2023-04-13T13:21:00 CPT®2023 American Medical Association.  All Rights Reserved. This is the hospital’s machine-readable pricing file and does NOT contain patient’s out-of-pocket cost information; patients are encouraged to use the online patient estimation tool for an estimate of out-of-pocket costs specific to a medical service. This file identifies an individual item/service charge and the contracted rate negotiated between payer and provider for the single item/service. If NA is listed for an item/service for a payer or the discounted cash charge, the contracted rates negotiated between payer and provider were either not found within the payer contract, are bundled with other services, or reimburse using a different code set. Contracts are often complex and the rates contained in this file may not reflect actual negotiated rates or final charges once services are rendered. The information is not an estimate of out-of-pocket costs, nor is it a guarantee of payment or benefits for healthcare services. Anesthesia for procedures on salivary glands, including biopsy 15.0000 Minutes 11236.10 7865.2700 4831.52 11236.10 Anesthesia for reconstructive procedures of eyelid (eg, blepharoplasty, ptosis surgery) 15.0000 Minutes 8572.51 6000.7600 3686.18 8572.51 Anesthesia for procedures on external, middle, and inner ear including biopsy; not otherwise specified 15.0000 Minutes 8881.00 6216.7000 3818.83 8881.00 Anesthesia for procedures on external, middle, and inner ear including biopsy; otoscopy 15.0000 Minutes 9364.17 6554.9200 4026.59 9364.17 Anesthesia for procedures on external, middle, and inner ear including biopsy; tympanotomy 15.0000 Minutes 4924.07 3446.8500 2117.35 4924.07 Anesthesia for procedures on eye; not otherwise specified 15.0000 Minutes 9715.30 6800.7100 4177.58 9715.30 Anesthesia for procedures on eye; lens surgery 15.0000 Minutes 10643.08 7450.1500 4576.52 10643.08 Anesthesia for procedures on eye; vitreoretinal surgery 15.0000 Minutes 18198.64 12739.0500 7825.42 18198.64 Anesthesia for procedures on eye; ophthalmoscopy 15.0000 Minutes 6544.88 4581.4200 2814.30 6544.88 Anesthesia for procedures on nose and accessory sinuses; not otherwise specified 15.0000 Minutes 7153.17 5007.2200 3075.86 7153.17 Anesthesia for procedures on nose and accessory sinuses; radical surgery 15.0000 Minutes 19960.27 13972.1900 8582.91 19960.26 Anesthesia for intraoral procedures, including biopsy; not otherwise specified 15.0000 Minutes 9343.48 6540.4400 4017.70 9343.48 Anesthesia for procedures on facial bones or skull; not otherwise specified 15.0000 Minutes 13194.89 9236.4200 5673.80 13194.88 Anesthesia for procedures on facial bones or skull; radical surgery (including prognathism) 15.0000 Minutes 12849.59 8994.7100 172.08 12849.59 Anesthesia for intracranial procedures; not otherwise specified 15.0000 Minutes 10799.91 7559.9300 4643.96 10799.91 Anesthesia for intracranial procedures; cranioplasty or elevation of depressed skull fracture, extradural (simple or compound) 15.0000 Minutes 14516.14 10161.2900 215.10 14516.14 Anesthesia for intracranial procedures; cerebrospinal fluid shunting procedures 15.0000 Minutes 14973.59 10481.5100 6438.64 14973.58 Anesthesia for all procedures on the integumentary system, muscles and nerves of head, neck, and posterior trunk, not otherwise specified 15.0000 Minutes 13456.89 9419.8200 5786.46 13456.89 Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, DNA, spike protein, adenovirus type 26 (Ad26) vector, preservative free, 5x1010 viral particles/0.5 mL dosage; single dose 1.0000 each 48.00 33.6000 20.64 48.00 Anesthesia for all procedures on esophagus, thyroid, larynx, trachea and lymphatic system of neck; not otherwise specified, age 1 year or older 15.0000 Minutes 12327.33 8629.1300 5300.75 12327.33 Anesthesia for all procedures on the larynx and trachea in children younger than 1 year of age 15.0000 Minutes 6471.07 4529.7500 2782.56 6471.07 Anesthesia for procedures on major vessels of neck; not otherwise specified 15.0000 Minutes 7441.17 5208.8200 3199.70 7441.17 Anesthesia for procedures on major vessels of neck; simple ligation 15.0000 Minutes 7700.59 5390.4100 3311.25 7700.59 Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; not otherwise specified 15.0000 Minutes 11357.12 7949.9800 4883.56 11357.12 Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; reconstructive procedures on breast (eg, reduction or augmentation mammoplasty, muscle flaps) 15.0000 Minutes 15033.05 10523.1300 6464.21 15033.04 Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; radical or modified radical procedures on breast 15.0000 Minutes 8029.27 5620.4900 3452.58 8029.27 Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; electrical conversion of arrhythmias 15.0000 Minutes 6121.64 4285.1400 2632.30 6121.64 Cerebral perfusion analysis using computed tomography with contrast administration, including post-processing of parametric maps with determination of cerebral blood flow, cerebral blood volume, and mean transit time 1.0000 each 3131.00 2191.7000 700.00 3131.00 Anesthesia for procedures on clavicle and scapula; not otherwise specified 15.0000 Minutes 1943.62 1360.5300 835.76 1943.62 Anesthesia for partial rib resection; not otherwise specified 15.0000 Minutes 15782.48 11047.7300 6786.46 15782.48 Anesthesia for closed chest procedures; (including bronchoscopy) not otherwise specified 15.0000 Minutes 1737.08 1215.9600 746.94 1737.08 Anesthesia for permanent transvenous pacemaker insertion 15.0000 Minutes 14800.96 10360.6700 6364.41 14800.96 Anesthesia for access to central venous circulation 15.0000 Minutes 8144.79 5701.3500 3502.26 8144.78 Anesthesia for transvenous insertion or replacement of pacing cardioverter-defibrillator 15.0000 Minutes 13929.86 9750.9000 5989.84 13929.86 Anesthesia for cardiac electrophysiologic procedures including radiofrequency ablation 15.0000 Minutes 21708.00 15195.6000 9334.44 21708.00 Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on fluoroscopic images (List separately in addition to code for primary procedure) 1.0000 each 12489.06 8742.3400 1795.00 12489.06 Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on CT/MRI images (List separately in addition to code for primary procedure) 1.0000 each 12739.31 8917.5100 1795.00 12739.31 Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; without pump oxygenator 15.0000 Minutes 8614.73 6030.3100 344.16 8614.73 Anesthesia for procedures on cervical spine and cord; not otherwise specified 15.0000 Minutes 6500.89 4550.6300 2795.38 6500.89 Anesthesia for procedures on thoracic spine and cord, not otherwise specified 15.0000 Minutes 22120.67 15484.4700 9511.89 22120.67 Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; not utilizing 1 lung ventilation 15.0000 Minutes 3867.49 2707.2400 1663.02 3867.49 Anesthesia for procedures on the thoracic spine and cord, via an anterior transthoracic approach; utilizing 1 lung ventilation 15.0000 Minutes 6046.95 4232.8600 2600.19 6046.95 Anesthesia for procedures in lumbar region; not otherwise specified 15.0000 Minutes 14233.18 9963.2200 6120.27 14233.18 Anesthesia for procedures in lumbar region; diagnostic or therapeutic lumbar puncture 15.0000 Minutes 2239.91 1567.9300 963.16 2239.90 Anesthesia for manipulation of the spine or for closed procedures on the cervical, thoracic or lumbar spine 15.0000 Minutes 13824.90 9677.4300 5944.70 13824.90 Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, 50 mcg/0.25 mL dosage, booster dose 1.0000 each 48.00 33.6000 20.64 48.00 Anesthesia for extensive spine and spinal cord procedures (eg, spinal instrumentation or vascular procedures) 15.0000 Minutes 10228.24 7159.7700 4398.14 10228.24 Anesthesia for procedures on upper anterior abdominal wall; not otherwise specified 15.0000 Minutes 7618.57 5333.0000 3275.98 7618.56 Anesthesia for procedures on upper anterior abdominal wall; percutaneous liver biopsy 15.0000 Minutes 1788.00 1251.6000 768.84 1788.00 Anesthesia for procedures on upper posterior abdominal wall 15.0000 Minutes 656.35 459.4400 282.23 656.35 Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; not otherwise specified 15.0000 minutes 3241.20 2268.8400 1393.71 3241.20 Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenum; endoscopic retrograde cholangiopancreatography (ERCP) 1.0000 each 20793.61 14555.5300 8941.25 20793.61 Anesthesia for hernia repairs in upper abdomen; not otherwise specified 15.0000 Minutes 9786.70 6850.6900 4208.28 9786.70 Anesthesia for hernia repairs in upper abdomen; lumbar and ventral (incisional) hernias and/or wound dehiscence 15.0000 Minutes 11995.69 8396.9800 5158.15 11995.69 Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; initial vessel 1.0000 each 24400.24 17080.1700 3364.00 24400.24 Transcatheter placement of extracranial vertebral artery stent(s), including radiologic supervision and interpretation, open or percutaneous; each additional vessel (List separately in addition to code for primary procedure) 1.0000 each 24400.24 17080.1700 3364.00 24400.24 Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified 15.0000 Minutes 1546.04 1082.2200 664.80 1546.04 Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; gastric restrictive procedure for morbid obesity 15.0000 Minutes 12826.70 8978.6900 5515.48 12826.70 Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified 15.0000 Minutes 7997.37 5598.1600 3438.87 7997.37 Anesthesia for procedures on lower anterior abdominal wall; panniculectomy 15.0000 Minutes 15522.65 10865.8600 6674.74 15522.65 Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; not otherwise specified 15.0000 minutes 6584.76 4609.3300 2831.45 6584.76 Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy 15.0000 minutes 6797.55 4758.2800 2922.95 6797.55 Anesthesia for combined upper and lower gastrointestinal endoscopic procedures, endoscope introduced both proximal to and distal to the duodenum 15.0000 minutes 6335.23 4434.6600 2724.15 6335.23 Anesthesia for procedures on lower posterior abdominal wall 15.0000 Minutes 10265.82 7186.0700 4414.30 10265.82 Anesthesia for hernia repairs in lower abdomen; not otherwise specified 15.0000 Minutes 9714.61 6800.2300 4177.28 9714.61 Anesthesia for hernia repairs in lower abdomen; ventral and incisional hernias 15.0000 Minutes 12286.21 8600.3400 5283.07 12286.21 Anesthesia for hernia repairs in the lower abdomen not otherwise specified, younger than 1 year of age 15.0000 Minutes 8547.36 5983.1500 3675.36 8547.36 Anesthesia for hernia repairs in the lower abdomen not otherwise specified, infants younger than 37 weeks gestational age at birth and younger than 50 weeks gestational age at time of surgery 15.0000 Minutes 7403.03 5182.1200 3183.30 7403.03 Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified 15.0000 Minutes 1706.96 1194.8700 733.99 1706.96 Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy 15.0000 Minutes 20131.04 14091.7300 193.59 20131.04 Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; tubal ligation/transection 15.0000 Minutes 13150.67 9205.4700 5654.79 13150.66 Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; not otherwise specified 15.0000 Minutes 11508.68 8056.0800 4948.73 11508.68 Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal procedures, including upper one-third of ureter, or donor nephrectomy 15.0000 Minutes 10497.05 7347.9400 4513.73 10497.05 Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; radical prostatectomy (suprapubic, retropubic) 15.0000 Minutes 15362.67 10753.8700 6605.95 15362.67 Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; cystolithotomy 15.0000 Minutes 10182.27 7127.5900 4378.38 10182.27 Anesthesia for lithotripsy, extracorporeal shock wave; with water bath 15.0000 Minutes 12575.98 8803.1800 5407.67 12575.98 Anesthesia for lithotripsy, extracorporeal shock wave; without water bath 15.0000 Minutes 11465.05 8025.5400 4929.97 11465.05 Anesthesia for procedures on major lower abdominal vessels; not otherwise specified 15.0000 Minutes 14921.96 10445.3700 6416.44 14921.96 Anesthesia for; anorectal procedure 15.0000 Minutes 7824.51 5477.1600 3364.54 7824.51 Anesthesia for; radical perineal procedure 15.0000 Minutes 11927.32 8349.1200 172.08 11927.32 Anesthesia for; vulvectomy 15.0000 Minutes 9556.43 6689.5000 4109.26 9556.43 Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise specified 15.0000 Minutes 7719.47 5403.6300 3319.37 7719.47 Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s) 15.0000 Minutes 9543.70 6680.5900 4103.79 9543.70 Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of prostate 15.0000 Minutes 13881.36 9716.9500 5968.98 13881.36 Anesthesia for transurethral procedures (including urethrocystoscopy); post-transurethral resection bleeding 15.0000 Minutes 11173.82 7821.6700 4804.74 11173.82 Anesthesia for transurethral procedures (including urethrocystoscopy); with fragmentation, manipulation and/or removal of ureteral calculus 15.0000 Minutes 12481.29 8736.9000 5366.95 12481.29 Anesthesia for procedures on male genitalia (including open urethral procedures); not otherwise specified 15.0000 Minutes 8145.28 5701.7000 3502.47 8145.28 Anesthesia for procedures on male genitalia (including open urethral procedures); vasectomy, unilateral or bilateral 15.0000 Minutes 7717.57 5402.3000 3318.56 7717.57 Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, inguinal 15.0000 Minutes 18172.17 12720.5200 7814.03 18172.17 Anesthesia for procedures on male genitalia (including open urethral procedures); orchiopexy, unilateral or bilateral 15.0000 Minutes 7729.59 5410.7100 3323.72 7729.59 Anesthesia for procedures on male genitalia (including open urethral procedures); insertion of penile prosthesis (perineal approach) 15.0000 Minutes 6343.03 4440.1200 2727.50 6343.03 Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); not otherwise specified 15.0000 Minutes 8155.70 5708.9900 3506.95 8155.70 Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); colpotomy, vaginectomy, colporrhaphy, and open urethral procedures 15.0000 Minutes 9655.48 6758.8300 4151.85 9655.48 Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); vaginal hysterectomy 15.0000 Minutes 18436.32 12905.4200 7927.62 18436.32 Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); cervical cerclage 15.0000 Minutes 8461.13 5922.7900 3638.29 8461.13 Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); hysteroscopy and/or hysterosalpingography 15.0000 Minutes 9394.66 6576.2600 4039.70 9394.66 Anesthesia for bone marrow aspiration and/or biopsy, anterior or posterior iliac crest 15.0000 Minutes 11864.75 8305.3200 5101.84 11864.75 Anesthesia for procedures on bony pelvis 15.0000 Minutes 16656.22 11659.3500 7162.17 16656.22 Anesthesia for closed procedures involving symphysis pubis or sacroiliac joint 15.0000 Minutes 17065.28 11945.7000 7338.07 17065.28 Anesthesia for open procedures involving symphysis pubis or sacroiliac joint 15.0000 Minutes 13873.71 9711.6000 5965.70 13873.71 Anesthesia for all closed procedures involving hip joint 15.0000 Minutes 8344.54 5841.1800 3588.15 8344.54 Anesthesia for arthroscopic procedures of hip joint 15.0000 Minutes 10540.97 7378.6800 4532.62 10540.97 Anesthesia for open procedures involving hip joint; not otherwise specified 15.0000 Minutes 11480.10 8036.0700 4936.44 11480.10 Anesthesia for open procedures involving hip joint; total hip arthroplasty 15.0000 Minutes 20356.08 14249.2500 8753.11 20356.08 Anesthesia for open procedures involving hip joint; revision of total hip arthroplasty 15.0000 Minutes 23712.62 16598.8300 10196.43 23712.62 Anesthesia for all closed procedures involving upper two-thirds of femur 15.0000 Minutes 13510.82 9457.5700 5809.65 13510.82 Anesthesia for open procedures involving upper two-thirds of femur; not otherwise specified 15.0000 Minutes 13486.60 9440.6200 5799.24 13486.60 Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of upper leg 15.0000 Minutes 8244.79 5771.3600 3545.26 8244.79 Anesthesia for procedures involving arteries of upper leg, including bypass graft; not otherwise specified 15.0000 Minutes 14332.40 10032.6800 6162.93 14332.40 Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of knee and/or popliteal area 15.0000 Minutes 14267.77 9987.4400 6135.14 14267.76 Anesthesia for all open procedures on lower one-third of femur 15.0000 Minutes 16239.05 11367.3300 6982.79 16239.05 Anesthesia for all closed procedures on knee joint 15.0000 Minutes 8867.11 6206.9800 3812.86 8867.11 Anesthesia for diagnostic arthroscopic procedures of knee joint 15.0000 Minutes 12382.48 8667.7300 5324.46 12382.48 Anesthesia for all closed procedures on upper ends of tibia, fibula, and/or patella 15.0000 Minutes 9255.00 6478.5000 3979.65 9255.00 Anesthesia for all open procedures on upper ends of tibia, fibula, and/or patella 15.0000 Minutes 14222.60 9955.8200 6115.72 14222.60 Anesthesia for open or surgical arthroscopic procedures on knee joint; not otherwise specified 15.0000 Minutes 12533.98 8773.7800 5389.61 12533.98 Anesthesia for open or surgical arthroscopic procedures on knee joint; total knee arthroplasty 15.0000 Minutes 18045.35 12631.7400 7759.50 18045.34 Anesthesia for procedures on arteries of knee and popliteal area; not otherwise specified 15.0000 Minutes 16186.07 11330.2500 6960.01 16186.07 Anesthesia for all closed procedures on lower leg, ankle, and foot 15.0000 Minutes 10769.40 7538.5800 4630.84 10769.40 Anesthesia for arthroscopic procedures of ankle and/or foot 15.0000 Minutes 12014.35 8410.0400 5166.17 12014.34 Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; not otherwise specified 15.0000 Minutes 11427.74 7999.4200 4913.93 11427.74 Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; repair of ruptured Achilles tendon, with or without graft 15.0000 Minutes 14215.42 9950.7900 6112.63 14215.42 Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; gastrocnemius recession (eg, Strayer procedure) 15.0000 Minutes 11173.03 7821.1200 4804.40 11173.03 Anesthesia for open procedures on bones of lower leg, ankle, and foot; not otherwise specified 15.0000 Minutes 2674.08 1871.8600 1149.85 2674.08 Anesthesia for open procedures on bones of lower leg, ankle, and foot; radical resection (including below knee amputation) 15.0000 Minutes 10333.29 7233.3000 4443.31 10333.29 Anesthesia for open procedures on bones of lower leg, ankle, and foot; osteotomy or osteoplasty of tibia and/or fibula 15.0000 Minutes 20388.03 14271.6200 8766.85 20388.02 Anesthesia for open procedures on bones of lower leg, ankle, and foot; total ankle replacement 15.0000 Minutes 17767.43 12437.2000 7639.99 17767.43 Anesthesia for procedures on arteries of lower leg, including bypass graft; not otherwise specified 15.0000 Minutes 15468.51 10827.9600 6651.46 15468.51 Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of shoulder and axilla 15.0000 Minutes 5121.54 3585.0800 2202.26 5121.54 Anesthesia for all closed procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint 15.0000 Minutes 14925.87 10448.1100 6418.12 14925.87 Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; not otherwise specified 15.0000 Minutes 11198.66 7839.0600 4815.42 11198.66 Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; total shoulder replacement 15.0000 Minutes 15002.64 10501.8500 6451.13 15002.64 Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; not otherwise specified 15.0000 Minutes 5836.57 4085.6000 2509.73 5836.57 Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenotomy, elbow to shoulder, open 15.0000 Minutes 13178.63 9225.0400 5666.81 13178.62 Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenoplasty, elbow to shoulder 15.0000 Minutes 13611.10 9527.7700 5852.77 13611.10 Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenodesis, rupture of long tendon of biceps 15.0000 Minutes 6962.73 4873.9100 2993.97 6962.73 Anesthesia for all closed procedures on humerus and elbow 15.0000 Minutes 12964.35 9075.0500 5574.67 12964.35 Anesthesia for open or surgical arthroscopic procedures of the elbow; not otherwise specified 15.0000 Minutes 14286.93 10000.8500 6143.38 14286.93 Anesthesia for open or surgical arthroscopic procedures of the elbow; osteotomy of humerus 15.0000 Minutes 10217.33 7152.1300 4393.45 10217.33 Anesthesia for open or surgical arthroscopic procedures of the elbow; repair of nonunion or malunion of humerus 15.0000 Minutes 19803.61 13862.5200 8515.55 19803.60 Anesthesia for open or surgical arthroscopic procedures of the elbow; total elbow replacement 15.0000 Minutes 12047.24 8433.0700 5180.31 12047.24 Anesthesia for procedures on arteries of upper arm and elbow; not otherwise specified 15.0000 Minutes 7762.29 5433.6000 3337.78 7762.29 Anesthesia for procedures on veins of upper arm and elbow; not otherwise specified 15.0000 Minutes 11792.47 8254.7300 5070.76 11792.47 Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of forearm, wrist, and hand 15.0000 Minutes 6681.27 4676.8900 2872.95 6681.27 Anesthesia for all closed procedures on radius, ulna, wrist, or hand bones 15.0000 Minutes 11110.50 7777.3500 4777.51 11110.50 Anesthesia for open or surgical arthroscopic/endoscopic procedures on distal radius, distal ulna, wrist, or hand joints; not otherwise specified 15.0000 Minutes 13341.52 9339.0600 5736.85 13341.52 Anesthesia for procedures on arteries of forearm, wrist, and hand; not otherwise specified 15.0000 Minutes 12444.22 8710.9500 5351.01 12444.22 Anesthesia for vascular shunt, or shunt revision, any type (eg, dialysis) 15.0000 Minutes 10226.74 7158.7100 4397.50 10226.74 Excision of rectal tumor, transanal endoscopic microsurgical approach (ie, TEMS), including muscularis propria (ie, full thickness) 1.0000 each 23053.55 16137.4800 4743.27 23053.54 Anesthesia for procedures on veins of forearm, wrist, and hand; not otherwise specified 15.0000 Minutes 5414.48 3790.1400 2328.23 5414.48 Anesthesia for diagnostic arteriography/venography 15.0000 Minutes 9518.49 6662.9400 4092.95 9518.49 Anesthesia for cardiac catheterization including coronary angiography and ventriculography (not to include Swan-Ganz catheter) 15.0000 Minutes 12811.41 8967.9900 5508.91 12811.41 Anesthesia for non-invasive imaging or radiation therapy 15.0000 Minutes 6054.40 4238.0800 2603.39 6054.40 Anesthesia for therapeutic interventional radiological procedures involving the arterial system; not otherwise specified 15.0000 Minutes 15512.12 10858.4800 6670.21 15512.12 Anesthesia for therapeutic interventional radiological procedures involving the arterial system; carotid or coronary 15.0000 Minutes 8376.27 5863.3900 3601.80 8376.27 Anesthesia for therapeutic interventional radiological procedures involving the arterial system; intracranial, intracardiac, or aortic 15.0000 Minutes 14732.32 10312.6200 6334.90 14732.32 Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); not otherwise specified 15.0000 Minutes 9796.63 6857.6400 4212.55 9796.63 Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrathoracic or jugular 15.0000 Minutes 9837.86 6886.5000 4230.28 9837.86 Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intracranial 15.0000 Minutes 11962.10 8373.4700 5143.70 11962.10 Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral 1.0000 each 3553.32 2487.3200 21.51 3553.32 Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic 1.0000 each 19012.54 13308.7800 21.51 19012.54 Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral 1.0000 each 14966.84 10476.7900 21.51 14966.84 Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (TBSA) treated during anesthesia and surgery; between 4% and 9% of total body surface area 15.0000 Minutes 3861.04 2702.7300 1660.25 3861.04 Anesthesia for incomplete or missed abortion procedures 15.0000 Minutes 7577.10 5303.9700 3258.15 7577.10 Anesthesia for induced abortion procedures 15.0000 Minutes 8402.79 5881.9500 3613.20 8402.79 Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); other than the prone position 15.0000 Minutes 9405.80 6584.0600 4044.49 9405.80 Anesthesia for diagnostic or therapeutic nerve blocks and injections (when block or injection is performed by a different physician or other qualified health care professional); prone position 15.0000 Minutes 6893.88 4825.7200 2964.37 6893.88 Unlisted anesthesia procedure(s) 15.0000 Minutes 10318.75 7223.1200 4437.06 10318.75 Percutaneous sacral augmentation (sacroplasty), unilateral injection(s), including the use of a balloon or mechanical device, when used, 1 or more needles, includes imaging guidance and bone biopsy, when performed 1.0000 each 12442.36 8709.6500 5118.00 12442.36 Percutaneous sacral augmentation (sacroplasty), bilateral injections, including the use of a balloon or mechanical device, when used, 2 or more needles, includes imaging guidance and bone biopsy, when performed 1.0000 each 13375.54 9362.8800 5118.00 13375.54 Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation when performed 4.0000 Each 15328.66 10730.0600 341.73 15328.66 Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; brachiocephalic trunk and branches, each vessel 1.0000 each 7377.66 5164.3600 3172.40 9607.70 Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; iliac artery, each vessel 1.0000 each 40022.51 28015.7600 10098.00 40022.51 Transcatheter mitral valve repair percutaneous approach via the coronary sinus 1.0000 each 7668.96 5368.2700 3297.65 7668.96 Insertion or replacement of permanent cardiac contractility modulation system, including contractility evaluation when performed, and programming of sensing and therapeutic parameters; pulse generator with transvenous electrodes 1.0000 each 27960.71 19572.5000 7000.00 29031.64 Insertion or replacement of permanent cardiac contractility modulation system, including contractility evaluation when performed, and programming of sensing and therapeutic parameters; pulse generator only 1.0000 each 27960.71 19572.5000 7000.00 27960.71 Insertion or replacement of permanent cardiac contractility modulation system, including contractility evaluation when performed, and programming of sensing and therapeutic parameters; atrial electrode only 1.0000 each 9892.59 6924.8100 4253.81 9892.59 Insertion or replacement of permanent cardiac contractility modulation system, including contractility evaluation when performed, and programming of sensing and therapeutic parameters; ventricular electrode only 1.0000 each 9892.59 6924.8100 4253.81 9892.59 Removal of permanent cardiac contractility modulation system; pulse generator only 1.0000 each 4175.34 2922.7400 1795.40 4175.34 Removal of permanent cardiac contractility modulation system; transvenous electrode (atrial or ventricular) 1.0000 each 4175.34 2922.7400 1795.40 4175.34 Removal and replacement of permanent cardiac contractility modulation system pulse generator only 1.0000 each 27960.71 19572.5000 7000.00 27960.71 Repositioning of previously implanted cardiac contractility modulation transvenous electrode (atrial or ventricular lead) Each 660.78 462.5500 284.14 660.78 Ablation, percutaneous, cryoablation, includes imaging guidance; upper extremity distal/peripheral nerve 1.0000 each 4781.80 3347.2600 1626.90 4781.80 Ablation, percutaneous, cryoablation, includes imaging guidance; lower extremity distal/peripheral nerve 1.0000 each 4781.80 3347.2600 1626.90 4781.80 Ablation, percutaneous, cryoablation, includes imaging guidance; nerve plexus or other truncal nerve (eg, brachial plexus, pudendal nerve) 1.0000 each 5140.44 3598.3100 2210.39 5592.17 Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; percutaneous approach, including transseptal puncture, when performed Each 37494.51 26246.1600 3364.00 37494.51 Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; transthoracic exposure (eg, thoracotomy, transapical) Each 53983.74 37788.6200 3364.00 53983.74 Endovenous femoral-popliteal arterial revascularization, with transcatheter placement of intravascular stent graft(s) and closure by any method, including percutaneous or open vascular access, ultrasound guidance for vascular access when performed, all catheterization(s) and intraprocedural roadmapping and imaging guidance necessary to complete the intervention, all associated radiological supervision and interpretation, when performed, with crossing of the occlusive lesion in an extraluminal fashion 1.0000 each 8725.59 6107.9100 3752.00 9607.70 Anatomic model 3D-printed from image data set(s); first individually prepared and processed component of an anatomic structure 1.0000 each 3105.74 2174.0200 52.02 3105.74 Anatomic model 3D-printed from image data set(s); each additional individually prepared and processed component of an anatomic structure (List separately in addition to code for primary procedure) 1.0000 each 2329.31 1630.5200 1001.60 2329.31 Anatomic guide 3D-printed and designed from image data set(s); first anatomic guide 1.0000 each 3105.74 2174.0200 52.02 3105.74 Anatomic guide 3D-printed and designed from image data set(s); each additional anatomic guide (List separately in addition to code for primary procedure) 1.0000 each 2329.31 1630.5200 1001.60 2329.31 Transcatheter tricuspid valve repair, percutaneous approach; initial prosthesis 1.0000 each 48878.18 34214.7300 3364.00 48878.18 Transcatheter tricuspid valve repair, percutaneous approach; each additional prosthesis during same session (List separately in addition to code for primary procedure) 1.0000 each 48878.18 34214.7300 3364.00 48878.18 Endovascular venous arterialization, tibial or peroneal vein, with transcatheter placement of intravascular stent graft(s) and closure by any method, including percutaneous or open vascular access, ultrasound guidance for vascular access when performed, all catheterization(s) and intraprocedural roadmapping and imaging guidance necessary to complete the intervention, all associated radiological supervision and interpretation, when performed Each 8725.59 6107.9100 3752.00 15547.10 Transcatheter removal or debulking of intracardiac mass (eg, vegetations, thrombus) via suction (eg, vacuum, aspiration) device, percutaneous approach, with intraoperative reinfusion of aspirated blood, including imaging guidance, when performed Each 9844.43 6891.1000 4233.10 9844.43 Percutaneous transluminal coronary lithotripsy (list separately in addition to code for primary procedure) 1.0000 each 7582.21 5307.5500 3260.35 7582.21 Fine needle aspiration biopsy, including ultrasound guidance; first lesion Each 1812.49 1268.7400 587.37 1812.49 Fine needle aspiration biopsy, including ultrasound guidance; each additional lesion (List separately in addition to code for primary procedure) 1.0000 each 906.26 634.3800 389.69 906.26 Fine needle aspiration biopsy, including CT guidance; first lesion Each 980.68 686.4800 421.69 980.68 Fine needle aspiration biopsy, without imaging guidance; first lesion Each 731.60 512.1200 314.59 731.60 Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, seroma, lymphocele, cyst), soft tissue (eg, extremity, abdominal wall, neck), percutaneous Each 692.97 485.0800 297.98 692.97 Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single Each 655.50 458.8500 163.44 655.50 Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple Each 1262.60 883.8200 337.66 1262.60 Incision and drainage of pilonidal cyst; simple Each 2112.28 1478.6000 587.37 2112.28 Incision and drainage of pilonidal cyst; complicated Each 2270.70 1589.4900 587.37 2270.70 Incision and removal of foreign body, subcutaneous tissues; simple Each 1262.60 883.8200 337.66 1262.60 Incision and removal of foreign body, subcutaneous tissues; complicated Each 5136.69 3595.6800 1357.21 5136.69 Incision and drainage of hematoma, seroma or fluid collection Each 5136.69 3595.6800 1357.21 5136.69 Puncture aspiration of abscess, hematoma, bulla, or cyst Each 101092.57 70764.8000 337.66 101092.57 Incision and drainage, complex, postoperative wound infection Each 8652.46 6056.7200 1923.21 8652.46 Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; abdominal wall, with or without fascial closure 1.0000 each 13219.15 9253.4000 3364.00 13219.15 Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin and subcutaneous tissues Each 7807.97 5465.5800 587.37 7807.97 Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin, subcutaneous tissue, muscle fascia, and muscle Each 7877.02 5513.9200 587.37 7877.02 Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin, subcutaneous tissue, muscle fascia, muscle, and bone Each 9562.42 6693.6900 1923.21 9562.42 Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less Each 1306.04 914.2300 337.66 1306.04 Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less Each 2051.49 1436.0400 525.81 2051.49 Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less Each 4778.32 3344.8200 1357.21 4778.32 Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure) 1.0000 each 587.25 411.0800 252.52 587.25 Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure) 1.0000 each 890.07 623.0500 382.73 890.07 Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure) 1.0000 each 2389.17 1672.4200 1027.34 2389.17 Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion Each 567.23 397.0600 163.44 567.23 Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); 2 to 4 lesions Each 609.77 426.8400 163.44 609.77 Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); more than 4 lesions Each 567.23 397.0600 163.44 567.23 Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); single lesion Each 655.50 458.8500 163.44 655.50 Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); each separate/additional lesion (List separately in addition to code for primary procedure) 1.0000 each 327.75 229.4200 140.93 327.75 Punch biopsy of skin (including simple closure, when performed); single lesion Each 1092.57 764.8000 337.66 1092.57 Punch biopsy of skin (including simple closure, when performed); each separate/additional lesion (List separately in addition to code for primary procedure) 1.0000 each 546.28 382.4000 234.90 546.28 Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); single lesion Each 1330.38 931.2700 525.81 1330.38 Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); each separate/additional lesion (List separately in addition to code for primary procedure) 1.0000 each 956.83 669.7800 411.44 956.83 Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions Each 8913.84 6239.6900 163.44 8913.84 Removal of skin tags, multiple fibrocutaneous tags, any area; each additional 10 lesions, or part thereof (List separately in addition to code for primary procedure) 1.0000 each 4629.75 3240.8200 1795.00 4629.75 Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.5 cm or less Each 6953.91 4867.7400 587.37 6953.91 Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 1.1 to 2.0 cm Each 7901.60 5531.1200 587.37 7901.60 Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 2.1 to 3.0 cm Each 7816.73 5471.7100 587.37 7816.73 Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 3.1 to 4.0 cm Each 6053.32 4237.3200 1357.21 6053.32 Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter over 4.0 cm Each 6462.10 4523.4700 1357.21 6462.10 Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less Each 5977.32 4184.1300 1357.21 5977.32 Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm Each 2683.43 1878.4000 587.37 2683.43 Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm Each 16569.59 11598.7100 1357.21 16569.59 Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm Each 5788.42 4051.9000 1357.21 5788.42 Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm Each 6019.01 4213.3100 1357.21 6019.01 Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm Each 5522.67 3865.8700 1923.21 5522.67 Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.5 cm or less Each 7241.74 5069.2100 587.37 7241.74 Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.6 to 1.0 cm Each 4801.62 3361.1400 587.37 4801.62 Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 1.1 to 2.0 cm Each 4829.46 3380.6200 587.37 4829.46 Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 2.1 to 3.0 cm Each 11208.09 7845.6600 1357.21 11208.09 Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter over 4.0 cm Each 7773.84 5441.6900 1923.21 7773.84 Excision of skin and subcutaneous tissue for hidradenitis, axillary; with simple or intermediate repair Each 8286.02 5800.2200 1923.21 8286.02 Excision of skin and subcutaneous tissue for hidradenitis, axillary; with complex repair Each 5917.28 4142.0900 1923.21 5917.28 Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with simple or intermediate repair Each 6916.40 4841.4800 1923.21 6916.40 Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with complex repair Each 10869.73 7608.8100 1923.21 10869.73 Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or umbilical; with simple or intermediate repair Each 8677.72 6074.4100 1923.21 8677.72 Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.5 cm or less Each 7245.69 5071.9800 587.37 7245.69 Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 1.1 to 2.0 cm Each 5183.37 3628.3600 337.66 5183.37 Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 2.1 to 3.0 cm Each 3789.18 2652.4300 587.37 3789.18 Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm Each 5590.86 3913.6000 1357.21 5590.86 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm Each 5080.79 3556.5500 587.37 5080.79 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm Each 7286.56 5100.5900 587.37 7286.56 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm Each 7286.56 5100.5900 1357.21 7286.56 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm Each 4923.60 3446.5200 1923.21 4923.60 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.6 to 1.0 cm Each 7205.85 5044.1000 587.37 7205.85 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 1.1 to 2.0 cm Each 4734.97 3314.4800 587.37 4734.97 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm Each 6539.79 4577.8500 1357.21 6539.79 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 3.1 to 4.0 cm Each 7579.76 5305.8300 1357.21 7579.76 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter over 4.0 cm Each 5961.55 4173.0800 1923.21 5961.55 Trimming of nondystrophic nails, any number Each 260.39 182.2700 52.02 260.39 Debridement of nail(s) by any method(s); 1 to 5 1.0000 each 203.21 142.2500 52.02 203.21 Debridement of nail(s) by any method(s); 6 or more 1.0000 each 387.92 271.5400 52.02 387.92 Avulsion of nail plate, partial or complete, simple; single Each 655.50 458.8500 163.44 655.50 Avulsion of nail plate, partial or complete, simple; each additional nail plate (List separately in addition to code for primary procedure) 1.0000 each 327.75 229.4200 140.93 327.75 Evacuation of subungual hematoma Each 684.32 479.0200 105.09 684.32 Excision of nail and nail matrix, partial or complete (eg, ingrown or deformed nail), for permanent removal Each 1027.37 719.1600 337.66 1027.37 Repair of nail bed Each 990.85 693.5900 426.06 990.85 Excision of pilonidal cyst or sinus; simple Each 692.98 485.0900 415.79 2338.05 Excision of pilonidal cyst or sinus; extensive Each 19357.24 13550.0700 2198.61 19357.24 Excision of pilonidal cyst or sinus; complicated Each 8020.19 5614.1400 2198.61 8020.19 Injection, intralesional; up to and including 7 lesions Each 1100.00 770.0000 163.44 1100.00 Replacement of tissue expander with permanent implant Each 10741.97 7519.3800 2198.61 10741.97 Removal of tissue expander without insertion of implant Each 11045.86 7732.1000 1432.08 11045.86 Removal, non-biodegradable drug delivery implant Each 487.37 341.1600 209.57 487.37 Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.5 cm or less Each 833.96 583.7700 163.44 833.96 Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.6 cm to 7.5 cm Each 833.96 583.7700 163.44 833.96 Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm Each 833.96 583.7700 163.44 833.96 Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 12.6 cm to 20.0 cm Each 754.35 528.0400 337.66 754.35 Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 20.1 cm to 30.0 cm Each 883.63 618.5400 337.66 883.63 Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less Each 714.31 500.0100 163.44 714.31 Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm Each 733.77 513.6400 163.44 733.77 Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm Each 747.60 523.3200 163.44 747.60 Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm Each 1057.24 740.0700 163.44 1057.24 Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm Each 1025.86 718.1000 337.66 1025.86 Treatment of superficial wound dehiscence; simple closure Each 11111.10 7777.7700 525.81 11111.10 Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.5 cm or less Each 30.88 21.6200 13.28 337.66 Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.6 cm to 7.5 cm Each 833.96 583.7700 337.66 833.96 Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 7.6 cm to 12.5 cm Each 1232.46 862.7200 337.66 1232.46 Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 12.6 cm to 20.0 cm Each 712.37 498.6600 337.66 712.37 Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 20.1 cm to 30.0 cm Each 5916.35 4141.4400 525.81 5916.35 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less Each 682.58 477.8100 293.51 682.58 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.6 cm to 7.5 cm Each 708.40 495.8800 304.61 708.40 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 7.6 cm to 12.5 cm Each 765.20 535.6400 459.12 765.20 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 12.6 cm to 20.0 cm Each 1584.95 1109.4600 525.81 1584.95 Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less Each 711.61 498.1300 305.99 711.61 Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm Each 709.39 496.5700 305.04 709.39 Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm Each 1104.42 773.0900 337.66 1104.42 Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm Each 420.11 294.0700 252.06 420.11 Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 20.1 cm to 30.0 cm Each 879.10 615.3700 337.66 879.10 Repair, complex, trunk; 1.1 cm to 2.5 cm Each 5734.00 4013.8000 525.81 5734.00 Repair, complex, trunk; 2.6 cm to 7.5 cm Each 6108.34 4275.8400 525.81 6108.34 Repair, complex, trunk; each additional 5 cm or less (List separately in addition to code for primary procedure) 1.0000 Each 2495.87 1747.1100 1432.08 2495.87 Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm Each 6400.06 4480.0400 525.81 6400.06 Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm Each 920.44 644.3100 525.81 920.44 Repair, complex, scalp, arms, and/or legs; each additional 5 cm or less (List separately in addition to code for primary procedure) 1.0000 Each 3256.16 2279.3100 1432.08 3256.16 Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 1.1 cm to 2.5 cm Each 12660.89 8862.6200 337.66 12660.88 Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 2.6 cm to 7.5 cm Each 733.77 513.6400 440.26 733.77 Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; each additional 5 cm or less (List separately in addition to code for primary procedure) 1.0000 each 2295.75 1607.0200 1377.45 2295.75 Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm Each 9744.65 6821.2600 525.81 9744.65 Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm Each 717.80 502.4600 430.68 717.80 Secondary closure of surgical wound or dehiscence, extensive or complicated Each 2263.77 1584.6400 1358.26 2263.77 Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less Each 7760.92 5432.6500 1562.04 7760.92 Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm Each 8893.61 6225.5300 1562.04 8893.61 Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10 sq cm or less Each 9665.84 6766.0900 1562.04 9665.84 Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10.1 sq cm to 30.0 sq cm Each 5455.77 3819.0400 1562.04 5455.77 Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less Each 6809.46 4766.6200 1562.04 6809.46 Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10.1 sq cm to 30.0 sq cm Each 4801.62 3361.1400 1562.04 4801.62 Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or less Each 7973.01 5581.1100 1562.04 7973.01 Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10.1 sq cm to 30.0 sq cm Each 5991.63 4194.1400 1562.04 5991.63 Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm Each 6316.30 4421.4100 2712.69 6316.30 Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, or part thereof (List separately in addition to code for primary procedure) 1.0000 each 5804.64 4063.2500 1795.00 5804.64 Filleted finger or toe flap, including preparation of recipient site Each 5620.47 3934.3300 1562.04 5620.47 Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; first 100 sq cm or 1% of body area of infants and children Each 6136.06 4295.2400 1562.04 6136.06 Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; each additional 100 sq cm, or part thereof, or each additional 1% of body area of infants and children (List separately in addition to code for primary procedure) 1.0000 each 3668.12 2567.6800 1432.08 3668.12 Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet and/or multiple digits; first 100 sq cm or 1% of body area of infants and children Each 6592.37 4614.6600 525.81 6592.37 Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet and/or multiple digits; each additional 100 sq cm, or part thereof, or each additional 1% of body area of infants and children (List separately in addition to code for primary procedure) 1.0000 each 5118.64 3583.0500 1432.08 5118.64 Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children (except 15050) Each 6261.34 4382.9400 1562.04 6261.34 Split-thickness autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure) 1.0000 each 4321.20 3024.8400 1795.00 4321.20 Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children (except 15050) Each 5595.17 3916.6200 1923.21 5595.17 Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure) 1.0000 each 5186.92 3630.8400 1795.00 5186.92 Full thickness graft, free, including direct closure of donor site, trunk; 20 sq cm or less Each 15673.32 10971.3200 1562.04 15673.32 Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 20 sq cm or less Each 6398.19 4478.7300 1562.04 6398.19 Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; 20 sq cm or less Each 6809.81 4766.8700 1562.04 6809.81 Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure) 1.0000 each 1767.93 1237.5500 1060.76 1767.93 Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area Each 3596.05 2517.2400 1562.04 3596.05 Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (List separately in addition to code for primary procedure) 1.0000 each 1798.02 1258.6100 1078.81 1798.02 Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children Each 5827.06 4078.9400 1923.21 5827.06 Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure) 1.0000 each 2364.36 1655.0500 1418.62 2364.36 Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area Each 3596.05 2517.2400 1562.04 3596.05 Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (List separately in addition to code for primary procedure) 1.0000 each 1932.87 1353.0100 1159.72 1932.87 Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children Each 2213.18 1549.2300 1327.91 2213.18 Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure) 1.0000 each 2213.18 1549.2300 1327.91 2213.18 Delay of flap or sectioning of flap (division and inset); at scalp, arms, or legs Each 7165.04 5015.5300 1562.04 7165.04 Delay of flap or sectioning of flap (division and inset); at forehead, cheeks, chin, neck, axillae, genitalia, hands, or feet Each 3808.15 2665.7100 1562.04 3808.15 Delay of flap or sectioning of flap (division and inset); at eyelids, nose, ears, or lips Each 7945.15 5561.6000 1562.04 7945.15 Transfer, intermediate, of any pedicle flap (eg, abdomen to wrist, Walking tube), any location Each 6251.74 4376.2200 1562.04 6251.74 Midface flap (ie, zygomaticofacial flap) with preservation of vascular pedicle(s) Each 6776.47 4743.5300 2913.88 6776.47 Forehead flap with preservation of vascular pedicle (eg, axial pattern flap, paramedian forehead flap) Each 9405.82 6584.0800 2944.26 9405.82 Muscle, myocutaneous, or fasciocutaneous flap; head and neck with named vascular pedicle (ie, buccinators, genioglossus, temporalis, masseter, sternocleidomastoid, levator scapulae) Each 7443.94 5210.7600 2198.61 7443.94 Muscle, myocutaneous, or fasciocutaneous flap; trunk Each 16409.18 11486.4300 2198.61 16409.18 Muscle, myocutaneous, or fasciocutaneous flap; lower extremity Each 11627.57 8139.3000 2198.61 11627.57 Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia) Each 7001.52 4901.0600 2712.69 7001.52 Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; 50 cc or less injectate Each 7286.58 5100.6100 2712.69 7286.58 Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; each additional 50 cc injectate, or part thereof (List separately in addition to code for primary procedure) 50.0000 cc 3123.05 2186.1400 1795.00 3123.05 Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; 25 cc or less injectate Each 7925.09 5547.5600 1562.04 7925.09 Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; each additional 25 cc injectate, or part thereof (List separately in addition to code for primary procedure) 25.0000 cc 7925.09 5547.5600 1795.00 7925.09 Implantation of biologic implant (eg, acellular dermal matrix) for soft tissue reinforcement (ie, breast, trunk) (List separately in addition to code for primary procedure) 1.0000 each 5888.69 4122.0800 1795.00 5888.69 Blepharoplasty, lower eyelid Each 8572.51 6000.7600 1562.04 8572.51 Blepharoplasty, lower eyelid; with extensive herniated fat pad Each 15232.30 10662.6100 1562.04 15232.30 Blepharoplasty, upper eyelid Each 9007.23 6305.0600 1562.04 9007.23 Blepharoplasty, upper eyelid; with excessive skin weighting down lid Each 9218.78 6453.1400 1562.04 9218.78 Rhytidectomy; forehead Each 2042.00 1429.4000 1225.20 2042.00 Rhytidectomy; glabellar frown lines Each 650.00 455.0000 390.00 2944.26 Rhytidectomy; cheek, chin, and neck Each 23021.84 16115.2900 2198.61 23021.84 Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy Each 15522.65 10865.8600 2198.61 15522.65 Excision, excessive skin and subcutaneous tissue (includes lipectomy); thigh Each 4375.00 3062.5000 2198.61 4375.00 Excision, excessive skin and subcutaneous tissue (includes lipectomy); leg Each 17136.88 11995.8200 2198.61 17136.88 Excision, excessive skin and subcutaneous tissue (includes lipectomy); hip Each 8500.00 5950.0000 2198.61 8500.00 Excision, excessive skin and subcutaneous tissue (includes lipectomy); buttock Each 8500.00 5950.0000 2198.61 8500.00 Excision, excessive skin and subcutaneous tissue (includes lipectomy); arm Each 10019.08 7013.3600 2198.61 10019.08 Excision, excessive skin and subcutaneous tissue (includes lipectomy); other area Each 6700.93 4690.6500 2198.61 6700.93 Excision, excessive skin and subcutaneous tissue (includes lipectomy), abdomen (eg, abdominoplasty) (includes umbilical transposition and fascial plication) (List separately in addition to code for primary procedure) 1.0000 each 12770.87 8939.6100 1795.00 12770.86 Intravenous injection of agent (eg, fluorescein) to test vascular flow in flap or graft Each 5987.59 4191.3100 341.73 5987.59 Suction assisted lipectomy; trunk Each 8423.22 5896.2500 2198.61 8423.22 Suction assisted lipectomy; upper extremity Each 2479.00 1735.3000 1487.40 2479.00 Excision, ischial pressure ulcer, with ostectomy, in preparation for muscle or myocutaneous flap or skin graft closure Each 8072.86 5651.0000 1562.04 8072.86 Dressings and/or debridement of partial-thickness burns, initial or subsequent; small (less than 5% total body surface area) Each 655.50 458.8500 163.44 655.50 Dressings and/or debridement of partial-thickness burns, initial or subsequent; medium (eg, whole face or whole extremity, or 5% to 10% total body surface area) Each 914.35 640.0400 163.44 914.35 Dressings and/or debridement of partial-thickness burns, initial or subsequent; large (eg, more than 1 extremity, or greater than 10% total body surface area) Each 1214.92 850.4400 337.66 1214.92 Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions Each 5084.77 3559.3400 163.44 5084.77 Chemical cauterization of granulation tissue (ie, proud flesh) Each 655.50 458.8500 163.44 655.50 Unlisted procedure, skin, mucous membrane and subcutaneous tissue Each 12.60 8.8200 5.42 163.44 Puncture aspiration of cyst of breast Each 1092.49 764.7400 469.77 1092.49 Puncture aspiration of cyst of breast; each additional cyst (List separately in addition to code for primary procedure) 1.0000 each 595.54 416.8800 256.08 595.54 Mastotomy with exploration or drainage of abscess, deep Each 7959.87 5571.9100 1357.21 7959.87 Injection procedure only for mammary ductogram or galactogram Each 1705.99 1194.1900 733.58 1705.99 Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including stereotactic guidance Each 4663.22 3264.2500 1357.21 4663.22 Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including stereotactic guidance (List separately in addition to code for primary procedure) 1.0000 each 4051.31 2835.9200 1742.06 4051.31 Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including ultrasound guidance Each 4915.57 3440.9000 1357.21 4915.57 Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including ultrasound guidance (List separately in addition to code for primary procedure) 1.0000 each 2457.79 1720.4500 1056.85 2457.79 Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including magnetic resonance guidance Each 4570.69 3199.4800 1357.21 4570.69 Biopsy of breast; open, incisional Each 5831.03 4081.7200 1923.21 5831.03 Ablation, cryosurgical, of fibroadenoma, including ultrasound guidance, each fibroadenoma Each 3170.24 2219.1700 1363.20 3170.24 Nipple exploration, with or without excision of a solitary lactiferous duct or a papilloma lactiferous duct Each 7935.07 5554.5500 1923.21 7935.07 Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19300), open, male or female, 1 or more lesions Each 6987.16 4891.0100 2198.61 6987.16 Excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion Each 9868.73 6908.1100 2198.61 9868.73 Excision of breast lesion identified by preoperative placement of radiological marker, open; each additional lesion separately identified by a preoperative radiological marker (List separately in addition to code for primary procedure) 1.0000 each 4424.99 3097.4900 1795.00 4424.99 Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including mammographic guidance Each 1248.49 873.9400 749.09 1357.21 Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including mammographic guidance (List separately in addition to code for primary procedure) 1.0000 each 2102.18 1471.5300 1261.31 2102.18 Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including stereotactic guidance Each 2055.94 1439.1600 587.37 2055.94 Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including stereotactic guidance (List separately in addition to code for primary procedure) 1.0000 each 3838.08 2686.6500 1432.08 3838.08 Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including ultrasound guidance Each 2440.66 1708.4600 587.37 2440.66 Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including ultrasound guidance (List separately in addition to code for primary procedure) 1.0000 each 2728.64 1910.0500 1432.08 2728.64 Mastectomy for gynecomastia Each 12372.28 8660.5900 2712.69 12372.28 Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy) Each 5320.61 3724.4300 2198.61 5320.61 Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy); with axillary lymphadenectomy Each 7905.86 5534.1000 4291.65 7905.86 Mastectomy, simple, complete Each 7217.07 5051.9500 2712.69 7217.07 Mastectomy, modified radical, including axillary lymph nodes, with or without pectoralis minor muscle, but excluding pectoralis major muscle Each 8918.83 6243.1800 5351.30 8918.83 Mastopexy Each 7148.15 5003.7100 2712.69 7148.15 Breast reduction Each 17423.00 12196.1000 2712.69 17423.00 Breast augmentation with implant Each 8239.28 5767.5000 4943.57 8239.28 Removal of intact breast implant Each 5944.62 4161.2400 1432.08 5944.62 Removal of ruptured breast implant, including implant contents (eg, saline, silicone gel) Each 7746.97 5422.8800 1432.08 7746.97 Insertion of breast implant on same day of mastectomy (ie, immediate) Each 5183.08 3628.1600 1923.21 5379.03 Insertion or replacement of breast implant on separate day from mastectomy Each 7732.34 5412.6400 2198.61 7969.90 Nipple/areola reconstruction Each 9270.10 6489.0700 2712.69 9270.10 Tissue expander placement in breast reconstruction, including subsequent expansion(s) Each 7093.18 4965.2200 3093.66 15100.15 Breast reconstruction; with latissimus dorsi flap Each 586.30 410.4100 252.11 586.30 Breast reconstruction; with free flap (eg, fTRAM, DIEP, SIEA, GAP flap) Each 5183.08 3628.1600 3093.66 5183.08 Revision of peri-implant capsule, breast, including capsulotomy, capsulorrhaphy, and/or partial capsulectomy Each 6788.10 4751.6700 2712.69 6788.10 Peri-implant capsulectomy, breast, complete, including removal of all intracapsular contents Each 8792.81 6154.9600 2712.69 8792.80 Revision of reconstructed breast (eg, significant removal of tissue, re-advancement and/or re-inset of flaps in autologous reconstruction or significant capsular revision combined with soft tissue excision in implant-based reconstruction) Each 9278.08 6494.6600 3093.66 9278.08 Unlisted procedure, breast Each 11967.59 8377.3200 3111.48 11967.59 Exploration of penetrating wound (separate procedure); abdomen/flank/back Each 699.66 489.7600 300.85 1562.04 Exploration of penetrating wound (separate procedure); extremity Each 2936.56 2055.5900 1262.72 2936.56 Biopsy, muscle; deep Each 6814.96 4770.4700 2198.61 6814.96 Biopsy, muscle, percutaneous needle Each 2664.94 1865.4600 1357.21 2664.94 Biopsy, bone, trocar, or needle; superficial (eg, ilium, sternum, spinous process, ribs) Each 3007.19 2105.0300 1357.21 3007.19 Biopsy, bone, trocar, or needle; deep (eg, vertebral body, femur) Each 3961.90 2773.3300 1357.21 3961.90 Biopsy, bone, open; deep (eg, humeral shaft, ischium, femoral shaft) Each 8468.86 5928.2000 2198.61 8468.86 Biopsy, vertebral body, open; lumbar or cervical Each 17048.70 11934.0900 2198.61 17048.70 Injection of sinus tract; therapeutic (separate procedure) Each 2417.23 1692.0600 1039.41 2417.23 Injection of sinus tract; diagnostic (sinogram) Each 827.05 578.9400 355.63 827.05 Removal of foreign body in muscle or tendon sheath; simple Each 692.98 485.0900 297.98 1357.21 Removal of foreign body in muscle or tendon sheath; deep or complicated Each 16336.63 11435.6400 2198.61 16336.63 Injection(s); single tendon origin/insertion Each 871.59 610.1100 246.08 871.59 Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) Each 736.81 515.7700 246.08 736.81 Injection(s); single or multiple trigger point(s), 3 or more muscles Each 736.81 515.7700 246.08 736.81 Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidance Each 963.44 674.4100 246.08 963.44 Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance Each 1443.76 1010.6300 246.08 1443.76 Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance Each 1254.83 878.3800 246.08 1254.83 Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); with ultrasound guidance, with permanent recording and reporting Each 2748.10 1923.6700 246.08 2748.10 Aspiration and injection for treatment of bone cyst Each 754.54 528.1800 324.45 754.54 Removal of implant; superficial (eg, buried wire, pin or rod) (separate procedure) Each 6943.84 4860.6900 1357.21 6943.84 Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate) Each 34718.09 24302.6600 2198.61 34718.08 Application of a uniplane (pins or wires in 1 plane), unilateral, external fixation system Each 9385.70 6569.9900 1923.21 9385.70 Application of a multiplane (pins or wires in more than 1 plane), unilateral, external fixation system (eg, Ilizarov, Monticelli type) Each 9641.03 6748.7200 2198.61 11809.56 Removal, under anesthesia, of external fixation system Each 10038.82 7027.1700 1298.36 10038.82 Application of multiplane (pins or wires in more than 1 plane), unilateral, external fixation with stereotactic computer-assisted adjustment (eg, spatial frame), including imaging; initial and subsequent alignment(s), assessment(s), and computation(s) of adjustment schedule(s) Each 9145.37 6401.7600 3932.51 19819.11 Manual preparation and insertion of drug-delivery device(s), intramedullary (List separately in addition to code for primary procedure) 1.0000 each 5670.29 3969.2000 1795.00 5670.29 Bone graft, any donor area; minor or small (eg, dowel or button) Each 11948.26 8363.7800 2198.61 11948.26 Bone graft, any donor area; major or large Each 10378.68 7265.0700 2712.69 10378.68 Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition to code for primary procedure) 1.0000 each 6446.04 4512.2300 1795.00 6446.04 Allograft, structural, for spine surgery only (List separately in addition to code for primary procedure) 1.0000 each 6477.51 4534.2500 1795.00 6477.51 Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process, or laminar fragments) obtained from same incision (List separately in addition to code for primary procedure) 1.0000 each 6355.78 4449.0400 2732.98 6355.78 Autograft for spine surgery only (includes harvesting the graft); morselized (through separate skin or fascial incision) (List separately in addition to code for primary procedure) 1.0000 each 7936.04 5555.2300 3412.50 7936.04 Bone marrow aspiration for bone grafting, spine surgery only, through separate skin or fascial incision (List separately in addition to code for primary procedure) 1.0000 each 5788.19 4051.7400 1795.00 5788.19 Ablation therapy for reduction or eradication of 1 or more bone tumors (eg, metastasis) including adjacent soft tissue when involved by tumor extension, percutaneous, including imaging guidance when performed; radiofrequency Each 15326.28 10728.4000 5986.77 15326.28 Ablation therapy for reduction or eradication of 1 or more bone tumors (eg, metastasis) including adjacent soft tissue when involved by tumor extension, percutaneous, including imaging guidance when performed; cryoablation Each 14341.58 10039.1100 5986.77 14341.58 Computer-assisted surgical navigational procedure for musculoskeletal procedures, image-less (List separately in addition to code for primary procedure) 1.0000 each 12460.61 8722.4200 1795.00 12460.60 Unlisted procedure, musculoskeletal system, general Each 908.26 635.7800 187.36 908.26 Excision, tumor, soft tissue of face or scalp, subcutaneous; less than 2 cm Each 6687.51 4681.2600 1357.21 6687.51 Excision, tumor, soft tissue of face or scalp, subcutaneous; 2 cm or greater Each 6998.87 4899.2100 1357.21 6998.87 Excision, tumor, soft tissue of face and scalp, subfascial (eg, subgaleal, intramuscular); less than 2 cm Each 7334.04 5133.8300 1357.21 7334.04 Excision, tumor, soft tissue of face and scalp, subfascial (eg, subgaleal, intramuscular); 2 cm or greater Each 5974.87 4182.4100 2338.05 5974.87 Excision of bone (eg, for osteomyelitis or bone abscess); mandible Each 12063.89 8444.7200 1923.21 12063.88 Excision of bone (eg, for osteomyelitis or bone abscess); facial bone(s) Each 4181.65 2927.1500 1923.21 4832.83 Excision of benign tumor or cyst of maxilla or zygoma by enucleation and curettage Each 6087.95 4261.5700 2617.82 6087.95 Coronoidectomy (separate procedure) Each 12215.32 8550.7200 2198.61 12215.32 Application of interdental fixation device for conditions other than fracture or dislocation, includes removal Each 14000.16 9800.1100 1256.38 14000.16 Genioplasty; augmentation (autograft, allograft, prosthetic material) Each 1100.00 770.0000 660.00 4832.83 Osteotomy, mandible, segmental Each 21338.89 14937.2200 4132.00 21338.88 Graft, bone; mandible (includes obtaining graft) Each 20428.05 14299.6400 4291.65 20428.05 Graft; ear cartilage, autogenous, to nose or ear (includes obtaining graft) Each 8040.69 5628.4800 3612.00 8040.69 Arthroplasty, temporomandibular joint, with or without autograft (includes obtaining graft) Each 15328.66 10730.0600 2712.69 15328.66 Medial canthopexy (separate procedure) Each 8532.43 5972.7000 2574.98 8532.43 Lateral canthopexy Each 10257.74 7180.4100 2574.98 10257.74 Unlisted craniofacial and maxillofacial procedure Each 8140.53 5698.3700 188.10 8140.53 Closed treatment of nasal bone fracture with manipulation; without stabilization Each 11116.42 7781.4900 1256.38 11116.42 Closed treatment of nasal bone fracture with manipulation; with stabilization Each 7288.29 5101.8000 1923.21 7288.28 Closed treatment of nasal septal fracture, with or without stabilization Each 7916.68 5541.6700 1923.21 7916.68 Open treatment of nasomaxillary complex fracture (LeFort II type); with wiring and/or local fixation Each 19960.27 13972.1900 4132.00 19960.26 Open treatment of depressed zygomatic arch fracture (eg, Gillies approach) Each 10200.61 7140.4300 2198.61 10200.61 Open treatment of complicated (eg, comminuted or involving cranial nerve foramina) fracture(s) of malar area, including zygomatic arch and malar tripod; with internal fixation and multiple surgical approaches Each 9549.73 6684.8100 3093.66 9549.73 Open treatment of orbital floor blowout fracture; transantral approach (Caldwell-Luc type operation) Each 13188.29 9231.8000 3093.66 13188.28 Open treatment of orbital floor blowout fracture; periorbital approach Each 18536.23 12975.3600 3093.66 18536.23 Open treatment of orbital floor blowout fracture; combined approach Each 13112.54 9178.7800 3093.66 13112.54 Open treatment of orbital floor blowout fracture; periorbital approach, with alloplastic or other implant Each 9254.92 6478.4400 4291.65 9254.92 Open treatment of fracture of orbit, except blowout; without implant Each 6863.91 4804.7400 2712.69 6863.91 Closed treatment of palatal or maxillary fracture (LeFort I type), with interdental wire fixation or fixation of denture or splint Each 6407.22 4485.0500 2574.98 6407.22 Open treatment of palatal or maxillary fracture (LeFort I type) Each 11116.42 7781.4900 3093.66 11116.42 Closed treatment of mandibular fracture; without manipulation Each 6860.67 4802.4700 413.46 6860.67 Closed treatment of mandibular fracture with interdental fixation Each 8573.71 6001.6000 2198.61 8573.71 Open treatment of mandibular fracture; without interdental fixation Each 11355.85 7949.0900 2712.69 11355.85 Open treatment of mandibular fracture; with interdental fixation Each 31167.49 21817.2400 3093.66 31167.48 Open treatment of mandibular condylar fracture Each 15083.41 10558.3900 2712.69 15083.41 Open treatment of complicated mandibular fracture by multiple surgical approaches including internal fixation, interdental fixation, and/or wiring of dentures or splints Each 16882.19 11817.5300 3093.66 16882.19 Closed treatment of temporomandibular dislocation; initial or subsequent Each 1104.42 773.0900 187.36 1104.42 Incision and drainage, deep abscess or hematoma, soft tissues of neck or thorax Each 1053.24 737.2700 631.94 2338.05 Biopsy, soft tissue of neck or thorax Each 3647.39 2553.1700 1357.21 3647.39 Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; 3 cm or greater Each 4629.75 3240.8200 1990.79 4629.75 Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, intramuscular); 5 cm or greater Each 8051.40 5635.9800 2338.05 8051.40 Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; less than 3 cm Each 7596.94 5317.8600 1357.21 7596.94 Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, intramuscular); less than 5 cm Each 7596.84 5317.7800 1923.21 7596.84 Division of scalenus anticus; without resection of cervical rib Each 8182.00 5727.4000 1923.21 8182.00 Division of scalenus anticus; with resection of cervical rib Each 15782.48 11047.7300 3364.00 15782.48 Excision, tumor, soft tissue of back or flank, subcutaneous; less than 3 cm Each 4597.81 3218.4700 1357.21 4597.81 Excision, tumor, soft tissue of back or flank, subcutaneous; 3 cm or greater Each 8954.95 6268.4700 1357.21 8954.95 Excision, tumor, soft tissue of back or flank, subfascial (eg, intramuscular); less than 5 cm Each 6374.77 4462.3400 2338.05 6374.77 Excision, tumor, soft tissue of back or flank, subfascial (eg, intramuscular); 5 cm or greater Each 9146.93 6402.8500 2338.05 9146.93 Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracic Each 21686.14 15180.3000 2694.12 21686.14 Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; lumbosacral Each 15966.33 11176.4300 2694.12 15966.33 Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; each additional cervicothoracic or lumbosacral vertebral body (List separately in addition to code for primary procedure) 1.0000 each 10855.25 7598.6800 1795.00 10855.25 Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic Each 16338.94 11437.2600 5986.77 16338.94 Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar Each 13967.35 9777.1400 5986.77 13967.35 Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; each additional thoracic or lumbar vertebral body (List separately in addition to code for primary procedure) 1.0000 each 16338.94 11437.2600 1795.00 16338.94 Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2 Each 6511.26 4557.8800 2799.84 11809.56 Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2, each additional interspace (List separately in addition to code for primary procedure) 1.0000 each 6273.58 4391.5000 2697.64 6273.58 Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); cervical below C2 Each 4964.39 3475.0800 2134.69 11809.56 Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar Each 7705.22 5393.6600 3313.25 7705.22 Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when performed) Each 8323.37 5826.3600 3579.05 19819.11 Arthrodesis, posterior or posterolateral technique, single interspace; each additional interspace (List separately in addition to code for primary procedure) 1.0000 each 9359.06 6551.3400 1795.00 9359.06 Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, lumbar; Each 7936.04 5555.2300 3364.00 19819.11 Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace, lumbar; Each 8714.45 6100.1200 3747.21 19819.11 Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace, lumbar; each additional interspace (List separately in addition to code for primary procedure) 1.0000 each 7385.04 5169.5300 1795.00 7385.04 Exploration of spinal fusion Each 10249.28 7174.5000 3364.00 10249.28 Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) (List separately in addition to code for primary procedure) 1.0000 each 8360.07 5852.0500 1795.00 8360.07 Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary procedure) 1.0000 each 7244.97 5071.4800 1795.00 7244.97 Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure) 1.0000 each 6390.81 4473.5700 2748.05 6390.81 Anterior instrumentation; 4 to 7 vertebral segments (List separately in addition to code for primary procedure) 1.0000 each 12435.39 8704.7700 5347.22 12435.39 Reinsertion of spinal fixation device Each 14615.23 10230.6600 3364.00 14615.22 Removal of posterior nonsegmental instrumentation (eg, Harrington rod) Each 15743.02 11020.1100 3364.00 15743.02 Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure) 1.0000 each 7260.00 5082.0000 1795.00 7260.00 Removal of anterior instrumentation Each 4341.34 3038.9400 1866.78 4341.34 Unlisted procedure, spine Each 18240.82 12768.5700 187.36 18240.82 Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular); less than 5 cm Each 5091.21 3563.8500 2338.05 5091.21 Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular); 5 cm or greater Each 8354.81 5848.3600 2338.05 8354.80 Excision, tumor, soft tissue of abdominal wall, subcutaneous; less than 3 cm Each 10847.18 7593.0300 1357.21 10847.18 Excision, tumor, soft tissue of abdominal wall, subcutaneous; 3 cm or greater Each 6612.17 4628.5200 2338.05 6612.17 Radical resection of tumor (eg, sarcoma), soft tissue of abdominal wall; 5 cm or greater Each 14058.01 9840.6000 2338.05 14058.00 Unlisted procedure, abdomen, musculoskeletal system Each 17533.32 12273.3200 187.36 17533.32 Capsular contracture release (eg, Sever type procedure) Each 14075.81 9853.0700 1923.21 14075.81 Excision, tumor, soft tissue of shoulder area, subcutaneous; 3 cm or greater Each 9502.22 6651.5500 1357.21 9502.22 Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); 5 cm or greater Each 4680.45 3276.3100 2012.59 4680.45 Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); less than 5 cm Each 5164.71 3615.2900 1923.21 5164.71 Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), proximal humerus Each 12295.21 8606.6500 2712.69 12295.21 Injection procedure for shoulder arthrography or enhanced CT/MRI shoulder arthrography Each 1028.53 719.9700 442.27 1028.53 Tenotomy, shoulder area; single tendon Each 8182.00 5727.4000 1923.21 8182.00 Tenotomy, shoulder area; multiple tendons through same incision Each 8182.00 5727.4000 1923.21 8182.00 Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; acute Each 14075.81 9853.0700 3093.66 14075.81 Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; chronic Each 12732.48 8912.7400 4291.65 12732.48 Reconstruction of complete shoulder (rotator) cuff avulsion, chronic (includes acromioplasty) Each 8550.20 5985.1400 4291.65 8550.20 Tenodesis of long tendon of biceps Each 12381.68 8667.1700 2712.69 12381.68 Capsulorrhaphy, anterior, any type; with coracoid process transfer Each 14847.87 10393.5100 4291.65 14847.87 Capsulorrhaphy, glenohumeral joint, posterior, with or without bone block Each 4840.58 3388.4100 2904.35 5986.77 Arthroplasty, glenohumeral joint; hemiarthroplasty Each 8659.78 6061.8500 3723.71 11809.56 Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (eg, total shoulder)) Each 36247.48 25373.2400 10098.00 36247.48 Revision of total shoulder arthroplasty, including allograft when performed; humeral or glenoid component Each 14841.64 10389.1500 6381.91 14841.64 Revision of total shoulder arthroplasty, including allograft when performed; humeral and glenoid component Each 11224.74 7857.3200 3364.00 11224.74 Osteotomy, clavicle, with or without internal fixation; with bone graft for nonunion or malunion (includes obtaining graft and/or necessary fixation) Each 15331.17 10731.8200 4291.65 15331.17 Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; proximal humerus Each 11266.11 7886.2700 2198.61 11809.56 Open treatment of clavicular fracture, includes internal fixation, when performed Each 19528.60 13670.0200 2198.61 19528.60 Closed treatment of sternoclavicular dislocation; with manipulation Each 851.55 596.0800 187.36 851.55 Closed treatment of acromioclavicular dislocation; with manipulation Each 381.46 267.0200 187.36 381.46 Closed treatment of scapular fracture; with manipulation, with or without skeletal traction (with or without shoulder joint involvement) Each 3895.93 2727.1500 1298.36 3895.93 Open treatment of scapular fracture (body, glenoid or acromion) includes internal fixation, when performed Each 11266.11 7886.2700 2198.61 11266.10 Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed, includes repair of tuberosity(s), when performed Each 12537.21 8776.0400 2712.69 12537.21 Closed treatment of shoulder dislocation, with manipulation; without anesthesia Each 1051.57 736.1000 187.36 1051.57 Closed treatment of shoulder dislocation, with manipulation; requiring anesthesia Each 756.29 529.4000 453.77 1298.36 Closed treatment of shoulder dislocation, with fracture of greater humeral tuberosity, with manipulation Each 653.31 457.3100 391.98 1298.36 Closed treatment of shoulder dislocation, with surgical or anatomical neck fracture, with manipulation Each 1045.00 731.5000 627.00 1298.36 Open treatment of shoulder dislocation, with surgical or anatomical neck fracture, includes internal fixation, when performed Each 10626.15 7438.3000 2198.61 11809.56 Manipulation under anesthesia, shoulder joint, including application of fixation apparatus (dislocation excluded) Each 8263.68 5784.5700 1298.36 8263.68 Unlisted procedure, shoulder Each 10626.15 7438.3000 187.36 10626.15 Incision and drainage, upper arm or elbow area; bursa Each 1045.81 732.0700 627.49 1357.21 Excision, tumor, soft tissue of upper arm or elbow area, subcutaneous; 3 cm or greater Each 4629.75 3240.8200 1990.79 4629.75 Excision, tumor, soft tissue of upper arm or elbow area, subfascial (eg, intramuscular); 5 cm or greater Each 3845.75 2692.0200 1653.67 3845.75 Excision, tumor, soft tissue of upper arm or elbow area, subcutaneous; less than 3 cm Each 8001.68 5601.1800 1357.21 8001.68 Excision, tumor, soft tissue of upper arm or elbow area, subfascial (eg, intramuscular); less than 5 cm Each 5897.93 4128.5500 1923.21 5897.93 Excision, olecranon bursa Each 5553.23 3887.2600 2198.61 5553.23 Excision, radial head Each 12047.24 8433.0700 2198.61 12047.24 Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), humerus Each 10217.33 7152.1300 2198.61 10217.33 Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), olecranon process Each 723.29 506.3000 433.97 2694.12 Removal of foreign body, upper arm or elbow area; subcutaneous Each 6967.16 4877.0100 1357.21 6967.16 Removal of foreign body, upper arm or elbow area; deep (subfascial or intramuscular) Each 8068.87 5648.2100 1923.21 8068.87 Manipulation, elbow, under anesthesia Each 9504.21 6652.9400 1298.36 9504.21 Muscle or tendon transfer, any type, upper arm or elbow, single (excluding 24320-24331) Each 8101.75 5671.2200 2712.69 8101.75 Tenotomy, open, elbow to shoulder, each tendon Each 3258.36 2280.8500 1955.01 3258.36 Tenodesis of biceps tendon at elbow (separate procedure) Each 12408.92 8686.2400 2198.61 12408.92 Repair, tendon or muscle, upper arm or elbow, each tendon or muscle, primary or secondary (excludes rotator cuff) Each 4840.58 3388.4100 2198.61 5986.77 Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon graft Each 13611.10 9527.7700 2198.61 13611.10 Repair lateral collateral ligament, elbow, with local tissue Each 9182.08 6427.4500 2694.12 9182.08 Reconstruction lateral collateral ligament, elbow, with tendon graft (includes harvesting of graft) Each 9881.25 6916.8800 4248.94 9881.25 Reconstruction medial collateral ligament, elbow, with tendon graft (includes harvesting of graft) Each 9881.25 6916.8800 4248.94 11809.56 Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfer's elbow); debridement, soft tissue and/or bone, open with tendon repair or reattachment Each 12353.76 8647.6300 2198.61 12353.76 Arthroplasty, elbow; with distal humerus and proximal ulnar prosthetic replacement (eg, total elbow) Each 12047.24 8433.0700 4291.65 19819.11 Arthroplasty, radial head; with implant Each 21164.54 14815.1800 3093.66 21164.54 Repair of nonunion or malunion, humerus; with iliac or other autograft (includes obtaining graft) Each 11706.34 8194.4400 2712.69 11809.56 Prophylactic treatment (nailing, pinning, plating or wiring), with or without methylmethacrylate, humeral shaft Each 10802.04 7561.4300 2198.61 11809.56 Open treatment of humeral shaft fracture with plate/screws, with or without cerclage Each 19037.57 13326.3000 2712.69 19037.57 Treatment of humeral shaft fracture, with insertion of intramedullary implant, with or without cerclage and/or locking screws Each 16271.80 11390.2600 2712.69 16271.80 Closed treatment of supracondylar or transcondylar humeral fracture, with or without intercondylar extension; with manipulation, with or without skin or skeletal traction Each 419.77 293.8400 251.86 1298.36 Percutaneous skeletal fixation of supracondylar or transcondylar humeral fracture, with or without intercondylar extension Each 13276.99 9293.8900 1923.21 13276.98 Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when performed; without intercondylar extension Each 14473.40 10131.3800 2712.69 14473.40 Open treatment of humeral supracondylar or transcondylar fracture, includes internal fixation, when performed; with intercondylar extension Each 13766.53 9636.5700 3093.66 13766.53 Open treatment of humeral epicondylar fracture, medial or lateral, includes internal fixation, when performed Each 10030.13 7021.0900 2198.61 11809.56 Closed treatment of humeral condylar fracture, medial or lateral; with manipulation Each 103.92 72.7400 62.35 1298.36 Open treatment of humeral condylar fracture, medial or lateral, includes internal fixation, when performed Each 14899.46 10429.6200 2198.61 14899.46 Percutaneous skeletal fixation of humeral condylar fracture, medial or lateral, with manipulation Each 14847.66 10393.3600 1923.21 14847.66 Open treatment of periarticular fracture and/or dislocation of the elbow (fracture distal humerus and proximal ulna and/or proximal radius) Each 18207.56 12745.2900 2712.69 18207.56 Treatment of closed elbow dislocation; without anesthesia Each 1142.16 799.5100 187.36 1142.16 Treatment of closed elbow dislocation; requiring anesthesia Each 1100.78 770.5500 660.47 1298.36 Closed treatment of Monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of radial head), with manipulation Each 237.82 166.4700 142.69 1298.36 Open treatment of Monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of radial head), includes internal fixation, when performed Each 15391.69 10774.1800 2198.61 15391.69 Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation Each 1104.42 773.0900 187.36 1104.42 Closed treatment of radial head or neck fracture; with manipulation Each 1027.37 719.1600 616.42 1298.36 Open treatment of radial head or neck fracture, includes internal fixation or radial head excision, when performed Each 11730.42 8211.2900 2712.69 11730.42 Open treatment of radial head or neck fracture, includes internal fixation or radial head excision, when performed; with radial head prosthetic replacement Each 9182.08 6427.4500 2712.69 11809.56 Open treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process[es]), includes internal fixation, when performed Each 16997.15 11898.0000 2198.61 16997.15 Unlisted procedure, humerus or elbow Each 361.92 253.3500 155.63 361.92 Incision, extensor tendon sheath, wrist (eg, de Quervains disease) Each 12006.22 8404.3500 1298.36 12006.22 Incision, flexor tendon sheath, wrist (eg, flexor carpi radialis) Each 13132.29 9192.6000 2694.12 13132.28 Decompression fasciotomy, forearm and/or wrist, flexor AND extensor compartment; without debridement of nonviable muscle and/or nerve Each 14027.37 9819.1600 2198.61 14027.36 Excision, tumor, soft tissue of forearm and/or wrist area, subcutaneous; 3 cm or greater Each 6302.28 4411.5900 1357.21 6302.28 Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (eg, intramuscular); 3 cm or greater Each 6540.89 4578.6200 2338.05 6540.89 Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (eg, intramuscular); less than 3 cm Each 8036.62 5625.6300 1357.21 8036.62 Radical resection of tumor (eg, sarcoma), soft tissue of forearm and/or wrist area; 3 cm or greater Each 7483.23 5238.2600 2338.05 7483.23 Excision of tendon, forearm and/or wrist, flexor or extensor, each Each 101.07 70.7500 43.46 2694.12 Excision of ganglion, wrist (dorsal or volar); primary Each 9711.65 6798.1600 1298.36 9711.65 Excision of ganglion, wrist (dorsal or volar); recurrent Each 10104.15 7072.9000 1298.36 10104.14 Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, Tbc, or other granulomas, rheumatoid arthritis); flexors Each 7770.86 5439.6000 1298.36 7770.86 Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, Tbc, or other granulomas, rheumatoid arthritis); extensors, with or without transposition of dorsal retinaculum Each 17316.67 12121.6700 2694.12 17316.67 Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); ulna Each 8904.80 6233.3600 1923.21 8904.80 Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); radius Each 8847.60 6193.3200 1923.21 8847.60 Carpectomy; 1 bone Each 5857.22 4100.0500 2198.61 5857.22 Excision distal ulna partial or complete (eg, Darrach type or matched resection) Each 8621.50 6035.0500 2694.12 8621.50 Injection procedure for wrist arthrography Each 804.96 563.4700 346.13 804.96 Repair, tendon or muscle, flexor, forearm and/or wrist; primary, single, each tendon or muscle Each 5625.85 3938.1000 2694.12 5625.85 Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, with free graft (includes obtaining graft), each tendon or muscle Each 11059.83 7741.8800 2198.61 11059.83 Repair, tendon or muscle, extensor, forearm and/or wrist; primary, single, each tendon or muscle Each 4476.52 3133.5600 2685.91 4476.52 Tenotomy, open, flexor or extensor tendon, forearm and/or wrist, single, each tendon Each 977.51 684.2600 586.50 2694.12 Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; each tendon Each 8514.84 5960.3900 2198.61 8514.84 Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; with tendon graft(s) (includes obtaining graft), each tendon Each 8733.13 6113.1900 2694.12 8733.13 Reconstruction for stabilization of unstable distal ulna or distal radioulnar joint, secondary by soft tissue stabilization (eg, tendon transfer, tendon graft or weave, or tenodesis) with or without open reduction of distal radioulnar joint Each 5670.29 3969.2000 3093.66 5986.77 Osteotomy; ulna Each 5670.29 3969.2000 2198.61 5986.77 Osteoplasty, radius OR ulna; shortening Each 11512.18 8058.5300 2198.61 11512.18 Osteoplasty, radius OR ulna; lengthening with autograft Each 9956.61 6969.6200 2712.69 11809.56 Repair of nonunion or malunion, radius OR ulna; without graft (eg, compression technique) Each 14851.65 10396.1500 2198.61 14851.64 Repair of nonunion or malunion, radius OR ulna; with autograft (includes obtaining graft) Each 9938.44 6956.9100 2712.69 9938.44 Repair of nonunion or malunion, radius AND ulna; with autograft (includes obtaining graft) Each 16117.55 11282.2800 2712.69 16117.55 Arthroplasty, interposition, intercarpal or carpometacarpal joints Each 8733.13 6113.1900 2694.12 8733.13 Closed treatment of radial shaft fracture; with manipulation Each 879.87 615.9100 527.92 1298.36 Open treatment of radial shaft fracture, includes internal fixation, when performed Each 15428.31 10799.8200 2198.61 15428.31 Closed treatment of ulnar shaft fracture; with manipulation Each 1044.48 731.1400 187.36 1044.48 Open treatment of ulnar shaft fracture, includes internal fixation, when performed Each 9263.95 6484.7700 2198.61 9263.95 Closed treatment of radial and ulnar shaft fractures; with manipulation Each 1271.64 890.1400 762.98 1298.36 Open treatment of radial AND ulnar shaft fractures, with internal fixation, when performed; of radius AND ulna Each 15771.18 11039.8300 2198.61 15771.18 Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; with manipulation Each 1135.13 794.5900 681.08 1298.36 Percutaneous skeletal fixation of distal radial fracture or epiphyseal separation Each 12111.12 8477.7800 2198.61 12111.12 Open treatment of distal radial extra-articular fracture or epiphyseal separation, with internal fixation Each 9342.49 6539.7400 3093.66 9342.49 Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 2 fragments Each 11597.82 8118.4800 3093.66 11597.82 Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 3 or more fragments Each 16064.64 11245.2400 3093.66 16064.64 Open treatment of carpal scaphoid (navicular) fracture, includes internal fixation, when performed Each 16190.33 11333.2300 2198.61 16190.33 Percutaneous skeletal fixation of ulnar styloid fracture Each 7411.12 5187.7800 2694.12 7411.12 Open treatment of ulnar styloid fracture Each 11442.49 8009.7400 4920.27 11442.49 Closed treatment of distal radioulnar dislocation with manipulation Each 2072.33 1450.6300 187.36 2072.33 Open treatment of lunate dislocation Each 9443.31 6610.3200 1923.21 9443.31 Arthrodesis, wrist; with autograft (includes obtaining graft) Each 9534.78 6674.3500 3093.66 9534.78 Drainage of finger abscess; simple Each 733.77 513.6400 163.44 733.77 Drainage of finger abscess; complicated (eg, felon) Each 685.21 479.6500 411.13 1357.21 Drainage of tendon sheath, digit and/or palm, each Each 8410.53 5887.3700 1923.21 8410.52 Fasciotomy, palmar (eg, Dupuytren's contracture); open, partial Each 6218.89 4353.2200 2198.61 6218.89 Tendon sheath incision (eg, for trigger finger) Each 22973.26 16081.2800 1298.36 22973.26 Arthrotomy, with exploration, drainage, or removal of loose or foreign body; interphalangeal joint, each Each 5149.40 3604.5800 1298.36 5149.40 Excision, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial (eg, intramuscular); 1.5 cm or greater Each 8865.70 6205.9900 1357.21 8865.70 Excision, tumor or vascular malformation, soft tissue of hand or finger, subcutaneous; less than 1.5 cm Each 7323.98 5126.7900 1357.21 7323.98 Excision, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial (eg, intramuscular); less than 1.5 cm Each 5414.48 3790.1400 1357.21 5414.48 Fasciectomy, palm only, with or without Z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft) Each 8303.65 5812.5500 2694.12 8303.64 Fasciectomy, partial palmar with release of single digit including proximal interphalangeal joint, with or without Z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft) Each 14000.82 9800.5700 2694.12 14000.82 Synovectomy, proximal interphalangeal joint, including extensor reconstruction, each interphalangeal joint Each 4483.34 3138.3300 1298.36 4483.34 Synovectomy, tendon sheath, radical (tenosynovectomy), flexor tendon, palm and/or finger, each tendon Each 4087.83 2861.4800 1298.36 4087.83 Excision of lesion of tendon sheath or joint capsule (eg, cyst, mucous cyst, or ganglion), hand or finger Each 5319.60 3723.7200 1298.36 5319.60 Excision of tendon, finger, flexor or extensor, each tendon Each 7392.41 5174.6800 1298.36 7392.41 Sesamoidectomy, thumb or finger (separate procedure) Each 7698.49 5388.9400 1298.36 7698.49 Excision or curettage of bone cyst or benign tumor of metacarpal Each 10016.96 7011.8700 1298.36 10016.96 Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); proximal or middle phalanx of finger Each 14312.63 10018.8400 1298.36 14312.63 Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); distal phalanx of finger Each 6341.61 4439.1300 1298.36 6341.61 Removal of implant from finger or hand Each 10973.62 7681.5300 1357.21 10973.62 Manipulation, finger joint, under anesthesia, each joint Each 8802.21 6161.5500 1298.36 8802.21 Repair or advancement, flexor tendon, not in zone 2 digital flexor tendon sheath (eg, no man's land); primary or secondary without free graft, each tendon Each 1715.21 1200.6500 1029.13 2694.12 Repair or advancement, flexor tendon, not in zone 2 digital flexor tendon sheath (eg, no man's land); secondary with free graft (includes obtaining graft), each tendon Each 10412.23 7288.5600 2712.69 10412.23 Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, no man's land); primary, without free graft, each tendon Each 17969.33 12578.5300 2694.12 17969.32 Repair, extensor tendon, hand, primary or secondary; without free graft, each tendon Each 14034.92 9824.4400 1298.36 14034.92 Repair, extensor tendon, finger, primary or secondary; without free graft, each tendon Each 711.61 498.1300 426.97 1298.36 Tenolysis, flexor tendon; palm OR finger, each tendon Each 10661.83 7463.2800 1298.36 10661.83 Tenolysis, extensor tendon, hand OR finger, each tendon Each 4873.51 3411.4600 2198.61 4873.51 Tenotomy, flexor, finger, open, each tendon Each 9791.23 6853.8600 1298.36 9791.23 Tenotomy, extensor, hand or finger, open, each tendon Each 2039.91 1427.9400 1223.95 2039.91 Tenodesis; of proximal interphalangeal joint, each joint Each 6856.76 4799.7300 1923.21 6856.76 Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; without free graft, each tendon Each 5217.31 3652.1200 2198.61 5217.31 Transfer of tendon to restore intrinsic function; ring and small finger Each 9811.43 6868.0000 2198.61 9811.42 Capsulectomy or capsulotomy; metacarpophalangeal joint, each joint Each 2549.89 1784.9200 1529.93 2694.12 Capsulectomy or capsulotomy; interphalangeal joint, each joint Each 8265.30 5785.7100 1298.36 8265.30 Arthroplasty, metacarpophalangeal joint; with prosthetic implant, each joint Each 4931.81 3452.2600 2959.08 5986.77 Repair of collateral ligament, metacarpophalangeal or interphalangeal joint Each 13724.50 9607.1500 2694.12 13724.50 Reconstruction of polydactylous digit, soft tissue and bone Each 12658.23 8860.7600 2694.12 12658.23 Closed treatment of metacarpal fracture, single; with manipulation, each bone Each 532.40 372.6800 187.36 532.40 Open treatment of metacarpal fracture, single, includes internal fixation, when performed, each bone Each 8069.60 5648.7200 2694.12 8069.60 Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; without anesthesia Each 1027.37 719.1600 187.36 1027.37 Percutaneous skeletal fixation of carpometacarpal dislocation, other than thumb, with manipulation, each joint Each 7494.46 5246.1200 1923.21 7494.46 Closed treatment of metacarpophalangeal dislocation, single, with manipulation; without anesthesia Each 1104.42 773.0900 187.36 1104.42 Closed treatment of metacarpophalangeal dislocation, single, with manipulation; requiring anesthesia Each 564.67 395.2700 338.80 1298.36 Open treatment of metacarpophalangeal dislocation, single, includes internal fixation, when performed Each 11503.46 8052.4200 2694.12 11503.46 Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; with manipulation, with or without skin or skeletal traction, each Each 1027.37 719.1600 187.36 1027.37 Percutaneous skeletal fixation of unstable phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, with manipulation, each Each 9681.34 6776.9400 2694.12 9681.34 Open treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, includes internal fixation, when performed, each Each 15834.16 11083.9100 2694.12 15834.16 Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; with manipulation, each Each 935.34 654.7300 561.20 1298.36 Open treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint, includes internal fixation, when performed, each Each 19138.68 13397.0800 2694.12 19138.68 Closed treatment of distal phalangeal fracture, finger or thumb; with manipulation, each Each 596.64 417.6500 187.36 596.64 Percutaneous skeletal fixation of distal phalangeal fracture, finger or thumb, each Each 11166.72 7816.7000 1923.21 11166.72 Open treatment of distal phalangeal fracture, finger or thumb, includes internal fixation, when performed, each Each 5805.59 4063.9100 2694.12 5805.59 Closed treatment of interphalangeal joint dislocation, single, with manipulation; without anesthesia Each 1060.26 742.1800 187.36 1060.26 Closed treatment of interphalangeal joint dislocation, single, with manipulation; requiring anesthesia Each 604.68 423.2700 217.14 604.68 Percutaneous skeletal fixation of interphalangeal joint dislocation, single, with manipulation Each 6434.95 4504.4600 1923.21 6434.95 Open treatment of interphalangeal joint dislocation, includes internal fixation, when performed, single Each 21391.71 14974.2000 1923.21 21391.71 Arthrodesis, carpometacarpal joint, digit, other than thumb, each; with autograft (includes obtaining graft) Each 10750.52 7525.3700 2198.61 10750.52 Arthrodesis, metacarpophalangeal joint, with or without internal fixation Each 10451.32 7315.9200 2712.69 10451.32 Arthrodesis, interphalangeal joint, with or without internal fixation Each 15801.67 11061.1700 2198.61 15801.66 Arthrodesis, interphalangeal joint, with or without internal fixation; each additional interphalangeal joint (List separately in addition to code for primary procedure) 1.0000 each 5804.94 4063.4600 1795.00 5804.94 Amputation, metacarpal, with finger or thumb (ray amputation), single, with or without interosseous transfer Each 18714.31 13100.0100 2198.61 18714.30 Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including neurectomies; with direct closure Each 12577.36 8804.1500 1923.21 12577.36 Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including neurectomies; with local advancement flaps (V-Y, hood) Each 13157.71 9210.4000 2694.12 13157.71 Unlisted procedure, hands or fingers Each 8092.42 5664.6900 187.36 8092.42 Incision and drainage, pelvis or hip joint area; deep abscess or hematoma Each 13685.12 9579.5800 1432.08 13685.12 Arthrotomy, hip, with drainage (eg, infection) Each 12378.01 8664.6100 2198.61 12378.01 Capsulectomy or capsulotomy, hip, with or without excision of heterotopic bone, with release of hip flexor muscles (ie, gluteus medius, gluteus minimus, tensor fascia latae, rectus femoris, sartorius, iliopsoas) Each 1100.00 770.0000 473.00 1100.00 Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; 3 cm or greater Each 9808.12 6865.6800 2338.05 9808.12 Excision, tumor, soft tissue of pelvis and hip area, subfascial (eg, intramuscular); 5 cm or greater Each 9724.40 6807.0800 2338.05 9724.40 Excision, tumor, soft tissue of pelvis and hip area, subfascial (eg, intramuscular); less than 5 cm Each 6203.55 4342.4900 2198.61 6203.55 Excision; trochanteric bursa or calcification Each 10341.36 7238.9500 2694.12 10341.36 Injection procedure for hip arthrography; without anesthesia Each 871.77 610.2400 374.86 871.77 Injection procedure for hip arthrography; with anesthesia Each 4670.69 3269.4800 1795.00 4670.69 Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance (fluoroscopy or CT) including arthrography when performed Each 33838.53 0.0000 N/A N/A Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft Each 15626.43 10938.5000 6719.36 15626.43 Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft Each 20207.12 14144.9800 8689.06 20207.12 Revision of total hip arthroplasty; both components, with or without autograft or allograft Each 23712.62 16598.8300 10098.00 23712.62 Revision of total hip arthroplasty; femoral component only, with or without allograft Each 15935.48 11154.8400 6852.26 15935.48 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or dislocation, for fracture patterns that disrupt the pelvic ring, unilateral (includes ipsilateral ilium, sacroiliac joint and/or sacrum) 1.0000 each 16022.12 11215.4800 5118.00 16022.12 Percutaneous skeletal fixation of femoral fracture, proximal end, neck Each 13510.82 9457.5700 5118.00 13510.82 Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement Each 9635.09 6744.5600 3364.00 9635.08 Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with intramedullary implant, with or without interlocking screws and/or cerclage Each 9536.23 6675.3600 3612.00 9536.22 Open treatment of greater trochanteric fracture, includes internal fixation, when performed Each 15767.61 11037.3300 3364.00 15767.61 Closed treatment of hip dislocation, traumatic; without anesthesia Each 2069.65 1448.7500 187.36 2069.65 Closed treatment of hip dislocation, traumatic; requiring anesthesia Each 1243.78 870.6500 746.27 1298.36 Treatment of spontaneous hip dislocation (developmental, including congenital or pathological), by abduction, splint or traction; with manipulation, requiring anesthesia Each 786.25 550.3800 471.75 1298.36 Closed treatment of post hip arthroplasty dislocation; without anesthesia Each 994.10 695.8700 187.36 994.10 Closed treatment of post hip arthroplasty dislocation; requiring regional or general anesthesia Each 1160.56 812.3900 696.33 1298.36 Arthrodesis, sacroiliac joint, percutaneous or minimally invasive (indirect visualization), with image guidance, includes obtaining bone graft when performed, and placement of transfixing device Each 12739.31 8917.5100 5477.90 19819.11 Unlisted procedure, pelvis or hip joint Each 11359.01 7951.3100 187.36 11359.01 Incision and drainage, deep abscess, bursa, or hematoma, thigh or knee region Each 7886.92 5520.8400 2198.61 7886.92 Arthrotomy, knee, with exploration, drainage, or removal of foreign body (eg, infection) Each 9423.29 6596.3000 2694.12 9423.29 Excision, tumor, soft tissue of thigh or knee area, subcutaneous; less than 3 cm Each 4443.78 3110.6500 1357.21 4443.78 Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); less than 5 cm Each 6522.33 4565.6300 2198.61 6522.32 Arthrotomy, knee; including joint exploration, biopsy, or removal of loose or foreign bodies Each 11009.21 7706.4500 2694.12 11009.21 Arthrotomy, with synovectomy, knee; anterior OR posterior Each 11616.52 8131.5600 2694.12 11616.52 Arthrotomy, with synovectomy, knee; anterior AND posterior including popliteal area Each 12039.82 8427.8800 2712.69 12039.82 Excision, tumor, soft tissue of thigh or knee area, subcutaneous; 3 cm or greater Each 6219.97 4353.9800 2338.05 6219.97 Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); 5 cm or greater Each 9113.02 6379.1100 2338.05 9113.02 Excision, prepatellar bursa Each 12762.83 8933.9800 2198.61 12762.83 Excision of synovial cyst of popliteal space (eg, Baker's cyst) Each 10996.86 7697.8000 2694.12 10996.86 Patellectomy or hemipatellectomy Each 12536.16 8775.3100 2712.69 12536.16 Excision or curettage of bone cyst or benign tumor of femur Each 13450.53 9415.3700 2198.61 13450.53 Partial excision (craterization, saucerization, or diaphysectomy) bone, femur, proximal tibia and/or fibula (eg, osteomyelitis or bone abscess) Each 11568.61 8098.0200 2694.12 11568.61 Injection procedure for contrast knee arthrography or contrast enhanced CT/MRI knee arthrography Each 730.16 511.1100 313.97 730.16 Removal of foreign body, deep, thigh region or knee area Each 692.98 485.0900 415.79 2338.05 Suture of infrapatellar tendon; primary Each 12536.16 8775.3100 1432.08 12536.16 Suture of infrapatellar tendon; secondary reconstruction, including fascial or tendon graft Each 20450.94 14315.6500 2198.61 20450.94 Suture of quadriceps or hamstring muscle rupture; primary Each 12754.16 8927.9100 2198.61 12754.16 Arthrotomy with meniscus repair, knee Each 11009.21 7706.4500 2712.69 11009.21 Repair, primary, torn ligament and/or capsule, knee; collateral Each 18166.37 12716.4600 2712.69 18166.37 Reconstruction of dislocating patella; with extensor realignment and/or muscle advancement or release (eg, Campbell, Goldwaite type procedure) Each 19512.10 13658.4700 4291.65 19512.10 Ligamentous reconstruction (augmentation), knee; extra-articular Each 12991.92 9094.3400 2198.61 12991.92 Ligamentous reconstruction (augmentation), knee; intra-articular (open) Each 21272.19 14890.5300 2712.69 21272.19 Arthroplasty, patella; with prosthesis Each 17783.10 12448.1700 3093.66 17783.10 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment Each 14783.13 10348.1900 6356.75 14783.13 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty) Each 17965.85 12576.1000 7725.32 17965.85 Osteotomy, proximal tibia, including fibular excision or osteotomy (includes correction of genu varus [bowleg] or genu valgus [knock-knee]); after epiphyseal closure Each 14222.60 9955.8200 6115.72 14222.60 Arrest, epiphyseal, any method (eg, epiphysiodesis); combined distal femur, proximal tibia and fibula Each 17624.41 12337.0900 5118.00 17624.41 Arrest, hemiepiphyseal, distal femur or proximal tibia or fibula (eg, genu varus or valgus) Each 16997.72 11898.4000 5118.00 16997.72 Revision of total knee arthroplasty, with or without allograft; 1 component Each 24481.50 17137.0500 10098.00 24481.50 Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component Each 23996.90 16797.8300 10098.00 23996.90 Prophylactic treatment (nailing, pinning, plating, or wiring) with or without methylmethacrylate, femur Each 9635.09 6744.5600 3364.00 9635.08 Closed treatment of femoral shaft fracture, without manipulation Each 1033.21 723.2500 187.36 1033.21 Closed treatment of femoral shaft fracture, with manipulation, with or without skin or skeletal traction Each 948.69 664.0800 569.21 1298.36 Open treatment of femoral shaft fracture, with or without external fixation, with insertion of intramedullary implant, with or without cerclage and/or locking screws Each 948.69 664.0800 407.94 948.69 Open treatment of femoral fracture, distal end, medial or lateral condyle, includes internal fixation, when performed Each 24746.83 17322.7800 3364.00 24746.83 Open treatment of patellar fracture, with internal fixation and/or partial or complete patellectomy and soft tissue repair Each 17854.89 12498.4200 2198.61 17854.89 Closed treatment of tibial fracture, proximal (plateau); with or without manipulation, with skeletal traction Each 10204.89 7143.4200 1432.08 10204.89 Open treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed Each 10469.16 7328.4100 2198.61 10469.16 Open treatment of tibial fracture, proximal (plateau); bicondylar, with or without internal fixation Each 9291.52 6504.0700 3995.36 9291.52 Open treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the knee, includes internal fixation, when performed Each 15806.87 11064.8100 6796.95 15806.87 Closed treatment of patellar dislocation; without anesthesia Each 1030.00 721.0000 187.36 1030.00 Closed treatment of patellar dislocation; requiring anesthesia Each 1233.38 863.3700 187.36 1233.38 Open treatment of patellar dislocation, with or without partial or total patellectomy Each 16541.82 11579.2800 1923.21 16541.82 Manipulation of knee joint under general anesthesia (includes application of traction or other fixation devices) Each 8867.11 6206.9800 1298.36 8867.11 Unlisted procedure, femur or knee Each 14514.15 10159.9000 187.36 14514.15 Decompression fasciotomy, leg; anterior and/or lateral, and posterior compartment(s) Each 12128.05 8489.6400 2198.61 12128.05 Arthrotomy, ankle, including exploration, drainage, or removal of foreign body Each 19857.73 13900.4100 1923.21 19857.73 Excision, tumor, soft tissue of leg or ankle area, subcutaneous; less than 3 cm Each 3829.97 2680.9800 1357.21 3829.97 Excision, tumor, soft tissue of leg or ankle area, subfascial (eg, intramuscular); less than 5 cm Each 6637.36 4646.1500 2198.61 6637.36 Arthrotomy, with synovectomy, ankle; including tenosynovectomy Each 9666.87 6766.8100 2694.12 9666.87 Excision of lesion of tendon sheath or capsule (eg, cyst or ganglion), leg and/or ankle Each 9606.60 6724.6200 2198.61 9606.60 Excision, tumor, soft tissue of leg or ankle area, subcutaneous; 3 cm or greater Each 4186.63 2930.6400 1800.25 4186.63 Excision, tumor, soft tissue of leg or ankle area, subfascial (eg, intramuscular); 5 cm or greater Each 6431.54 4502.0800 2338.05 6431.54 Excision or curettage of bone cyst or benign tumor, tibia or fibula Each 10209.64 7146.7500 2198.61 10209.64 Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, osteomyelitis); tibia Each 10447.29 7313.1000 1923.21 10447.29 Repair, primary, open or percutaneous, ruptured Achilles tendon Each 16202.79 11341.9500 2198.61 16202.79 Repair, secondary, Achilles tendon, with or without graft Each 7937.88 5556.5200 2198.61 7937.88 Repair, flexor tendon, leg; primary, without graft, each tendon Each 14028.69 9820.0800 1432.08 14028.69 Repair, flexor tendon, leg; secondary, with or without graft, each tendon Each 7437.94 5206.5600 1923.21 7437.94 Repair, extensor tendon, leg; primary, without graft, each tendon Each 9378.50 6564.9500 1923.21 9378.50 Repair, extensor tendon, leg; secondary, with or without graft, each tendon Each 6641.24 4648.8700 1923.21 6641.24 Repair, dislocating peroneal tendons; without fibular osteotomy Each 10269.97 7188.9800 1923.21 10269.97 Repair, dislocating peroneal tendons; with fibular osteotomy Each 7364.22 5154.9600 2198.61 7364.22 Tenolysis, flexor or extensor tendon, leg and/or ankle; single, each tendon Each 8131.98 5692.3900 2198.61 8131.98 Lengthening or shortening of tendon, leg or ankle; single tendon (separate procedure) Each 11275.22 7892.6600 2198.61 11275.22 Gastrocnemius recession (eg, Strayer procedure) Each 9231.35 6461.9400 2198.61 9231.35 Transfer or transplant of single tendon (with muscle redirection or rerouting); deep (eg, anterior tibial or posterior tibial through interosseous space, flexor digitorum longus, flexor hallucis longus, or peroneal tendon to midfoot or hindfoot) Each 14125.23 9887.6600 2712.69 14125.23 Repair, primary, disrupted ligament, ankle; collateral Each 9474.73 6632.3100 1923.21 9474.73 Repair, primary, disrupted ligament, ankle; both collateral ligaments Each 8586.78 6010.7500 1923.21 8586.78 Repair, secondary, disrupted ligament, ankle, collateral (eg, Watson-Jones procedure) Each 12831.96 8982.3700 1923.21 12831.96 Arthroplasty, ankle; with implant (total ankle) Each 17767.43 12437.2000 3364.00 19819.11 Osteotomy; tibia and fibula Each 10460.04 7322.0300 1923.21 11809.56 Osteoplasty, tibia and fibula, lengthening or shortening Each 26831.32 18781.9200 2712.69 26831.32 Repair of nonunion or malunion, tibia; with iliac or other autograft (includes obtaining graft) Each 13628.36 9539.8500 3364.00 13628.36