEN",,,28,,NW,,,,,,"$2,650.77",$0.00,1,1,1,1,1,1,20161001,,,,
L6714,HCPCS,"PED TERM DEV, HAND, VOL CLOS",,,28,,NW,,,,,,"$2,232.58",$0.00,1,1,1,1,1,1,20161001,,,,
L6715,HCPCS,"TERM DEVICE, MULTI ART DIGIT",,,28,,NW,,,,,,"$5,441.25",$0.00,1,1,1,1,1,1,20161001,,,,
L6721,HCPCS,"HOOK/HAND, HVY DTY, VOL OPEN",,,28,,NW,,,,,,"$4,032.24",$0.00,1,1,1,1,1,1,20161001,,,,
L6722,HCPCS,"HOOK/HAND, HVY DTY, VOL CLOS",,,28,,NW,,,,,,"$3,464.72",$0.00,1,1,1,1,1,1,20161001,,,,
L6805,HCPCS,TERM DEV MODIFIER WRIST UNIT,,,28,,NW,,,,,,$598.68,$0.00,1,1,1,1,1,1,20161001,,,,
L6810,HCPCS,TERM DEV PRECISION PINCH DEV,,,28,,NW,,,,,,$281.03,$0.00,1,1,1,1,1,1,20161001,,,,
L6880,HCPCS,ELEC HAND IND ART DIGITS,,,28,,NW,,,,,,"$41,719.17",$0.00,1,1,1,1,1,1,20161001,,,,
L6881,HCPCS,TERM DEV AUTO GRASP FEATURE,,,28,,NW,,,,,,"$7,069.75",$0.00,1,1,1,1,1,1,20161001,,,,
L6882,HCPCS,MICROPROCESSOR CONTROL UPLMB,,,28,,NW,,,,,,"$5,342.86",$0.00,1,1,1,1,1,1,20161001,,,,
L6883,HCPCS,REPLC SOCKT BELOW E/W DISA,,,28,,NW,,,,,,"$3,082.55",$0.00,1,1,1,1,1,1,20161001,,,,
L6884,HCPCS,REPLC SOCKT ABOVE ELBOW DISA,,,28,,NW,,,,,,"$4,454.16",$0.00,1,1,1,1,1,1,20161001,,,,
L6885,HCPCS,REPLC SOCKT SHLDR DIS/INTERC,,,28,,NW,,,,,,"$6,328.56",$0.00,1,1,1,1,1,1,20161001,,,,
L6890,HCPCS,PREFAB GLOVE FOR TERM DEVICE,,,28,,NW,,,,,,$260.74,$0.00,1,1,1,1,1,1,20161001,,,,
L6895,HCPCS,CUSTOM GLOVE FOR TERM DEVICE,,,28,,NW,,,,,,$989.87,$0.00,1,1,1,1,1,1,20161001,,,,
L6900,HCPCS,HAND RESTORAT THUMB/1 FINGER,,,28,,NW,,,,,,"$3,062.09",$0.00,1,1,1,1,1,1,20161001,,,,
L6905,HCPCS,HAND RESTORATION MULTIPLE FI,,,28,,NW,,,,,,"$2,979.70",$0.00,1,1,1,1,1,1,20161001,,,,
L6910,HCPCS,HAND RESTORATION NO FINGERS,,,28,,NW,,,,,,"$2,875.29",$0.00,1,1,1,1,1,1,20161001,,,,
L6915,HCPCS,HAND RESTORATION REPLACMNT G,,,28,,NW,,,,,,"$1,196.60",$0.00,1,1,1,1,1,1,20161001,,,,
L6920,HCPCS,WRIST DISARTICUL SWITCH CTRL,,,28,,NW,,,,,,"$12,987.96",$0.00,1,1,1,1,1,1,20161001,,,,
L6925,HCPCS,WRIST DISART MYOELECTRONIC C,,,28,,NW,,,,,,"$14,871.53",$0.00,1,1,1,1,1,1,20161001,,,,
L6930,HCPCS,BELOW ELBOW SWITCH CONTROL,,,28,,NW,,,,,,"$12,874.38",$0.00,1,1,1,1,1,1,20161001,,,,
L6935,HCPCS,BELOW ELBOW MYOELECTRONIC CT,,,28,,NW,,,,,,"$15,086.46",$0.00,1,1,1,1,1,1,20161001,,,,
L6940,HCPCS,ELBOW DISARTICULATION SWITCH,,,28,,NW,,,,,,"$16,593.51",$0.00,1,1,1,1,1,1,20161001,,,,
L6945,HCPCS,ELBOW DISART MYOELECTRONIC C,,,28,,NW,,,,,,"$19,078.73",$0.00,1,1,1,1,1,1,20161001,,,,
L6950,HCPCS,ABOVE ELBOW SWITCH CONTROL,,,28,,NW,,,,,,"$17,931.25",$0.00,1,1,1,1,1,1,20161001,,,,
L6955,HCPCS,ABOVE ELBOW MYOELECTRONIC CT,,,28,,NW,,,,,,"$21,501.40",$0.00,1,1,1,1,1,1,20161001,,,,
L6960,HCPCS,SHLDR DISARTIC SWITCH CONTRO,,,28,,NW,,,,,,"$22,785.56",$0.00,1,1,1,1,1,1,20161001,,,,
L6965,HCPCS,SHLDR DISARTIC MYOELECTRONIC,,,28,,NW,,,,,,"$26,881.00",$0.00,1,1,1,1,1,1,20161001,,,,
L6970,HCPCS,INTERSCAPULAR-THOR SWITCH CT,,,28,,NW,,,,,,"$28,119.60",$0.00,1,1,1,1,1,1,20161001,,,,
L6975,HCPCS,INTERSCAP-THOR MYOELECTRONIC,,,28,,NW,,,,,,"$30,907.89",$0.00,1,1,1,1,1,1,20161001,,,,
L7007,HCPCS,ADULT ELECTRIC HAND,,,28,,NW,,,,,,"$6,402.38",$0.00,1,1,1,1,1,1,20161001,,,,
L7008,HCPCS,PEDIATRIC ELECTRIC HAND,,,28,,NW,,,,,,"$10,377.13",$0.00,1,1,1,1,1,1,20161001,,,,
L7009,HCPCS,ADULT ELECTRIC HOOK,,,28,,NW,,,,,,"$6,522.24",$0.00,1,1,1,1,1,1,20161001,,,,
L7040,HCPCS,PREHENSILE ACTUATOR,,,28,,NW,,,,,,"$5,222.35",$0.00,1,1,1,1,1,1,20161001,,,,
L7045,HCPCS,PEDIATRIC ELECTRIC HOOK,,,28,,NW,,,,,,"$2,870.39",$0.00,1,1,1,1,1,1,20161001,,,,
L7170,HCPCS,ELECTRONIC ELBOW HOSMER SWIT,,,28,,NW,,,,,,"$11,274.76",$0.00,1,1,1,1,1,1,20161001,,,,
L7180,HCPCS,ELECTRONIC ELBOW SEQUENTIAL,,,28,,NW,,,,,,"$63,989.05",$0.00,1,1,1,1,1,1,20161001,,,,
L7181,HCPCS,ELECTRONIC ELBO SIMULTANEOUS,,,28,,NW,,,,,,"$70,014.32",$0.00,1,1,1,1,1,1,20161001,,,,
L7185,HCPCS,ELECTRON ELBOW ADOLESCENT SW,,,28,,NW,,,,,,"$11,685.11",$0.00,1,1,1,1,1,1,20161001,,,,
L7186,HCPCS,ELECTRON ELBOW CHILD SWITCH,,,28,,NW,,,,,,"$17,334.98",$0.00,1,1,1,1,1,1,20161001,,,,
L7190,HCPCS,ELBOW ADOLESCENT MYOELECTRON,,,28,,NW,,,,,,"$14,699.38",$0.00,1,1,1,1,1,1,20161001,,,,
L7191,HCPCS,ELBOW CHILD MYOELECTRONIC CT,,,28,,NW,,,,,,"$18,140.38",$0.00,1,1,1,1,1,1,20161001,,,,
L7259,HCPCS,ELECTRONIC WRIST ROTATOR ANY,,,28,,NW,,,,,,"$6,562.33",$0.00,1,1,1,1,1,1,20161001,,,,
L7360,HCPCS,SIX VOLT BAT OTTO BOCK/EQ EA,,,28,,NW,,,,,,$369.33,$0.00,1,1,1,1,1,1,20161001,,,,
L7362,HCPCS,BATTERY CHRGR SIX VOLT OTTO,,,28,,NW,,,,,,$396.76,$0.00,1,1,1,1,1,1,20161001,,,,
L7364,HCPCS,TWELVE VOLT BATTERY UTAH/EQU,,,28,,NW,,,,,,$761.25,$0.00,1,1,1,1,1,1,20161001,,,,
L7366,HCPCS,BATTERY CHRGR 12 VOLT UTAH/E,,,28,,NW,,,,,,"$1,047.39",$0.00,1,1,1,1,1,1,20161001,,,,
L7367,HCPCS,REPLACEMNT LITHIUM IONBATTER,,,28,,NW,,,,,,$598.71,$0.00,1,1,1,1,1,1,20161001,,,,
L7368,HCPCS,LITHIUM ION BATTERY CHARGER,,,28,,NW,,,,,,$800.55,$0.00,1,1,1,1,1,1,20161001,,,,
L7400,HCPCS,"ADD UE PROST BE/WD, ULTLITE",,,28,,NW,,,,,,$453.80,$0.00,1,1,1,1,1,1,20161001,,,,
L7401,HCPCS,ADD UE PROST A/E ULTLITE MAT,,,28,,NW,,,,,,$517.87,$0.00,1,1,1,1,1,1,20161001,,,,
L7402,HCPCS,ADD UE PROST S/D ULTLITE MAT,,,28,,NW,,,,,,$565.84,$0.00,1,1,1,1,1,1,20161001,,,,
L7403,HCPCS,ADD UE PROST B/E ACRYLIC,,,28,,NW,,,,,,$561.87,$0.00,1,1,1,1,1,1,20161001,,,,
L7404,HCPCS,ADD UE PROST A/E ACRYLIC,,,28,,NW,,,,,,$889.98,$0.00,1,1,1,1,1,1,20161001,,,,
L7405,HCPCS,ADD UE PROST S/D ACRYLIC,,,28,,NW,,,,,,"$1,189.32",$0.00,1,1,1,1,1,1,20161001,,,,
L7499,HCPCS,UPPER EXTREMITY PROSTHES NOS,,,28,,NW,,,,,,"$1,923.83",$0.00,1,1,1,1,1,1,20161001,,,,
L7510,HCPCS,PROSTHETIC DEVICE REPAIR REP,,,28,,NW,,,,,,$67.09,$0.00,1,1,1,1,1,1,20161001,,,,
L7520,HCPCS,REPAIR PROSTHESIS PER 15 MIN,,,28,,NW,,,,,,$47.61,$0.00,1,1,1,1,1,1,20161001,,,,
L7600,HCPCS,PROSTHETIC DONNING SLEEVE,,,28,,NW,,,,,,$54.03,$0.00,1,1,1,1,1,1,20161001,,,,
L7900,HCPCS,MALE VACUUM ERECTION SYSTEM,,,28,,NW,,,,,,$851.65,$0.00,1,1,1,1,1,1,20161001,,,,
L7902,HCPCS,"TENSION RING, VAC ERECT DEV",,,28,,NW,,,,,,$32.69,$0.00,1,1,1,1,1,1,20161001,,,,
L8000,HCPCS,MASTECTOMY BRA,,,28,,NW,,,,,,$40.76,$0.00,1,1,1,1,1,1,20161001,,,,
L8001,HCPCS,BREAST PROSTHESIS BRA & FORM,,,28,,NW,,,,,,$137.05,$0.00,1,1,1,1,1,1,20161001,,,,
L8002,HCPCS,BRST PRSTH BRA & BILAT FORM,,,28,,NW,,,,,,$206.24,$0.00,1,1,1,1,1,1,20161001,,,,
L8010,HCPCS,MASTECTOMY SLEEVE,,,28,,NW,,,,,,$51.65,$0.00,1,1,1,1,1,1,20161001,,,,
L8015,HCPCS,EXT BREASTPROSTHESIS GARMENT,,,28,,NW,,,,,,$55.34,$0.00,1,1,1,1,1,1,20161001,,,,
L8020,HCPCS,MASTECTOMY FORM,,,28,,NW,,,,,,$315.31,$0.00,1,1,1,1,1,1,20161001,,,,
L8030,HCPCS,BREAST PROSTHES W/O ADHESIVE,,,28,,NW,,,,,,$526.20,$0.00,1,1,1,1,1,1,20161001,,,,
L8031,HCPCS,BREAST PROSTHESIS W ADHESIVE,,,28,,NW,,,,,,$526.20,$0.00,1,1,1,1,1,1,20161001,,,,
L8032,HCPCS,REUSABLE NIPPLE PROSTHESIS,,,28,,NW,,,,,,$38.78,$0.00,1,1,1,1,1,1,20161001,,,,
L8035,HCPCS,CUSTOM BREAST PROSTHESIS,,,28,,NW,,,,,,"$6,326.91",$0.00,1,1,1,1,1,1,20161001,,,,
L8039,HCPCS,BREAST PROSTHESIS NOS,,,28,,NW,,,,,,$40.76,$0.00,1,1,1,1,1,1,20161001,,,,
L8040,HCPCS,NASAL PROSTHESIS,,,28,,NW,,,,,,"$4,302.07",$0.00,1,1,1,1,1,1,20161001,,,,
L8040,HCPCS,NASAL PROSTHESIS,KM,,28,,NW,,,,,,"$4,082.84",$0.00,1,1,1,1,1,1,20161001,,,,
L8040,HCPCS,NASAL PROSTHESIS,KN,,28,,NW,,,,,,"$1,671.39",$0.00,1,1,1,1,1,1,20161001,,,,
L8041,HCPCS,MIDFACIAL PROSTHESIS,,,28,,NW,,,,,,"$5,202.30",$0.00,1,1,1,1,1,1,20161001,,,,
L8041,HCPCS,MIDFACIAL PROSTHESIS,KM,,28,,NW,,,,,,"$4,938.05",$0.00,1,1,1,1,1,1,20161001,,,,
L8041,HCPCS,MIDFACIAL PROSTHESIS,KN,,28,,NW,,,,,,"$2,031.51",$0.00,1,1,1,1,1,1,20161001,,,,
L8042,HCPCS,ORBITAL PROSTHESIS,,,28,,NW,,,,,,"$5,855.46",$0.00,1,1,1,1,1,1,20161001,,,,
L8042,HCPCS,ORBITAL PROSTHESIS,KM,,28,,NW,,,,,,"$5,558.55",$0.00,1,1,1,1,1,1,20161001,,,,
L8042,HCPCS,ORBITAL PROSTHESIS,KN,,28,,NW,,,,,,"$2,292.76",$0.00,1,1,1,1,1,1,20161001,,,,
L8043,HCPCS,UPPER FACIAL PROSTHESIS,,,28,,NW,,,,,,"$6,568.02",$0.00,1,1,1,1,1,1,20161001,,,,
L8043,HCPCS,UPPER FACIAL PROSTHESIS,KM,,28,,NW,,,,,,"$6,235.49",$0.00,1,1,1,1,1,1,20161001,,,,
L8043,HCPCS,UPPER FACIAL PROSTHESIS,KN,,28,,NW,,,,,,"$2,577.77",$0.00,1,1,1,1,1,1,20161001,,,,
L8044,HCPCS,HEMI-FACIAL PROSTHESIS,,,28,,NW,,,,,,"$7,280.54",$0.00,1,1,1,1,1,1,20161001,,,,
L8044,HCPCS,HEMI-FACIAL PROSTHESIS,KM,,28,,NW,,,,,,"$6,912.40",$0.00,1,1,1,1,1,1,20161001,,,,
L8044,HCPCS,HEMI-FACIAL PROSTHESIS,KN,,28,,NW,,,,,,"$2,862.79",$0.00,1,1,1,1,1,1,20161001,,,,
L8045,HCPCS,AURICULAR PROSTHESIS,,,28,,NW,,,,,,"$4,780.63",$0.00,1,1,1,1,1,1,20161001,,,,
L8045,HCPCS,AURICULAR PROSTHESIS,KM,,28,,NW,,,,,,"$4,537.48",$0.00,1,1,1,1,1,1,20161001,,,,
L8045,HCPCS,AURICULAR PROSTHESIS,KN,,28,,NW,,,,,,"$1,862.82",$0.00,1,1,1,1,1,1,20161001,,,,
L8046,HCPCS,PARTIAL FACIAL PROSTHESIS,,,28,,NW,,,,,,"$4,667.90",$0.00,1,1,1,1,1,1,20161001,,,,
L8046,HCPCS,PARTIAL FACIAL PROSTHESIS,KM,,28,,NW,,,,,,"$4,430.38",$0.00,1,1,1,1,1,1,20161001,,,,
L8046,HCPCS,PARTIAL FACIAL PROSTHESIS,KN,,28,,NW,,,,,,"$1,817.72",$0.00,1,1,1,1,1,1,20161001,,,,
L8047,HCPCS,NASAL SEPTAL PROSTHESIS,,,28,,NW,,,,,,"$2,352.12",$0.00,1,1,1,1,1,1,20161001,,,,
L8047,HCPCS,NASAL SEPTAL PROSTHESIS,KM,,28,,NW,,,,,,"$2,230.41",$0.00,1,1,1,1,1,1,20161001,,,,
L8047,HCPCS,NASAL SEPTAL PROSTHESIS,KN,,28,,NW,,,,,,$891.43,$0.00,1,1,1,1,1,1,20161001,,,,
L8048,HCPCS,UNSPEC MAXILLOFACIAL PROSTH,,,28,,NW,,,,,,$927.62,$0.00,1,1,1,1,1,1,20161001,,,,
L8049,HCPCS,REPAIR MAXILLOFACIAL PROSTH,,,28,,NW,,,,,,$63.47,$0.00,1,1,1,1,1,1,20161001,,,,
L8300,HCPCS,TRUSS SINGLE W/ STANDARD PAD,,,28,,NW,,,,,,$83.36,$0.00,1,1,1,1,1,1,20161001,,,,
L8310,HCPCS,TRUSS DOUBLE W/ STANDARD PAD,,,28,,NW,,,,,,$186.71,$0.00,1,1,1,1,1,1,20161001,,,,
L8320,HCPCS,TRUSS ADDITION TO STD PAD WA,,,28,,NW,,,,,,$57.57,$0.00,1,1,1,1,1,1,20161001,,,,
L8330,HCPCS,TRUSS ADD TO STD PAD SCROTAL,,,28,,NW,,,,,,$53.80,$0.00,1,1,1,1,1,1,20161001,,,,
L8400,HCPCS,SHEATH BELOW KNEE,,,28,,NW,,,,,,$22.07,$0.00,1,1,1,1,1,1,20161001,,,,
L8410,HCPCS,SHEATH ABOVE KNEE,,,28,,NW,,,,,,$26.29,$0.00,1,1,1,1,1,1,20161001,,,,
L8415,HCPCS,SHEATH UPPER LIMB,,,28,,NW,,,,,,$26.09,$0.00,1,1,1,1,1,1,20161001,,,,
L8417,HCPCS,PROS SHEATH/SOCK W GEL CUSHN,,,28,,NW,,,,,,$67.42,$0.00,1,1,1,1,1,1,20161001,,,,
L8420,HCPCS,PROSTHETIC SOCK MULTI PLY BK,,,28,,NW,,,,,,$25.58,$0.00,1,1,1,1,1,1,20161001,,,,
L8430,HCPCS,PROSTHETIC SOCK MULTI PLY AK,,,28,,NW,,,,,,$27.63,$0.00,1,1,1,1,1,1,20161001,,,,
L8435,HCPCS,PROS SOCK MULTI PLY UPPER LM,,,28,,NW,,,,,,$26.65,$0.00,1,1,1,1,1,1,20161001,,,,
L8440,HCPCS,SHRINKER BELOW KNEE,,,28,,NW,,,,,,$46.49,$0.00,1,1,1,1,1,1,20161001,,,,
L8460,HCPCS,SHRINKER ABOVE KNEE,,,28,,NW,,,,,,$66.92,$0.00,1,1,1,1,1,1,20161001,,,,
L8465,HCPCS,SHRINKER UPPER LIMB,,,28,,NW,,,,,,$52.19,$0.00,1,1,1,1,1,1,20161001,,,,
L8470,HCPCS,PROS SOCK SINGLE PLY BK,,,28,,NW,,,,,,$12.36,$0.00,1,1,1,1,1,1,20161001,,,,
L8480,HCPCS,PROS SOCK SINGLE PLY AK,,,28,,NW,,,,,,$15.50,$0.00,1,1,1,1,1,1,20161001,,,,
L8485,HCPCS,PROS SOCK SINGLE PLY UPPER L,,,28,,NW,,,,,,$17.36,$0.00,1,1,1,1,1,1,20161001,,,,
L8499,HCPCS,UNLISTED MISC PROSTHETIC SER,,,28,,NW,,,,,,$9.98,$0.00,1,1,1,1,1,1,20161001,,,,
L8500,HCPCS,ARTIFICIAL LARYNX,,,28,,NW,,,,,,"$1,176.14",$0.00,1,1,1,1,1,1,20161001,,,,
L8501,HCPCS,TRACHEOSTOMY SPEAKING VALVE,,,28,,NW,,,,,,$141.26,$0.00,1,1,1,1,1,1,20161001,,,,
L8505,HCPCS,"ARTIFICIAL LARYNX, ACCESSORY",,,28,,NW,,,,,,$122.54,$0.00,1,1,1,1,1,1,20161001,,,,
L8507,HCPCS,TRACH-ESOPH VOICE PROS PT IN,,,28,,NW,,,,,,$40.90,$0.00,1,1,1,1,1,1,20161001,,,,
L8509,HCPCS,TRACH-ESOPH VOICE PROS MD IN,,,28,,NW,,,,,,$108.68,$0.00,1,1,1,1,1,1,20161001,,,,
L8510,HCPCS,VOICE AMPLIFIER,,,28,,NW,,,,,,$359.70,$0.00,1,1,1,1,1,1,20161001,,,,
L8511,HCPCS,INDWELLING TRACH INSERT,,,28,,NW,,,,,,$65.45,$0.00,1,1,1,1,1,1,20161001,,,,
L8512,HCPCS,GEL CAP FOR TRACH VOICE PROS,,,28,,NW,,,,,,$3.70,$0.00,1,1,1,1,1,1,20161001,,,,
L8513,HCPCS,TRACH PROS CLEANING DEVICE,,,28,,NW,,,,,,$8.81,$0.00,1,1,1,1,1,1,20161001,,,,
L8514,HCPCS,REPL TRACH PUNCTURE DILATOR,,,28,,NW,,,,,,$82.62,$0.00,1,1,1,1,1,1,20161001,,,,
L8515,HCPCS,GEL CAP APP DEVICE FOR TRACH,,,28,,NW,,,,,,$57.80,$0.00,1,1,1,1,1,1,20161001,,,,
L8600,HCPCS,IMPLANT BREAST SILICONE/EQ,,,28,,NW,,,,,,"$1,102.49",$0.00,1,1,1,1,1,1,20161001,,,,
L8603,HCPCS,COLLAGEN IMP URINARY 2.5 ML,,,28,,NW,,,,,,$680.89,$0.00,1,1,1,1,1,1,20161001,,,,
L8605,HCPCS,INJ BULKING AGENT ANAL CANAL,,,28,,NW,,,,,,"$1,170.70",$0.00,1,1,1,1,1,1,20161001,,,,
L8606,HCPCS,SYNTHETIC IMPLNT URINARY 1ML,,,28,,NW,,,,,,$301.25,$0.00,1,1,1,1,1,1,20161001,,,,
L8607,HCPCS,INJ VOCAL CORD BULKING AGENT,,,28,,NW,,,,,,$30.90,$0.00,1,1,1,0,0,1,20161001,,,,
L8609,HCPCS,ARTIFICIAL CORNEA,,,28,,NW,,,,,,"$11,240.75",$0.00,1,1,1,1,1,1,20161001,,,,
L8610,HCPCS,OCULAR IMPLANT,,,28,,NW,,,,,,"$1,037.79",$0.00,1,1,1,1,1,1,20161001,,,,
L8612,HCPCS,AQUEOUS SHUNT PROSTHESIS,,,28,,NW,,,,,,"$1,143.81",$0.00,1,1,1,1,1,1,20161001,,,,
L8613,HCPCS,OSSICULAR IMPLANT,,,28,,NW,,,,,,$455.16,$0.00,1,1,1,1,1,1,20161001,,,,
L8614,HCPCS,COCHLEAR DEVICE,,,28,,NW,,,,,,"$33,676.28",$0.00,1,1,1,1,1,1,20161001,,,,
L8615,HCPCS,COCH IMPLANT HEADSET REPLACE,,,28,,NW,,,,,,$701.43,$0.00,1,1,1,1,1,1,20161001,,,,
L8616,HCPCS,COCH IMPLANT MICROPHONE REPL,,,28,,NW,,,,,,$100.17,$0.00,1,1,1,1,1,1,20161001,,,,
L8617,HCPCS,COCH IMPLANT TRANS COIL REPL,,,28,,NW,,,,,,$80.11,$0.00,1,1,1,1,1,1,20161001,,,,
L8618,HCPCS,COCH IMPLANT TRAN CABLE REPL,,,28,,NW,,,,,,$28.29,$0.00,1,1,1,1,1,1,20161001,,,,
L8619,HCPCS,COCH IMP EXT PROC/CONTR RPLC,,,28,,NW,,,,,,"$14,407.78",$0.00,1,1,1,1,1,1,20161001,,,,
L8621,HCPCS,REPL ZINC AIR BATTERY,,,28,,NW,,,,,,$1.04,$0.00,1,1,1,1,1,1,20161001,,,,
L8622,HCPCS,REPL ALKALINE BATTERY,,,28,,NW,,,,,,$0.54,$0.00,1,1,1,1,1,1,20161001,,,,
L8623,HCPCS,"LITH ION BATT CID,NON-EARLVL",,,28,,NW,,,,,,$58.70,$0.00,1,1,1,1,1,1,20161001,,,,
L8624,HCPCS,"LITH ION BATT CID, EAR LEVEL",,,28,,NW,,,,,,$197.85,$0.00,1,1,1,1,1,1,20161001,,,,
L8627,HCPCS,CID EXT SPEECH PROCESS REPL,,,28,,NW,,,,,,"$12,306.81",$0.00,1,1,1,1,1,1,20161001,,,,
L8628,HCPCS,CID EXT CONTROLLER REPL,,,28,,NW,,,,,,"$2,114.48",$0.00,1,1,1,1,1,1,20161001,,,,
L8629,HCPCS,CID TRANSMIT COIL AND CABLE,,,28,,NW,,,,,,$230.89,$0.00,1,1,1,1,1,1,20161001,,,,
L8630,HCPCS,METACARPOPHALANGEAL IMPLANT,,,28,,NW,,,,,,$553.21,$0.00,1,1,1,1,1,1,20161001,,,,
L8631,HCPCS,MCP JOINT REPL 2 PC OR MORE,,,28,,NW,,,,,,"$3,760.70",$0.00,1,1,1,1,1,1,20161001,,,,
L8641,HCPCS,METATARSAL JOINT IMPLANT,,,28,,NW,,,,,,$558.72,$0.00,1,1,1,1,1,1,20161001,,,,
L8642,HCPCS,HALLUX IMPLANT,,,28,,NW,,,,,,$465.75,$0.00,1,1,1,1,1,1,20161001,,,,
L8658,HCPCS,INTERPHALANGEAL JOINT SPACER,,,28,,NW,,,,,,$477.95,$0.00,1,1,1,1,1,1,20161001,,,,
L8659,HCPCS,INTERPHALANGEAL JOINT REPL,,,28,,NW,,,,,,"$3,271.20",$0.00,1,1,1,1,1,1,20161001,,,,
L8670,HCPCS,"VASCULAR GRAFT, SYNTHETIC",,,28,,NW,,,,,,$887.42,$0.00,1,1,1,1,1,1,20161001,,,,
L8679,HCPCS,IMP NEUROSTI PLS GN ANY TYPE,,,28,,NW,,,,,,"$14,634.07",$0.00,1,1,1,1,1,1,20161001,,,,
L8680,HCPCS,IMPLT NEUROSTIM ELCTR EACH,,,28,,NW,,,,,,$726.72,$0.00,1,1,1,1,1,1,20161001,,,,
L8681,HCPCS,PT PRGRM FOR IMPLT NEUROSTIM,,,28,,NW,,,,,,"$1,923.84",$0.00,1,1,1,1,1,1,20161001,,,,
L8682,HCPCS,IMPLT NEUROSTIM RADIOFQ REC,,,28,,NW,,,,,,"$10,432.24",$0.00,1,1,1,1,1,1,20161001,,,,
L8683,HCPCS,RADIOFQ TRSMTR FOR IMPLT NEU,,,28,,NW,,,,,,"$9,172.88",$0.00,1,1,1,1,1,1,20161001,,,,
L8684,HCPCS,RADIOF TRSMTR IMPLT SCRL NEU,,,28,,NW,,,,,,"$1,256.91",$0.00,1,1,1,1,1,1,20161001,,,,
L8685,HCPCS,IMPLT NROSTM PLS GEN SNG REC,,,28,,NW,,,,,,"$22,948.49",$0.00,1,1,1,1,1,1,20161001,,,,
L8686,HCPCS,IMPLT NROSTM PLS GEN SNG NON,,,28,,NW,,,,,,"$14,613.43",$0.00,1,1,1,1,1,1,20161001,,,,
L8687,HCPCS,IMPLT NROSTM PLS GEN DUA REC,,,28,,NW,,,,,,"$29,890.67",$0.00,1,1,1,1,1,1,20161001,,,,
L8688,HCPCS,IMPLT NROSTM PLS GEN DUA NON,,,28,,NW,,,,,,"$19,043.07",$0.00,1,1,1,1,1,1,20161001,,,,
L8689,HCPCS,EXTERNAL RECHARG SYS INTERN,,,28,,NW,,,,,,"$2,935.52",$0.00,1,1,1,1,1,1,20161001,,,,
L8690,HCPCS,"AUD OSSEO DEV, INT/EXT COMP",,,28,,NW,,,,,,"$8,240.60",$0.00,1,1,1,1,1,1,20161001,,,,
L8691,HCPCS,OSSEOINTEGRATED SND PROC RPL,,,28,,NW,,,,,,"$4,582.92",$0.00,1,1,1,1,1,1,20161001,,,,
L8692,HCPCS,NON-OSSEOINTEGRATED SND PROC,,,28,,NW,,,,,,$303.57,$0.00,1,1,1,1,1,1,20161001,,,,
L8693,HCPCS,"AUD OSSEO DEV, ABUTMENT",,,28,,NW,,,,,,"$2,552.84",$0.00,1,1,1,1,1,1,20161001,,,,
L8695,HCPCS,EXTERNAL RECHARG SYS EXTERN,,,28,,NW,,,,,,$20.73,$0.00,1,1,1,1,1,1,20161001,,,,
L8696,HCPCS,EXT ANTENNA PHREN NERVE STIM,,,28,,NW,,,,,,$296.83,$0.00,1,1,1,1,1,1,20161001,,,,
L8699,HCPCS,PROSTHETIC IMPLANT NOS,,,28,,NW,,,,,,$197.85,$0.00,1,1,1,1,1,1,20161001,,,,
L9900,HCPCS,O&P SUPPLY/ACCESSORY/SERVICE,,,28,,NW,,,,,,$274.27,$0.00,1,1,1,1,1,1,20161001,,,,
M0076,HCPCS,PROLOTHERAPY,,,14,,TotalUnits,,,,1.04 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
M0300,HCPCS,IV CHELATIONTHERAPY,,,4,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P2031,HCPCS,HAIR ANALYSIS,,,17,,TotalUnits,,,,0.53 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P2038,HCPCS,BLOOD MUCOPROTEIN,,,17,,TotalUnits,,,,0.19 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P3000,HCPCS,SCREEN PAP BY TECH W MD SUPV,,,17,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P3001,HCPCS,SCREENING PAP SMEAR BY PHYS,,,17,,RBRVS,0.42 ,0.47 ,0.47 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
P7001,HCPCS,CULTURE BACTERIAL URINE,,,17,,TotalUnits,,,,0.65 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9010,HCPCS,WHOLE BLOOD FOR TRANSFUSION,,,14,,TotalUnits,,,,1.89 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9011,HCPCS,BLOOD SPLIT UNIT,,,14,,TotalUnits,,,,2.70 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9012,HCPCS,CRYOPRECIPITATE EACH UNIT,,,14,,TotalUnits,,,,0.55 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9016,HCPCS,RBC LEUKOCYTES REDUCED,,,14,,TotalUnits,,,,3.98 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9017,HCPCS,PLASMA 1 DONOR FRZ W/IN 8 HR,,,14,,TotalUnits,,,,0.10 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9019,HCPCS,"PLATELETS, EACH UNIT",,,14,,TotalUnits,,,,0.87 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9020,HCPCS,PLAELET RICH PLASMA UNIT,,,14,,TotalUnits,,,,4.15 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9021,HCPCS,RED BLOOD CELLS UNIT,,,14,,TotalUnits,,,,2.50 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9022,HCPCS,WASHED RED BLOOD CELLS UNIT,,,14,,TotalUnits,,,,1.30 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9031,HCPCS,PLATELETS LEUKOCYTES REDUCED,,,14,,TotalUnits,,,,1.95 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9032,HCPCS,"PLATELETS, IRRADIATED",,,14,,TotalUnits,,,,1.38 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9034,HCPCS,"PLATELETS, PHERESIS",,,14,,TotalUnits,,,,6.94 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9035,HCPCS,PLATELET PHERES LEUKOREDUCED,,,14,,TotalUnits,,,,12.13 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9037,HCPCS,PLATE PHERES LEUKOREDU IRRAD,,,14,,TotalUnits,,,,13.34 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9040,HCPCS,RBC LEUKOREDUCED IRRADIATED,,,14,,TotalUnits,,,,5.97 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9041,HCPCS,"ALBUMIN (HUMAN),5%, 50ML",,,14,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9043,HCPCS,"PLASMA PROTEIN FRACT,5%,50ML",,,14,,TotalUnits,,,,0.63 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9045,HCPCS,"ALBUMIN (HUMAN), 5%, 250 ML",,,14,,TotalUnits,,,,3.19 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9046,HCPCS,"ALBUMIN (HUMAN), 25%, 20 ML",,,14,,TotalUnits,,,,1.04 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9047,HCPCS,"ALBUMIN (HUMAN), 25%, 50ML",,,14,,TotalUnits,,,,2.60 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9048,HCPCS,"PLASMAPROTEIN FRACT,5%,250ML",,,14,,TotalUnits,,,,1.25 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9053,HCPCS,"PLT, PHER, L/R CMV-NEG, IRR",,,14,,TotalUnits,,,,14.03 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9058,HCPCS,"RBC, L/R, CMV-NEG, IRRAD",,,14,,TotalUnits,,,,7.51 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9059,HCPCS,"PLASMA, FRZ BETWEEN 8-24HOUR",,,14,,TotalUnits,,,,0.83 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9070,HCPCS,PATHOGEN REDUCED PLASMA POOL,,,14,,TotalUnits,,,,0.83 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9071,HCPCS,PATHOGEN REDUCED PLASMA SING,,,14,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9072,HCPCS,PATHOGEN REDUCED PLATELETS,,,14,,TotalUnits,,,,13.34 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9603,HCPCS,ONE-WAY ALLOW PRORATED MILES,,,17,,TotalUnits,,,,0.01 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9604,HCPCS,ONE-WAY ALLOW PRORATED TRIP,,,17,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9612,HCPCS,CATHETERIZE FOR URINE SPEC,,,17,,TotalUnits,,,,0.08 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
P9615,HCPCS,URINE SPECIMEN COLLECT MULT,,,17,,TotalUnits,,,,0.08 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
Q0035,HCPCS,CARDIOKYMOGRAPHY,,,4,,RBRVS,0.17 ,0.40 ,0.40 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
Q0035,HCPCS,CARDIOKYMOGRAPHY,26,,4,,RBRVS,0.17 ,0.07 ,0.07 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
Q0035,HCPCS,CARDIOKYMOGRAPHY,TC,,4,,RBRVS,,0.33 ,0.33 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
Q0081,HCPCS,INFUSION THER OTHER THAN CHE,,,22,,TotalUnits,,,,1.93 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
Q0083,HCPCS,CHEMO BY OTHER THAN INFUSION,,,14,,TotalUnits,,,,0.91 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
Q0084,HCPCS,CHEMOTHERAPY BY INFUSION,,,14,,TotalUnits,,,,1.18 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
Q0085,HCPCS,CHEMO BY BOTH INFUSION AND O,,,14,,TotalUnits,,,,6.14 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
Q0091,HCPCS,OBTAINING SCREEN PAP SMEAR,,,17,,RBRVS,0.37 ,0.15 ,0.86 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
Q0092,HCPCS,SET UP PORT XRAY EQUIPMENT,,TC,20,,RBRVS,,0.70 ,0.70 ,,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
Q0111,HCPCS,WET MOUNTS/ W PREPARATIONS,,,17,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
Q0112,HCPCS,POTASSIUM HYDROXIDE PREPS,,,17,,TotalUnits,,,,0.16 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
Q0113,HCPCS,PINWORM EXAMINATIONS,,,17,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
Q0114,HCPCS,FERN TEST,,,17,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
Q0115,HCPCS,POST-COITAL MUCOUS EXAM,,,17,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
Q0138,HCPCS,"FERUMOXYTOL, NON-ESRD",,,29,,NW,,,,,,$5.59,$0.00,1,1,1,0,0,1,20161001,,,,
Q0139,HCPCS,"FERUMOXYTOL, ESRD USE",,,28,,NW,,,,,,$2.26,$0.00,1,1,1,0,0,1,20161001,,,,
Q0144,HCPCS,"AZITHROMYCIN DIHYDRATE, ORAL",,,29,,NW,,,,,,$40.32,$0.00,1,1,1,0,0,1,20161001,,,,
Q0162,HCPCS,ONDANSETRON ORAL,,,29,,NW,,,,,,$1.69,$0.00,1,1,1,0,0,1,20161001,,,,
Q0163,HCPCS,DIPHENHYDRAMINE HCL 50MG,,,29,,NW,,,,,,$1.69,$0.00,1,1,1,0,0,1,20161001,,,,
Q0164,HCPCS,PROCHLORPERAZINE MALEATE 5MG,,,29,,NW,,,,,,$1.69,$0.00,1,1,1,0,0,1,20161001,,,,
Q0166,HCPCS,GRANISETRON HCL 1 MG ORAL,,,29,,NW,,,,,,$6.75,$0.00,1,1,1,0,0,1,20161001,,,,
Q0167,HCPCS,DRONABINOL 2.5MG ORAL,,,29,,NW,,,,,,$32.08,$0.00,1,1,1,0,0,1,20161001,,,,
Q0169,HCPCS,PROMETHAZINE HCL 12.5MG ORAL,,,29,,NW,,,,,,$1.69,$0.00,1,1,1,0,0,1,20161001,,,,
Q0173,HCPCS,TRIMETHOBENZAMIDE HCL 250MG,,,29,,NW,,,,,,$3.38,$0.00,1,1,1,0,0,1,20161001,,,,
Q0174,HCPCS,THIETHYLPERAZINE MALEATE10MG,,,29,,NW,,,,,,$3.38,$0.00,1,1,1,0,0,1,20161001,,,,
Q0175,HCPCS,PERPHENAZINE 4MG ORAL,,,29,,NW,,,,,,$3.38,$0.00,1,1,1,0,0,1,20161001,,,,
Q0177,HCPCS,HYDROXYZINE PAMOATE 25MG,,,29,,NW,,,,,,$10.13,$0.00,1,1,1,0,0,1,20161001,,,,
Q0180,HCPCS,DOLASETRON MESYLATE ORAL,,,29,,NW,,,,,,$312.52,$0.00,1,1,1,0,0,1,20161001,,,,
Q0181,HCPCS,UNSPECIFIED ORAL ANTI-EMETIC,,,29,,NW,,,,,,$50.47,$0.00,1,1,1,0,0,1,20161001,,,,
Q0478,HCPCS,"POWER ADAPTER, COMBO VAD",,,28,,NW,,,,,,$236.97,$0.00,1,1,1,0,0,1,20161001,,,,
Q0479,HCPCS,"POWER MODULE COMBO VAD, REP",,,28,,NW,,,,,,"$20,907.38",$0.00,1,1,1,0,0,1,20161001,,,,
Q0480,HCPCS,"DRIVER PNEUMATIC VAD, REP",,,28,,NW,,,,,,"$157,491.68",$0.00,1,1,1,0,0,1,20161001,,,,
Q0481,HCPCS,"MICROPRCSR CU ELEC VAD, REP",,,28,,NW,,,,,,"$25,340.36",$0.00,1,1,1,0,0,1,20161001,,,,
Q0482,HCPCS,"MICROPRCSR CU COMBO VAD, REP",,,28,,NW,,,,,,"$7,880.50",$0.00,1,1,1,0,0,1,20161001,,,,
Q0483,HCPCS,"MONITOR ELEC VAD, REP",,,28,,NW,,,,,,"$32,721.11",$0.00,1,1,1,0,0,1,20161001,,,,
Q0484,HCPCS,MONITOR ELEC OR COMB VAD REP,,,28,,NW,,,,,,"$6,287.95",$0.00,1,1,1,0,0,1,20161001,,,,
Q0485,HCPCS,"MONITOR CABLE ELEC VAD, REP",,,28,,NW,,,,,,$532.67,$0.00,1,1,1,0,0,1,20161001,,,,
Q0486,HCPCS,MON CABLE ELEC/PNEUM VAD REP,,,28,,NW,,,,,,$429.51,$0.00,1,1,1,0,0,1,20161001,,,,
Q0487,HCPCS,"LEADS ANY TYPE VAD, REP ONLY",,,28,,NW,,,,,,$514.83,$0.00,1,1,1,0,0,1,20161001,,,,
Q0488,HCPCS,"PWR PACK BASE ELEC VAD, REP",,,28,,NW,,,,,,"$23,342.42",$0.00,1,1,1,0,0,1,20161001,,,,
Q0489,HCPCS,"PWR PCK BASE COMBO VAD, REP",,,28,,NW,,,,,,"$28,356.46",$0.00,1,1,1,0,0,1,20161001,,,,
Q0490,HCPCS,"EMR PWR SOURCE ELEC VAD, REP",,,28,,NW,,,,,,"$1,147.75",$0.00,1,1,1,0,0,1,20161001,,,,
Q0491,HCPCS,EMR PWR SOURCE COMBO VAD REP,,,28,,NW,,,,,,"$1,851.50",$0.00,1,1,1,0,0,1,20161001,,,,
Q0492,HCPCS,"EMR PWR CBL ELEC VAD, REP",,,28,,NW,,,,,,$78.45,$0.00,1,1,1,0,0,1,20161001,,,,
Q0493,HCPCS,"EMR PWR CBL COMBO VAD, REP",,,28,,NW,,,,,,$361.23,$0.00,1,1,1,0,0,1,20161001,,,,
Q0494,HCPCS,"EMR HD PMP ELEC/COMBO, REP",,,28,,NW,,,,,,$293.01,$0.00,1,1,1,0,0,1,20161001,,,,
Q0495,HCPCS,"CHARGER ELEC/COMBO VAD, REP",,,28,,NW,,,,,,"$7,225.68",$0.00,1,1,1,0,0,1,20161001,,,,
Q0496,HCPCS,"BATTERY ELEC/COMBO VAD, REP",,,28,,NW,,,,,,"$2,540.60",$0.00,1,1,1,0,0,1,20161001,,,,
Q0497,HCPCS,"BAT CLPS ELEC/COMB VAD, REP",,,28,,NW,,,,,,$736.65,$0.00,1,1,1,0,0,1,20161001,,,,
Q0498,HCPCS,"HOLSTER ELEC/COMBO VAD, REP",,,28,,NW,,,,,,$816.29,$0.00,1,1,1,0,0,1,20161001,,,,
Q0499,HCPCS,BELT/VEST ELEC/COMBO VAD REP,,,28,,NW,,,,,,$209.60,$0.00,1,1,1,0,0,1,20161001,,,,
Q0500,HCPCS,"FILTERS ELEC/COMBO VAD, REP",,,28,,NW,,,,,,$31.87,$0.00,1,1,1,0,0,1,20161001,,,,
Q0501,HCPCS,"SHWR COV ELEC/COMBO VAD, REP",,,28,,NW,,,,,,$811.10,$0.00,1,1,1,0,0,1,20161001,,,,
Q0502,HCPCS,"MOBILITY CART PNEUM VAD, REP",,,28,,NW,,,,,,"$1,055.14",$0.00,1,1,1,0,0,1,20161001,,,,
Q0503,HCPCS,BATTERY PNEUM VAD REPLACEMNT,,,28,,NW,,,,,,"$2,192.71",$0.00,1,1,1,0,0,1,20161001,,,,
Q0504,HCPCS,"PWR ADPT PNEUM VAD, REP VEH",,,28,,NW,,,,,,"$1,118.12",$0.00,1,1,1,0,0,1,20161001,,,,
Q0506,HCPCS,LITH-ION BATT ELEC/PNEUM VAD,,,28,,NW,,,,,,"$1,411.97",$0.00,1,1,1,0,0,1,20161001,,,,
Q0507,HCPCS,MISC SUP/ACC EXT VAD,,,28,,NW,,,,,,$310.68,$0.00,1,1,1,0,0,1,20161001,,,,
Q0508,HCPCS,MIS SUP/ACC IMP VAD,,,28,,NW,,,,,,$12.00,$0.00,1,1,1,0,0,1,20161001,,,,
Q0509,HCPCS,MIS SUP/AC IMP VAD NOPAY MED,,,28,,NW,,,,,,$184.01,$0.00,1,1,1,0,0,1,20161001,,,,
Q0510,HCPCS,DISPENS FEE IMMUNOSUPRESSIVE,,,29,,NW,,,,,,$72.69,$0.00,1,1,1,0,0,1,20161001,,,,
Q0511,HCPCS,"SUP FEE ANTIEM,ANTICA,IMMUNO",,,29,,NW,,,,,,$34.89,$0.00,1,1,1,0,0,1,20161001,,,,
Q0512,HCPCS,PX SUP FEE ANTI-CAN SUB PRES,,,29,,NW,,,,,,$23.26,$0.00,1,1,1,0,0,1,20161001,,,,
Q0513,HCPCS,DISP FEE INHAL DRUGS/30 DAYS,,,29,,NW,,,,,,$58.15,$0.00,1,1,1,0,0,1,20161001,,,,
Q0514,HCPCS,DISP FEE INHAL DRUGS/90 DAYS,,,29,,NW,,,,,,$95.95,$0.00,1,1,1,0,0,1,20161001,,,,
Q0515,HCPCS,SERMORELIN ACETATE INJECTION,,,29,,NW,,,,,,$7.89,$0.00,1,1,1,0,0,1,20161001,,,,
Q2004,HCPCS,BLADDER CALCULI IRRIG SOL,,,29,,NW,,,,,,$43.78,$0.00,1,1,1,0,0,1,20161001,,,,
Q2009,HCPCS,FOSPHENYTOIN INJ PE,,,29,,NW,,,,,,$13.51,$0.00,1,1,1,0,0,1,20161001,,,,
Q2017,HCPCS,"TENIPOSIDE, 50 MG",,,29,,NW,,,,,,$834.93,$0.00,1,1,1,0,0,1,20161001,,,,
Q2026,HCPCS,RADIESSE INJECTION,,,14,,TotalUnits,,,,5.21 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
Q2028,HCPCS,"INJ, SCULPTRA, 0.5MG",,,14,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
Q2034,HCPCS,AGRIFLU VACCINE,,,29,,NW,,,,,,$43.61,$0.00,1,1,1,0,1,1,20161001,,,,
Q2035,HCPCS,"AFLURIA VACC, 3 YRS & >, IM",,,9,,TotalUnits,,,,0.43 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
Q2036,HCPCS,"FLULAVAL VACC, 3 YRS & >, IM",,,9,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
Q2037,HCPCS,"FLUVIRIN VACC, 3 YRS & >, IM",,,9,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
Q2038,HCPCS,"FLUZONE VACC, 3 YRS & >, IM",,,9,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
Q2039,HCPCS,"NOS FLU VACC, 3 YRS & >, IM",,,9,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
Q2043,HCPCS,SIPULEUCEL-T AUTO CD54+,,,29,,NW,,,,,,"$84,119.69",$0.00,1,1,1,0,0,1,20161001,,,,
Q2049,HCPCS,IMPORTED LIPODOX INJ,,,29,,NW,,,,,,"$1,482.20",$0.00,1,1,1,0,0,1,20161001,,,,
Q2050,HCPCS,DOXORUBICIN INJ 10MG,,,29,,NW,,,,,,"$1,453.51",$0.00,1,1,1,0,0,1,20161001,,,,
Q3001,HCPCS,BRACHYTHERAPY RADIOELEMENTS,,,28,,NW,,,,,,$141.50,$0.00,1,1,1,0,0,1,20161001,,,,
Q3014,HCPCS,TELEHEALTH FACILITY FEE,,,14,,TotalUnits,,,,0.35 ,,$0.00,$0.00,1,1,1,0,0,0,20161001,,,,
Q3027,HCPCS,INJ BETA INTERFERON IM 1 MCG,,,29,,NW,,,,,,$95.67,$0.00,1,1,1,0,0,1,20161001,,,,
Q3028,HCPCS,INJ BETA INTERFERON SQ 1 MCG,,,29,,NW,,,,,,$16.58,$0.00,1,1,1,0,0,1,20161001,,,,
Q4001,HCPCS,CAST SUP BODY CAST PLASTER,,,28,,NW,,,,,,$140.49,$0.00,1,1,1,0,0,1,20161001,,,,
Q4002,HCPCS,CAST SUP BODY CAST FIBERGLAS,,,28,,NW,,,,,,$437.73,$0.00,1,1,1,0,0,1,20161001,,,,
Q4003,HCPCS,CAST SUP SHOULDER CAST PLSTR,,,28,,NW,,,,,,$89.08,$0.00,1,1,1,0,0,1,20161001,,,,
Q4004,HCPCS,CAST SUP SHOULDER CAST FBRGL,,,28,,NW,,,,,,$271.53,$0.00,1,1,1,0,0,1,20161001,,,,
Q4005,HCPCS,CAST SUP LONG ARM ADULT PLST,,,28,,NW,,,,,,$36.73,$0.00,1,1,1,0,0,1,20161001,,,,
Q4006,HCPCS,CAST SUP LONG ARM ADULT FBRG,,,28,,NW,,,,,,$84.80,$0.00,1,1,1,0,0,1,20161001,,,,
Q4007,HCPCS,CAST SUP LONG ARM PED PLSTER,,,28,,NW,,,,,,$19.35,$0.00,1,1,1,0,0,1,20161001,,,,
Q4008,HCPCS,CAST SUP LONG ARM PED FBRGLS,,,28,,NW,,,,,,$40.58,$0.00,1,1,1,0,0,1,20161001,,,,
Q4009,HCPCS,CAST SUP SHT ARM ADULT PLSTR,,,28,,NW,,,,,,$25.85,$0.00,1,1,1,0,0,1,20161001,,,,
Q4010,HCPCS,CAST SUP SHT ARM ADULT FBRGL,,,28,,NW,,,,,,$59.78,$0.00,1,1,1,0,0,1,20161001,,,,
Q4011,HCPCS,CAST SUP SHT ARM PED PLASTER,,,28,,NW,,,,,,$13.98,$0.00,1,1,1,0,0,1,20161001,,,,
Q4012,HCPCS,CAST SUP SHT ARM PED FBRGLAS,,,28,,NW,,,,,,$28.36,$0.00,1,1,1,0,0,1,20161001,,,,
Q4013,HCPCS,CAST SUP GAUNTLET PLASTER,,,28,,NW,,,,,,$36.43,$0.00,1,1,1,0,0,1,20161001,,,,
Q4014,HCPCS,CAST SUP GAUNTLET FIBERGLASS,,,28,,NW,,,,,,$69.80,$0.00,1,1,1,0,0,1,20161001,,,,
Q4015,HCPCS,CAST SUP GAUNTLET PED PLSTER,,,28,,NW,,,,,,$17.97,$0.00,1,1,1,0,0,1,20161001,,,,
Q4016,HCPCS,CAST SUP GAUNTLET PED FBRGLS,,,28,,NW,,,,,,$33.20,$0.00,1,1,1,0,0,1,20161001,,,,
Q4017,HCPCS,CAST SUP LNG ARM SPLINT PLST,,,28,,NW,,,,,,$25.87,$0.00,1,1,1,0,0,1,20161001,,,,
Q4018,HCPCS,CAST SUP LNG ARM SPLINT FBRG,,,28,,NW,,,,,,$46.09,$0.00,1,1,1,0,0,1,20161001,,,,
Q4019,HCPCS,CAST SUP LNG ARM SPLNT PED P,,,28,,NW,,,,,,$12.57,$0.00,1,1,1,0,0,1,20161001,,,,
Q4020,HCPCS,CAST SUP LNG ARM SPLNT PED F,,,28,,NW,,,,,,$22.51,$0.00,1,1,1,0,0,1,20161001,,,,
Q4021,HCPCS,CAST SUP SHT ARM SPLINT PLST,,,28,,NW,,,,,,$20.93,$0.00,1,1,1,0,0,1,20161001,,,,
Q4022,HCPCS,CAST SUP SHT ARM SPLINT FBRG,,,28,,NW,,,,,,$42.16,$0.00,1,1,1,0,0,1,20161001,,,,
Q4023,HCPCS,CAST SUP SHT ARM SPLNT PED P,,,28,,NW,,,,,,$11.07,$0.00,1,1,1,0,0,1,20161001,,,,
Q4024,HCPCS,CAST SUP SHT ARM SPLNT PED F,,,28,,NW,,,,,,$20.99,$0.00,1,1,1,0,0,1,20161001,,,,
Q4025,HCPCS,CAST SUP HIP SPICA PLASTER,,,28,,NW,,,,,,$111.95,$0.00,1,1,1,0,0,1,20161001,,,,
Q4026,HCPCS,CAST SUP HIP SPICA FIBERGLAS,,,28,,NW,,,,,,$304.80,$0.00,1,1,1,0,0,1,20161001,,,,
Q4027,HCPCS,CAST SUP HIP SPICA PED PLSTR,,,28,,NW,,,,,,$54.31,$0.00,1,1,1,0,0,1,20161001,,,,
Q4028,HCPCS,CAST SUP HIP SPICA PED FBRGL,,,28,,NW,,,,,,$150.75,$0.00,1,1,1,0,0,1,20161001,,,,
Q4029,HCPCS,CAST SUP LONG LEG PLASTER,,,28,,NW,,,,,,$70.75,$0.00,1,1,1,0,0,1,20161001,,,,
Q4030,HCPCS,CAST SUP LONG LEG FIBERGLASS,,,28,,NW,,,,,,$178.30,$0.00,1,1,1,0,0,1,20161001,,,,
Q4031,HCPCS,CAST SUP LNG LEG PED PLASTER,,,28,,NW,,,,,,$33.57,$0.00,1,1,1,0,0,1,20161001,,,,
Q4032,HCPCS,CAST SUP LNG LEG PED FBRGLS,,,28,,NW,,,,,,$87.58,$0.00,1,1,1,0,0,1,20161001,,,,
Q4033,HCPCS,CAST SUP LNG LEG CYLINDER PL,,,28,,NW,,,,,,$63.47,$0.00,1,1,1,0,0,1,20161001,,,,
Q4034,HCPCS,CAST SUP LNG LEG CYLINDER FB,,,28,,NW,,,,,,$155.13,$0.00,1,1,1,0,0,1,20161001,,,,
Q4035,HCPCS,CAST SUP LNGLEG CYLNDR PED P,,,28,,NW,,,,,,$31.89,$0.00,1,1,1,0,0,1,20161001,,,,
Q4036,HCPCS,CAST SUP LNGLEG CYLNDR PED F,,,28,,NW,,,,,,$76.01,$0.00,1,1,1,0,0,1,20161001,,,,
Q4037,HCPCS,CAST SUP SHRT LEG PLASTER,,,28,,NW,,,,,,$53.58,$0.00,1,1,1,0,0,1,20161001,,,,
Q4038,HCPCS,CAST SUP SHRT LEG FIBERGLASS,,,28,,NW,,,,,,$128.23,$0.00,1,1,1,0,0,1,20161001,,,,
Q4039,HCPCS,CAST SUP SHRT LEG PED PLSTER,,,28,,NW,,,,,,$25.76,$0.00,1,1,1,0,0,1,20161001,,,,
Q4040,HCPCS,CAST SUP SHRT LEG PED FBRGLS,,,28,,NW,,,,,,$62.54,$0.00,1,1,1,0,0,1,20161001,,,,
Q4041,HCPCS,CAST SUP LNG LEG SPLNT PLSTR,,,28,,NW,,,,,,$46.90,$0.00,1,1,1,0,0,1,20161001,,,,
Q4042,HCPCS,CAST SUP LNG LEG SPLNT FBRGL,,,28,,NW,,,,,,$89.41,$0.00,1,1,1,0,0,1,20161001,,,,
Q4043,HCPCS,CAST SUP LNG LEG SPLNT PED P,,,28,,NW,,,,,,$22.98,$0.00,1,1,1,0,0,1,20161001,,,,
Q4044,HCPCS,CAST SUP LNG LEG SPLNT PED F,,,28,,NW,,,,,,$43.14,$0.00,1,1,1,0,0,1,20161001,,,,
Q4045,HCPCS,CAST SUP SHT LEG SPLNT PLSTR,,,28,,NW,,,,,,$27.04,$0.00,1,1,1,0,0,1,20161001,,,,
Q4046,HCPCS,CAST SUP SHT LEG SPLNT FBRGL,,,28,,NW,,,,,,$51.21,$0.00,1,1,1,0,0,1,20161001,,,,
Q4047,HCPCS,CAST SUP SHT LEG SPLNT PED P,,,28,,NW,,,,,,$13.55,$0.00,1,1,1,0,0,1,20161001,,,,
Q4048,HCPCS,CAST SUP SHT LEG SPLNT PED F,,,28,,NW,,,,,,$24.24,$0.00,1,1,1,0,0,1,20161001,,,,
Q4049,HCPCS,"FINGER SPLINT, STATIC",,,28,,NW,,,,,,$7.18,$0.00,1,1,1,0,0,1,20161001,,,,
Q4050,HCPCS,CAST SUPPLIES UNLISTED,,,28,,NW,,,,,,$34.69,$0.00,1,1,1,0,0,1,20161001,,,,
Q4051,HCPCS,SPLINT SUPPLIES MISC,,,28,,NW,,,,,,$33.36,$0.00,1,1,1,0,0,1,20161001,,,,
Q4074,HCPCS,ILOPROST NON-COMP UNIT DOSE,,,29,,NW,,,,,,$253.06,$0.00,1,1,1,0,0,1,20161001,,,,
Q4081,HCPCS,"EPOETIN ALFA, 100 UNITS ESRD",,,29,,NW,,,,,,$6.74,$0.00,1,1,1,0,0,1,20161001,,,,
Q4082,HCPCS,DRUG/BIO NOC PART B DRUG CAP,,,29,,NW,,,,,,"$2,992.05",$0.00,1,1,1,0,0,1,20161001,,,,
Q4100,HCPCS,"SKIN SUBSTITUTE, NOS",,,29,,NW,,,,,,"$1,701.17",$0.00,1,1,1,0,0,1,20161001,,,,
Q4101,HCPCS,APLIGRAF,,,29,,NW,,,,,,$84.42,$0.00,1,1,1,0,0,1,20161001,,,,
Q4102,HCPCS,OASIS WOUND MATRIX,,,29,,NW,,,,,,$28.21,$0.00,1,1,1,0,0,1,20161001,,,,
Q4103,HCPCS,OASIS BURN MATRIX,,,29,,NW,,,,,,$28.21,$0.00,1,1,1,0,0,1,20161001,,,,
Q4104,HCPCS,INTEGRA BMWD,,,29,,NW,,,,,,$67.99,$0.00,1,1,1,0,0,1,20161001,,,,
Q4105,HCPCS,INTEGRA DRT,,,29,,NW,,,,,,$48.97,$0.00,1,1,1,0,0,1,20161001,,,,
Q4106,HCPCS,DERMAGRAFT,,,29,,NW,,,,,,$92.21,$0.00,1,1,1,0,0,1,20161001,,,,
Q4107,HCPCS,GRAFTJACKET,,,29,,NW,,,,,,$238.36,$0.00,1,1,1,0,0,1,20161001,,,,
Q4108,HCPCS,INTEGRA MATRIX,,,29,,NW,,,,,,$79.23,$0.00,1,1,1,0,0,1,20161001,,,,
Q4110,HCPCS,PRIMATRIX,,,29,,NW,,,,,,$96.53,$0.00,1,1,1,0,0,1,20161001,,,,
Q4111,HCPCS,GAMMAGRAFT,,,29,,NW,,,,,,$23.89,$0.00,1,1,1,0,0,1,20161001,,,,
Q4112,HCPCS,CYMETRA INJECTABLE,,,29,,NW,,,,,,$797.02,$0.00,1,1,1,0,0,1,20161001,,,,
Q4113,HCPCS,GRAFTJACKET XPRESS,,,29,,NW,,,,,,$797.02,$0.00,1,1,1,0,0,1,20161001,,,,
Q4114,HCPCS,INTEGRA FLOWABLE WOUND MATRI,,,29,,NW,,,,,,"$3,258.24",$0.00,1,1,1,0,0,1,20161001,,,,
Q4115,HCPCS,ALLOSKIN,,,29,,NW,,,,,,$30.81,$0.00,1,1,1,0,0,1,20161001,,,,
Q4116,HCPCS,ALLODERM,,,29,,NW,,,,,,$85.29,$0.00,1,1,1,0,0,1,20161001,,,,
Q4118,HCPCS,MATRISTEM MICROMATRIX,,,29,,NW,,,,,,$7.27,$0.00,1,1,1,0,0,1,20161001,,,,
Q4119,HCPCS,MATRISTEM WOUND MATRIX,,,29,,NW,,,,,,$14.54,$0.00,1,1,1,0,0,1,20161001,,,,
Q4120,HCPCS,MATRISTEM BURN MATRIX,,,29,,NW,,,,,,"$3,307.29",$0.00,1,1,1,0,0,1,20161001,,,,
Q4121,HCPCS,THERASKIN,,,29,,NW,,,,,,$94.80,$0.00,1,1,1,0,0,1,20161001,,,,
Q4122,HCPCS,DERMACELL,,,29,,NW,,,,,,"$1,891.07",$0.00,1,1,1,0,0,1,20161001,,,,
Q4123,HCPCS,ALLOSKIN,,,29,,NW,,,,,,$40.32,$0.00,1,1,1,0,0,1,20161001,,,,
Q4125,HCPCS,ARTHROFLEX,,,29,,NW,,,,,,"$2,516.40",$0.00,1,1,1,0,0,1,20161001,,,,
Q4126,HCPCS,MEMODERM/DERMA/TRANZ/INTEGUP,,,29,,NW,,,,,,$390.44,$0.00,1,1,1,0,0,1,20161001,,,,
Q4127,HCPCS,TALYMED,,,29,,NW,,,,,,$2.93,$0.00,1,1,1,0,0,1,20161001,,,,
Q4128,HCPCS,FLEXHD/ALLOPATCHHD/MATRIXHD,,,29,,NW,,,,,,$307.19,$0.00,1,1,1,0,0,1,20161001,,,,
Q4129,HCPCS,UNITE BIOMATRIX,,,29,,NW,,,,,,$247.93,$0.00,1,1,1,0,0,1,20161001,,,,
Q4130,HCPCS,STRATTICE TM,,,29,,NW,,,,,,"$18,957.22",$0.00,1,1,1,0,0,1,20161001,,,,
Q4131,HCPCS,EPIFIX,,,29,,NW,,,,,,$529.80,$0.00,1,1,1,0,0,1,20161001,,,,
Q4132,HCPCS,GRAFIX CORE,,,29,,NW,,,,,,"$3,725.23",$0.00,1,1,1,0,0,1,20161001,,,,
Q4133,HCPCS,GRAFIX PRIME,,,29,,NW,,,,,,"$3,692.87",$0.00,1,1,1,0,0,1,20161001,,,,
Q4134,HCPCS,HMATRIX,,,29,,NW,,,,,,"$4,058.23",$0.00,1,1,1,0,0,1,20161001,,,,
Q4137,HCPCS,"AMNIOEXCEL OR BIODEXCEL, 1CM",,,29,,NW,,,,,,"$1,276.61",$0.00,1,1,1,0,0,1,20161001,,,,
Q4139,HCPCS,"AMNIO OR BIODMATRIX, INJ 1CC",,,29,,NW,,,,,,"$3,134.88",$0.00,1,1,1,0,0,1,20161001,,,,
Q4140,HCPCS,BIODFENCE 1CM,,,29,,NW,,,,,,"$3,911.36",$0.00,1,1,1,0,0,1,20161001,,,,
Q4141,HCPCS,"ALLOSKIN AC, 1 CM",,,29,,NW,,,,,,$27.70,$0.00,1,1,1,0,0,1,20161001,,,,
Q4142,HCPCS,XCM BIOLOGIC TISS MATRIX 1CM,,,29,,NW,,,,,,"$2,731.08",$0.00,1,1,1,0,0,1,20161001,,,,
Q4145,HCPCS,"EPIFIX, INJ, 1MG",,,29,,NW,,,,,,$58.87,$0.00,1,1,1,0,0,1,20161001,,,,
Q4146,HCPCS,"TENSIX, 1CM",,,29,,NW,,,,,,$214.72,$0.00,1,1,1,0,0,1,20161001,,,,
Q4147,HCPCS,ARCHITECT ECM PX FX 1 SQ CM,,,29,,NW,,,,,,"$3,745.67",$0.00,1,1,1,0,0,1,20161001,,,,
Q4148,HCPCS,"NEOX 1K, 1CM",,,29,,NW,,,,,,$238.36,$0.00,1,1,1,0,0,1,20161001,,,,
Q5001,HCPCS,HOSPICE OR HOME HLTH IN HOME,,,14,,TotalUnits,,,,1.35 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
Q5002,HCPCS,HOSPICE/HOME HLTH IN ASST LV,,,14,,TotalUnits,,,,1.61 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
Q5003,HCPCS,HOSPICE IN LT/NON-SKILLED NF,,,14,,TotalUnits,,,,0.06 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
Q5004,HCPCS,HOSPICE IN SNF,,,14,,TotalUnits,,,,1.52 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
Q5005,HCPCS,"HOSPICE, INPATIENT HOSPITAL",,,14,,TotalUnits,,,,5.03 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
Q5006,HCPCS,HOSPICE IN HOSPICE FACILITY,,,14,,TotalUnits,,,,6.27 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
Q5010,HCPCS,HOSPICE HOME CARE IN HOSPICE,,,14,,TotalUnits,,,,6.27 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
Q5101,HCPCS,INJ FILGRASTIM GCSF BIOSIMIL,,,29,,NW,,,,,,$6.74,$0.00,1,1,1,0,0,1,20161001,,,,
Q9951,HCPCS,"LOCM >= 400 MG/ML IODINE,1ML",,,28,,NW,,,,,,$5.66,$0.00,1,1,1,0,0,1,20161001,,,,
Q9953,HCPCS,"INJ FE-BASED MR CONTRAST,1ML",,,28,,NW,,,,,,$42.45,$0.00,1,1,1,0,0,1,20161001,,,,
Q9954,HCPCS,"ORAL MR CONTRAST, 100 ML",,,28,,NW,,,,,,$14.19,$0.00,1,1,1,0,0,1,20161001,,,,
Q9955,HCPCS,"INJ PERFLEXANE LIP MICROS,ML",,,28,,NW,,,,,,$4.39,$0.00,1,1,1,0,0,1,20161001,,,,
Q9956,HCPCS,"INJ OCTAFLUOROPROPANE MIC,ML",,,28,,NW,,,,,,$106.12,$0.00,1,1,1,0,0,1,20161001,,,,
Q9957,HCPCS,"INJ PERFLUTREN LIP MICROS,ML",,,28,,NW,,,,,,$218.07,$0.00,1,1,1,0,0,1,20161001,,,,
Q9958,HCPCS,"HOCM <=149 MG/ML IODINE, 1ML",,,28,,NW,,,,,,$0.26,$0.00,1,1,1,0,0,1,20161001,,,,
Q9959,HCPCS,"HOCM 150-199MG/ML IODINE,1ML",,,28,,NW,,,,,,$0.55,$0.00,1,1,1,0,0,1,20161001,,,,
Q9960,HCPCS,"HOCM 200-249MG/ML IODINE,1ML",,,28,,NW,,,,,,$1.10,$0.00,1,1,1,0,0,1,20161001,,,,
Q9961,HCPCS,"HOCM 250-299MG/ML IODINE,1ML",,,28,,NW,,,,,,$1.65,$0.00,1,1,1,0,0,1,20161001,,,,
Q9962,HCPCS,"HOCM 300-349MG/ML IODINE,1ML",,,28,,NW,,,,,,$1.70,$0.00,1,1,1,0,0,1,20161001,,,,
Q9963,HCPCS,"HOCM 350-399MG/ML IODINE,1ML",,,28,,NW,,,,,,$2.16,$0.00,1,1,1,0,0,1,20161001,,,,
Q9964,HCPCS,"HOCM>= 400MG/ML IODINE, 1ML",,,28,,NW,,,,,,$2.60,$0.00,1,1,1,0,0,1,20161001,,,,
Q9965,HCPCS,"LOCM 100-199MG/ML IODINE,1ML",,,28,,NW,,,,,,$3.30,$0.00,1,1,1,0,0,1,20161001,,,,
Q9966,HCPCS,"LOCM 200-299MG/ML IODINE,1ML",,,28,,NW,,,,,,$3.73,$0.00,1,1,1,0,0,1,20161001,,,,
Q9967,HCPCS,"LOCM 300-399MG/ML IODINE,1ML",,,28,,NW,,,,,,$3.99,$0.00,1,1,1,0,0,1,20161001,,,,
R0070,HCPCS,TRANSPORT PORTABLE X-RAY,,TC,20,,TotalUnits,,,,1.56 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
R0075,HCPCS,TRANSPORT PORT X-RAY MULTIPL,,TC,20,,TotalUnits,,,,0.81 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
R0076,HCPCS,TRANSPORT PORTABLE EKG,,,20,,TotalUnits,,,,0.88 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
S0012,HCPCS,"BUTORPHANOL TARTRATE, NASAL",,,28,,NW,,,,,,$346.77,$0.00,1,1,1,0,0,1,20161001,,,,
S0014,HCPCS,"TACRINE HYDROCHLORIDE, 10 MG",,,28,,NW,,,,,,$11.87,$0.00,1,1,1,0,0,1,20161001,,,,
S0017,HCPCS,"INJECTION, AMINOCAPROIC ACID",,,28,,NW,,,,,,$29.06,$0.00,1,1,1,0,0,1,20161001,,,,
S0020,HCPCS,"INJECTION, BUPIVICAINE HYDRO",,,28,,NW,,,,,,$17.30,$0.00,1,1,1,0,0,1,20161001,,,,
S0021,HCPCS,"INJECTION, CEFOPERAZONE SOD",,,28,,NW,,,,,,$7.36,$0.00,1,1,1,0,0,1,20161001,,,,
S0023,HCPCS,"INJECTION, CIMETIDINE HYDROC",,,28,,NW,,,,,,$12.36,$0.00,1,1,1,0,0,1,20161001,,,,
S0028,HCPCS,"INJECTION, FAMOTIDINE, 20 MG",,,28,,NW,,,,,,$23.89,$0.00,1,1,1,0,0,1,20161001,,,,
S0030,HCPCS,"INJECTION, METRONIDAZOLE",,,28,,NW,,,,,,$45.68,$0.00,1,1,1,0,0,1,20161001,,,,
S0032,HCPCS,"INJECTION, NAFCILLIN SODIUM",,,28,,NW,,,,,,$106.76,$0.00,1,1,1,0,0,1,20161001,,,,
S0034,HCPCS,"INJECTION, OFLOXACIN, 400 MG",,,28,,NW,,,,,,$33.03,$0.00,1,1,1,0,0,1,20161001,,,,
S0039,HCPCS,"INJECTION, SULFAMETHOXAZOLE",,,28,,NW,,,,,,$23.99,$0.00,1,1,1,0,0,1,20161001,,,,
S0040,HCPCS,"INJECTION, TICARCILLIN DISOD",,,28,,NW,,,,,,$65.68,$0.00,1,1,1,0,0,1,20161001,,,,
S0073,HCPCS,"INJECTION, AZTREONAM, 500 MG",,,28,,NW,,,,,,$81.12,$0.00,1,1,1,0,0,1,20161001,,,,
S0074,HCPCS,"INJECTION, CEFOTETAN DISODIU",,,28,,NW,,,,,,$57.34,$0.00,1,1,1,0,0,1,20161001,,,,
S0077,HCPCS,"INJECTION, CLINDAMYCIN PHOSP",,,28,,NW,,,,,,$20.40,$0.00,1,1,1,0,0,1,20161001,,,,
S0078,HCPCS,"INJECTION, FOSPHENYTOIN SODI",,,28,,NW,,,,,,$795.63,$0.00,1,1,1,0,0,1,20161001,,,,
S0080,HCPCS,"INJECTION, PENTAMIDINE ISETH",,,28,,NW,,,,,,$309.29,$0.00,1,1,1,0,0,1,20161001,,,,
S0081,HCPCS,"INJECTION, PIPERACILLIN SODI",,,28,,NW,,,,,,$8.49,$0.00,1,1,1,0,0,1,20161001,,,,
S0088,HCPCS,IMATINIB 100 MG,,,28,,NW,,,,,,$108.83,$0.00,1,1,1,0,0,1,20161001,,,,
S0090,HCPCS,"SILDENAFIL CITRATE, 25 MG",,,28,,NW,,,,,,$76.77,$0.00,1,1,1,0,0,1,20161001,,,,
S0091,HCPCS,GRANISETRON 1MG,,,28,,NW,,,,,,$356.70,$0.00,1,1,1,0,0,1,20161001,,,,
S0092,HCPCS,HYDROMORPHONE 250 MG,,,28,,NW,,,,,,$466.58,$0.00,1,1,1,0,0,1,20161001,,,,
S0093,HCPCS,MORPHINE 500 MG,,,28,,NW,,,,,,$553.74,$0.00,1,1,1,0,0,1,20161001,,,,
S0104,HCPCS,"ZIDOVUDINE, ORAL, 100 MG",,,28,,NW,,,,,,$8.21,$0.00,1,1,1,0,0,1,20161001,,,,
S0106,HCPCS,BUPROPION HCL SR 60 TABLETS,,,28,,NW,,,,,,$493.57,$0.00,1,1,1,0,0,1,20161001,,,,
S0108,HCPCS,MERCAPTOPURINE 50 MG,,,28,,NW,,,,,,$17.03,$0.00,1,1,1,0,0,1,20161001,,,,
S0109,HCPCS,METHADONE ORAL 5MG,,,28,,NW,,,,,,$1.26,$0.00,1,1,1,0,0,1,20161001,,,,
S0119,HCPCS,ONDANSETRON 4 MG,,,28,,NW,,,,,,$46.45,$0.00,1,1,1,0,0,1,20161001,,,,
S0122,HCPCS,INJ MENOTROPINS 75 IU,,,28,,NW,,,,,,$317.02,$0.00,1,1,1,0,0,1,20161001,,,,
S0126,HCPCS,INJ FOLLITROPIN ALFA 75 IU,,,28,,NW,,,,,,$361.89,$0.00,1,1,1,0,0,1,20161001,,,,
S0128,HCPCS,INJ FOLLITROPIN BETA 75 IU,,,28,,NW,,,,,,$344.33,$0.00,1,1,1,0,0,1,20161001,,,,
S0132,HCPCS,INJ GANIRELIX ACETAT 250 MCG,,,28,,NW,,,,,,$476.78,$0.00,1,1,1,0,0,1,20161001,,,,
S0136,HCPCS,"CLOZAPINE, 25 MG",,,28,,NW,,,,,,$5.85,$0.00,1,1,1,0,0,1,20161001,,,,
S0137,HCPCS,"DIDANOSINE, 25 MG",,,28,,NW,,,,,,$16.53,$0.00,1,1,1,0,0,1,20161001,,,,
S0138,HCPCS,"FINASTERIDE, 5 MG",,,28,,NW,,,,,,$12.72,$0.00,1,1,1,0,0,1,20161001,,,,
S0139,HCPCS,"MINOXIDIL, 10 MG",,,28,,NW,,,,,,$5.04,$0.00,1,1,1,0,0,1,20161001,,,,
S0140,HCPCS,"SAQUINAVIR, 200 MG",,,28,,NW,,,,,,$8.49,$0.00,1,1,1,0,0,1,20161001,,,,
S0142,HCPCS,COLISTIMETHATE INH SOL MG,,,28,,NW,,,,,,$22.05,$0.00,1,1,1,0,0,1,20161001,,,,
S0145,HCPCS,PEG INTERFERON ALFA-2A/180,,,28,,NW,,,,,,$55.33,$0.00,1,1,1,0,0,1,20161001,,,,
S0155,HCPCS,EPOPROSTENOL DILUTANT,,,28,,NW,,,,,,$32.26,$0.00,1,1,1,0,0,1,20161001,,,,
S0156,HCPCS,"EXEMESTANE, 25 MG",,,28,,NW,,,,,,$37.96,$0.00,1,1,1,0,0,1,20161001,,,,
S0157,HCPCS,"BECAPLERMIN GEL 1%, 0.5 GM",,,28,,NW,,,,,,$79.38,$0.00,1,1,1,0,0,1,20161001,,,,
S0160,HCPCS,DEXTROAMPHETAMINE,,,28,,NW,,,,,,$1.79,$0.00,1,1,1,0,0,1,20161001,,,,
S0164,HCPCS,INJECTION PANTROPRAZOLE,,,28,,NW,,,,,,$58.53,$0.00,1,1,1,0,0,1,20161001,,,,
S0166,HCPCS,INJ OLANZAPINE 2.5MG,,,28,,NW,,,,,,$26.58,$0.00,1,1,1,0,0,1,20161001,,,,
S0170,HCPCS,ANASTROZOLE 1 MG,,,28,,NW,,,,,,$36.50,$0.00,1,1,1,0,0,1,20161001,,,,
S0171,HCPCS,BUMETANIDE 0.5 MG,,,28,,NW,,,,,,$5.36,$0.00,1,1,1,0,0,1,20161001,,,,
S0172,HCPCS,CHLORAMBUCIL 2 MG,,,28,,NW,,,,,,$10.00,$0.00,1,1,1,0,0,1,20161001,,,,
S0174,HCPCS,DOLASETRON 50 MG,,,28,,NW,,,,,,$233.78,$0.00,1,1,1,0,0,1,20161001,,,,
S0175,HCPCS,FLUTAMIDE 125 MG,,,28,,NW,,,,,,$9.67,$0.00,1,1,1,0,0,1,20161001,,,,
S0176,HCPCS,HYDROXYUREA 500 MG,,,28,,NW,,,,,,$5.16,$0.00,1,1,1,0,0,1,20161001,,,,
S0177,HCPCS,LEVAMISOLE 50 MG,,,28,,NW,,,,,,$22.48,$0.00,1,1,1,0,0,1,20161001,,,,
S0178,HCPCS,LOMUSTINE 10 MG,,,28,,NW,,,,,,$112.48,$0.00,1,1,1,0,0,1,20161001,,,,
S0179,HCPCS,MEGESTROL 20 MG,,,28,,NW,,,,,,$2.53,$0.00,1,1,1,0,0,1,20161001,,,,
S0182,HCPCS,"PROCARBAZINE, ORAL",,,28,,NW,,,,,,$233.09,$0.00,1,1,1,0,0,1,20161001,,,,
S0183,HCPCS,PROCHLORPERAZINE 5 MG,,,28,,NW,,,,,,$2.97,$0.00,1,1,1,0,0,1,20161001,,,,
S0187,HCPCS,TAMOXIFEN 10 MG,,,28,,NW,,,,,,$9.39,$0.00,1,1,1,0,0,1,20161001,,,,
S0189,HCPCS,TESTOSTERONE PELLET 75 MG,,,28,,NW,,,,,,$130.63,$0.00,1,1,1,0,0,1,20161001,,,,
S0190,HCPCS,"MIFEPRISTONE, ORAL, 200 MG",,,28,,NW,,,,,,$292.01,$0.00,1,1,1,0,0,1,20161001,,,,
S0191,HCPCS,"MISOPROSTOL, ORAL, 200 MCG",,,28,,NW,,,,,,$10.43,$0.00,1,1,1,0,0,1,20161001,,,,
S0199,HCPCS,MED ABORTION INC ALL EX DRUG,,,12,,TotalUnits,,,,4.65 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S0201,HCPCS,PARTIAL HOSPITALIZATION SERV,,,14,,TotalUnits,,,,0.48 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S0207,HCPCS,PARAMEDICINTERCEP NONHOSPALS,,,14,,TotalUnits,,,,7.09 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S0208,HCPCS,PARAMED INTRCEPT NONVOL,,,14,,TotalUnits,,,,4.56 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S0209,HCPCS,WC VAN MILEAGE PER MI,,,14,,TotalUnits,,,,0.02 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S0220,HCPCS,MEDICAL CONFERENCE BY PHYSIC,,,15,,TotalUnits,,,,2.81 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S0221,HCPCS,"MEDICAL CONFERENCE, 60 MIN",,,15,,RBRVS,1.42 ,0.44 ,1.10 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S0255,HCPCS,HOSPICE REFER VISIT NONMD,,,15,,RBRVS,0.48 ,0.11 ,0.36 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S0257,HCPCS,END OF LIFE COUNSELING,,,15,,TotalUnits,,,,0.38 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S0260,HCPCS,H&P FOR SURGERY,,,15,,TotalUnits,,,,3.45 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S0265,HCPCS,GENETIC COUNSEL 15 MINS,,,14,,TotalUnits,,,,0.54 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S0280,HCPCS,"MEDICAL HOME, INITIAL PLAN",,,14,,TotalUnits,,,,0.41 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S0281,HCPCS,"MEDICAL HOME, MAINTENANCE",,,14,,TotalUnits,,,,0.43 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S0302,HCPCS,COMPLETED EPSDT,,,18,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S0315,HCPCS,DISEASE MANAGEMENT PROGRAM,,,14,,TotalUnits,,,,1.12 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S0316,HCPCS,FOLLOW-UP/REASSESSMENT,,,14,,TotalUnits,,,,0.83 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S0317,HCPCS,DISEASE MGMT PER DIEM,,,14,,TotalUnits,,,,1.47 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S0390,HCPCS,ROUT FOOT CARE PER VISIT,,,14,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S0395,HCPCS,IMPRESSION CASTING FT,,,28,,NW,,,,,,$134.79,$0.00,1,1,1,0,0,1,20161001,,,,
S0400,HCPCS,GLOBAL ESWL KIDNEY,,,21,,RBRVS,9.64 ,6.13 ,17.10 ,,,$0.00,$0.00,1,0,0,0,0,1,20161001,,,,
S0500,HCPCS,DISPOS CONT LENS,,,28,,NW,,,,,,$103.69,$0.00,1,1,1,1,1,1,20161001,,,,
S0504,HCPCS,SINGL PRSCRP LENS,,,28,,NW,,,,,,$148.52,$0.00,1,1,1,1,1,1,20161001,,,,
S0506,HCPCS,BIFOC PRSCP LENS,,,28,,NW,,,,,,$150.83,$0.00,1,1,1,1,1,1,20161001,,,,
S0508,HCPCS,TRIFOC PRSCRP LENS,,,28,,NW,,,,,,$81.90,$0.00,1,1,1,1,1,1,20161001,,,,
S0510,HCPCS,NON-PRSCRP LENS,,,28,,NW,,,,,,$51.09,$0.00,1,1,1,1,1,1,20161001,,,,
S0512,HCPCS,DAILY CONT LENS,,,28,,NW,,,,,,$102.49,$0.00,1,1,1,1,1,1,20161001,,,,
S0514,HCPCS,COLOR CONT LENS,,,28,,NW,,,,,,$202.37,$0.00,1,1,1,1,1,1,20161001,,,,
S0515,HCPCS,SCLERAL LENS LIQUID BANDAGE,,,28,,NW,,,,,,$402.92,$0.00,1,1,1,1,1,1,20161001,,,,
S0516,HCPCS,SAFETY FRAMES,,,28,,NW,,,,,,$104.82,$0.00,1,1,1,1,1,1,20161001,,,,
S0518,HCPCS,SUNGLASS FRAMES,,,28,,NW,,,,,,$66.98,$0.00,1,1,1,1,1,1,20161001,,,,
S0580,HCPCS,POLYCARB LENS,,,28,,NW,,,,,,$72.04,$0.00,1,1,1,1,1,1,20161001,,,,
S0581,HCPCS,NONSTND LENS,,,28,,NW,,,,,,$759.14,$0.00,1,1,1,1,1,1,20161001,,,,
S0592,HCPCS,COMP CONT LENS EVAL,,,23,,TotalUnits,,,,1.13 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S0595,HCPCS,NEW LENSES IN PTS OLD FRAME,,,28,,NW,,,,,,$7.78,$0.00,1,1,1,1,1,1,20161001,,,,
S0601,HCPCS,SCREENING PROCTOSCOPY,,,21,,RBRVS,0.55 ,0.38 ,1.37 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S0610,HCPCS,ANNUAL GYNECOLOGICAL EXAMINA,,,18,,TotalUnits,,,,2.79 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S0612,HCPCS,ANNUAL GYNECOLOGICAL EXAMINA,,,18,,TotalUnits,,,,1.95 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S0613,HCPCS,ANN BREAST EXAM,,,18,,TotalUnits,,,,0.93 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S0618,HCPCS,AUDIOMETRY FOR HEARING AID,,,8,,TotalUnits,,,,1.20 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S0620,HCPCS,ROUTINE OPHTHALMOLOGICAL EXA,,,23,,TotalUnits,,,,1.25 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S0621,HCPCS,ROUTINE OPHTHALMOLOGICAL EXA,,,23,,TotalUnits,,,,1.40 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S0622,HCPCS,PHYS EXAM FOR COLLEGE,,,14,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S0630,HCPCS,REMOVAL OF SUTURES,,,14,,TotalUnits,,,,0.63 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S0800,HCPCS,LASER IN SITU KERATOMILEUSIS,,,14,,TotalUnits,,,,15.46 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S0810,HCPCS,PHOTOREFRACTIVE KERATECTOMY,,,14,,TotalUnits,,,,16.09 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S0812,HCPCS,PHOTOTHERAP KERATECT,,,14,,RBRVS,0.92 ,0.64 ,0.86 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S1001,HCPCS,DELUXE ITEM,,,28,,NW,,,,,,$24.44,$0.00,1,1,1,1,1,1,20161001,,,,
S1002,HCPCS,CUSTOM ITEM,,,28,,NW,,,,,,$24.79,$0.00,1,1,1,1,1,1,20161001,,,,
S1015,HCPCS,IV TUBING EXTENSION SET,,,28,,NW,,,,,,$39.59,$0.00,1,1,1,0,0,1,20161001,,,,
S1016,HCPCS,NON-PVC INTRAVENOUS ADMINIST,,,28,,NW,,,,,,$55.57,$0.00,1,1,1,0,0,1,20161001,,,,
S1040,HCPCS,CRANIAL REMOLDING ORTHOSIS,,,28,,NW,,,,,,$426.86,$0.00,1,1,1,0,0,1,20161001,,,,
S2053,HCPCS,TRANSPLANTATION OF SMALL INT,,,21,,RBRVS,83.29 ,27.76 ,27.76 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2054,HCPCS,TRANSPLANTATION OF MULTIVISC,,,21,,RBRVS,61.68 ,22.96 ,22.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2055,HCPCS,HARVESTING OF DONOR MULTIVIS,,,21,,RBRVS,61.68 ,22.96 ,22.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2060,HCPCS,LOBAR LUNG TRANSPLANTATION,,,21,,RBRVS,40.94 ,20.19 ,20.19 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2065,HCPCS,SIMULT PANC KIDN TRANS,,,21,,RBRVS,61.68 ,22.96 ,22.96 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2068,HCPCS,BREAST DIEP OR SIEA FLAP,,,21,,TotalUnits,,,,211.74 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2070,HCPCS,CYSTO LASER TX URETERAL CALC,,,21,,RBRVS,6.87 ,3.46 ,3.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2080,HCPCS,LAUP,,,21,,RBRVS,9.63 ,7.49 ,7.49 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2083,HCPCS,ADJUSTMENT GASTRIC BAND,,,21,,TotalUnits,,,,1.96 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2095,HCPCS,TRANSCATH EMBOLIZ MICROSPHER,,,21,,RBRVS,18.11 ,6.24 ,6.24 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2102,HCPCS,ISLET CELL TISSUE TRANSPLANT,,,21,,TotalUnits,,,,48.84 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2115,HCPCS,PERIACETABULAR OSTEOTOMY,,,21,,RBRVS,21.87 ,12.02 ,12.02 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2120,HCPCS,LOW DENSITY LIPOPROTEIN(LDL),,,17,,TotalUnits,,,,41.06 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2140,HCPCS,CORD BLOOD HARVESTING,,,21,,TotalUnits,,,,1.86 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2142,HCPCS,CORD BLOOD-DERIVED STEM-CELL,,,21,,TotalUnits,,,,1.62 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2150,HCPCS,BMT HARV/TRANSPL 28D PKG,,,21,,RBRVS,2.24 ,0.94 ,0.94 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2202,HCPCS,ECHOSCLEROTHERAPY,,,14,,RBRVS,1.09 ,0.64 ,2.41 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2205,HCPCS,MINIMALLY INVASIVE DIRECT CO,,,21,,RBRVS,33.64 ,12.57 ,12.57 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2206,HCPCS,MINIMALLY INVASIVE DIRECT CO,,,21,,RBRVS,39.77 ,14.75 ,14.75 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2207,HCPCS,MINIMALLY INVASIVE DIRECT CO,,,21,,RBRVS,34.87 ,12.92 ,12.92 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2225,HCPCS,MYRINGOTOMY LASER-ASSIST,,,21,,RBRVS,1.35 ,1.56 ,3.32 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2230,HCPCS,IMPLANT SEMI-IMP HEAR,,,21,,TotalUnits,,,,15.48 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2235,HCPCS,IMPLANT AUDITORY BRAIN IMP,,,21,,RBRVS,0.73 ,8.52 ,8.52 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2260,HCPCS,INDUCED ABORTION 17-24 WEEKS,,,12,,RBRVS,5.90 ,2.46 ,2.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2265,HCPCS,INDUCED ABORTION 25-28 WKS,,,12,,RBRVS,5.90 ,2.46 ,2.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2266,HCPCS,INDUCED ABORTION 29-31 WKS,,,12,,RBRVS,5.90 ,2.46 ,2.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2267,HCPCS,INDUCED ABORTION 32 OR MORE,,,12,,RBRVS,5.90 ,2.46 ,2.46 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2300,HCPCS,"ARTHROSCOPY, SHOULDER, SURGI",,,21,,TotalUnits,,,,12.49 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2340,HCPCS,CHEMODENERVATION OF ABDUCTOR,,,21,,RBRVS,3.86 ,1.65 ,4.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2341,HCPCS,CHEMODENERV ADDUCT VOCAL,,,21,,RBRVS,3.86 ,1.65 ,4.26 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2342,HCPCS,NASAL ENDOSCOP PO DEBRID,,,21,,RBRVS,2.98 ,1.39 ,4.90 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2348,HCPCS,DECOMPRESS DISC RF LUMBAR,,,21,,RBRVS,8.88 ,4.30 ,4.30 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2350,HCPCS,"DISKECTOMY, ANTERIOR, WITH D",,,21,,RBRVS,22.75 ,11.08 ,11.08 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2351,HCPCS,"DISKECTOMY, ANTERIOR, WITH D",,,21,,RBRVS,3.28 ,1.21 ,1.21 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S2900,HCPCS,ROBOTIC SURGICAL SYSTEM,,,21,,TotalUnits,,,,16.80 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S3005,HCPCS,EVAL SELF-ASSESS DEPRESSION,,,16,,TotalUnits,,,,1.02 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S3600,HCPCS,STAT LAB,,,17,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S3601,HCPCS,STAT LAB HOME/NF,,,17,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S3620,HCPCS,NEWBORN METABOLIC SCREENING,,,17,,TotalUnits,,,,0.35 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
S3630,HCPCS,EOSINOPHIL BLOOD COUNT,,,17,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S3645,HCPCS,HIV-1 ANTIBODY TESTING OF OR,,,17,,TotalUnits,,,,0.15 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S3650,HCPCS,"SALIVA TEST, HORMONE LEVEL;",,,17,,TotalUnits,,,,3.09 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S3652,HCPCS,"SALIVA TEST, HORMONE LEVEL;",,,17,,TotalUnits,,,,2.51 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S3655,HCPCS,ANTISPERM ANTIBODIES TEST,,,17,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S3900,HCPCS,SURFACE EMG,,,17,,TotalUnits,,,,1.27 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S4005,HCPCS,INTERIM LABOR FACILITY GLOBA,,,12,,TotalUnits,,,,13.24 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S4011,HCPCS,IVF PACKAGE,,,14,,TotalUnits,,,,66.38 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S4015,HCPCS,COMPLETE IVF NOS CASE RATE,,,14,,TotalUnits,,,,71.73 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S4016,HCPCS,FROZEN IVF CASE RATE,,,14,,TotalUnits,,,,20.87 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S4022,HCPCS,ASST OOCYTE FERT CASE RATE,,,14,,TotalUnits,,,,14.68 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S4035,HCPCS,STIMULATED IUI CASE RATE,,,14,,TotalUnits,,,,17.70 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S4040,HCPCS,MONIT STORE CRYO EMBRYO 30 D,,,14,,TotalUnits,,,,0.78 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S4042,HCPCS,OVULATION MGMT PER CYCLE,,,14,,TotalUnits,,,,3.70 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S4981,HCPCS,INSERT LEVONORGESTREL IUS,,,14,,TotalUnits,,,,1.74 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S4989,HCPCS,CONTRACEPT IUD,,,28,,NW,,,,,,$750.24,$0.00,1,1,1,1,1,1,20161001,,,,
S4990,HCPCS,NICOTINE PATCH LEGEND,,,28,,NW,,,,,,$31.69,$0.00,1,1,1,0,0,1,20161001,,,,
S4993,HCPCS,CONTRACEPTIVE PILLS FOR BC,,,28,,NW,,,,,,$34.38,$0.00,1,1,1,1,1,1,20161001,,,,
S4995,HCPCS,SMOKING CESSATION GUM,,,28,,NW,,,,,,$67.50,$0.00,1,1,1,0,0,1,20161001,,,,
S5000,HCPCS,"PRESCRIPTION DRUG, GENERIC",,,28,,NW,,,,,,$23.60,$0.00,1,1,1,0,0,1,20161001,,,,
S5001,HCPCS,"PRESCRIPTION DRUG,BRAND NAME",,,28,,NW,,,,,,$100.84,$0.00,1,1,1,0,0,1,20161001,,,,
S5010,HCPCS,5% DEXTROSE AND 0.45% SALINE,,,28,,NW,,,,,,$24.16,$0.00,1,1,1,0,0,1,20161001,,,,
S5012,HCPCS,5% DEXTROSE WITH POTASSIUM,,,28,,NW,,,,,,$84.01,$0.00,1,1,1,0,0,1,20161001,,,,
S5013,HCPCS,5%DEXTROSE/0.45%SALINE1000ML,,,28,,NW,,,,,,$23.43,$0.00,1,1,1,0,0,1,20161001,,,,
S5014,HCPCS,D5W/0.45NS W KCL AND MGS04,,,28,,NW,,,,,,$14.12,$0.00,1,1,1,0,0,1,20161001,,,,
S5035,HCPCS,HIT ROUTINE DEVICE MAINT,,,14,,RBRVS,0.18 ,0.37 ,0.37 ,,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S5100,HCPCS,ADULT DAYCARE SERVICES 15MIN,,,14,,TotalUnits,,,,0.82 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S5102,HCPCS,ADULT DAY CARE PER DIEM,,,14,,TotalUnits,,,,0.56 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S5105,HCPCS,CENTERBASED DAY CARE PERDIEM,,,14,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S5108,HCPCS,HOMECARE TRAIN PT 15 MIN,,,14,,RBRVS,0.45 ,0.37 ,0.37 ,,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S5109,HCPCS,HOMECARE TRAIN PT SESSION,,,14,,TotalUnits,,,,1.08 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S5110,HCPCS,FAMILY HOMECARE TRAINING 15M,,,14,,TotalUnits,,,,0.09 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S5111,HCPCS,FAMILY HOMECARE TRAIN/SESSIO,,,14,,TotalUnits,,,,1.68 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S5115,HCPCS,NONFAMILY HOMECARE TRAIN/15M,,,14,,TotalUnits,,,,1.68 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S5116,HCPCS,NONFAMILY HC TRAIN/SESSION,,,14,,TotalUnits,,,,1.68 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S5126,HCPCS,ATTENDANT CARE SERVICE /DIEM,,,14,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S5136,HCPCS,ADULT COMPANIONCARE PER DIEM,,,14,,TotalUnits,,,,0.58 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S5140,HCPCS,ADULT FOSTER CARE PER DIEM,,,14,,TotalUnits,,,,0.51 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S5145,HCPCS,CHILD FOSTERCARE TH PER DIEM,,,14,,TotalUnits,,,,1.07 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S5151,HCPCS,UNSKILLED RESPITECARE /DIEM,,,14,,TotalUnits,,,,1.59 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S5161,HCPCS,EMER RSPNS SYS SERV PERMONTH,,,14,,TotalUnits,,,,0.27 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S5180,HCPCS,HH RESPIRATORY THRPY IN EVAL,,,14,,TotalUnits,,,,1.47 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S5181,HCPCS,HH RESPIRATORY THRPY NOS/DAY,,,14,,TotalUnits,,,,1.47 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S5190,HCPCS,WELLNESS ASSESSMENT BY NONPH,,,14,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S5199,HCPCS,PERSONAL CARE ITEM NOS EACH,,,28,,NW,,,,,,$48.29,$0.00,1,1,1,0,0,1,20161001,,,,
S5497,HCPCS,HIT CATH CARE NOC,,,28,,NW,,,,,,$48.29,$0.00,1,1,1,1,1,1,20161001,,,,
S5498,HCPCS,HIT SIMPLE CATH CARE,,,28,,NW,,,,,,$40.91,$0.00,1,1,1,1,1,1,20161001,,,,
S5501,HCPCS,HIT COMPLEX CATH CARE,,,28,,NW,,,,,,$44.10,$0.00,1,1,1,1,1,1,20161001,,,,
S5502,HCPCS,HIT INTERIM CATH CARE,,,28,,NW,,,,,,$77.69,$0.00,1,1,1,1,1,1,20161001,,,,
S5517,HCPCS,HIT DECLOTTING KIT,,,28,,NW,,,,,,$89.82,$0.00,1,1,1,1,1,1,20161001,,,,
S5520,HCPCS,HIT PICC INSERT KIT,,,28,,NW,,,,,,$108.74,$0.00,1,1,1,1,1,1,20161001,,,,
S5521,HCPCS,HIT MIDLINE CATH INSERT KIT,,,28,,NW,,,,,,$160.82,$0.00,1,1,1,1,1,1,20161001,,,,
S5522,HCPCS,HIT PICC INSERT NO SUPP,,,14,,TotalUnits,,,,1.45 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S5523,HCPCS,HIP MIDLINE CATH INSERT KIT,,,14,,TotalUnits,,,,1.53 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S5550,HCPCS,INSULIN RAPID 5 U,,,28,,NW,,,,,,$0.15,$0.00,1,1,1,0,0,1,20161001,,,,
S5551,HCPCS,INSULIN MOST RAPID 5 U,,,28,,NW,,,,,,$0.15,$0.00,1,1,1,0,0,1,20161001,,,,
S5552,HCPCS,INSULIN INTERMED 5 U,,,28,,NW,,,,,,$0.15,$0.00,1,1,1,0,0,1,20161001,,,,
S5553,HCPCS,INSULIN LONG ACTING 5 U,,,28,,NW,,,,,,$0.15,$0.00,1,1,1,0,0,1,20161001,,,,
S5560,HCPCS,INSULIN REUSE PEN 1.5 ML,,,28,,NW,,,,,,$3.90,$0.00,1,1,1,1,1,1,20161001,,,,
S8030,HCPCS,TANTALUM RING APPLICATION,,,20,,RBRVS,9.46 ,7.66 ,7.66 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S8037,HCPCS,MRCP,,,20,,TotalUnits,,,,7.77 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S8040,HCPCS,TOPOGRAPHIC BRAIN MAPPING,,,14,,RBRVS,2.97 ,3.05 ,3.05 ,,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S8080,HCPCS,SCINTIMAMMOGRAPHY,,,20,,TotalUnits,,,,3.57 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S8085,HCPCS,FLUORINE-18 FLUORODEOXYGLUCO,,,20,,TotalUnits,,,,2.91 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
S8092,HCPCS,ELECTRON BEAM COMPUTED TOMOG,,,20,,TotalUnits,,,,2.28 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
S8096,HCPCS,PORTABLE PEAK FLOW METER,,,28,,NW,,,,,,$58.87,$0.00,1,1,1,1,1,1,20161001,,,,
S8097,HCPCS,ASTHMA KIT,,,28,,NW,,,,,,$61.01,$0.00,1,1,1,0,0,1,20161001,,,,
S8100,HCPCS,SPACER WITHOUT MASK,,,28,,NW,,,,,,$69.27,$0.00,1,1,1,0,0,1,20161001,,,,
S8101,HCPCS,SPACER WITH MASK,,,28,,NW,,,,,,$197.91,$0.00,1,1,1,0,0,1,20161001,,,,
S8110,HCPCS,PEAK EXPIRATORY FLOW RATE (P,,,14,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S8130,HCPCS,INTERFERENTIAL STIM 2 CHAN,,,28,,NW,,,,,,"$5,539.86",$0.00,1,1,1,0,0,1,20161001,,,,
S8131,HCPCS,INTERFERENTIAL STIM 4 CHAN,,,28,,NW,,,,,,"$1,601.60",$0.00,1,1,1,0,0,1,20161001,,,,
S8185,HCPCS,FLUTTER DEVICE,,,28,,NW,,,,,,$79.85,$0.00,1,1,1,0,0,1,20161001,,,,
S8186,HCPCS,SWIVEL ADAPTOR,,,28,,NW,,,,,,$6.21,$0.00,1,1,1,0,0,1,20161001,,,,
S8189,HCPCS,TRACH SUPPLY NOC,,,28,,NW,,,,,,$48.29,$0.00,1,1,1,0,0,1,20161001,,,,
S8210,HCPCS,MUCUS TRAP,,,28,,NW,,,,,,$1.38,$0.00,1,1,1,0,0,1,20161001,,,,
S8265,HCPCS,HABERMAN FEEDER,,,28,,NW,,,,,,$71.85,$0.00,1,1,1,0,0,1,20161001,,,,
S8301,HCPCS,INFECT CONTROL SUPPLIES NOS,,,28,,NW,,,,,,$48.29,$0.00,1,1,1,0,0,1,20161001,,,,
S8415,HCPCS,SUPPLIES FOR HOME DELIVERY,,,28,,NW,,,,,,$169.34,$0.00,1,1,1,0,0,1,20161001,,,,
S8420,HCPCS,CUSTOM GRADIENT SLEEV/GLOV,,,28,,NW,,,,,,$172.38,$0.00,1,1,1,0,0,1,20161001,,,,
S8421,HCPCS,READY GRADIENT SLEEV/GLOV,,,28,,NW,,,,,,$64.13,$0.00,1,1,1,0,0,1,20161001,,,,
S8422,HCPCS,CUSTOM GRAD SLEEVE MED,,,28,,NW,,,,,,$198.94,$0.00,1,1,1,0,0,1,20161001,,,,
S8423,HCPCS,CUSTOM GRAD SLEEVE HEAVY,,,28,,NW,,,,,,$225.04,$0.00,1,1,1,0,0,1,20161001,,,,
S8424,HCPCS,READY GRADIENT SLEEVE,,,28,,NW,,,,,,$69.75,$0.00,1,1,1,0,0,1,20161001,,,,
S8425,HCPCS,CUSTOM GRAD GLOVE MED,,,28,,NW,,,,,,$111.19,$0.00,1,1,1,0,0,1,20161001,,,,
S8426,HCPCS,CUSTOM GRAD GLOVE HEAVY,,,28,,NW,,,,,,$138.15,$0.00,1,1,1,0,0,1,20161001,,,,
S8427,HCPCS,READY GRADIENT GLOVE,,,28,,NW,,,,,,$29.52,$0.00,1,1,1,0,0,1,20161001,,,,
S8428,HCPCS,READY GRADIENT GAUNTLET,,,28,,NW,,,,,,$77.50,$0.00,1,1,1,0,0,1,20161001,,,,
S8429,HCPCS,GRADIENT PRESSURE WRAP,,,28,,NW,,,,,,$103.18,$0.00,1,1,1,0,0,1,20161001,,,,
S8430,HCPCS,PADDING FOR COMPRSSN BDG,,,28,,NW,,,,,,$24.60,$0.00,1,1,1,0,0,1,20161001,,,,
S8431,HCPCS,COMPRESSION BANDAGE,,,28,,NW,,,,,,$17.43,$0.00,1,1,1,0,0,1,20161001,,,,
S8450,HCPCS,SPLINT DIGIT,,,28,,NW,,,,,,$33.02,$0.00,1,1,1,0,0,1,20161001,,,,
S8451,HCPCS,SPLINT WRIST OR ANKLE,,,28,,NW,,,,,,$44.70,$0.00,1,1,1,0,0,1,20161001,,,,
S8452,HCPCS,SPLINT ELBOW,,,28,,NW,,,,,,$48.29,$0.00,1,1,1,0,0,1,20161001,,,,
S8460,HCPCS,CAMISOLE POST-MAST,,,28,,NW,,,,,,$92.09,$0.00,1,1,1,0,0,1,20161001,,,,
S8490,HCPCS,100 INSULIN SYRINGES,,,28,,NW,,,,,,$1.38,$0.00,1,1,1,1,1,1,20161001,,,,
S8930,HCPCS,AURICULAR ELECTROSTIMULATION,,,14,,TotalUnits,,,,1.03 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S8940,HCPCS,HIPPOTHERAPY PER SESSION,,,19,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S8948,HCPCS,LOW-LEVEL LASER TRMT 15 MIN,,,14,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S8950,HCPCS,"COMPLEX LYMPHEDEMA THERAPY,",,,14,,TotalUnits,,,,0.60 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S8990,HCPCS,PT OR MANIP FOR MAINT,,,19,,TotalUnits,,,,0.62 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S8999,HCPCS,RESUSCITATION BAG,,,28,,NW,,,,,,$248.68,$0.00,1,1,1,0,0,1,20161001,,,,
S9001,HCPCS,HOME UTERINE MONITOR WITH OR,,,28,,NW,,,,,,$126.55,$0.00,1,1,1,0,0,1,20161001,,,,
S9024,HCPCS,PARANASAL SINUS ULTRASOUND,,,20,,TotalUnits,,,,2.17 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S9034,HCPCS,ESWL FOR GALLSTONES,,,21,,RBRVS,9.64 ,6.13 ,17.10 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S9061,HCPCS,MEDICAL SUPPLIES AND EQUIPME,,,28,,NW,,,,,,$73.58,$0.00,1,1,1,0,0,1,20161001,,,,
S9083,HCPCS,URGENT CARE CENTER GLOBAL,,,15,,TotalUnits,,,,1.90 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S9088,HCPCS,SERVICES PROVIDED IN URGENT,,,15,,TotalUnits,,,,1.23 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S9090,HCPCS,VERTEBRAL AXIAL DECOMPRESSIO,,,14,,TotalUnits,,,,0.66 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S9097,HCPCS,HOME VISIT WOUND CARE,,,14,,TotalUnits,,,,1.15 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S9098,HCPCS,HOME PHOTOTHERAPY VISIT,,,14,,TotalUnits,,,,1.89 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S9117,HCPCS,BACK SCHOOL VISIT,,,14,,RBRVS,0.17 ,0.06 ,0.32 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S9122,HCPCS,HOME HEALTH AIDE OR CERTIFIE,,,14,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S9123,HCPCS,NURSING CARE IN HOME RN,,,14,,TotalUnits,,,,0.76 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S9124,HCPCS,"NURSING CARE, IN THE HOME; B",,,14,,TotalUnits,,,,0.49 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S9125,HCPCS,"RESPITE CARE, IN THE HOME, P",,,14,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S9126,HCPCS,"HOSPICE CARE, IN THE HOME, P",,,14,,TotalUnits,,,,1.38 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S9127,HCPCS,"SOCIAL WORK VISIT, IN THE HO",,,14,,TotalUnits,,,,1.64 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S9128,HCPCS,"SPEECH THERAPY, IN THE HOME,",,,14,,TotalUnits,,,,1.21 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S9129,HCPCS,"OCCUPATIONAL THERAPY, IN THE",,,14,,TotalUnits,,,,1.19 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S9131,HCPCS,PT IN THE HOME PER DIEM,,,14,,TotalUnits,,,,1.20 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S9140,HCPCS,"DIABETIC MANAGEMENT PROGRAM,",,,14,,TotalUnits,,,,1.36 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S9141,HCPCS,"DIABETIC MANAGEMENT PROGRAM,",,,14,,RBRVS,,0.59 ,0.59 ,,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S9145,HCPCS,INSULIN PUMP INITIATION,,,14,,TotalUnits,,,,3.81 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S9152,HCPCS,"SPEECH THERAPY, RE-EVAL",,,8,,TotalUnits,,,,2.94 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S9208,HCPCS,HOME MGMT PRETERM LABOR,,,28,,NW,,,,,,$275.02,$0.00,1,1,1,1,1,1,20161001,,,,
S9211,HCPCS,HOME MGMT GEST HYPERTENSION,,,28,,NW,,,,,,$116.56,$0.00,1,1,1,1,1,1,20161001,,,,
S9212,HCPCS,HM POSTPAR HYPER PER DIEM,,,28,,NW,,,,,,$137.77,$0.00,1,1,1,1,1,1,20161001,,,,
S9213,HCPCS,HM PREECLAMP PER DIEM,,,28,,NW,,,,,,$271.93,$0.00,1,1,1,1,1,1,20161001,,,,
S9214,HCPCS,HM GEST DM PER DIEM,,,28,,NW,,,,,,$251.80,$0.00,1,1,1,1,1,1,20161001,,,,
S9325,HCPCS,HIT PAIN MGMT PER DIEM,,,28,,NW,,,,,,$140.47,$0.00,1,1,1,1,1,1,20161001,,,,
S9326,HCPCS,HIT CONT PAIN PER DIEM,,,28,,NW,,,,,,$199.44,$0.00,1,1,1,1,1,1,20161001,,,,
S9327,HCPCS,HIT INT PAIN PER DIEM,,,28,,NW,,,,,,$197.89,$0.00,1,1,1,1,1,1,20161001,,,,
S9328,HCPCS,HIT PAIN IMP PUMP DIEM,,,28,,NW,,,,,,$143.71,$0.00,1,1,1,1,1,1,20161001,,,,
S9329,HCPCS,HIT CHEMO PER DIEM,,,28,,NW,,,,,,$214.46,$0.00,1,1,1,1,1,1,20161001,,,,
S9330,HCPCS,HIT CONT CHEM DIEM,,,28,,NW,,,,,,$210.92,$0.00,1,1,1,1,1,1,20161001,,,,
S9331,HCPCS,HIT INTERMIT CHEMO DIEM,,,28,,NW,,,,,,$234.87,$0.00,1,1,1,1,1,1,20161001,,,,
S9335,HCPCS,HT HEMODIALYSIS DIEM,,,28,,NW,,,,,,$644.03,$0.00,1,1,1,1,1,1,20161001,,,,
S9336,HCPCS,HIT CONT ANTICOAG DIEM,,,28,,NW,,,,,,$201.72,$0.00,1,1,1,1,1,1,20161001,,,,
S9338,HCPCS,HIT IMMUNOTHERAPY DIEM,,,28,,NW,,,,,,$249.93,$0.00,1,1,1,1,1,1,20161001,,,,
S9339,HCPCS,HIT PERITON DIALYSIS DIEM,,,28,,NW,,,,,,$519.07,$0.00,1,1,1,1,1,1,20161001,,,,
S9340,HCPCS,HIT ENTERAL PER DIEM,,,28,,NW,,,,,,$83.36,$0.00,1,1,1,1,1,1,20161001,,,,
S9341,HCPCS,HIT ENTERAL GRAV DIEM,,,28,,NW,,,,,,$57.22,$0.00,1,1,1,1,1,1,20161001,,,,
S9342,HCPCS,HIT ENTERAL PUMP DIEM,,,28,,NW,,,,,,$61.46,$0.00,1,1,1,1,1,1,20161001,,,,
S9343,HCPCS,HIT ENTERAL BOLUS NURS,,,28,,NW,,,,,,$38.13,$0.00,1,1,1,1,1,1,20161001,,,,
S9345,HCPCS,HIT ANTI-HEMOPHIL DIEM,,,28,,NW,,,,,,$127.22,$0.00,1,1,1,1,1,1,20161001,,,,
S9346,HCPCS,HIT ALPHA-1-PROTEINAS DIEM,,,28,,NW,,,,,,$89.03,$0.00,1,1,1,1,1,1,20161001,,,,
S9347,HCPCS,HIT LONGTERM INFUSION DIEM,,,28,,NW,,,,,,$99.26,$0.00,1,1,1,1,1,1,20161001,,,,
S9348,HCPCS,HIT SYMPATHOMIM DIEM,,,28,,NW,,,,,,$220.20,$0.00,1,1,1,1,1,1,20161001,,,,
S9349,HCPCS,HIT TOCOLYSIS DIEM,,,28,,NW,,,,,,$317.61,$0.00,1,1,1,1,1,1,20161001,,,,
S9351,HCPCS,HIT CONT ANTIEMETIC DIEM,,,28,,NW,,,,,,$404.05,$0.00,1,1,1,1,1,1,20161001,,,,
S9353,HCPCS,HIT CONT INSULIN DIEM,,,28,,NW,,,,,,$552.48,$0.00,1,1,1,1,1,1,20161001,,,,
S9355,HCPCS,HIT CHELATION DIEM,,,28,,NW,,,,,,$164.99,$0.00,1,1,1,1,1,1,20161001,,,,
S9357,HCPCS,HIT ENZYME REPLACE DIEM,,,28,,NW,,,,,,$179.28,$0.00,1,1,1,1,1,1,20161001,,,,
S9359,HCPCS,HIT ANTI-TNF PER DIEM,,,28,,NW,,,,,,$328.10,$0.00,1,1,1,1,1,1,20161001,,,,
S9361,HCPCS,HIT DIURETIC INFUS DIEM,,,28,,NW,,,,,,$119.44,$0.00,1,1,1,1,1,1,20161001,,,,
S9363,HCPCS,HIT ANTI-SPASMOTIC DIEM,,,28,,NW,,,,,,$240.86,$0.00,1,1,1,1,1,1,20161001,,,,
S9364,HCPCS,HIT TPN TOTAL DIEM,,,28,,NW,,,,,,$375.55,$0.00,1,1,1,1,1,1,20161001,,,,
S9365,HCPCS,HIT TPN 1 LITER DIEM,,,28,,NW,,,,,,$432.82,$0.00,1,1,1,1,1,1,20161001,,,,
S9366,HCPCS,HIT TPN 2 LITER DIEM,,,28,,NW,,,,,,$528.18,$0.00,1,1,1,1,1,1,20161001,,,,
S9367,HCPCS,HIT TPN 3 LITER DIEM,,,28,,NW,,,,,,$588.10,$0.00,1,1,1,1,1,1,20161001,,,,
S9368,HCPCS,HIT TPN OVER 3L DIEM,,,28,,NW,,,,,,$753.43,$0.00,1,1,1,1,1,1,20161001,,,,
S9370,HCPCS,HT INJ ANTIEMETIC DIEM,,,28,,NW,,,,,,$152.62,$0.00,1,1,1,1,1,1,20161001,,,,
S9372,HCPCS,HT INJ ANTICOAG DIEM,,,28,,NW,,,,,,$103.49,$0.00,1,1,1,1,1,1,20161001,,,,
S9373,HCPCS,HIT HYDRA TOTAL DIEM,,,28,,NW,,,,,,$115.88,$0.00,1,1,1,1,1,1,20161001,,,,
S9374,HCPCS,HIT HYDRA 1 LITER DIEM,,,28,,NW,,,,,,$167.49,$0.00,1,1,1,1,1,1,20161001,,,,
S9375,HCPCS,HIT HYDRA 2 LITER DIEM,,,28,,NW,,,,,,$214.57,$0.00,1,1,1,1,1,1,20161001,,,,
S9376,HCPCS,HIT HYDRA 3 LITER DIEM,,,28,,NW,,,,,,$233.86,$0.00,1,1,1,1,1,1,20161001,,,,
S9377,HCPCS,HIT HYDRA OVER 3L DIEM,,,28,,NW,,,,,,$253.15,$0.00,1,1,1,1,1,1,20161001,,,,
S9379,HCPCS,HIT NOC PER DIEM,,,28,,NW,,,,,,$48.29,$0.00,1,1,1,1,1,1,20161001,,,,
S9401,HCPCS,ANTICOAG CLINIC PER SESSION,,,14,,TotalUnits,,,,0.30 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S9430,HCPCS,PHARMACY COMP/DISP SERV,,,14,,TotalUnits,,,,0.66 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S9433,HCPCS,MEDICAL FOOD ORAL 100% NUTR,,,28,,NW,,,,,,$35.81,$0.00,1,1,1,0,1,1,20161001,,,,
S9434,HCPCS,MOD SOLID FOOD SUPPL,,,28,,NW,,,,,,$54.81,$0.00,1,1,1,0,1,1,20161001,,,,
S9435,HCPCS,MEDICAL FOODS FOR INBORN ERR,,,28,,NW,,,,,,$34.51,$0.00,1,1,1,0,1,1,20161001,,,,
S9436,HCPCS,LAMAZE CLASS,,,14,,TotalUnits,,,,1.06 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S9441,HCPCS,ASTHMA EDUCATION,,,14,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S9442,HCPCS,BIRTHING CLASS,,,14,,TotalUnits,,,,0.42 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S9443,HCPCS,LACTATION CLASS,,,14,,TotalUnits,,,,0.48 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S9449,HCPCS,WEIGHT MGMT CLASS,,,14,,TotalUnits,,,,0.39 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S9451,HCPCS,EXERCISE CLASS,,,14,,TotalUnits,,,,0.24 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S9452,HCPCS,NUTRITION CLASS,,,14,,TotalUnits,,,,0.12 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S9453,HCPCS,SMOKING CESSATION CLASS,,,14,,TotalUnits,,,,1.53 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S9455,HCPCS,"DIABETIC MANAGEMENT PROGRAM,",,,14,,TotalUnits,,,,0.40 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S9460,HCPCS,"DIABETIC MANAGEMENT PROGRAM,",,,14,,TotalUnits,,,,0.69 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S9465,HCPCS,"DIABETIC MANAGEMENT PROGRAM,",,,14,,TotalUnits,,,,1.26 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
S9470,HCPCS,"NUTRITIONAL COUNSELING, DIET",,,14,,TotalUnits,,,,0.96 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
S9474,HCPCS,ENTEROSTOMAL THERAPY BY A RE,,,14,,TotalUnits,,,,0.67 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
S9475,HCPCS,AMBULATORY SETTING SUBSTANCE,,,16,,TotalUnits,,,,1.79 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
S9480,HCPCS,INTENSIVE OUTPATIENT PSYCHIA,,,16,,TotalUnits,,,,2.14 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S9484,HCPCS,CRISIS INTERVENTION PER HOUR,,,16,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S9485,HCPCS,CRISIS INTERVENTION MENTAL H,,,16,,TotalUnits,,,,4.63 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
S9490,HCPCS,HIT CORTICOSTEROID/DIEM,,,28,,NW,,,,,,$259.63,$0.00,1,1,1,1,1,1,20161001,,,,
S9494,HCPCS,HIT ANTIBIOTIC TOTAL DIEM,,,28,,NW,,,,,,$207.20,$0.00,1,1,1,1,1,1,20161001,,,,
S9497,HCPCS,HIT ANTIBIOTIC Q3H DIEM,,,28,,NW,,,,,,$258.37,$0.00,1,1,1,1,1,1,20161001,,,,
S9500,HCPCS,HIT ANTIBIOTIC Q24H DIEM,,,28,,NW,,,,,,$296.57,$0.00,1,1,1,1,1,1,20161001,,,,
S9501,HCPCS,HIT ANTIBIOTIC Q12H DIEM,,,28,,NW,,,,,,$289.85,$0.00,1,1,1,1,1,1,20161001,,,,
S9502,HCPCS,HIT ANTIBIOTIC Q8H DIEM,,,28,,NW,,,,,,$361.75,$0.00,1,1,1,1,1,1,20161001,,,,
S9503,HCPCS,HIT ANTIBIOTIC Q6H DIEM,,,28,,NW,,,,,,$333.54,$0.00,1,1,1,1,1,1,20161001,,,,
S9504,HCPCS,HIT ANTIBIOTIC Q4H DIEM,,,28,,NW,,,,,,$307.53,$0.00,1,1,1,1,1,1,20161001,,,,
S9529,HCPCS,VENIPUNCTURE HOME/SNF,,,28,,NW,,,,,,$103.33,$0.00,1,1,1,0,1,1,20161001,,,,
S9537,HCPCS,HT HEM HORM INJ DIEM,,,28,,NW,,,,,,$86.03,$0.00,1,1,1,1,1,1,20161001,,,,
S9538,HCPCS,HIT BLOOD PRODUCTS DIEM,,,28,,NW,,,,,,$278.99,$0.00,1,1,1,1,1,1,20161001,,,,
S9542,HCPCS,HT INJ NOC PER DIEM,,,28,,NW,,,,,,$48.29,$0.00,1,1,1,1,1,1,20161001,,,,
S9558,HCPCS,HT INJ GROWTH HORM DIEM,,,28,,NW,,,,,,$37.38,$0.00,1,1,1,1,1,1,20161001,,,,
S9559,HCPCS,HIT INJ INTERFERON DIEM,,,28,,NW,,,,,,$351.31,$0.00,1,1,1,1,1,1,20161001,,,,
S9560,HCPCS,HT INJ HORMONE DIEM,,,28,,NW,,,,,,$95.67,$0.00,1,1,1,1,1,1,20161001,,,,
S9562,HCPCS,HT INJ PALIVIZUMAB DIEM,,,28,,NW,,,,,,$95.67,$0.00,1,1,1,1,1,1,20161001,,,,
S9590,HCPCS,HT IRRIGATION DIEM,,,28,,NW,,,,,,$137.30,$0.00,1,1,1,1,1,1,20161001,,,,
S9810,HCPCS,HT PHARM PER HOUR,,,28,,NW,,,,,,$81.38,$0.00,1,1,1,0,0,1,20161001,,,,
S9900,HCPCS,CHRISTIAN SCI PRACT VISIT,,,14,,TotalUnits,,,,0.08 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S9970,HCPCS,HEALTH CLUB MEMBERSHIP YR,,,14,,TotalUnits,,,,0.86 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S9981,HCPCS,MED RECORD COPY ADMIN,,,14,,TotalUnits,,,,0.35 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S9986,HCPCS,NOT MEDICALLY NECESSARY SVC,,,14,,TotalUnits,,,,5.94 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S9988,HCPCS,SERV PART OF PHASE I TRIAL,,,14,,TotalUnits,,,,0.06 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S9990,HCPCS,SERVICES PROVIDED AS PART OF,,,14,,TotalUnits,,,,1.04 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
S9999,HCPCS,SALES TAX,,,14,,TotalUnits,,,,0.46 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
T1000,HCPCS,PRIVATE DUTY/INDEPENDENT NSG,,,15,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
T1001,HCPCS,NURSING ASSESSMENT/EVALUATN,,,15,,TotalUnits,,,,1.06 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
T1002,HCPCS,RN SERVICES UP TO 15 MINUTES,,,15,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
T1003,HCPCS,LPN/LVN SERVICES UP TO 15MIN,,,15,,TotalUnits,,,,0.17 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
T1004,HCPCS,NSG AIDE SERVICE UP TO 15MIN,,,15,,TotalUnits,,,,0.21 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
T1005,HCPCS,RESPITE CARE SERVICE 15 MIN,,,15,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
T1006,HCPCS,FAMILY/COUPLE COUNSELING,,,16,,TotalUnits,,,,0.47 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
T1007,HCPCS,TREATMENT PLAN DEVELOPMENT,,,16,,TotalUnits,,,,3.02 ,,$0.00,$0.00,1,1,1,0,1,1,20161001,,,,
T1009,HCPCS,CHILD SITTING SERVICES,,,14,,TotalUnits,,,,0.06 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
T1012,HCPCS,ALCOHOL/SUBSTANCE ABUSE SKIL,,,16,,TotalUnits,,,,0.13 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
T1013,HCPCS,SIGN LANG/ORAL INTERPRETER,,,14,,TotalUnits,,,,0.31 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
T1015,HCPCS,CLINIC SERVICE,,,15,,TotalUnits,,,,1.00 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
T1016,HCPCS,CASE MANAGEMENT,,,15,,TotalUnits,,,,0.37 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
T1019,HCPCS,PERSONAL CARE SER PER 15 MIN,,,15,,TotalUnits,,,,0.09 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
T1020,HCPCS,PERSONAL CARE SER PER DIEM,,,15,,TotalUnits,,,,1.88 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
T1021,HCPCS,HH AIDE OR CN AIDE PER VISIT,,,15,,TotalUnits,,,,0.79 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
T1023,HCPCS,PROGRAM INTAKE ASSESSMENT,,,15,,TotalUnits,,,,0.82 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
T1024,HCPCS,TEAM EVALUATION & MANAGEMENT,,,15,,TotalUnits,,,,0.32 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
T1026,HCPCS,"PED COMPR CARE PKG, PER HOUR",,,15,,TotalUnits,,,,0.81 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
T1027,HCPCS,FAMILY TRAINING & COUNSELING,,,16,,TotalUnits,,,,0.14 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
T1028,HCPCS,HOME ENVIRONMENT ASSESSMENT,,,16,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
T1030,HCPCS,RN HOME CARE PER DIEM,,,15,,TotalUnits,,,,1.99 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
T1031,HCPCS,LPN HOME CARE PER DIEM,,,15,,TotalUnits,,,,0.64 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
T1502,HCPCS,MEDICATION ADMIN VISIT,,,15,,TotalUnits,,,,0.25 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
T2001,HCPCS,N-ET; PATIENT ATTEND/ESCORT,,,14,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
T2003,HCPCS,N-ET; ENCOUNTER/TRIP,,,14,,TotalUnits,,,,0.50 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
T2004,HCPCS,N-ET; COMMERC CARRIER PASS,,,14,,TotalUnits,,,,0.07 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
T2005,HCPCS,N-ET; STRETCHER VAN,,,14,,TotalUnits,,,,0.13 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
T2007,HCPCS,NON-EMER TRANSPORT WAIT TIME,,,14,,TotalUnits,,,,0.26 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
T2013,HCPCS,HABIL ED WAIVER PER HOUR,,,14,,TotalUnits,,,,0.52 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
T2014,HCPCS,"HABIL PREVOC WAIVER, PER D",,,14,,TotalUnits,,,,0.57 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
T2016,HCPCS,HABIL RES WAIVER PER DIEM,,,14,,TotalUnits,,,,1.82 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
T2017,HCPCS,HABIL RES WAIVER 15 MIN,,,14,,TotalUnits,,,,0.11 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
T2018,HCPCS,HABIL SUP EMPL WAIVER/DIEM,,,14,,TotalUnits,,,,1.82 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
T2020,HCPCS,DAY HABIL WAIVER PER DIEM,,,14,,TotalUnits,,,,1.05 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
T2022,HCPCS,"CASE MANAGEMENT, PER MONTH",,,14,,TotalUnits,,,,0.63 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
T2023,HCPCS,TARGETED CASE MGMT PER MONTH,,,14,,TotalUnits,,,,1.51 ,,$0.00,$0.00,1,0,1,1,1,1,20161001,,,,
T2025,HCPCS,"WAIVER SERVICE, NOS",,,14,,TotalUnits,,,,0.18 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
T2031,HCPCS,ASSIST LIVING WAIVER/DIEM,,,14,,TotalUnits,,,,2.47 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
T2032,HCPCS,"RES CARE, NOS WAIVER/MONTH",,,14,,TotalUnits,,,,2.48 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
T2033,HCPCS,"RES, NOS WAIVER PER DIEM",,,14,,TotalUnits,,,,1.65 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
T2040,HCPCS,FINANCIAL MGT WAIVER/15MIN,,,14,,TotalUnits,,,,0.13 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
T2042,HCPCS,HOSPICE ROUTINE HOME CARE,,,14,,TotalUnits,,,,1.20 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
T2043,HCPCS,HOSPICE CONTINUOUS HOME CARE,,,14,,TotalUnits,,,,0.28 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
T2045,HCPCS,HOSPICE GENERAL CARE,,,14,,TotalUnits,,,,5.70 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
T2046,HCPCS,"HOSPICE LONG TERM CARE, R&B",,,14,,TotalUnits,,,,1.37 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
T2048,HCPCS,"BH LTC RES R&B, PER DIEM",,,14,,TotalUnits,,,,1.67 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
T2049,HCPCS,"N-ET; STRETCHER VAN, MILEAGE",,,14,,TotalUnits,,,,0.10 ,,$0.00,$0.00,1,1,1,1,1,1,20161001,,,,
T4521,HCPCS,ADULT SIZE BRIEF/DIAPER SM,,,28,,NW,,,,,,$1.45,$0.00,1,1,1,0,0,1,20161001,,,,
T4522,HCPCS,ADULT SIZE BRIEF/DIAPER MED,,,28,,NW,,,,,,$1.48,$0.00,1,1,1,0,0,1,20161001,,,,
T4523,HCPCS,ADULT SIZE BRIEF/DIAPER LG,,,28,,NW,,,,,,$1.60,$0.00,1,1,1,0,0,1,20161001,,,,
T4524,HCPCS,ADULT SIZE BRIEF/DIAPER XL,,,28,,NW,,,,,,$1.95,$0.00,1,1,1,0,0,1,20161001,,,,
T4525,HCPCS,ADULT SIZE PULL-ON SM,,,28,,NW,,,,,,$1.77,$0.00,1,1,1,0,0,1,20161001,,,,
T4526,HCPCS,ADULT SIZE PULL-ON MED,,,28,,NW,,,,,,$1.78,$0.00,1,1,1,0,0,1,20161001,,,,
T4527,HCPCS,ADULT SIZE PULL-ON LG,,,28,,NW,,,,,,$1.80,$0.00,1,1,1,0,0,1,20161001,,,,
T4528,HCPCS,ADULT SIZE PULL-ON XL,,,28,,NW,,,,,,$1.94,$0.00,1,1,1,0,0,1,20161001,,,,
T4529,HCPCS,PED SIZE BRIEF/DIAPER SM/MED,,,28,,NW,,,,,,$1.44,$0.00,1,1,1,0,0,1,20161001,,,,
T4530,HCPCS,PED SIZE BRIEF/DIAPER LG,,,28,,NW,,,,,,$1.65,$0.00,1,1,1,0,0,1,20161001,,,,
T4531,HCPCS,PED SIZE PULL-ON SM/MED,,,28,,NW,,,,,,$1.89,$0.00,1,1,1,0,0,1,20161001,,,,
T4532,HCPCS,PED SIZE PULL-ON LG,,,28,,NW,,,,,,$2.15,$0.00,1,1,1,0,0,1,20161001,,,,
T4533,HCPCS,YOUTH SIZE BRIEF/DIAPER,,,28,,NW,,,,,,$1.55,$0.00,1,1,1,0,0,1,20161001,,,,
T4534,HCPCS,YOUTH SIZE PULL-ON,,,28,,NW,,,,,,$1.91,$0.00,1,1,1,0,0,1,20161001,,,,
T4535,HCPCS,DISPOSABLE LINER/SHIELD/PAD,,,28,,NW,,,,,,$1.32,$0.00,1,1,1,0,0,1,20161001,,,,
T4536,HCPCS,REUSABLE PULL-ON ANY SIZE,,,28,,NW,,,,,,$1.51,$0.00,1,1,1,0,0,1,20161001,,,,
T4537,HCPCS,REUSABLE UNDERPAD BED SIZE,,,28,,NW,,,,,,$25.07,$0.00,1,1,1,0,0,1,20161001,,,,
T4539,HCPCS,REUSE DIAPER/BRIEF ANY SIZE,,,28,,NW,,,,,,$10.61,$0.00,1,1,1,0,0,1,20161001,,,,
T4540,HCPCS,REUSABLE UNDERPAD CHAIR SIZE,,,28,,NW,,,,,,$9.68,$0.00,1,1,1,0,0,1,20161001,,,,
T4541,HCPCS,LARGE DISPOSABLE UNDERPAD,,,28,,NW,,,,,,$1.25,$0.00,1,1,1,0,0,1,20161001,,,,
T4542,HCPCS,SMALL DISPOSABLE UNDERPAD,,,28,,NW,,,,,,$1.44,$0.00,1,1,1,0,0,1,20161001,,,,
T4543,HCPCS,ADULT DISP BRIEF/DIAP ABV XL,,,28,,NW,,,,,,$2.24,$0.00,1,1,1,0,0,1,20161001,,,,
T4544,HCPCS,ADLT DISP UND/PULL ON ABV XL,,,28,,NW,,,,,,$2.42,$0.00,1,1,1,0,0,1,20161001,,,,
T5001,HCPCS,POSITION SEAT SPEC ORTH NEED,,,28,,NW,,,,,,$740.25,$0.00,1,1,1,1,1,1,20161001,,,,
T5999,HCPCS,"SUPPLY, NOS",,,28,,NW,,,,,,$24.48,$0.00,1,1,1,0,0,1,20161001,,,,
V2020,HCPCS,VISION SVCS FRAMES PURCHASES,,,28,,NW,,,,,,$126.72,$0.00,1,1,1,1,1,1,20161001,,,,
V2025,HCPCS,EYEGLASSES DELUX FRAMES,,,28,,NW,,,,,,$82.94,$0.00,1,1,1,1,1,1,20161001,,,,
V2100,HCPCS,LENS SPHER SINGLE PLANO 4.00,,,28,,NW,,,,,,$76.27,$0.00,1,1,1,1,1,1,20161001,,,,
V2101,HCPCS,SINGLE VISN SPHERE 4.12-7.00,,,28,,NW,,,,,,$79.08,$0.00,1,1,1,1,1,1,20161001,,,,
V2102,HCPCS,SINGL VISN SPHERE 7.12-20.00,,,28,,NW,,,,,,$91.29,$0.00,1,1,1,1,1,1,20161001,,,,
V2103,HCPCS,SPHEROCYLINDR 4.00D/12-2.00D,,,28,,NW,,,,,,$72.18,$0.00,1,1,1,1,1,1,20161001,,,,
V2104,HCPCS,SPHEROCYLINDR 4.00D/2.12-4D,,,28,,NW,,,,,,$74.65,$0.00,1,1,1,1,1,1,20161001,,,,
V2105,HCPCS,SPHEROCYLINDER 4.00D/4.25-6D,,,28,,NW,,,,,,$77.93,$0.00,1,1,1,1,1,1,20161001,,,,
V2106,HCPCS,SPHEROCYLINDER 4.00D/>6.00D,,,28,,NW,,,,,,$81.73,$0.00,1,1,1,1,1,1,20161001,,,,
V2107,HCPCS,SPHEROCYLINDER 4.25D/12-2D,,,28,,NW,,,,,,$81.28,$0.00,1,1,1,1,1,1,20161001,,,,
V2108,HCPCS,SPHEROCYLINDER 4.25D/2.12-4D,,,28,,NW,,,,,,$81.23,$0.00,1,1,1,1,1,1,20161001,,,,
V2109,HCPCS,SPHEROCYLINDER 4.25D/4.25-6D,,,28,,NW,,,,,,$86.22,$0.00,1,1,1,1,1,1,20161001,,,,
V2110,HCPCS,SPHEROCYLINDER 4.25D/OVER 6D,,,28,,NW,,,,,,$84.66,$0.00,1,1,1,1,1,1,20161001,,,,
V2111,HCPCS,SPHEROCYLINDR 7.25D/.25-2.25,,,28,,NW,,,,,,$87.24,$0.00,1,1,1,1,1,1,20161001,,,,
V2112,HCPCS,SPHEROCYLINDR 7.25D/2.25-4D,,,28,,NW,,,,,,$91.44,$0.00,1,1,1,1,1,1,20161001,,,,
V2113,HCPCS,SPHEROCYLINDR 7.25D/4.25-6D,,,28,,NW,,,,,,$96.52,$0.00,1,1,1,1,1,1,20161001,,,,
V2114,HCPCS,SPHEROCYLINDER OVER 12.00D,,,28,,NW,,,,,,$100.91,$0.00,1,1,1,1,1,1,20161001,,,,
V2115,HCPCS,LENS LENTICULAR BIFOCAL,,,28,,NW,,,,,,$104.92,$0.00,1,1,1,1,1,1,20161001,,,,
V2118,HCPCS,LENS ANISEIKONIC SINGLE,,,28,,NW,,,,,,$105.39,$0.00,1,1,1,1,1,1,20161001,,,,
V2121,HCPCS,"LENTICULAR LENS, SINGLE",,,28,,NW,,,,,,$106.75,$0.00,1,1,1,1,1,1,20161001,,,,
V2199,HCPCS,LENS SINGLE VISION NOT OTH C,,,28,,NW,,,,,,$76.27,$0.00,1,1,1,1,1,1,20161001,,,,
V2200,HCPCS,LENS SPHER BIFOC PLANO 4.00D,,,28,,NW,,,,,,$85.65,$0.00,1,1,1,1,1,1,20161001,,,,
V2201,HCPCS,LENS SPHERE BIFOCAL 4.12-7.0,,,28,,NW,,,,,,$89.79,$0.00,1,1,1,1,1,1,20161001,,,,
V2202,HCPCS,LENS SPHERE BIFOCAL 7.12-20.,,,28,,NW,,,,,,$95.71,$0.00,1,1,1,1,1,1,20161001,,,,
V2203,HCPCS,LENS SPHCYL BIFOCAL 4.00D/.1,,,28,,NW,,,,,,$86.50,$0.00,1,1,1,1,1,1,20161001,,,,
V2204,HCPCS,LENS SPHCY BIFOCAL 4.00D/2.1,,,28,,NW,,,,,,$88.09,$0.00,1,1,1,1,1,1,20161001,,,,
V2205,HCPCS,LENS SPHCY BIFOCAL 4.00D/4.2,,,28,,NW,,,,,,$91.04,$0.00,1,1,1,1,1,1,20161001,,,,
V2206,HCPCS,LENS SPHCY BIFOCAL 4.00D/OVE,,,28,,NW,,,,,,$95.73,$0.00,1,1,1,1,1,1,20161001,,,,
V2207,HCPCS,LENS SPHCY BIFOCAL 4.25-7D/.,,,28,,NW,,,,,,$90.71,$0.00,1,1,1,1,1,1,20161001,,,,
V2208,HCPCS,LENS SPHCY BIFOCAL 4.25-7/2.,,,28,,NW,,,,,,$92.89,$0.00,1,1,1,1,1,1,20161001,,,,
V2209,HCPCS,LENS SPHCY BIFOCAL 4.25-7/4.,,,28,,NW,,,,,,$95.71,$0.00,1,1,1,1,1,1,20161001,,,,
V2210,HCPCS,LENS SPHCY BIFOCAL 4.25-7/OV,,,28,,NW,,,,,,$101.83,$0.00,1,1,1,1,1,1,20161001,,,,
V2211,HCPCS,LENS SPHCY BIFO 7.25-12/.25-,,,28,,NW,,,,,,$102.55,$0.00,1,1,1,1,1,1,20161001,,,,
V2212,HCPCS,LENS SPHCYL BIFO 7.25-12/2.2,,,28,,NW,,,,,,$104.20,$0.00,1,1,1,1,1,1,20161001,,,,
V2213,HCPCS,LENS SPHCYL BIFO 7.25-12/4.2,,,28,,NW,,,,,,$104.47,$0.00,1,1,1,1,1,1,20161001,,,,
V2214,HCPCS,LENS SPHCYL BIFOCAL OVER 12.,,,28,,NW,,,,,,$110.35,$0.00,1,1,1,1,1,1,20161001,,,,
V2215,HCPCS,LENS LENTICULAR BIFOCAL,,,28,,NW,,,,,,$116.08,$0.00,1,1,1,1,1,1,20161001,,,,
V2218,HCPCS,LENS ANISEIKONIC BIFOCAL,,,28,,NW,,,,,,$123.78,$0.00,1,1,1,1,1,1,20161001,,,,
V2219,HCPCS,LENS BIFOCAL SEG WIDTH OVER,,,28,,NW,,,,,,$79.94,$0.00,1,1,1,1,1,1,20161001,,,,
V2220,HCPCS,LENS BIFOCAL ADD OVER 3.25D,,,28,,NW,,,,,,$75.14,$0.00,1,1,1,1,1,1,20161001,,,,
V2221,HCPCS,"LENTICULAR LENS, BIFOCAL",,,28,,NW,,,,,,$115.16,$0.00,1,1,1,1,1,1,20161001,,,,
V2299,HCPCS,LENS BIFOCAL SPECIALITY,,,28,,NW,,,,,,$70.19,$0.00,1,1,1,1,1,1,20161001,,,,
V2300,HCPCS,LENS SPHERE TRIFOCAL 4.00D,,,28,,NW,,,,,,$96.84,$0.00,1,1,1,1,1,1,20161001,,,,
V2301,HCPCS,LENS SPHERE TRIFOCAL 4.12-7.,,,28,,NW,,,,,,$106.45,$0.00,1,1,1,1,1,1,20161001,,,,
V2302,HCPCS,LENS SPHERE TRIFOCAL 7.12-20,,,28,,NW,,,,,,$107.83,$0.00,1,1,1,1,1,1,20161001,,,,
V2303,HCPCS,LENS SPHCY TRIFOCAL 4.0/.12-,,,28,,NW,,,,,,$96.50,$0.00,1,1,1,1,1,1,20161001,,,,
V2304,HCPCS,LENS SPHCY TRIFOCAL 4.0/2.25,,,28,,NW,,,,,,$98.58,$0.00,1,1,1,1,1,1,20161001,,,,
V2305,HCPCS,LENS SPHCY TRIFOCAL 4.0/4.25,,,28,,NW,,,,,,$105.90,$0.00,1,1,1,1,1,1,20161001,,,,
V2306,HCPCS,LENS SPHCYL TRIFOCAL 4.00/>6,,,28,,NW,,,,,,$107.86,$0.00,1,1,1,1,1,1,20161001,,,,
V2307,HCPCS,LENS SPHCY TRIFOCAL 4.25-7/.,,,28,,NW,,,,,,$104.64,$0.00,1,1,1,1,1,1,20161001,,,,
V2308,HCPCS,LENS SPHC TRIFOCAL 4.25-7/2.,,,28,,NW,,,,,,$107.08,$0.00,1,1,1,1,1,1,20161001,,,,
V2309,HCPCS,LENS SPHC TRIFOCAL 4.25-7/4.,,,28,,NW,,,,,,$113.93,$0.00,1,1,1,1,1,1,20161001,,,,
V2310,HCPCS,LENS SPHC TRIFOCAL 4.25-7/>6,,,28,,NW,,,,,,$113.05,$0.00,1,1,1,1,1,1,20161001,,,,
V2311,HCPCS,LENS SPHC TRIFO 7.25-12/.25-,,,28,,NW,,,,,,$117.86,$0.00,1,1,1,1,1,1,20161001,,,,
V2312,HCPCS,LENS SPHC TRIFO 7.25-12/2.25,,,28,,NW,,,,,,$116.41,$0.00,1,1,1,1,1,1,20161001,,,,
V2313,HCPCS,LENS SPHC TRIFO 7.25-12/4.25,,,28,,NW,,,,,,$126.47,$0.00,1,1,1,1,1,1,20161001,,,,
V2314,HCPCS,LENS SPHCYL TRIFOCAL OVER 12,,,28,,NW,,,,,,$130.22,$0.00,1,1,1,1,1,1,20161001,,,,
V2315,HCPCS,LENS LENTICULAR TRIFOCAL,,,28,,NW,,,,,,$141.81,$0.00,1,1,1,1,1,1,20161001,,,,
V2318,HCPCS,LENS ANISEIKONIC TRIFOCAL,,,28,,NW,,,,,,$162.81,$0.00,1,1,1,1,1,1,20161001,,,,
V2319,HCPCS,LENS TRIFOCAL SEG WIDTH > 28,,,28,,NW,,,,,,$84.21,$0.00,1,1,1,1,1,1,20161001,,,,
V2320,HCPCS,LENS TRIFOCAL ADD OVER 3.25D,,,28,,NW,,,,,,$88.53,$0.00,1,1,1,1,1,1,20161001,,,,
V2321,HCPCS,"LENTICULAR LENS, TRIFOCAL",,,28,,NW,,,,,,$139.86,$0.00,1,1,1,1,1,1,20161001,,,,
V2399,HCPCS,LENS TRIFOCAL SPECIALITY,,,28,,NW,,,,,,$171.01,$0.00,1,1,1,1,1,1,20161001,,,,
V2410,HCPCS,LENS VARIAB ASPHERICITY SING,,,28,,NW,,,,,,$118.39,$0.00,1,1,1,1,1,1,20161001,,,,
V2430,HCPCS,LENS VARIABLE ASPHERICITY BI,,,28,,NW,,,,,,$131.73,$0.00,1,1,1,1,1,1,20161001,,,,
V2499,HCPCS,VARIABLE ASPHERICITY LENS,,,28,,NW,,,,,,$126.21,$0.00,1,1,1,1,1,1,20161001,,,,
V2500,HCPCS,CONTACT LENS PMMA SPHERICAL,,,28,,NW,,,,,,$111.00,$0.00,1,1,1,1,1,1,20161001,,,,
V2501,HCPCS,CNTCT LENS PMMA-TORIC/PRISM,,,28,,NW,,,,,,$142.70,$0.00,1,1,1,1,1,1,20161001,,,,
V2502,HCPCS,CONTACT LENS PMMA BIFOCAL,,,28,,NW,,,,,,$170.44,$0.00,1,1,1,1,1,1,20161001,,,,
V2503,HCPCS,CNTCT LENS PMMA COLOR VISION,,,28,,NW,,,,,,$156.67,$0.00,1,1,1,1,1,1,20161001,,,,
V2510,HCPCS,CNTCT GAS PERMEABLE SPHERICL,,,28,,NW,,,,,,$134.26,$0.00,1,1,1,1,1,1,20161001,,,,
V2511,HCPCS,CNTCT TORIC PRISM BALLAST,,,28,,NW,,,,,,$175.15,$0.00,1,1,1,1,1,1,20161001,,,,
V2512,HCPCS,CNTCT LENS GAS PERMBL BIFOCL,,,28,,NW,,,,,,$199.77,$0.00,1,1,1,1,1,1,20161001,,,,
V2513,HCPCS,CONTACT LENS EXTENDED WEAR,,,28,,NW,,,,,,$179.72,$0.00,1,1,1,1,1,1,20161001,,,,
V2520,HCPCS,CONTACT LENS HYDROPHILIC,,,28,,NW,,,,,,$128.72,$0.00,1,1,1,1,1,1,20161001,,,,
V2521,HCPCS,CNTCT LENS HYDROPHILIC TORIC,,,28,,NW,,,,,,$189.50,$0.00,1,1,1,1,1,1,20161001,,,,
V2522,HCPCS,CNTCT LENS HYDROPHIL BIFOCL,,,28,,NW,,,,,,$190.73,$0.00,1,1,1,1,1,1,20161001,,,,
V2523,HCPCS,CNTCT LENS HYDROPHIL EXTEND,,,28,,NW,,,,,,$165.26,$0.00,1,1,1,1,1,1,20161001,,,,
V2530,HCPCS,CONTACT LENS GAS IMPERMEABLE,,,28,,NW,,,,,,$221.68,$0.00,1,1,1,1,1,1,20161001,,,,
V2531,HCPCS,CONTACT LENS GAS PERMEABLE,,,28,,NW,,,,,,$428.65,$0.00,1,1,1,1,1,1,20161001,,,,
V2599,HCPCS,CONTACT LENS/ES OTHER TYPE,,,28,,NW,,,,,,$67.03,$0.00,1,1,1,1,1,1,20161001,,,,
V2600,HCPCS,HAND HELD LOW VISION AIDS,,,28,,NW,,,,,,$207.40,$0.00,1,1,1,1,1,1,20161001,,,,
V2610,HCPCS,SINGLE LENS SPECTACLE MOUNT,,,28,,NW,,,,,,$130.78,$0.00,1,1,1,1,1,1,20161001,,,,
V2615,HCPCS,TELESCOP/OTHR COMPOUND LENS,,,28,,NW,,,,,,$438.33,$0.00,1,1,1,1,1,1,20161001,,,,
V2623,HCPCS,PLASTIC EYE PROSTH CUSTOM,,,28,,NW,,,,,,"$2,860.62",$0.00,1,1,1,1,1,1,20161001,,,,
V2624,HCPCS,POLISHING ARTIFICAL EYE,,,28,,NW,,,,,,$75.28,$0.00,1,1,1,1,1,1,20161001,,,,
V2625,HCPCS,ENLARGEMNT OF EYE PROSTHESIS,,,28,,NW,,,,,,"$1,518.94",$0.00,1,1,1,1,1,1,20161001,,,,
V2626,HCPCS,REDUCTION OF EYE PROSTHESIS,,,28,,NW,,,,,,$890.73,$0.00,1,1,1,1,1,1,20161001,,,,
V2627,HCPCS,SCLERAL COVER SHELL,,,28,,NW,,,,,,"$3,709.53",$0.00,1,1,1,1,1,1,20161001,,,,
V2628,HCPCS,FABRICATION & FITTING,,,28,,NW,,,,,,"$1,323.26",$0.00,1,1,1,1,1,1,20161001,,,,
V2629,HCPCS,PROSTHETIC EYE OTHER TYPE,,,28,,NW,,,,,,$975.87,$0.00,1,1,1,1,1,1,20161001,,,,
V2630,HCPCS,ANTER CHAMBER INTRAOCUL LENS,,,28,,NW,,,,,,$373.02,$0.00,1,1,1,0,1,1,20161001,,,,
V2631,HCPCS,IRIS SUPPORT INTRAOCLR LENS,,,28,,NW,,,,,,$373.02,$0.00,1,1,1,0,1,1,20161001,,,,
V2632,HCPCS,POST CHMBR INTRAOCULAR LENS,,,28,,NW,,,,,,$373.02,$0.00,1,1,1,0,1,1,20161001,,,,
V2700,HCPCS,BALANCE LENS,,,28,,NW,,,,,,$80.11,$0.00,1,1,1,1,1,1,20161001,,,,
V2702,HCPCS,DELUXE LENS FEATURE,,,28,,NW,,,,,,$21.86,$0.00,1,1,1,1,1,1,20161001,,,,
V2710,HCPCS,GLASS/PLASTIC SLAB OFF PRISM,,,28,,NW,,,,,,$97.59,$0.00,1,1,1,1,1,1,20161001,,,,
V2715,HCPCS,PRISM LENS/ES,,,28,,NW,,,,,,$17.51,$0.00,1,1,1,1,1,1,20161001,,,,
V2718,HCPCS,FRESNELL PRISM PRESS-ON LENS,,,28,,NW,,,,,,$67.87,$0.00,1,1,1,1,1,1,20161001,,,,
V2730,HCPCS,SPECIAL BASE CURVE,,,28,,NW,,,,,,$61.84,$0.00,1,1,1,1,1,1,20161001,,,,
V2744,HCPCS,TINT PHOTOCHROMATIC LENS/ES,,,28,,NW,,,,,,$44.81,$0.00,1,1,1,1,1,1,20161001,,,,
V2745,HCPCS,"TINT, ANY COLOR/SOLID/GRAD",,,28,,NW,,,,,,$7.06,$0.00,1,1,1,1,1,1,20161001,,,,
V2750,HCPCS,ANTI-REFLECTIVE COATING,,,28,,NW,,,,,,$60.90,$0.00,1,1,1,1,1,1,20161001,,,,
V2755,HCPCS,UV LENS/ES,,,28,,NW,,,,,,$42.82,$0.00,1,1,1,1,1,1,20161001,,,,
V2756,HCPCS,EYE GLASS CASE,,,28,,NW,,,,,,$4.15,$0.00,1,1,1,1,1,1,20161001,,,,
V2760,HCPCS,SCRATCH RESISTANT COATING,,,28,,NW,,,,,,$42.68,$0.00,1,1,1,1,1,1,20161001,,,,
V2761,HCPCS,MIRROR COATING,,,28,,NW,,,,,,$34.06,$0.00,1,1,1,1,1,1,20161001,,,,
V2762,HCPCS,"POLARIZATION, ANY LENS",,,28,,NW,,,,,,$87.02,$0.00,1,1,1,1,1,1,20161001,,,,
V2770,HCPCS,OCCLUDER LENS/ES,,,28,,NW,,,,,,$60.60,$0.00,1,1,1,1,1,1,20161001,,,,
V2780,HCPCS,OVERSIZE LENS/ES,,,28,,NW,,,,,,$20.62,$0.00,1,1,1,1,1,1,20161001,,,,
V2781,HCPCS,PROGRESSIVE LENS PER LENS,,,28,,NW,,,,,,$80.14,$0.00,1,1,1,1,1,1,20161001,,,,
V2782,HCPCS,"LENS, 1.54-1.65 P/1.60-1.79G",,,28,,NW,,,,,,$90.39,$0.00,1,1,1,1,1,1,20161001,,,,
V2783,HCPCS,"LENS, >= 1.66 P/>=1.80 G",,,28,,NW,,,,,,$96.18,$0.00,1,1,1,1,1,1,20161001,,,,
V2784,HCPCS,LENS POLYCARB OR EQUAL,,,28,,NW,,,,,,$78.27,$0.00,1,1,1,1,1,1,20161001,,,,
V2785,HCPCS,CORNEAL TISSUE PROCESSING,,,28,,NW,,,,,,"$4,902.92",$0.00,1,1,1,1,1,1,20161001,,,,
V2786,HCPCS,OCCUPATIONAL MULTIFOCAL LENS,,,28,,NW,,,,,,$128.53,$0.00,1,1,1,1,1,1,20161001,,,,
V2787,HCPCS,ASTIGMATISM-CORRECT FUNCTION,,,28,,NW,,,,,,$728.54,$0.00,1,1,1,1,1,1,20161001,,,,
V2788,HCPCS,PRESBYOPIA-CORRECT FUNCTION,,,28,,NW,,,,,,"$1,522.66",$0.00,1,1,1,1,1,1,20161001,,,,
V2790,HCPCS,AMNIOTIC MEMBRANE,,,28,,NW,,,,,,"$1,024.24",$0.00,1,1,1,0,1,1,20161001,,,,
V2797,HCPCS,VIS ITEM/SVC IN OTHER CODE,,,28,,NW,,,,,,$248.06,$0.00,1,1,1,1,1,1,20161001,,,,
V2799,HCPCS,MISC VISION ITEM OR SERVICE,,,28,,NW,,,,,,$77.20,$0.00,1,1,1,0,1,1,20161001,,,,
V5008,HCPCS,HEARING SCREENING,,,8,,TotalUnits,,,,1.18 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
V5010,HCPCS,ASSESSMENT FOR HEARING AID,,,8,,TotalUnits,,,,1.55 ,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
V5011,HCPCS,HEARING AID FITTING/CHECKING,,,28,,NW,,,,,,$147.09,$0.00,1,1,1,1,1,1,20161001,,,,
V5014,HCPCS,HEARING AID REPAIR/MODIFYING,,,28,,NW,,,,,,$137.32,$0.00,1,1,1,1,1,1,20161001,,,,
V5020,HCPCS,CONFORMITY EVALUATION,,,28,,NW,,,,,,$91.08,$0.00,1,1,1,1,1,1,20161001,,,,
V5030,HCPCS,BODY-WORN HEARING AID AIR,,,28,,NW,,,,,,"$2,763.03",$0.00,1,1,1,1,1,1,20161001,,,,
V5040,HCPCS,BODY-WORN HEARING AID BONE,,,28,,NW,,,,,,"$2,034.00",$0.00,1,1,1,1,1,1,20161001,,,,
V5050,HCPCS,HEARING AID MONAURAL IN EAR,,,28,,NW,,,,,,"$2,394.07",$0.00,1,1,1,1,1,1,20161001,,,,
V5060,HCPCS,BEHIND EAR HEARING AID,,,28,,NW,,,,,,"$1,955.46",$0.00,1,1,1,1,1,1,20161001,,,,
V5070,HCPCS,GLASSES AIR CONDUCTION,,,28,,NW,,,,,,$964.15,$0.00,1,1,1,1,1,1,20161001,,,,
V5080,HCPCS,GLASSES BONE CONDUCTION,,,28,,NW,,,,,,"$2,840.08",$0.00,1,1,1,1,1,1,20161001,,,,
V5090,HCPCS,HEARING AID DISPENSING FEE,,,28,,NW,,,,,,$665.88,$0.00,1,1,1,1,1,1,20161001,,,,
V5100,HCPCS,BODY-WORN BILAT HEARING AID,,,28,,NW,,,,,,"$4,723.42",$0.00,1,1,1,1,1,1,20161001,,,,
V5110,HCPCS,HEARING AID DISPENSING FEE,,,28,,NW,,,,,,$683.04,$0.00,1,1,1,1,1,1,20161001,,,,
V5120,HCPCS,BODY-WORN BINAUR HEARING AID,,,28,,NW,,,,,,"$4,093.66",$0.00,1,1,1,1,1,1,20161001,,,,
V5130,HCPCS,IN EAR BINAURAL HEARING AID,,,28,,NW,,,,,,"$4,373.72",$0.00,1,1,1,1,1,1,20161001,,,,
V5140,HCPCS,BEHIND EAR BINAUR HEARING AI,,,28,,NW,,,,,,"$4,558.94",$0.00,1,1,1,1,1,1,20161001,,,,
V5150,HCPCS,GLASSES BINAURAL HEARING AID,,,28,,NW,,,,,,"$4,886.41",$0.00,1,1,1,1,1,1,20161001,,,,
V5160,HCPCS,DISPENSING FEE BINAURAL,,,28,,NW,,,,,,"$1,073.80",$0.00,1,1,1,1,1,1,20161001,,,,
V5170,HCPCS,WITHIN EAR CROS HEARING AID,,,28,,NW,,,,,,"$3,314.25",$0.00,1,1,1,1,1,1,20161001,,,,
V5180,HCPCS,BEHIND EAR CROS HEARING AID,,,28,,NW,,,,,,"$2,763.03",$0.00,1,1,1,1,1,1,20161001,,,,
V5190,HCPCS,GLASSES CROS HEARING AID,,,28,,NW,,,,,,"$3,275.72",$0.00,1,1,1,1,1,1,20161001,,,,
V5200,HCPCS,CROS HEARING AID DISPENS FEE,,,28,,NW,,,,,,$672.18,$0.00,1,1,1,1,1,1,20161001,,,,
V5210,HCPCS,IN EAR BICROS HEARING AID,,,28,,NW,,,,,,"$3,625.42",$0.00,1,1,1,1,1,1,20161001,,,,
V5220,HCPCS,BEHIND EAR BICROS HEARING AI,,,28,,NW,,,,,,"$3,472.80",$0.00,1,1,1,1,1,1,20161001,,,,
V5230,HCPCS,GLASSES BICROS HEARING AID,,,28,,NW,,,,,,"$3,598.75",$0.00,1,1,1,1,1,1,20161001,,,,
V5240,HCPCS,DISPENSING FEE BICROS,,,28,,NW,,,,,,$714.87,$0.00,1,1,1,1,1,1,20161001,,,,
V5241,HCPCS,"DISPENSING FEE, MONAURAL",,,28,,NW,,,,,,$460.58,$0.00,1,1,1,1,1,1,20161001,,,,
V5242,HCPCS,"HEARING AID, MONAURAL, CIC",,,28,,NW,,,,,,"$1,963.63",$0.00,1,1,1,1,1,1,20161001,,,,
V5243,HCPCS,"HEARING AID, MONAURAL, ITC",,,28,,NW,,,,,,"$2,068.29",$0.00,1,1,1,1,1,1,20161001,,,,
V5244,HCPCS,"HEARING AID, PROG, MON, CIC",,,28,,NW,,,,,,"$2,720.12",$0.00,1,1,1,1,1,1,20161001,,,,
V5245,HCPCS,"HEARING AID, PROG, MON, ITC",,,28,,NW,,,,,,"$3,160.01",$0.00,1,1,1,1,1,1,20161001,,,,
V5246,HCPCS,"HEARING AID, PROG, MON, ITE",,,28,,NW,,,,,,"$2,297.17",$0.00,1,1,1,1,1,1,20161001,,,,
V5247,HCPCS,"HEARING AID, PROG, MON, BTE",,,28,,NW,,,,,,"$2,736.47",$0.00,1,1,1,1,1,1,20161001,,,,
V5248,HCPCS,"HEARING AID, BINAURAL, CIC",,,28,,NW,,,,,,"$2,528.15",$0.00,1,1,1,1,1,1,20161001,,,,
V5249,HCPCS,"HEARING AID, BINAURAL, ITC",,,28,,NW,,,,,,"$2,027.06",$0.00,1,1,1,1,1,1,20161001,,,,
V5250,HCPCS,"HEARING AID, PROG, BIN, CIC",,,28,,NW,,,,,,"$6,570.10",$0.00,1,1,1,1,1,1,20161001,,,,
V5251,HCPCS,"HEARING AID, PROG, BIN, ITC",,,28,,NW,,,,,,"$5,875.89",$0.00,1,1,1,1,1,1,20161001,,,,
V5252,HCPCS,"HEARING AID, PROG, BIN, ITE",,,28,,NW,,,,,,"$8,394.35",$0.00,1,1,1,1,1,1,20161001,,,,
V5253,HCPCS,"HEARING AID, PROG, BIN, BTE",,,28,,NW,,,,,,"$3,900.46",$0.00,1,1,1,1,1,1,20161001,,,,
V5254,HCPCS,"HEARING ID, DIGIT, MON, CIC",,,28,,NW,,,,,,"$4,388.54",$0.00,1,1,1,1,1,1,20161001,,,,
V5255,HCPCS,"HEARING AID, DIGIT, MON, ITC",,,28,,NW,,,,,,"$2,798.01",$0.00,1,1,1,1,1,1,20161001,,,,
V5256,HCPCS,"HEARING AID, DIGIT, MON, ITE",,,28,,NW,,,,,,"$2,302.89",$0.00,1,1,1,1,1,1,20161001,,,,
V5257,HCPCS,"HEARING AID, DIGIT, MON, BTE",,,28,,NW,,,,,,"$3,300.81",$0.00,1,1,1,1,1,1,20161001,,,,
V5258,HCPCS,"HEARING AID, DIGIT, BIN, CIC",,,28,,NW,,,,,,"$6,125.69",$0.00,1,1,1,1,1,1,20161001,,,,
V5259,HCPCS,"HEARING AID, DIGIT, BIN, ITC",,,28,,NW,,,,,,"$4,605.78",$0.00,1,1,1,1,1,1,20161001,,,,
V5260,HCPCS,"HEARING AID, DIGIT, BIN, ITE",,,28,,NW,,,,,,"$4,298.73",$0.00,1,1,1,1,1,1,20161001,,,,
V5261,HCPCS,"HEARING AID, DIGIT, BIN, BTE",,,28,,NW,,,,,,"$5,373.42",$0.00,1,1,1,1,1,1,20161001,,,,
V5262,HCPCS,"HEARING AID, DISP, MONAURAL",,,28,,NW,,,,,,$277.20,$0.00,1,1,1,1,1,1,20161001,,,,
V5263,HCPCS,"HEARING AID, DISP, BINAURAL",,,28,,NW,,,,,,$211.44,$0.00,1,1,1,1,1,1,20161001,,,,
V5264,HCPCS,EAR MOLD/INSERT,,,28,,NW,,,,,,$115.14,$0.00,1,1,1,1,1,1,20161001,,,,
V5265,HCPCS,"EAR MOLD/INSERT, DISP",,,28,,NW,,,,,,$61.41,$0.00,1,1,1,1,1,1,20161001,,,,
V5266,HCPCS,BATTERY FOR HEARING DEVICE,,,28,,NW,,,,,,$1.92,$0.00,1,1,1,1,1,1,20161001,,,,
V5267,HCPCS,HEARING AID SUP/ACCESS/DEV,,,28,,NW,,,,,,$10.75,$0.00,1,1,1,1,1,1,20161001,,,,
V5268,HCPCS,ALD TELEPHONE AMPLIFIER,,,28,,NW,,,,,,$123.84,$0.00,1,1,1,1,1,1,20161001,,,,
V5269,HCPCS,"ALERTING DEVICE, ANY TYPE",,,28,,NW,,,,,,$88.69,$0.00,1,1,1,1,1,1,20161001,,,,
V5270,HCPCS,"ALD, TV AMPLIFIER, ANY TYPE",,,28,,NW,,,,,,$299.54,$0.00,1,1,1,1,1,1,20161001,,,,
V5271,HCPCS,"ALD, TV CAPTION DECODER",,,28,,NW,,,,,,$484.03,$0.00,1,1,1,1,1,1,20161001,,,,
V5272,HCPCS,TDD,,,28,,NW,,,,,,$343.31,$0.00,1,1,1,1,1,1,20161001,,,,
V5273,HCPCS,ALD FOR COCHLEAR IMPLANT,,,28,,NW,,,,,,$720.24,$0.00,1,1,1,1,1,1,20161001,,,,
V5274,HCPCS,ALD UNSPECIFIED,,,28,,NW,,,,,,$161.48,$0.00,1,1,1,1,1,1,20161001,,,,
V5275,HCPCS,EAR IMPRESSION,,,28,,NW,,,,,,$46.06,$0.00,1,1,1,1,1,1,20161001,,,,
V5281,HCPCS,"ALD FM/DM SYSTEM, MONAURAL",,,28,,NW,,,,,,$183.50,$0.00,1,1,1,1,1,1,20161001,,,,
V5282,HCPCS,ALD FM/DM SYSTEM BINAURAL,,,28,,NW,,,,,,$563.06,$0.00,1,1,1,1,1,1,20161001,,,,
V5283,HCPCS,"ALD NECK, LOOP IND RECEIVER",,,28,,NW,,,,,,$316.97,$0.00,1,1,1,1,1,1,20161001,,,,
V5284,HCPCS,ALD FM/DM EAR LEVEL RECEIVER,,,28,,NW,,,,,,$549.36,$0.00,1,1,1,1,1,1,20161001,,,,
V5285,HCPCS,ALD FM/DM AUD INPUT RECEIVER,,,28,,NW,,,,,,$783.37,$0.00,1,1,1,1,1,1,20161001,,,,
V5286,HCPCS,ALD BLU TOOTH FM/DM RECEIVER,,,28,,NW,,,,,,$317.74,$0.00,1,1,1,1,1,1,20161001,,,,
V5287,HCPCS,"ALD FM/DM RECEIVER, NOS",,,28,,NW,,,,,,$414.23,$0.00,1,1,1,1,1,1,20161001,,,,
V5288,HCPCS,ALD FM/DM TRANSMITTER ALD,,,28,,NW,,,,,,$241.88,$0.00,1,1,1,1,1,1,20161001,,,,
V5289,HCPCS,ALD FM/DM ADAPT/BOOT COUPLIN,,,28,,NW,,,,,,$125.08,$0.00,1,1,1,1,1,1,20161001,,,,
V5290,HCPCS,ALD TRANSMITTER MICROPHONE,,,28,,NW,,,,,,$586.24,$0.00,1,1,1,1,1,1,20161001,,,,
V5298,HCPCS,HEARING AID NOC,,,28,,NW,,,,,,"$2,048.17",$0.00,1,1,1,1,1,1,20161001,,,,
V5299,HCPCS,HEARING SERVICE,,,28,,NW,,,,,,$85.05,$0.00,1,1,1,0,0,1,20161001,,,,
V5362,HCPCS,SPEECH SCREENING,,,8,,RBRVS,0.86 ,0.28 ,3.50 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
V5363,HCPCS,LANGUAGE SCREENING,,,8,,RBRVS,0.86 ,0.28 ,3.50 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,
V5364,HCPCS,DYSPHAGIA SCREENING,,,8,,RBRVS,,1.70 ,1.70 ,,,$0.00,$0.00,1,1,1,0,0,1,20161001,,,,