OWCP MEDICAL FEE SCHEDULE - EFFECTIVE AUGUST 30, 2019Table of RVU & Conversion Factor values by CPT/HCPCS CodesEffective Date: August 30, 2019Last Update: March 30, 2020Pay Status: B=Bundled (Non-ASC providers); C=Covered; D = Not Payable by DOL; R=Suspend for Review; S = Suspend for Review

Table of RVU & Conversion Factor values by CPT/HCPCS CodesCPT NON-FACILITY FACILITYADA PAY WORK PE PE MPE GLOBAL CONVERSION SHORT DESCRIPTION

HCPCS MODIFIER STATUS RVU RVU RVU RVU PERIOD FACTOR END DATE (ADA, HCPCS & OWCP codes only; Refer to AMA CPT)00100 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Salivary Gland00102 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Repair Of Cleft Lip00103 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Blepharoplasty00104 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Electroshock00120 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Ear Surgery00124 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Ear Exam00126 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Tympanotomy00140 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Procedures On Eye00142 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Lens Surgery00144 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Corneal Transplant00145 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Vitreoretinal Surg00147 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Iridectomy00148 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Eye Exam00160 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Nose/Sinus Surgery00162 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Nose/Sinus Surgery00164 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Biopsy Of Nose00170 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Procedure On Mouth00172 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Cleft Palate Repair00174 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Pharyngeal Surgery00176 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Pharyngeal Surgery00190 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Face/Skull Bone Surg00192 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Facial Bone Surgery00210 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Cranial Surg Nos00211 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Cran Surg Hemotoma00212 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Skull Drainage00214 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Skull Drainage00215 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Skull Repair/Fract00216 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Head Vessel Surgery00218 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Special Head Surgery00220 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Intrcrn Nerve00222 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Head Nerve Surgery00300 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Head/Neck/Ptrunk00320 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Neck Organ 1Yr/>00322 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Biopsy Of Thyroid00326 D 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Larynx/Trach < 1 Yr00350 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Neck Vessel Surgery00352 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Neck Vessel Surgery00400 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Skin Ext/Per/Atrunk00402 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Surgery Of Breast00404 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Surgery Of Breast00406 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Surgery Of Breast00410 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Correct Heart Rhythm00450 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Surgery Of Shoulder00454 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Collar Bone Biopsy00470 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Removal Of Rib00472 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Chest Wall Repair00474 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Surgery Of Rib00500 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Esophageal Surgery00520 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Chest Procedure00522 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Chest Lining Biopsy00524 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Chest Drainage00528 C 0.00 0.00 0.00 0.00 XXX 0.00 Anes Mediascpy & Dx Thorscpy00529 C 0.00 0.00 0.00 0.00 XXX 0.00 Anes Medscpy&Thorscpy 1 Lung00530 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Pacemaker Insertion00532 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Vascular Access00534 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Cardioverter/Defib00537 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Cardiac Electrophys00539 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Trach-Bronch Reconst00540 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Chest Surgery00541 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth One Lung Ventilation00542 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesthesia Removal Pleura00546 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Lung Chest Wall Surg00548 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Trachea Bronchi Surg00550 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Sternal Debridement00560 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Heart Surg W/O Pump00561 D 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Heart Surg

00632 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Removal Of Nerves00635 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Lumbar Puncture00640 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Spine Manipulation00670 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Spine Cord Surgery00700 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Abdominal Wall Surg00702 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth For Liver Biopsy00730 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Abdominal Wall Surg00731 C 0.00 0.00 0.00 0.00 XXX 0.00 Anes Upr Gi Ndsc Px Nos 00732 C 0.00 0.00 0.00 0.00 XXX 0.00 Anes Upr Gi Ndsc Px Ercp 00750 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Repair Of Hernia00752 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Repair Of Hernia00754 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Repair Of Hernia00756 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Repair Of Hernia00770 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Blood Vessel Repair00790 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Surg Upper Abdomen00792 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Hemorr/Excise Liver00794 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Pancreas Removal00796 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth For Liver Transplant00797 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Surgery For Obesity00800 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Abdominal Wall Surg00802 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Fat Layer Removal00811 C 0.00 0.00 0.00 0.00 XXX 0.00 Anes Lwr Intst Ndsc Nos 00812 C 0.00 0.00 0.00 0.00 XXX 0.00 Anes Lwr Intst Scr Colsc 00813 C 0.00 0.00 0.00 0.00 XXX 0.00 Anes Upr Lwr Gi Ndsc Px 00820 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Abdominal Wall Surg00830 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Repair Of Hernia00832 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Repair Of Hernia00834 D 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Hernia Repair < 1 Yr00836 D 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Hernia Repair Preemie00840 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Surg Lower Abdomen00842 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Amniocentesis00844 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Pelvis Surgery00846 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Hysterectomy00848 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Pelvic Organ Surg00851 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Tubal Ligation00860 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Surgery Of Abdomen00862 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Kidney/Ureter Surg00864 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Removal Of Bladder00865 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Removal Of Prostate00866 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Removal Of Adrenal00868 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Kidney Transplant00870 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Bladder Stone Surg00872 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Kidney Stone Destruct00873 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Kidney Stone Destruct00880 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Abdomen Vessel Surg00882 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Major Vein Ligation00902 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Anorectal Surgery00904 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Perineal Surgery00906 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Removal Of Vulva00908 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Removal Of Prostate00910 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Bladder Surgery00912 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Bladder Tumor Surg00914 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Removal Of Prostate00916 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Bleeding Control00918 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Stone Removal00920 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Genitalia Surgery00921 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Vasectomy00922 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Sperm Duct Surgery00924 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Testis Exploration00926 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Removal Of Testis00928 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Removal Of Testis00930 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Testis Suspension00932 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Amputation Of Penis00934 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Penis Nodes Removal00936 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Penis Nodes Removal00938 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Insert Penis Device00940 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Vaginal Procedures00942 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Surg On Vag/Urethral00944 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Vaginal Hysterectomy00948 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Repair Of Cervix00950 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Vaginal Endoscopy00952 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Hysteroscope/Graph01112 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Bone Aspirate/Bx01120 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Pelvis Surgery01130 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Body Cast Procedure01140 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Amputation At Pelvis01150 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Pelvic Tumor Surgery01160 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Pelvis Procedure01170 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Pelvis Surgery01173 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Fx Repair Pelvis01200 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Hip Joint Procedure01202 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Arthroscopy Of Hip01210 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Hip Joint Surgery01212 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Hip Disarticulation01214 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Hip Arthroplasty01215 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Revise Hip Repair01220 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Procedure On Femur01230 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Surgery Of Femur01232 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Amputation Of Femur01234 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Radical Femur Surg

01250 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Upper Leg Surgery01260 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Upper Leg Veins Surg01270 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Thigh Arteries Surg01272 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Femoral Artery Surg01274 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Femoral Embolectomy01320 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Knee Area Surgery01340 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Knee Area Procedure01360 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Knee Area Surgery01380 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Knee Joint Procedure01382 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Dx Knee Arthroscopy01390 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Knee Area Procedure01392 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Knee Area Surgery01400 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Knee Joint Surgery01402 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Knee Arthroplasty01404 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Amputation At Knee01420 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Knee Joint Casting01430 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Knee Veins Surgery01432 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Knee Vessel Surg01440 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Knee Arteries Surg01442 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Knee Artery Surg01444 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Knee Artery Repair01462 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Lower Leg Procedure01464 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Ankle/Ft Arthroscopy01470 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Lower Leg Surgery01472 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Achilles Tendon Surg01474 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Lower Leg Surgery01480 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Lower Leg Bone Surg01482 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Radical Leg Surgery01484 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Lower Leg Revision01486 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Ankle Replacement01490 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Lower Leg Casting01500 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Leg Arteries Surg01502 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Lwr Leg Embolectomy01520 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Lower Leg Vein Surg01522 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Lower Leg Vein Surg01610 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Surgery Of Shoulder01620 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Shoulder Procedure01622 C 0.00 0.00 0.00 0.00 XXX 0.00 Anes Dx Shoulder Arthroscopy01630 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Surgery Of Shoulder01634 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Shoulder Joint Amput01636 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Forequarter Amput01638 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Shoulder Replacement01650 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Shoulder Artery Surg01652 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Shoulder Vessel Surg01654 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Shoulder Vessel Surg01656 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Arm-Leg Vessel Surg01670 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Shoulder Vein Surg01680 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Shoulder Casting01710 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Elbow Area Surgery01712 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Uppr Arm Tendon Surg01714 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Uppr Arm Tendon Surg01716 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Biceps Tendon Repair01730 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Uppr Arm Procedure01732 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Dx Elbow Arthroscopy01740 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Upper Arm Surgery01742 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Humerus Surgery01744 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Humerus Repair01756 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Radical Humerus Surg01758 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Humeral Lesion Surg01760 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Elbow Replacement01770 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Uppr Arm Artery Surg01772 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Uppr Arm Embolectomy01780 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Upper Arm Vein Surg01782 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Uppr Arm Vein Repair01810 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Lower Arm Surgery01820 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Lower Arm Procedure01829 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Dx Wrist Arthroscopy01830 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Lower Arm Surgery01832 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Wrist Replacement01840 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Lwr Arm Artery Surg01842 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Lwr Arm Embolectomy01844 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Vascular Shunt Surg01850 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Lower Arm Vein Surg01852 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Lwr Arm Vein Repair01860 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Lower Arm Casting01916 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Dx Arteriography01920 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Catheterize Heart01922 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Cat Or MRI Scan01924 C 0.00 0.00 0.00 0.00 XXX 0.00 Anes Ther Interven Rad Artrl01925 C 0.00 0.00 0.00 0.00 XXX 0.00 Anes Ther Interven Rad Card01926 C 0.00 0.00 0.00 0.00 XXX 0.00 Anes Tx Interv Rad Hrt/Cran01930 C 0.00 0.00 0.00 0.00 XXX 0.00 Anes Ther Interven Rad Vein01931 C 0.00 0.00 0.00 0.00 XXX 0.00 Anes Ther Interven Rad Tips01932 C 0.00 0.00 0.00 0.00 XXX 0.00 Anes Tx Interv Rad Th Vein01933 C 0.00 0.00 0.00 0.00 XXX 0.00 Anes Tx Interv Rad Cran Vein01935 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Perc Img Dx Sp Proc01936 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Perc Img Tx Sp Proc01951 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Burn Less 4 Percent01952 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Burn 4-9 Percent01953 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Burn Each 9 Percent

01958 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Antepartum Manipul01960 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Vaginal Delivery01961 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Cs Delivery01962 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Emer Hysterectomy01963 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Cs Hysterectomy01965 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Inc/Missed Ab Proc01966 D 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Induced Ab Procedure01967 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth/Analg Vag Delivery01968 C 0.00 0.00 0.00 0.00 XXX 0.00 Anes/Analg Cs Deliver Add-On01969 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth/Analg Cs Hyst Add-On01990 C 0.00 0.00 0.00 0.00 XXX 0.00 Support For Organ Donor01991 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth Nerve Block/Inj01992 C 0.00 0.00 0.00 0.00 XXX 0.00 Anesth N Block/Inj Prone01996 C 0.00 0.00 0.00 0.00 XXX 0.00 Hosp Manage Cont Drug Admin01999 R 0.00 0.00 0.00 0.00 XXX 0.00 Unlisted Anesth Procedure10004 C 0.80 0.58 0.34 0.11 ZZZ 55.80 Fna Bx W/O Img Gdn Ea Addl 10005 C 1.46 1.98 0.49 0.15 XXX 55.80 Fna Bx W/Us Gdn 1St Les 10006 C 1.00 0.61 0.33 0.10 ZZZ 55.80 Fna Bx W/Us Gdn Ea Addl 10007 C 1.81 6.09 0.70 0.19 XXX 55.80 Fna Bx W/Fluor Gdn 1St Les 10008 C 1.18 3.26 0.46 0.12 ZZZ 55.80 Fna Bx W/Fluor Gdn Ea Addl 10009 C 2.26 10.76 0.79 0.22 XXX 55.80 Fna Bx W/Ct Gdn 1St Les 10010 C 1.65 6.17 0.58 0.16 ZZZ 55.80 Fna Bx W/Ct Gdn Ea Addl 10011 C 298.44 0.00 0.00 0.00 XXX 1.25 Fna Bx W/Mr Gdn 1St Les 10012 C 0.00 0.00 0.00 0.00 ZZZ 0.00 Fna Bx W/Mr Gdn Ea Addl 10021 C 1.03 1.61 0.44 0.14 XXX 55.80 Fna W/O Image10030 C 2.75 13.27 0.97 0.25 XXX 55.80 Guide Cathet Fluid Drainage10035 C 1.70 11.81 0.62 0.16 XXX 55.80 Perq Dev Soft Tiss 1St Imag10036 C 0.85 10.85 0.31 0.09 XXX 55.80 Perq Dev Soft Tiss Add Imag10040 C 0.91 2.05 0.62 0.13 010 55.80 Acne Surgery10060 C 1.22 2.02 1.46 0.13 010 55.80 Drainage Of Skin Abscess10061 C 2.45 3.12 2.41 0.30 010 55.80 Drainage Of Skin Abscess10080 C 1.22 3.84 1.54 0.17 010 55.80 Drainage Of Pilonidal Cyst10081 C 2.50 5.00 2.03 0.34 010 55.80 Drainage Of Pilonidal Cyst10120 C 1.22 2.96 1.60 0.14 010 55.80 Remove Foreign Body10121 C 2.74 4.63 2.18 0.40 010 55.80 Remove Foreign Body10140 C 1.58 2.99 1.62 0.20 010 55.80 Drainage Of Hematoma/Fluid10160 C 1.25 2.30 1.32 0.15 010 55.80 Puncture Drainage Of Lesion10180 C 2.30 4.33 2.31 0.49 010 55.80 Complex Drainage Wound11000 C 0.60 0.92 0.17 0.05 000 55.80 Debride Infected Skin11001 C 0.30 0.29 0.08 0.03 ZZZ 55.80 Debride Infected Skin Add-On11004 C 10.80 3.91 3.91 1.98 000 55.80 Debride Genitalia & Perineum11005 C 14.24 5.19 5.19 3.21 000 55.80 Debride Abdom Wall11006 C 13.10 4.76 4.76 2.58 000 55.80 Debride Genit/Per/Abdom Wall11008 C 5.00 1.82 1.82 1.14 ZZZ 55.80 Remove Mesh From Abd Wall11010 C 4.19 8.90 3.09 0.73 010 55.80 Debride Skin At Fx Site11011 C 4.94 9.35 2.77 0.97 000 55.80 Debride Skin Musc At Fx Site11012 C 6.87 11.59 3.99 1.33 000 55.80 Deb Skin Bone At Fx Site11042 C 1.01 2.33 0.63 0.12 000 55.80 Deb Subq Tissue 20 Sq Cm/<11043 C 2.70 3.48 1.36 0.39 000 55.80 Deb Musc/Fascia 20 Sq Cm/<11044 C 4.10 4.20 1.85 0.63 000 55.80 Deb Bone 20 Sq Cm/<11045 C 0.50 0.60 0.18 0.08 ZZZ 55.80 Deb Subq Tissue Add-On11046 C 1.03 0.88 0.40 0.18 ZZZ 55.80 Deb Musc/Fascia Add-On11047 C 1.80 1.39 0.71 0.34 ZZZ 55.80 Deb Bone Add-On11055 C 0.35 1.22 0.09 0.02 000 55.80 Trim Skin Lesion11056 C 0.50 1.37 0.12 0.03 000 55.80 Trim Skin Lesions 2 To 411057 C 0.65 1.42 0.16 0.04 000 55.80 Trim Skin Lesions Over 411102 C 0.66 2.05 0.39 0.09 000 55.80 Tangntl Bx Skin Single Les 11103 C 0.38 1.08 0.23 0.05 ZZZ 55.80 Tangntl Bx Skin Ea Sep/Addl 11104 C 0.83 2.58 0.49 0.11 000 55.80 Punch Bx Skin Single Lesion 11105 C 0.45 1.22 0.27 0.06 ZZZ 55.80 Punch Bx Skin Ea Sep/Addl 11106 C 1.01 3.11 0.59 0.14 000 55.80 Incal Bx Skn Single Les 11107 C 0.54 1.43 0.32 0.07 ZZZ 55.80 Incal Bx Skn Ea Sep/Addl 11200 C 0.82 1.59 1.18 0.10 010 55.80 Removal Of Skin Tags 2.0 Cm11305 C 0.80 2.03 0.25 0.07 000 55.80 Shave Skin Lesion 0.5 Cm/<11306 C 0.96 2.38 0.42 0.11 000 55.80 Shave Skin Lesion 0.6-1.0 Cm11307 C 1.20 2.74 0.57 0.15 000 55.80 Shave Skin Lesion 1.1-2.0 Cm11308 C 1.46 2.73 0.53 0.15 000 55.80 Shave Skin Lesion >2.0 Cm11310 C 0.80 2.32 0.45 0.11 000 55.80 Shave Skin Lesion 0.5 Cm/<11311 C 1.10 2.61 0.63 0.15 000 55.80 Shave Skin Lesion 0.6-1.0 Cm11312 C 1.30 3.03 0.74 0.19 000 55.80 Shave Skin Lesion 1.1-2.0 Cm11313 C 1.68 3.37 0.96 0.25 000 55.80 Shave Skin Lesion >2.0 Cm11400 C 0.90 2.50 1.30 0.13 010 55.80 Exc Tr-Ext B9+Marg 0.5 Cm<11401 C 1.28 2.83 1.52 0.19 010 55.80 Exc Tr-Ext B9+Marg 0.6-1 Cm11402 C 1.45 3.10 1.61 0.23 010 55.80 Exc Tr-Ext B9+Marg 1.1-2 Cm11403 C 1.84 3.37 2.09 0.32 010 55.80 Exc Tr-Ext B9+Marg 2.1-3Cm/<11404 C 2.11 3.77 2.17 0.39 010 55.80 Exc Tr-Ext B9+Marg 3.1-4 Cm11406 C 3.52 4.80 2.89 0.70 010 55.80 Exc Tr-Ext B9+Marg >4.0 Cm11420 C 1.03 2.39 1.19 0.11 010 55.80 Exc H-F-Nk-Sp B9+Marg 0.5/<11421 C 1.47 2.82 1.48 0.20 010 55.80 Exc H-F-Nk-Sp B9+Marg 0.6-111422 C 1.68 3.13 1.97 0.25 010 55.80 Exc H-F-Nk-Sp B9+Marg 1.1-211423 C 2.06 3.39 2.10 0.32 010 55.80 Exc H-F-Nk-Sp B9+Marg 2.1-311424 C 2.48 3.80 2.27 0.41 010 55.80 Exc H-F-Nk-Sp B9+Marg 3.1-411426 C 4.09 4.76 3.10 0.74 010 55.80 Exc H-F-Nk-Sp B9+Marg >4 Cm11440 C 1.05 2.73 1.78 0.13 010 55.80 Exc Face-Mm B9+Marg 0.5 Cm/<11441 C 1.53 3.08 2.01 0.22 010 55.80 Exc Face-Mm B9+Marg 0.6-1 Cm

11442 C 1.77 3.35 2.12 0.27 010 55.80 Exc Face-Mm B9+Marg 1.1-2 Cm11443 C 2.34 3.71 2.40 0.37 010 55.80 Exc Face-Mm B9+Marg 2.1-3 Cm11444 C 3.19 4.36 2.82 0.50 010 55.80 Exc Face-Mm B9+Marg 3.1-4 Cm11446 C 4.80 5.59 3.76 0.77 010 55.80 Exc Face-Mm B9+Marg >4 Cm11450 C 3.22 7.32 3.40 0.71 090 55.80 Removal Sweat Gland Lesion11451 C 4.43 8.79 4.01 0.93 090 55.80 Removal Sweat Gland Lesion11462 C 3.00 7.32 3.34 0.64 090 55.80 Removal Sweat Gland Lesion11463 C 4.43 9.01 4.11 0.88 090 55.80 Removal Sweat Gland Lesion11470 C 3.74 7.55 3.60 0.74 090 55.80 Removal Sweat Gland Lesion11471 C 4.89 8.92 4.20 0.90 090 55.80 Removal Sweat Gland Lesion11600 C 1.63 3.66 1.58 0.24 010 55.80 Exc Tr-Ext Mal+Marg 0.5 Cm/<11601 C 2.07 4.14 1.91 0.31 010 55.80 Exc Tr-Ext Mal+Marg 0.6-1 Cm11602 C 2.27 4.45 2.09 0.34 010 55.80 Exc Tr-Ext Mal+Marg 1.1-2 Cm11603 C 2.82 4.82 2.38 0.43 010 55.80 Exc Tr-Ext Mal+Marg 2.1-3 Cm11604 C 3.17 5.28 2.52 0.50 010 55.80 Exc Tr-Ext Mal+Marg 3.1-4 Cm11606 C 5.02 6.93 3.32 0.90 010 55.80 Exc Tr-Ext Mal+Marg >4 Cm11620 C 1.64 3.68 1.60 0.25 010 55.80 Exc H-F-Nk-Sp Mal+Marg 0.5/<11621 C 2.08 4.15 1.92 0.32 010 55.80 Exc S/N/H/F/G Mal+Mrg 0.6-111622 C 2.41 4.52 2.15 0.37 010 55.80 Exc S/N/H/F/G Mal+Mrg 1.1-211623 C 3.11 4.96 2.51 0.48 010 55.80 Exc S/N/H/F/G Mal+Mrg 2.1-311624 C 3.62 5.46 2.71 0.59 010 55.80 Exc S/N/H/F/G Mal+Mrg 3.1-411626 C 4.61 6.23 3.07 0.80 010 55.80 Exc S/N/H/F/G Mal+Mrg >4 Cm11640 C 1.67 3.82 1.69 0.25 010 55.80 Exc F/E/E/N/L Mal+Mrg 0.5Cm<11641 C 2.17 4.28 2.00 0.33 010 55.80 Exc F/E/E/N/L Mal+Mrg 0.6-111642 C 2.62 4.70 2.27 0.41 010 55.80 Exc F/E/E/N/L Mal+Mrg 1.1-211643 C 3.42 5.14 2.67 0.53 010 55.80 Exc F/E/E/N/L Mal+Mrg 2.1-311644 C 4.34 6.19 3.18 0.69 010 55.80 Exc F/E/E/N/L Mal+Mrg 3.1-411646 C 6.26 7.34 4.09 1.04 010 55.80 Exc F/E/E/N/L Mal+Mrg >4 Cm11719 C 0.17 0.23 0.04 0.01 000 55.80 Trim Nail(S) Any Number11720 C 0.32 0.60 0.08 0.02 000 55.80 Debride Nail 1-511721 C 0.54 0.71 0.13 0.04 000 55.80 Debride Nail 6 Or More11730 C 1.05 1.96 0.45 0.08 000 55.80 Removal Of Nail Plate11732 C 0.38 0.52 0.10 0.03 ZZZ 55.80 Remove Nail Plate Add-On11740 C 0.37 1.06 0.52 0.03 000 55.80 Drain Blood From Under Nail11750 C 1.58 2.71 1.22 0.12 010 55.80 Removal Of Nail Bed11755 C 1.25 2.13 0.45 0.09 000 55.80 Biopsy Nail Unit11760 C 1.63 3.65 1.46 0.18 010 55.80 Repair Of Nail Bed11762 C 2.94 4.93 2.11 0.28 010 55.80 Reconstruction Of Nail Bed11765 C 1.22 3.49 1.36 0.09 010 55.80 Excision Of Nail Fold Toe11770 C 2.66 4.88 2.09 0.56 010 55.80 Remove Pilonidal Cyst Simple11771 C 6.09 9.34 5.16 1.36 090 55.80 Remove Pilonidal Cyst Exten11772 C 7.35 11.13 7.63 1.62 090 55.80 Remove Pilonidal Cyst Compl11900 C 0.52 0.95 0.31 0.07 000 55.80 Inject Skin Lesions 711920 C 1.61 3.23 1.37 0.26 000 55.80 Correct Skin Color 6.0 Cm/<11921 C 1.93 3.61 1.57 0.30 000 55.80 Correct Skn Color 6.1-20.0Cm11922 C 0.49 1.16 0.28 0.08 ZZZ 55.80 Correct Skin Color Ea 20.0Cm11950 C 0.84 1.00 0.40 0.11 000 55.80 Tx Contour Defects 1 Cc/<11951 C 1.19 1.42 0.60 0.19 000 55.80 Tx Contour Defects 1.1-5.0Cc11952 C 1.69 1.84 0.86 0.25 000 55.80 Tx Contour Defects 5.1-10Cc11954 C 1.85 2.25 1.05 0.31 000 55.80 Tx Contour Defects >10.0 Cc11960 C 11.49 14.18 14.18 2.04 090 55.80 Insert Tissue Expander(S)11970 C 8.01 8.11 8.11 1.35 090 55.80 Replace Tissue Expander11971 C 3.41 9.54 5.18 0.57 090 55.80 Remove Tissue Expander(S)11976 D 1.78 2.13 0.68 0.20 000 55.80 Remove Contraceptive Capsule11980 C 1.10 1.47 0.39 0.12 000 55.80 Implant Hormone Pellet(S)11981 C 1.48 2.31 0.66 0.26 XXX 55.80 Insert Drug Implant Device11982 C 1.78 2.41 0.79 0.30 XXX 55.80 Remove Drug Implant Device11983 C 3.30 2.79 1.35 0.47 XXX 55.80 Remove/Insert Drug Implant12001 C 0.84 1.58 0.32 0.11 000 55.80 Rpr S/N/Ax/Gen/Trnk 2.5Cm/<12002 C 1.14 1.79 0.38 0.15 000 55.80 Rpr S/N/Ax/Gen/Trnk2.6-7.5Cm12004 C 1.44 1.98 0.46 0.19 000 55.80 Rpr S/N/Ax/Gen/Trk7.6-12.5Cm12005 C 1.97 2.45 0.47 0.27 000 55.80 Rpr S/N/A/Gen/Trk12.6-20.0Cm12006 C 2.39 2.81 0.60 0.34 000 55.80 Rpr S/N/A/Gen/Trk20.1-30.0Cm12007 C 2.90 3.03 0.81 0.44 000 55.80 Rpr S/N/Ax/Gen/Trnk >30.0 Cm12011 C 1.07 1.88 0.36 0.14 000 55.80 Rpr F/E/E/N/L/M 2.5 Cm/<12013 C 1.22 1.84 0.27 0.17 000 55.80 Rpr F/E/E/N/L/M 2.6-5.0 Cm12014 C 1.57 2.09 0.35 0.22 000 55.80 Rpr F/E/E/N/L/M 5.1-7.5 Cm12015 C 1.98 2.44 0.44 0.27 000 55.80 Rpr F/E/E/N/L/M 7.6-12.5 Cm12016 C 2.68 2.86 0.61 0.38 000 55.80 Rpr Fe/E/En/L/M 12.6-20.0 Cm12017 C 3.18 0.70 0.70 0.46 000 55.80 Rpr Fe/E/En/L/M 20.1-30.0 Cm12018 C 3.61 0.78 0.78 0.53 000 55.80 Rpr F/E/E/N/L/M >30.0 Cm12020 C 2.67 5.09 2.33 0.41 010 55.80 Closure Of Split Wound12021 C 1.89 2.56 1.78 0.31 010 55.80 Closure Of Split Wound12031 C 2.00 4.67 2.09 0.31 010 55.80 Intmd Rpr S/A/T/Ext 2.5 Cm/<12032 C 2.52 5.75 2.68 0.38 010 55.80 Intmd Rpr S/A/T/Ext 2.6-7.512034 C 2.97 5.64 2.53 0.46 010 55.80 Intmd Rpr S/Tr/Ext 7.6-12.512035 C 3.50 6.84 2.82 0.59 010 55.80 Intmd Rpr S/A/T/Ext 12.6-2012036 C 4.23 7.10 3.05 0.77 010 55.80 Intmd Rpr S/A/T/Ext 20.1-3012037 C 5.00 7.73 3.44 0.97 010 55.80 Intmd Rpr S/Tr/Ext >30.0 Cm12041 C 2.10 4.57 1.89 0.30 010 55.80 Intmd Rpr N-Hf/Genit 2.5Cm/<12042 C 2.79 5.21 2.55 0.41 010 55.80 Intmd Rpr N-Hf/Genit2.6-7.512044 C 3.19 6.75 2.51 0.47 010 55.80 Intmd Rpr N-Hf/Genit7.6-12.512045 C 3.75 7.14 3.39 0.57 010 55.80 Intmd Rpr N-Hf/Genit12.6-2012046 C 4.30 8.50 3.67 1.00 010 55.80 Intmd Rpr N-Hf/Genit20.1-3012047 C 4.95 9.06 3.90 1.14 010 55.80 Intmd Rpr N-Hf/Genit >30.0Cm12051 C 2.33 4.87 2.24 0.35 010 55.80 Intmd Rpr Face/Mm 2.5 Cm/<12052 C 2.87 5.26 2.56 0.42 010 55.80 Intmd Rpr Face/Mm 2.6-5.0 Cm12053 C 3.17 6.36 2.62 0.47 010 55.80 Intmd Rpr Face/Mm 5.1-7.5 Cm12054 C 3.50 6.44 2.35 0.52 010 55.80 Intmd Rpr Face/Mm 7.6-12.5Cm

12055 C 4.50 8.37 3.47 0.70 010 55.80 Intmd Rpr Face/Mm 12.6-20 Cm12056 C 5.30 9.83 4.85 0.85 010 55.80 Intmd Rpr Face/Mm 20.1-30.012057 C 6.00 10.00 5.28 0.93 010 55.80 Intmd Rpr Face/Mm >30.0 Cm13100 C 3.00 6.22 2.46 0.44 010 55.80 Cmplx Rpr Trunk 1.1-2.5 Cm13101 C 3.50 7.37 3.25 0.52 010 55.80 Cmplx Rpr Trunk 2.6-7.5 Cm13102 C 1.24 2.01 0.69 0.21 ZZZ 55.80 Cmplx Rpr Trunk Addl 5Cm/<13120 C 3.23 6.38 3.07 0.48 010 55.80 Cmplx Rpr S/A/L 1.1-2.5 Cm13121 C 4.00 7.67 3.08 0.59 010 55.80 Cmplx Rpr S/A/L 2.6-7.5 Cm13122 C 1.44 2.10 0.79 0.24 ZZZ 55.80 Cmplx Rpr S/A/L Addl 5 Cm/>13131 C 3.73 6.81 2.89 0.55 010 55.80 Cmplx Rpr F/C/C/M/N/Ax/G/H/F13132 C 4.78 8.17 3.54 0.71 010 55.80 Cmplx Rpr F/C/C/M/N/Ax/G/H/F13133 C 2.19 2.53 1.24 0.34 ZZZ 55.80 Cmplx Rpr F/C/C/M/N/Ax/G/H/F13151 C 4.34 7.14 3.26 0.65 010 55.80 Cmplx Rpr E/N/E/L 1.1-2.5 Cm13152 C 5.34 8.34 3.85 0.80 010 55.80 Cmplx Rpr E/N/E/L 2.6-7.5 Cm13153 C 2.38 2.74 1.31 0.38 ZZZ 55.80 Cmplx Rpr E/N/E/L Addl 5Cm/<13160 C 12.04 8.81 8.81 2.11 090 55.80 Late Closure Of Wound14000 C 6.37 10.30 6.88 1.13 090 55.80 Tis Trnfr Trunk 10 Sq Cm/<14001 C 8.78 12.40 8.30 1.64 090 55.80 Tis Trnfr Trunk 10.1-30Sqcm14020 C 7.22 11.50 7.89 1.15 090 55.80 Tis Trnfr S/A/L 10 Sq Cm/<14021 C 9.72 13.54 9.33 1.53 090 55.80 Tis Trnfr S/A/L 10.1-30 Sqcm14040 C 8.60 11.83 8.23 1.27 090 55.80 Tis Trnfr F/C/C/M/N/A/G/H/F14041 C 10.83 14.28 9.84 1.64 090 55.80 Tis Trnfr F/C/C/M/N/A/G/H/F14060 C 9.23 11.54 8.73 1.34 090 55.80 Tis Trnfr E/N/E/L 10 Sq Cm/<14061 C 11.48 15.56 10.66 1.73 090 55.80 Tis Trnfr E/N/E/L10.1-30Sqcm14301 C 12.65 16.04 10.50 2.10 090 55.80 Tis Trnfr Any 30.1-60 Sq Cm14302 C 3.73 1.96 1.96 0.65 ZZZ 55.80 Tis Trnfr Addl 30 Sq Cm/<14350 C 11.05 7.48 7.48 1.09 090 55.80 Filleted Finger/Toe Flap15002 C 3.65 5.66 2.19 0.63 000 55.80 Wound Prep Trk/Arm/Leg15003 C 0.80 1.15 0.36 0.16 ZZZ 55.80 Wound Prep Addl 100 Cm15004 C 4.58 6.18 2.48 0.62 000 55.80 Wound Prep F/N/Hf/G15005 C 1.60 1.61 0.73 0.31 ZZZ 55.80 Wnd Prep F/N/Hf/G Addl Cm15040 C 2.00 4.89 1.22 0.40 000 55.80 Harvest Cultured Skin Graft15050 C 5.57 9.65 6.27 0.92 090 55.80 Skin Pinch Graft15100 C 9.90 12.80 8.75 1.88 090 55.80 Skin Splt Grft Trnk/Arm/Leg15101 C 1.72 3.23 1.14 0.36 ZZZ 55.80 Skin Splt Grft T/A/L Add-On15110 C 10.97 10.00 7.00 1.85 090 55.80 Epidrm Autogrft Trnk/Arm/Leg15111 C 1.85 1.05 0.73 0.42 ZZZ 55.80 Epidrm Autogrft T/A/L Add-On15115 C 11.28 9.88 6.90 1.49 090 55.80 Epidrm A-Grft Face/Nck/Hf/G15116 C 2.50 1.88 1.46 0.42 ZZZ 55.80 Epidrm A-Grft F/N/Hf/G Addl15120 C 10.15 12.44 8.16 1.70 090 55.80 Skn Splt A-Grft Fac/Nck/Hf/G15121 C 2.00 3.56 1.47 0.39 ZZZ 55.80 Skn Splt A-Grft F/N/Hf/G Add15130 C 7.53 10.08 7.02 1.41 090 55.80 Derm Autograft Trnk/Arm/Leg15131 C 1.50 1.09 0.87 0.26 ZZZ 55.80 Derm Autograft T/A/L Add-On15135 C 11.03 11.93 8.87 1.56 090 55.80 Derm Autograft Face/Nck/Hf/G15136 C 1.50 1.06 0.87 0.26 ZZZ 55.80 Derm Autograft F/N/Hf/G Add15150 C 9.39 8.38 6.65 2.28 090 55.80 Cult Skin Grft T/Arm/Leg15151 C 2.00 0.97 0.71 0.48 ZZZ 55.80 Cult Skin Grft T/A/L Addl15152 C 2.50 1.15 0.88 0.60 ZZZ 55.80 Cult Skin Graft T/A/L +%15155 C 10.14 10.98 9.19 1.72 090 55.80 Cult Skin Graft F/N/Hf/G15156 C 2.75 1.24 0.97 0.66 ZZZ 55.80 Cult Skin Grft F/N/Hfg Add15157 C 3.00 1.45 1.06 0.72 ZZZ 55.80 Cult Epiderm Grft F/N/Hfg +%15200 C 9.15 13.10 8.61 1.58 090 55.80 Skin Full Graft Trunk15201 C 1.32 2.58 0.70 0.24 ZZZ 55.80 Skin Full Graft Trunk Add-On15220 C 8.09 12.66 8.27 1.31 090 55.80 Skin Full Graft Sclp/Arm/Leg15221 C 1.19 2.47 0.65 0.21 ZZZ 55.80 Skin Full Graft Add-On15240 C 10.41 14.63 10.96 1.64 090 55.80 Skin Full Grft Face/Genit/Hf15241 C 1.86 3.05 1.01 0.31 ZZZ 55.80 Skin Full Graft Add-On15260 C 11.64 15.55 11.32 1.69 090 55.80 Skin Full Graft Een & Lips15261 C 2.23 3.48 1.44 0.34 ZZZ 55.80 Skin Full Graft Add-On15271 C 1.50 2.43 0.71 0.21 000 55.80 Skin Sub Graft Trnk/Arm/Leg15272 C 0.33 0.38 0.12 0.05 ZZZ 55.80 Skin Sub Graft T/A/L Add-On15273 C 3.50 4.60 1.71 0.63 000 55.80 Skin Sub Grft T/Arm/Lg Child15274 C 0.80 1.18 0.36 0.17 ZZZ 55.80 Skn Sub Grft T/A/L Child Add15275 C 1.83 2.36 0.73 0.18 000 55.80 Skin Sub Graft Face/Nk/Hf/G15276 C 0.50 0.42 0.17 0.06 ZZZ 55.80 Skin Sub Graft F/N/Hf/G Addl15277 C 4.00 4.86 1.91 0.69 000 55.80 Skn Sub Grft F/N/Hf/G Child15278 C 1.00 1.34 0.46 0.20 ZZZ 55.80 Skn Sub Grft F/N/Hf/G Ch Add15570 C 10.21 13.99 9.02 1.84 090 55.80 Skin Pedicle Flap Trunk15572 C 10.12 13.48 9.51 1.73 090 55.80 Skin Pedicle Flap Arms/Legs15574 C 10.70 13.42 9.36 1.73 090 55.80 Pedcle Fh/Ch/Ch/M/N/Ax/G/H/F15576 C 9.37 12.22 8.46 1.34 090 55.80 Pedicle E/N/E/L/Ntroral15600 C 2.01 6.95 3.56 0.34 090 55.80 Delay Flap Trunk15610 C 2.52 7.22 3.92 0.42 090 55.80 Delay Flap Arms/Legs15620 C 3.75 8.18 4.93 0.59 090 55.80 Delay Flap F/C/C/N/Ax/G/H/F15630 C 4.08 8.38 5.16 0.63 090 55.80 Delay Flap Eye/Nos/Ear/Lip15650 C 4.77 8.97 5.46 0.78 090 55.80 Transfer Skin Pedicle Flap15730 C 13.50 28.33 11.13 1.83 090 55.80 Mdfc Flap W/Prsrv Vasc Pedcl 15731 C 14.38 15.45 12.17 2.21 090 55.80 Forehead Flap W/Vasc Pedicle15732 C 16.38 18.00 13.44 2.21 090 55.80 Muscle-Skin Graft Head/Neck15733 C 15.68 12.31 12.31 2.13 090 55.80 Musc Myoq/Fscq Flp H&N Pedcl 15734 C 23.00 15.85 15.85 4.62 090 55.80 Muscle-Skin Graft Trunk15736 C 17.04 15.12 15.12 3.14 090 55.80 Muscle-Skin Graft Arm15738 C 19.04 15.15 15.15 3.46 090 55.80 Muscle-Skin Graft Leg15740 C 11.80 15.22 10.66 1.81 090 55.80 Island Pedicle Flap Graft15750 C 12.96 11.18 11.18 2.25 090 55.80 Neurovascular Pedicle Flap15756 C 36.94 23.32 23.32 5.95 090 55.80 Free Myo/Skin Flap Microvasc15757 C 37.15 22.58 22.58 5.78 090 55.80 Free Skin Flap Microvasc15758 C 36.90 23.35 23.35 5.84 090 55.80 Free Fascial Flap Microvasc15760 C 9.86 12.95 8.95 1.45 090 55.80 Composite Skin Graft

15769FECA-D Energy-C 6.68 6.04 6.04 1.14 090 55.80 Grfg Autol Soft Tiss Dir Exc

15770 C 8.96 8.75 8.75 1.38 090 55.80 Derma-Fat-Fascia Graft

15771FECA-D Energy-C 6.73 5.88 8.67 1.15 090 55.80 Grfg Autol Fat Lipo 50 Cc/<

15772FECA-D Energy-C 2.50 1.14 2.29 0.43 XXX 55.80 Grfg Autol Fat Lipo Ea Addl

15773FECA-D Energy-C 6.83 5.93 8.72 1.15 090 55.80 Grfg Autol Fat Lipo 25 Cc/<

15774FECA-D Energy-C 2.41 1.10 2.25 0.40 XXX 55.80 Gfrg Autol Fat Lipo Ea Addl

15775 C 0.00 0.00 0.00 0.00 000 55.80 Hair Trnspl 1-15 Punch Grfts15776 C 5.53 6.47 3.02 0.57 000 55.80 Hair Trnspl >15 Punch Grafts15777 C 3.65 1.96 1.96 0.64 ZZZ 55.80 Acellular Derm Matrix Implt15780 C 8.73 16.12 10.09 1.31 090 55.80 Dermabrasion Total Face15781 C 5.02 9.85 6.47 0.84 090 55.80 Dermabrasion Segmental Face15782 C 4.44 11.26 6.81 0.66 090 55.80 Dermabrasion Other Than Face15783 C 4.41 8.55 5.55 0.66 090 55.80 Dermabrasion Suprfl Any Site15786 C 2.08 4.65 1.58 0.25 010 55.80 Abrasion Lesion Single15787 C 0.33 0.92 0.15 0.02 ZZZ 55.80 Abrasion Lesions Add-On15788 C 2.09 10.34 4.40 0.32 090 55.80 Chemical Peel Face Epiderm15789 C 4.91 9.93 6.06 0.91 090 55.80 Chemical Peel Face Dermal15792 C 1.86 9.62 4.84 0.32 090 55.80 Chemical Peel Nonfacial15793 C 3.96 9.34 5.63 0.78 090 55.80 Chemical Peel Nonfacial15819 D 10.65 10.30 10.30 1.81 090 55.80 Plastic Surgery Neck15820 D 6.27 9.24 7.58 0.70 090 55.80 Revision Of Lower Eyelid15821 D 6.84 9.89 8.05 0.65 090 55.80 Revision Of Lower Eyelid15822 D 4.62 7.63 6.01 0.49 090 55.80 Revision Of Upper Eyelid15823 C 6.81 10.00 8.14 0.56 090 55.80 Revision Of Upper Eyelid15824 D 0.00 0.00 0.00 0.00 000 0.00 Removal Of Forehead Wrinkles15825 D 0.00 0.00 0.00 0.00 000 0.00 Removal Of Neck Wrinkles15826 D 0.00 0.00 0.00 0.00 000 0.00 Removal Of Brow Wrinkles15828 D 0.00 0.00 0.00 0.00 000 0.00 Removal Of Face Wrinkles15829 D 0.00 0.00 0.00 0.00 000 0.00 Removal Of Skin Wrinkles15830 C 17.11 13.52 13.52 3.12 090 55.80 Exc Skin Abd15832 C 12.85 11.30 11.30 2.25 090 55.80 Excise Excessive Skin Thigh15833 C 11.90 11.12 11.12 1.94 090 55.80 Excise Excessive Skin Leg15834 C 12.17 11.27 11.27 2.08 090 55.80 Excise Excessive Skin Hip15835 C 12.99 11.64 11.64 2.21 090 55.80 Excise Excessive Skin Buttck15836 C 10.61 10.27 10.27 1.77 090 55.80 Excise Excessive Skin Arm15837 C 9.55 13.53 9.45 1.62 090 55.80 Excise Excess Skin Arm/Hand15838 C 8.25 8.70 8.70 1.39 090 55.80 Excise Excess Skin Fat Pad15839 C 10.50 12.92 8.80 1.85 090 55.80 Excise Excess Skin & Tissue15840 C 14.99 11.62 11.62 2.25 090 55.80 Nerve Palsy Fascial Graft15841 C 25.99 20.80 20.80 4.43 090 55.80 Nerve Palsy Muscle Graft15842 C 41.01 30.04 30.04 6.99 090 55.80 Nerve Palsy Microsurg Graft15845 C 14.32 13.03 13.03 1.52 090 55.80 Skin And Muscle Repair Face15847 C 2.26 1.43 1.43 0.01 YYY 55.80 Exc Skin Abd Add-On15850 B 0.78 1.67 0.30 0.11 XXX 55.80 Remove Sutures Same Surgeon15851 C 0.86 1.90 0.36 0.09 000 55.80 Remove Sutures Diff Surgeon15852 C 0.86 0.34 0.34 0.13 000 55.80 Dressing Change Not For Burn15860 C 1.95 0.81 0.81 0.34 000 55.80 Test For Blood Flow In Graft15876 D 890.59 0.00 0.00 0.00 000 2.00 Suction Lipectomy Head&Neck15877 D 890.59 0.00 0.00 0.00 000 2.00 Suction Lipectomy Trunk15878 D 797.93 0.00 0.00 0.00 000 1.25 Suction Lipectomy Upr Extrem15879 D 890.59 0.00 0.00 0.00 000 2.00 Suction Lipectomy Lwr Extrem15920 C 8.29 7.76 7.76 1.79 090 55.80 Removal Of Tail Bone Ulcer15922 C 10.38 10.39 10.39 1.73 090 55.80 Removal Of Tail Bone Ulcer15931 C 10.07 7.63 7.63 2.24 090 55.80 Remove Sacrum Pressure Sore15933 C 11.77 10.41 10.41 2.40 090 55.80 Remove Sacrum Pressure Sore15934 C 13.68 10.71 10.71 2.76 090 55.80 Remove Sacrum Pressure Sore15935 C 15.78 12.74 12.74 3.12 090 55.80 Remove Sacrum Pressure Sore15936 C 13.16 9.89 9.89 2.67 090 55.80 Remove Sacrum Pressure Sore15937 C 15.14 11.80 11.80 2.91 090 55.80 Remove Sacrum Pressure Sore15940 C 10.20 7.82 7.82 2.13 090 55.80 Remove Hip Pressure Sore15941 C 12.41 11.33 11.33 2.35 090 55.80 Remove Hip Pressure Sore15944 C 12.44 11.12 11.12 2.27 090 55.80 Remove Hip Pressure Sore15945 C 13.75 12.27 12.27 2.44 090 55.80 Remove Hip Pressure Sore15946 C 24.12 18.28 18.28 4.47 090 55.80 Remove Hip Pressure Sore15950 C 8.03 7.62 7.62 1.67 090 55.80 Remove Thigh Pressure Sore15951 C 11.58 11.83 11.83 1.88 090 55.80 Remove Thigh Pressure Sore15952 C 12.31 11.62 11.62 2.04 090 55.80 Remove Thigh Pressure Sore15953 C 13.57 12.78 12.78 2.31 090 55.80 Remove Thigh Pressure Sore15956 C 16.79 13.34 13.34 3.25 090 55.80 Remove Thigh Pressure Sore15958 C 16.75 14.21 14.21 3.10 090 55.80 Remove Thigh Pressure Sore

15999FECA-D Energy-R 0.00 0.00 0.00 0.00 YYY 0.00 Removal Of Pressure Sore

16000 C 0.89 1.00 0.32 0.11 000 55.80 Initial Treatment Of Burn(S)16020 C 0.71 1.51 0.74 0.10 000 55.80 Dress/Debrid P-Thick Burn S16025 C 1.74 2.26 1.16 0.26 000 55.80 Dress/Debrid P-Thick Burn M16030 C 2.08 2.98 1.40 0.34 000 55.80 Dress/Debrid P-Thick Burn L16035 C 3.74 1.39 1.39 0.52 000 55.80 Incision Of Burn Scab Initi16036 C 1.50 0.59 0.59 0.27 ZZZ 55.80 Escharotomy Addl Incision17000 C 0.61 1.16 0.84 0.08 010 55.80 Destruct Premalg Lesion17003 C 0.04 0.11 0.02 0.01 ZZZ 55.80 Destruct Premalg Les 2-1417004 C 1.37 2.75 1.29 0.19 010 55.80 Destroy Premal Lesions 15/>17106 C 3.69 5.58 3.73 0.51 090 55.80 Destruction Of Skin Lesions17107 C 4.79 7.16 4.66 0.72 090 55.80 Destruction Of Skin Lesions17108 C 7.49 9.74 6.60 1.12 090 55.80 Destruction Of Skin Lesions17110 C 0.70 2.34 1.17 0.09 010 55.80 Destruct B9 Lesion 1-1417111 C 0.97 2.61 1.31 0.13 010 55.80 Destruct Lesion 15 Or More17250 C 0.50 1.74 0.48 0.07 000 55.80 Chemical Cautery Tissue

17260 C 0.96 1.61 0.93 0.14 010 55.80 Destruction Of Skin Lesions17261 C 1.22 2.72 1.19 0.17 010 55.80 Destruction Of Skin Lesions17262 C 1.63 3.15 1.44 0.23 010 55.80 Destruction Of Skin Lesions17263 C 1.84 3.37 1.56 0.26 010 55.80 Destruction Of Skin Lesions17264 C 1.99 3.59 1.64 0.27 010 55.80 Destruction Of Skin Lesions17266 C 2.39 3.93 1.87 0.34 010 55.80 Destruction Of Skin Lesions17270 C 1.37 2.67 1.27 0.20 010 55.80 Destruction Of Skin Lesions17271 C 1.54 2.91 1.38 0.22 010 55.80 Destruction Of Skin Lesions17272 C 1.82 3.25 1.55 0.26 010 55.80 Destruction Of Skin Lesions17273 C 2.10 3.54 1.71 0.30 010 55.80 Destruction Of Skin Lesions17274 C 2.64 3.99 2.02 0.38 010 55.80 Destruction Of Skin Lesions17276 C 3.25 4.41 2.32 0.45 010 55.80 Destruction Of Skin Lesions17280 C 1.22 2.57 1.18 0.18 010 55.80 Destruction Of Skin Lesions17281 C 1.77 3.06 1.51 0.26 010 55.80 Destruction Of Skin Lesions17282 C 2.09 3.45 1.71 0.30 010 55.80 Destruction Of Skin Lesions17283 C 2.69 3.91 2.05 0.39 010 55.80 Destruction Of Skin Lesions17284 C 3.20 4.32 2.32 0.45 010 55.80 Destruction Of Skin Lesions17286 C 4.48 5.11 2.92 0.63 010 55.80 Destruction Of Skin Lesions17311 C 6.20 11.85 3.69 0.93 000 55.80 Mohs 1 Stage H/N/Hf/G17312 C 3.30 7.47 1.97 0.49 ZZZ 55.80 Mohs Addl Stage17313 C 5.56 11.37 3.32 0.82 000 55.80 Mohs 1 Stage T/A/L17314 C 3.06 7.24 1.83 0.45 ZZZ 55.80 Mohs Addl Stage T/A/L17315 C 0.87 1.26 0.52 0.13 ZZZ 55.80 Mohs Surg Addl Block17340 C 0.77 0.63 0.54 0.09 010 55.80 Cryotherapy Of Skin17360 C 1.46 1.94 1.10 0.21 010 55.80 Skin Peel Therapy17380 D 248.76 0.00 0.00 0.00 000 1.25 Hair Removal By Electrolysis17999 R 0.00 0.00 0.00 0.00 YYY 0.00 Skin Tissue Procedure19000 C 0.84 2.17 0.31 0.11 000 55.80 Drainage Of Breast Lesion19001 C 0.42 0.30 0.15 0.05 ZZZ 55.80 Drain Breast Lesion Add-On19020 C 3.83 8.83 4.17 0.84 090 55.80 Incision Of Breast Lesion19030 C 1.53 3.07 0.56 0.14 000 55.80 Injection For Breast X-Ray19081 C 3.29 14.77 1.20 0.36 000 55.80 Bx Breast 1St Lesion Strtctc19082 C 1.65 13.20 0.61 0.18 ZZZ 55.80 Bx Breast Add Lesion Strtctc19083 C 3.10 14.60 1.13 0.34 000 55.80 Bx Breast 1St Lesion Us Imag19084 C 1.55 12.78 0.57 0.16 ZZZ 55.80 Bx Breast Add Lesion Us Imag19085 C 3.64 23.43 1.34 0.32 000 55.80 Bx Breast 1St Lesion Mr Imag19086 C 1.82 19.99 0.67 0.16 ZZZ 55.80 Bx Breast Add Lesion Mr Imag19100 C 1.27 2.75 0.46 0.30 000 55.80 Bx Breast Percut W/O Image19101 C 3.23 5.68 2.43 0.73 010 55.80 Biopsy Of Breast Open19105 C 3.69 75.92 1.55 0.89 000 55.80 Cryosurg Ablate Fa Each19110 C 4.44 8.45 4.43 1.07 090 55.80 Nipple Exploration19112 C 3.81 8.42 4.31 0.92 090 55.80 Excise Breast Duct Fistula19120 C 5.92 7.00 4.62 1.38 090 55.80 Removal Of Breast Lesion19125 C 6.69 7.55 4.94 1.60 090 55.80 Excision Breast Lesion19126 C 2.93 1.05 1.05 0.70 ZZZ 55.80 Excision Addl Breast Lesion19260 C 17.78 12.42 12.42 4.14 090 55.80 Removal Of Chest Wall Lesion19271 C 22.19 18.85 18.85 5.11 090 55.80 Revision Of Chest Wall19272 C 25.17 19.31 19.31 5.85 090 55.80 Extensive Chest Wall Surgery19281 C 2.00 4.72 0.73 0.18 000 55.80 Perq Device Breast 1St Imag19282 C 1.00 3.73 0.37 0.09 ZZZ 55.80 Perq Device Breast Ea Imag19283 C 2.00 5.52 0.72 0.21 000 55.80 Perq Dev Breast 1St Strtctc19284 C 1.00 4.74 0.37 0.13 ZZZ 55.80 Perq Dev Breast Add Strtctc19285 C 1.70 11.92 0.63 0.17 000 55.80 Perq Dev Breast 1St Us Imag19286 C 0.85 10.97 0.31 0.09 ZZZ 55.80 Perq Dev Breast Add Us Imag19287 C 2.55 20.52 0.94 0.23 000 55.80 Perq Dev Breast 1St Mr Guide19288 C 1.28 17.27 0.48 0.11 ZZZ 55.80 Perq Dev Breast Add Mr Guide19294 C 3.00 1.15 1.15 0.56 ZZZ 55.80 Prep Tum Cav Iort Prtl Mast 19296 C 3.63 108.69 1.63 0.83 000 55.80 Place Po Breast Cath For Rad19297 C 1.72 0.62 0.62 0.41 ZZZ 55.80 Place Breast Cath For Rad19298 C 5.75 21.69 2.62 0.80 000 55.80 Place Breast Rad Tube/Caths19300 C 5.31 8.86 5.48 1.18 090 55.80 Removal Of Breast Tissue19301 C 10.13 6.34 6.34 2.39 090 55.80 Partial Mastectomy19302 C 13.99 8.64 8.64 3.34 090 55.80 P-Mastectomy W/Ln Removal19303 C 15.00 9.13 9.13 3.56 090 55.80 Mast Simple Complete19304 C 7.95 7.04 7.04 1.82 090 55.80 Mast Subq19305 C 17.46 11.11 11.11 4.16 090 55.80 Mast Radical19306 C 18.13 12.20 12.20 4.35 090 55.80 Mast Rad Urban Type19307 C 18.23 12.04 12.04 4.34 090 55.80 Mast Mod Rad19316 C 11.09 9.08 9.08 2.00 090 55.80 Suspension Of Breast19318 C 16.03 12.81 12.81 2.75 090 55.80 Reduction Of Large Breast19324 C 6.80 7.30 7.30 1.05 090 55.80 Enlarge Breast19325 C 8.64 8.38 8.38 1.44 090 55.80 Enlarge Breast With Implant19328 C 6.48 6.65 6.65 1.14 090 55.80 Removal Of Breast Implant19330 C 8.54 8.14 8.14 1.50 090 55.80 Removal Of Implant Material19340 C 13.99 12.17 12.17 2.44 090 55.80 Immediate Breast Prosthesis19342 C 12.63 11.77 11.77 2.13 090 55.80 Delayed Breast Prosthesis19350 C 9.11 12.94 8.64 1.56 090 55.80 Breast Reconstruction19355 C 8.52 11.60 7.83 1.41 090 55.80 Correct Inverted Nipple(S)19357 C 18.50 21.51 21.51 3.15 090 55.80 Breast Reconstruction19361 C 23.36 17.88 17.88 3.98 090 55.80 Breast Reconstr W/Lat Flap19364 C 42.58 29.41 29.41 7.22 090 55.80 Breast Reconstruction19366 C 21.84 14.49 14.49 4.05 090 55.80 Breast Reconstruction19367 C 26.80 19.96 19.96 4.58 090 55.80 Breast Reconstruction19368 C 33.90 23.56 23.56 5.76 090 55.80 Breast Reconstruction19369 C 31.31 22.05 22.05 5.32 090 55.80 Breast Reconstruction19370 C 9.17 8.98 8.98 1.58 090 55.80 Surgery Of Breast Capsule19371 C 10.62 10.11 10.11 1.83 090 55.80 Removal Of Breast Capsule19380 C 10.41 10.07 10.07 1.78 090 55.80 Revise Breast Reconstruction19396 C 2.17 5.69 1.63 0.37 000 55.80 Design Custom Breast Implant

19499FECA-D Energy-R 0.00 0.00 0.00 0.00 YYY 0.00 Breast Surgery Procedure

20100 C 10.38 4.99 4.99 2.17 010 55.80 Explore Wound Neck20101 C 3.23 8.96 2.04 0.77 010 55.80 Explore Wound Chest20102 C 3.98 9.16 2.51 0.90 010 55.80 Explore Wound Abdomen20103 C 5.34 10.33 3.71 0.94 010 55.80 Explore Wound Extremity20150 C 14.75 11.32 11.32 3.02 090 55.80 Excise Epiphyseal Bar20200 C 1.46 4.13 0.91 0.36 000 55.80 Muscle Biopsy20205 C 2.35 5.37 1.50 0.63 000 55.80 Deep Muscle Biopsy20206 C 0.99 5.63 0.60 0.09 000 55.80 Needle Biopsy Muscle20220 C 1.27 3.41 0.68 0.11 000 55.80 Bone Biopsy Trocar/Needle20225 C 1.87 12.66 1.02 0.18 000 55.80 Bone Biopsy Trocar/Needle20240 C 2.61 1.35 1.35 0.35 010 55.80 Bone Biopsy Open Superficial20245 C 6.00 3.13 3.13 1.00 010 55.80 Bone Biopsy Open Deep20250 C 5.19 4.81 4.81 1.50 010 55.80 Open Bone Biopsy20251 C 5.72 5.05 5.05 1.68 010 55.80 Open Bone Biopsy20500 C 1.28 1.68 1.04 0.13 010 55.80 Injection Of Sinus Tract20501 C 0.76 2.79 0.26 0.07 000 55.80 Inject Sinus Tract For X-Ray20520 C 1.90 3.71 2.04 0.26 010 55.80 Removal Of Foreign Body20525 C 3.54 9.47 2.95 0.62 010 55.80 Removal Of Foreign Body20526 C 0.94 1.10 0.56 0.16 000 55.80 Ther Injection Carp Tunnel20527 C 1.00 1.21 0.72 0.18 000 55.80 Inj Dupuytren Cord W/Enzyme20550 C 0.75 0.67 0.29 0.09 000 55.80 Inj Tendon Sheath/Ligament20551 C 0.75 0.70 0.32 0.08 000 55.80 Inj Tendon Origin/Insertion20552 C 0.66 0.84 0.36 0.07 000 55.80 Inj Trigger Point 1/2 Muscl20553 C 0.75 0.98 0.41 0.08 000 55.80 Inject Trigger Points 3/>20555 C 6.00 2.76 2.76 0.73 000 55.80 Place Ndl Musc/Tis For Rt20560 C 0.32 0.12 0.39 0.03 000 55.80 Ndl Insj W/O Njx 1 Or 2 Musc 20561 C 0.48 0.18 0.57 0.05 000 55.80 Ndl Insj W/O Njx 3+ Musc 20600 C 0.66 0.64 0.29 0.08 000 55.80 Drain/Inj Joint/Bursa W/O Us20604 C 0.89 1.11 0.35 0.10 000 55.80 Drain/Inj Joint/Bursa W/Us20605 C 0.68 0.68 0.31 0.08 000 55.80 Drain/Inj Joint/Bursa W/O Us20606 C 1.00 1.20 0.41 0.12 000 55.80 Drain/Inj Joint/Bursa W/Us20610 C 0.79 0.80 0.41 0.12 000 55.80 Drain/Inj Joint/Bursa W/O Us20611 C 1.10 1.36 0.50 0.15 000 55.80 Drain/Inj Joint/Bursa W/Us20612 C 0.70 0.92 0.41 0.09 000 55.80 Aspirate/Inj Ganglion Cyst20615 C 2.33 4.31 1.99 0.31 010 55.80 Treatment Of Bone Cyst20650 C 2.28 3.46 1.97 0.33 010 55.80 Insert And Remove Bone Pin20660 C 4.00 1.84 1.84 1.23 000 55.80 Apply Rem Fixation Device20661 C 5.26 7.46 7.46 1.81 090 55.80 Application Of Head Brace20662 C 6.38 7.07 7.07 1.30 090 55.80 Application Of Pelvis Brace20663 C 5.74 6.63 6.63 1.18 090 55.80 Application Of Thigh Brace20664 D 10.06 11.10 11.10 4.16 090 55.80 Application Of Halo20665 C 1.36 1.67 1.19 0.10 010 55.80 Removal Of Fixation Device20670 C 1.79 8.61 2.13 0.27 010 55.80 Removal Of Support Implant20680 C 5.96 10.66 5.18 1.00 090 55.80 Removal Of Support Implant20690 C 8.78 6.72 6.72 1.70 090 55.80 Apply Bone Fixation Device20692 C 16.27 13.17 13.17 2.83 090 55.80 Apply Bone Fixation Device20693 C 6.06 5.70 5.70 0.99 090 55.80 Adjust Bone Fixation Device20694 C 4.28 7.15 4.67 0.78 090 55.80 Remove Bone Fixation Device20696 C 17.56 13.70 13.70 3.23 090 55.80 Comp Multiplane Ext Fixation20697 C 0.00 58.89 58.89 0.02 000 55.80 Comp Ext Fixate Strut Change20700 C 1.50 0.67 0.67 0.27 000 55.80 Mnl Prep&Insj Dp Rx Dlvr Dev 20701 C 1.13 0.50 0.50 0.19 000 55.80 Rmvl Deep Rx Delivery Device 20702 C 2.50 1.10 1.10 0.46 000 55.80 Mnl Prep&Insj Imed Rx Dev 20703 C 1.80 0.80 0.80 0.31 000 55.80 Rmvl Imed Rx Delivery Device 20704 C 2.60 1.15 1.15 0.48 000 55.80 Mnl Prep&Insj I-Artic Rx Dev 20705 C 2.15 0.95 0.95 0.38 000 55.80 Rmvl I-Artic Rx Delivery Dev 20802 C 42.62 28.30 28.30 8.77 090 55.80 Replantation Arm Complete20805 C 51.46 32.83 32.83 10.60 090 55.80 Replant Forearm Complete20808 C 63.09 38.66 38.66 13.05 090 55.80 Replantation Hand Complete20816 C 31.95 21.18 21.18 6.55 090 55.80 Replantation Digit Complete20822 C 26.66 19.15 19.15 5.47 090 55.80 Replantation Digit Complete20824 C 31.95 21.28 21.28 6.55 090 55.80 Replantation Thumb Complete20827 C 27.48 19.56 19.56 5.33 090 55.80 Replantation Thumb Complete20838 C 42.88 28.99 28.99 8.82 090 55.80 Replantation Foot Complete20900 C 3.00 8.21 1.86 0.51 000 55.80 Removal Of Bone For Graft20902 C 4.58 2.75 2.75 0.87 000 55.80 Removal Of Bone For Graft20910 C 5.53 6.80 6.80 1.13 090 55.80 Remove Cartilage For Graft20912 C 6.54 6.08 6.08 0.98 090 55.80 Remove Cartilage For Graft20920 C 5.51 4.99 4.99 1.01 090 55.80 Removal Of Fascia For Graft20922 C 6.93 8.62 5.65 1.47 090 55.80 Removal Of Fascia For Graft20924 C 6.68 6.67 6.67 1.20 090 55.80 Removal Of Tendon For Graft20926 C 5.79 5.32 5.32 0.96 090 55.80 Removal Of Tissue For Graft20930 C 0.00 0.00 0.00 0.00 XXX 0.00 Sp Bone Algrft Morsel Add-On20931 C 1.81 0.85 0.85 0.60 ZZZ 55.80 Sp Bone Algrft Struct Add-On20932 C 13.01 5.48 5.48 2.05 ZZZ 55.80 Osteoart Algrft W/Surf & B1 20933 C 11.94 5.03 5.03 1.87 ZZZ 55.80 Hemicrt Intrclry Algrft Prtl 20934 C 13.00 5.48 5.48 2.05 ZZZ 55.80 Intercalary Algrft Compl 20936 C 0.00 0.00 0.00 0.00 XXX 0.00 Sp Bone Agrft Local Add-On20937 C 2.79 1.35 1.35 0.74 ZZZ 55.80 Sp Bone Agrft Morsel Add-On20938 C 3.02 1.44 1.44 0.94 ZZZ 55.80 Sp Bone Agrft Struct Add-On20939 C 1.16 0.60 0.60 0.16 ZZZ 55.80 Bone Marrow Aspir Bone Grfg 20950 C 1.26 5.93 1.12 0.22 000 55.80 Fluid Pressure Muscle20955 C 40.26 24.92 24.92 6.51 090 55.80 Fibula Bone Graft Microvasc20956 C 41.18 27.00 27.00 7.94 090 55.80 Iliac Bone Graft Microvasc20957 C 42.61 28.35 28.35 8.77 090 55.80 Mt Bone Graft Microvasc20962 C 39.21 29.78 29.78 8.05 090 55.80 Other Bone Graft Microvasc20969 C 45.43 26.70 26.70 7.01 090 55.80 Bone/Skin Graft Microvasc20970 C 44.58 29.09 29.09 8.71 090 55.80 Bone/Skin Graft Iliac Crest

20972 C 44.51 28.99 28.99 9.16 090 55.80 Bone/Skin Graft Metatarsal20973 C 47.27 30.32 30.32 9.72 090 55.80 Bone/Skin Graft Great Toe20974 C 0.62 1.47 0.69 0.15 000 55.80 Electrical Bone Stimulation20975 C 2.60 1.90 1.90 0.68 000 55.80 Electrical Bone Stimulation20979 C 0.62 0.79 0.23 0.08 000 55.80 Us Bone Stimulation20982 C 7.02 102.28 2.72 0.84 000 55.80 Ablate Bone Tumor(S) Perq20983 C 6.88 156.21 2.64 0.65 000 55.80 Ablate Bone Tumor(S) Perq20985 C 2.50 1.25 1.25 0.49 ZZZ 55.80 Cptr-Asst Dir Ms Px20999 R 0.00 0.00 0.00 0.00 YYY 0.00 Musculoskeletal Surgery21010 C 11.04 9.18 9.18 1.77 090 55.80 Incision Of Jaw Joint21011 C 2.99 6.60 3.87 0.53 090 55.80 Exc Face Les Sc 21013 C 5.42 8.66 5.18 0.95 090 55.80 Exc Face Tum Deep < 2 Cm21014 C 7.13 6.57 6.57 1.31 090 55.80 Exc Face Tum Deep 2 Cm/>21015 C 9.89 8.69 8.69 1.72 090 55.80 Resect Face/Scalp Tum < 2 Cm21016 C 15.26 11.15 11.15 2.74 090 55.80 Resect Face/Scalp Tum 2 Cm/>21025 C 10.03 13.17 9.37 1.67 090 55.80 Excision Of Bone Lower Jaw21026 C 5.70 10.37 7.19 0.95 090 55.80 Excision Of Facial Bone(S)21029 C 8.39 12.38 8.56 1.31 090 55.80 Contour Of Face Bone Lesion21030 C 4.91 8.91 5.99 0.81 090 55.80 Excise Max/Zygoma B9 Tumor21031 C 3.30 7.46 4.49 0.55 090 55.80 Remove Exostosis Mandible21032 C 3.34 7.49 4.32 0.55 090 55.80 Remove Exostosis Maxilla21034 C 17.38 17.41 12.92 2.71 090 55.80 Excise Max/Zygoma Mal Tumor21040 C 4.91 9.01 6.00 0.82 090 55.80 Excise Mandible Lesion21044 C 12.80 10.33 10.33 1.95 090 55.80 Removal Of Jaw Bone Lesion21045 C 18.37 13.88 13.88 2.87 090 55.80 Extensive Jaw Surgery21046 C 14.21 14.96 14.96 2.40 090 55.80 Remove Mandible Cyst Complex21047 C 20.07 14.39 14.39 3.23 090 55.80 Excise Lwr Jaw Cyst W/Repair21048 C 14.71 14.89 14.89 2.47 090 55.80 Remove Maxilla Cyst Complex21049 C 19.32 12.60 12.60 2.74 090 55.80 Excis Uppr Jaw Cyst W/Repair21050 C 11.76 12.16 12.16 2.00 090 55.80 Removal Of Jaw Joint21060 C 11.07 10.63 10.63 1.88 090 55.80 Remove Jaw Joint Cartilage21070 C 8.62 8.32 8.32 1.38 090 55.80 Remove Coronoid Process21073 C 3.45 7.00 3.28 0.57 090 55.80 Mnpj Of Tmj W/Anesth21076 C 13.40 11.95 7.51 2.25 010 55.80 Prepare Face/Oral Prosthesis21077 C 33.70 29.38 18.57 5.72 090 55.80 Prepare Face/Oral Prosthesis21079 C 22.31 20.57 12.76 3.78 090 55.80 Prepare Face/Oral Prosthesis21080 C 25.06 23.50 14.15 4.17 090 55.80 Prepare Face/Oral Prosthesis21081 C 22.85 21.82 13.09 3.86 090 55.80 Prepare Face/Oral Prosthesis21082 C 20.84 20.99 12.55 3.50 090 55.80 Prepare Face/Oral Prosthesis21083 C 19.27 20.66 11.74 3.29 090 55.80 Prepare Face/Oral Prosthesis21084 C 22.48 23.23 13.38 3.78 090 55.80 Prepare Face/Oral Prosthesis21085 C 8.99 10.57 5.23 1.49 010 55.80 Prepare Face/Oral Prosthesis21086 C 24.88 21.99 13.66 4.23 090 55.80 Prepare Face/Oral Prosthesis21087 C 24.88 21.99 13.66 4.23 090 55.80 Prepare Face/Oral Prosthesis21088 C 968.88 0.00 0.00 0.00 090 1.25 Prepare Face/Oral Prosthesis

21089FECA-D Energy-R 0.00 0.00 0.00 0.00 YYY 0.00 Prepare Face/Oral Prosthesis

21100 C 4.73 14.36 5.82 0.80 090 55.80 Maxillofacial Fixation21110 C 5.99 16.38 12.59 1.01 090 55.80 Interdental Fixation21116 C 0.81 4.13 0.43 0.14 000 55.80 Injection Jaw Joint X-Ray21120 C 5.10 13.36 9.28 0.85 090 55.80 Reconstruction Of Chin21121 C 7.81 11.82 8.75 1.32 090 55.80 Reconstruction Of Chin21122 C 8.71 12.20 12.20 1.47 090 55.80 Reconstruction Of Chin21123 C 11.34 12.86 12.86 1.92 090 55.80 Reconstruction Of Chin21125 C 10.80 70.23 8.80 1.74 090 55.80 Augmentation Lower Jaw Bone21127 C 12.44 97.65 10.12 2.11 090 55.80 Augmentation Lower Jaw Bone21137 C 10.24 9.64 9.64 1.74 090 55.80 Reduction Of Forehead21138 C 12.87 11.35 11.35 2.19 090 55.80 Reduction Of Forehead21139 C 15.02 14.57 14.57 2.56 090 55.80 Reduction Of Forehead21141 C 19.57 16.55 16.55 3.34 090 55.80 Lefort I-1 Piece W/O Graft21142 C 20.28 16.82 16.82 3.46 090 55.80 Lefort I-2 Piece W/O Graft21143 C 21.05 17.69 17.69 3.58 090 55.80 Lefort I-3/> Piece W/O Graft21145 C 23.94 18.23 18.23 4.07 090 55.80 Lefort I-1 Piece W/ Graft21146 C 24.87 19.10 19.10 4.11 090 55.80 Lefort I-2 Piece W/ Graft21147 C 26.47 19.86 19.86 4.51 090 55.80 Lefort I-3/> Piece W/ Graft21150 C 25.96 17.99 17.99 3.73 090 55.80 Lefort Ii Anterior Intrusion21151 C 29.02 19.29 19.29 4.17 090 55.80 Lefort Ii W/Bone Grafts21154 C 31.29 20.66 20.66 4.51 090 55.80 Lefort Iii W/O Lefort I21155 C 35.22 22.35 22.35 5.07 090 55.80 Lefort Iii W/ Lefort I21159 C 43.14 25.74 25.74 6.21 090 55.80 Lefort Iii W/Fhdw/O Lefort I21160 C 47.19 27.47 27.47 6.79 090 55.80 Lefort Iii W/Fhd W/ Lefort I21172 C 28.20 20.91 20.91 11.48 090 55.80 Reconstruct Orbit/Forehead21175 C 33.56 24.56 24.56 5.70 090 55.80 Reconstruct Orbit/Forehead21179 C 22.65 17.32 17.32 3.63 090 55.80 Reconstruct Entire Forehead21180 C 25.58 19.12 19.12 4.36 090 55.80 Reconstruct Entire Forehead21181 C 10.28 9.27 9.27 1.74 090 55.80 Contour Cranial Bone Lesion21182 C 32.58 23.14 23.14 5.29 090 55.80 Reconstruct Cranial Bone21183 C 35.70 24.97 24.97 6.08 090 55.80 Reconstruct Cranial Bone21184 C 38.62 26.67 26.67 6.57 090 55.80 Reconstruct Cranial Bone21188 C 23.15 21.18 21.18 3.73 090 55.80 Reconstruction Of Midface21193 C 18.90 14.77 14.77 3.11 090 55.80 Reconst Lwr Jaw W/O Graft21194 C 21.82 16.86 16.86 3.71 090 55.80 Reconst Lwr Jaw W/Graft21195 C 19.16 18.58 18.58 3.27 090 55.80 Reconst Lwr Jaw W/O Fixation21196 C 20.83 18.00 18.00 3.35 090 55.80 Reconst Lwr Jaw W/Fixation21198 C 15.71 14.86 14.86 2.51 090 55.80 Reconstr Lwr Jaw Segment21199 C 16.73 11.43 11.43 2.79 090 55.80 Reconstr Lwr Jaw W/Advance21206 C 15.59 15.94 15.94 2.61 090 55.80 Reconstruct Upper Jaw Bone21208 C 11.42 36.58 9.94 1.91 090 55.80 Augmentation Of Facial Bones21209 C 7.82 16.63 10.17 1.30 090 55.80 Reduction Of Facial Bones

21210 C 11.69 46.65 10.29 1.94 090 55.80 Face Bone Graft21215 C 12.23 100.42 10.64 2.06 090 55.80 Lower Jaw Bone Graft21230 C 11.17 8.49 8.49 1.69 090 55.80 Rib Cartilage Graft21235 C 7.50 12.15 7.62 1.12 090 55.80 Ear Cartilage Graft21240 C 16.07 13.35 13.35 2.73 090 55.80 Reconstruction Of Jaw Joint21242 C 14.59 12.94 12.94 2.39 090 55.80 Reconstruction Of Jaw Joint21243 C 24.53 20.23 20.23 4.16 090 55.80 Reconstruction Of Jaw Joint21244 C 13.62 14.26 14.26 2.14 090 55.80 Reconstruction Of Lower Jaw21245 C 13.12 19.56 12.18 2.19 090 55.80 Reconstruction Of Jaw21246 C 12.92 10.32 10.32 2.20 090 55.80 Reconstruction Of Jaw21247 C 24.37 18.82 18.82 3.85 090 55.80 Reconstruct Lower Jaw Bone21248 C 12.74 16.21 10.46 2.16 090 55.80 Reconstruction Of Jaw21249 C 18.77 22.93 14.73 3.20 090 55.80 Reconstruction Of Jaw21255 C 18.46 19.08 19.08 3.14 090 55.80 Reconstruct Lower Jaw Bone21256 C 17.66 15.13 15.13 3.00 090 55.80 Reconstruction Of Orbit21260 C 17.90 19.25 19.25 3.04 090 55.80 Revise Eye Sockets21261 C 34.07 31.33 31.33 5.79 090 55.80 Revise Eye Sockets21263 C 31.01 29.54 29.54 5.27 090 55.80 Revise Eye Sockets21267 C 20.69 22.83 22.83 3.33 090 55.80 Revise Eye Sockets21268 C 27.07 27.24 27.24 4.60 090 55.80 Revise Eye Sockets21270 C 10.63 16.63 9.20 1.80 090 55.80 Augmentation Cheek Bone21275 C 11.76 10.42 10.42 2.00 090 55.80 Revision Orbitofacial Bones21280 C 7.13 8.58 8.58 0.69 090 55.80 Revision Of Eyelid21282 C 4.27 6.24 6.24 0.50 090 55.80 Revision Of Eyelid21295 C 1.90 3.20 3.20 0.27 090 55.80 Revision Of Jaw Muscle/Bone21296 C 4.78 6.30 6.30 0.56 090 55.80 Revision Of Jaw Muscle/Bone

21299FECA-D Energy-R 0.00 0.00 0.00 0.00 YYY 0.00 Cranio/Maxillofacial Surgery

21310 C 0.58 3.10 0.12 0.08 000 55.80 Closed Tx Nose Fx W/O Manj21315 C 1.83 5.74 2.22 0.27 010 55.80 Closed Tx Nose Fx W/O Stablj21320 C 1.88 5.08 1.68 0.27 010 55.80 Closed Tx Nose Fx W/ Stablj21325 C 4.18 8.56 8.56 0.65 090 55.80 Open Tx Nose Fx Uncomplicatd21330 C 5.79 9.49 9.49 0.89 090 55.80 Open Tx Nose Fx W/Skele Fixj21335 C 9.02 10.20 10.20 1.31 090 55.80 Open Tx Nose & Septal Fx21336 C 6.77 10.60 10.60 1.02 090 55.80 Open Tx Septal Fx W/Wo Stabj21337 C 3.39 7.71 4.51 0.52 090 55.80 Closed Tx Septal&Nose Fx21338 C 6.87 11.02 11.02 0.99 090 55.80 Open Nasoethmoid Fx W/O Fixj21339 C 8.50 11.72 11.72 1.16 090 55.80 Open Nasoethmoid Fx W/ Fixj21340 C 11.49 8.20 8.20 1.65 090 55.80 Perq Tx Nasoethmoid Fx21343 C 14.32 14.46 14.46 2.04 090 55.80 Open Tx Dprsd Front Sinus Fx21344 C 21.57 15.04 15.04 3.05 090 55.80 Open Tx Compl Front Sinus Fx21345 C 9.06 11.90 7.57 1.29 090 55.80 Closed Tx Nose/Jaw Fx21346 C 11.45 13.51 13.51 1.64 090 55.80 Opn Tx Nasomax Fx W/Fixj21347 C 13.53 13.58 13.58 1.92 090 55.80 Opn Tx Nasomax Fx Multple21348 C 17.52 11.01 11.01 2.52 090 55.80 Opn Tx Nasomax Fx W/Graft21355 C 4.45 7.10 4.08 0.64 010 55.80 Perq Tx Malar Fracture21356 C 4.83 8.71 5.25 0.77 010 55.80 Opn Tx Dprsd Zygomatic Arch21360 C 7.19 6.39 6.39 1.02 090 55.80 Opn Tx Dprsd Malar Fracture21365 C 16.77 12.49 12.49 2.69 090 55.80 Opn Tx Complx Malar Fx21366 C 18.60 14.99 14.99 3.00 090 55.80 Opn Tx Complx Malar W/Grft21385 C 9.57 10.49 10.49 1.59 090 55.80 Opn Tx Orbit Fx Transantral21386 C 9.57 8.80 8.80 1.61 090 55.80 Opn Tx Orbit Fx Periorbital21387 C 10.11 10.80 10.80 1.67 090 55.80 Opn Tx Orbit Fx Combined21390 C 11.23 10.27 10.27 1.46 090 55.80 Opn Tx Orbit Periorbtl Implt21395 C 14.70 11.88 11.88 2.49 090 55.80 Opn Tx Orbit Periorbt W/Grft21400 C 1.50 3.99 2.85 0.24 090 55.80 Closed Tx Orbit W/O Manipulj21401 C 3.68 10.45 4.93 0.62 090 55.80 Closed Tx Orbit W/Manipulj21406 C 7.42 7.87 7.87 1.25 090 55.80 Opn Tx Orbit Fx W/O Implant21407 C 9.02 8.27 8.27 1.24 090 55.80 Opn Tx Orbit Fx W/Implant21408 C 12.78 11.00 11.00 2.17 090 55.80 Opn Tx Orbit Fx W/Bone Grft21421 C 6.02 13.29 10.17 1.02 090 55.80 Treat Mouth Roof Fracture21422 C 8.73 8.83 8.83 1.41 090 55.80 Treat Mouth Roof Fracture21423 C 10.85 9.64 9.64 1.73 090 55.80 Treat Mouth Roof Fracture21431 C 7.90 11.36 11.36 1.34 090 55.80 Treat Craniofacial Fracture21432 C 8.82 10.34 10.34 1.42 090 55.80 Treat Craniofacial Fracture21433 C 26.29 19.40 19.40 4.48 090 55.80 Treat Craniofacial Fracture21435 C 20.26 16.77 16.77 3.30 090 55.80 Treat Craniofacial Fracture21436 C 30.30 23.38 23.38 5.15 090 55.80 Treat Craniofacial Fracture21440 C 3.44 13.32 10.04 0.57 090 55.80 Treat Dental Ridge Fracture21445 C 6.26 14.95 10.76 1.05 090 55.80 Treat Dental Ridge Fracture21450 C 3.71 12.11 9.14 0.62 090 55.80 Treat Lower Jaw Fracture21451 C 5.65 15.14 11.67 0.96 090 55.80 Treat Lower Jaw Fracture21452 C 2.40 16.36 8.61 0.41 090 55.80 Treat Lower Jaw Fracture21453 C 6.64 19.89 15.91 1.09 090 55.80 Treat Lower Jaw Fracture21454 C 7.36 7.08 7.08 1.25 090 55.80 Treat Lower Jaw Fracture21461 C 9.31 48.63 17.29 1.50 090 55.80 Treat Lower Jaw Fracture21462 C 11.01 50.56 18.44 1.80 090 55.80 Treat Lower Jaw Fracture21465 C 13.12 10.56 10.56 2.19 090 55.80 Treat Lower Jaw Fracture21470 C 17.54 14.10 14.10 2.90 090 55.80 Treat Lower Jaw Fracture21480 C 0.61 2.37 0.21 0.09 000 55.80 Reset Dislocated Jaw21485 C 4.77 18.22 13.96 0.80 090 55.80 Reset Dislocated Jaw21490 C 12.95 10.41 10.41 2.20 090 55.80 Repair Dislocated Jaw21497 C 4.64 14.19 11.08 0.79 090 55.80 Interdental Wiring

21499FECA-D Energy-R 0.00 0.00 0.00 0.00 YYY 0.00 Head Surgery Procedure

21501 C 3.98 8.42 4.53 0.78 090 55.80 Drain Neck/Chest Lesion21502 C 7.55 5.22 5.22 1.75 090 55.80 Drain Chest Lesion21510 C 6.20 5.13 5.13 1.41 090 55.80 Drainage Of Bone Lesion21550 C 2.11 5.04 2.09 0.31 010 55.80 Biopsy Of Neck/Chest21552 C 6.49 4.93 4.93 1.44 090 55.80 Exc Neck Les Sc 3 Cm/>

21554 C 11.13 7.60 7.60 2.33 090 55.80 Exc Neck Tum Deep 5 Cm/>21555 C 3.96 7.31 4.02 0.80 090 55.80 Exc Neck Les Sc < 3 Cm21556 C 7.66 6.09 6.09 1.44 090 55.80 Exc Neck Tum Deep < 5 Cm21557 C 14.75 9.82 9.82 2.91 090 55.80 Resect Neck Thorax Tumor21600 C 7.26 7.04 7.04 1.55 090 55.80 Partial Removal Of Rib21601 C 17.78 12.24 12.24 4.15 090 55.80 Exc Chest Wall Tumor W/Ribs 21602 C 22.19 18.60 18.60 5.04 090 55.80 Exc Ch Wal Tum W/O Lymphadec 21603 C 25.17 19.71 19.71 5.84 090 55.80 Exc Ch Wal Tum W/Lymphadec 21610 C 15.91 12.60 12.60 6.19 090 55.80 Partial Removal Of Rib21615 C 10.45 4.75 4.75 2.38 090 55.80 Removal Of Rib21616 C 12.69 4.93 4.93 2.94 090 55.80 Removal Of Rib And Nerves21620 C 7.28 5.65 5.65 1.59 090 55.80 Partial Removal Of Sternum21627 C 7.30 6.60 6.60 1.59 090 55.80 Sternal Debridement21630 C 19.18 12.40 12.40 3.86 090 55.80 Extensive Sternum Surgery21632 C 19.68 10.55 10.55 4.66 090 55.80 Extensive Sternum Surgery21685 C 15.26 10.77 10.77 2.18 090 55.80 Hyoid Myotomy & Suspension21700 C 6.31 2.54 2.54 1.39 090 55.80 Revision Of Neck Muscle21705 C 9.92 3.23 3.23 2.24 090 55.80 Revision Of Neck Muscle/Rib21720 C 5.80 7.00 7.00 1.97 090 55.80 Revision Of Neck Muscle21725 C 7.19 6.92 6.92 1.47 090 55.80 Revision Of Neck Muscle21740 C 17.57 8.10 8.10 4.05 090 55.80 Reconstruction Of Sternum21742 C 999.77 0.00 0.00 0.00 090 1.25 Repair Stern/Nuss W/O Scope21743 C 720.34 0.00 0.00 0.00 090 2.50 Repair Sternum/Nuss W/Scope21750 C 11.40 5.69 5.69 2.62 090 55.80 Repair Of Sternum Separation21811 C 10.79 4.00 4.00 2.39 000 55.80 Optx Of Rib Fx W/Fixj Scope21812 C 13.00 5.17 5.17 2.90 000 55.80 Treatment Of Rib Fracture21813 C 17.61 6.79 6.79 4.00 000 55.80 Treatment Of Rib Fracture21820 C 1.36 2.48 2.50 0.24 090 55.80 Treat Sternum Fracture21825 C 7.76 6.07 6.07 1.76 090 55.80 Treat Sternum Fracture21899 R 0.00 0.00 0.00 0.00 YYY 0.00 Neck/Chest Surgery Procedure21920 C 2.11 4.87 2.12 0.32 010 55.80 Biopsy Soft Tissue Of Back21925 C 4.63 7.49 4.69 0.98 090 55.80 Biopsy Soft Tissue Of Back21930 C 4.94 7.86 4.52 1.03 090 55.80 Exc Back Les Sc < 3 Cm21931 C 6.88 5.12 5.12 1.56 090 55.80 Exc Back Les Sc 3 Cm/>21932 C 9.82 7.06 7.06 2.19 090 55.80 Exc Back Tum Deep < 5 Cm21933 C 11.13 7.67 7.67 2.49 090 55.80 Exc Back Tum Deep 5 Cm/>21935 C 15.72 10.44 10.44 3.49 090 55.80 Resect Back Tum < 5 Cm21936 C 22.55 13.37 13.37 5.04 090 55.80 Resect Back Tum 5 Cm/>22010 C 12.75 11.29 11.29 3.69 090 55.80 I&D P-Spine C/T/Cerv-Thor22015 C 12.64 11.21 11.21 3.55 090 55.80 I&D Abscess P-Spine L/S/Ls22100 C 11.00 10.66 10.66 3.22 090 55.80 Remove Part Of Neck Vertebra22101 C 11.08 10.50 10.50 3.22 090 55.80 Remove Part Thorax Vertebra22102 C 11.08 9.89 9.89 2.51 090 55.80 Remove Part Lumbar Vertebra22103 C 2.34 1.11 1.11 0.65 ZZZ 55.80 Remove Extra Spine Segment22110 C 14.00 11.88 11.88 4.41 090 55.80 Remove Part Of Neck Vertebra22112 C 14.07 12.84 12.84 5.14 090 55.80 Remove Part Thorax Vertebra22114 C 14.07 12.84 12.84 5.53 090 55.80 Remove Part Lumbar Vertebra22116 C 2.32 1.09 1.09 0.71 ZZZ 55.80 Remove Extra Spine Segment22206 C 37.18 23.13 23.13 11.02 090 55.80 Incis Spine 3 Column Thorac22207 C 36.68 22.95 22.95 10.26 090 55.80 Incis Spine 3 Column Lumbar22208 C 9.66 4.60 4.60 3.02 ZZZ 55.80 Incis Spine 3 Column Adl Seg22210 C 25.38 18.81 18.81 7.87 090 55.80 Incis 1 Vertebral Seg Cerv22212 C 20.99 16.54 16.54 5.69 090 55.80 Incis 1 Vertebral Seg Thorac22214 C 21.02 16.58 16.58 5.80 090 55.80 Incis 1 Vertebral Seg Lumbar22216 C 6.03 2.92 2.92 1.66 ZZZ 55.80 Incis Addl Spine Segment22220 C 22.94 17.24 17.24 6.86 090 55.80 Incis W/Discectomy Cervical22222 C 23.09 18.41 18.41 8.53 090 55.80 Incis W/Discectomy Thoracic22224 C 23.09 17.20 17.20 5.61 090 55.80 Incis W/Discectomy Lumbar22226 C 6.03 2.89 2.89 1.66 ZZZ 55.80 Revise Extra Spine Segment22310 C 3.89 4.12 3.47 0.81 090 55.80 Closed Tx Vert Fx W/O Manj22315 C 10.11 12.79 9.64 2.47 090 55.80 Closed Tx Vert Fx W/Manj22318 C 22.72 16.40 16.40 8.53 090 55.80 Treat Odontoid Fx W/O Graft22319 C 25.33 17.75 17.75 9.69 090 55.80 Treat Odontoid Fx W/Graft22325 C 19.87 15.99 15.99 6.11 090 55.80 Treat Spine Fracture22326 C 20.84 15.61 15.61 7.02 090 55.80 Treat Neck Spine Fracture22327 C 20.77 16.42 16.42 6.69 090 55.80 Treat Thorax Spine Fracture22328 C 4.60 2.18 2.18 1.47 ZZZ 55.80 Treat Each Add Spine Fx22505 C 1.87 1.54 1.54 0.38 010 55.80 Manipulation Of Spine22510 C 7.90 40.98 3.69 0.95 010 55.80 Perq Cervicothoracic Inject22511 C 7.33 41.11 3.54 0.89 010 55.80 Perq Lumbosacral Injection22512 C 4.00 21.04 1.43 0.56 ZZZ 55.80 Vertebroplasty Addl Inject22513 C 8.65 185.31 4.72 1.59 010 55.80 Perq Vertebral Augmentation22514 C 7.99 185.46 4.48 1.47 010 55.80 Perq Vertebral Augmentation22515 C 4.00 108.36 1.67 0.79 ZZZ 55.80 Perq Vertebral Augmentation22526 C 5.85 58.37 3.12 0.79 010 55.80 Idet Single Level22527 C 3.03 51.18 1.16 0.42 ZZZ 55.80 Idet 1 Or More Levels22532 C 25.99 18.05 18.05 8.36 090 55.80 Lat Thorax Spine Fusion22533 C 24.79 17.25 17.25 6.08 090 55.80 Lat Lumbar Spine Fusion22534 C 5.99 2.86 2.86 1.67 ZZZ 55.80 Lat Thor/Lumb Addl Seg22548 C 27.06 19.23 19.23 10.66 090 55.80 Neck Spine Fusion22551 C 25.00 16.63 16.63 8.03 090 55.80 Neck Spine Fuse&Remov Bel C222552 C 6.50 3.07 3.07 2.07 ZZZ 55.80 Addl Neck Spine Fusion22554 C 17.69 13.30 13.30 5.41 090 55.80 Neck Spine Fusion22556 C 24.70 16.55 16.55 7.33 090 55.80 Thorax Spine Fusion22558 C 23.53 14.86 14.86 6.10 090 55.80 Lumbar Spine Fusion22585 C 5.52 2.51 2.51 1.52 ZZZ 55.80 Additional Spinal Fusion22586 C 28.12 19.79 19.79 11.03 090 55.80 Prescrl Fuse W/ Instr L5-S122590 C 21.76 16.46 16.46 7.77 090 55.80 Spine & Skull Spinal Fusion22595 C 20.64 15.93 15.93 7.31 090 55.80 Neck Spinal Fusion

22600 C 17.40 14.30 14.30 5.78 090 55.80 Neck Spine Fusion22610 C 17.28 14.13 14.13 5.37 090 55.80 Thorax Spine Fusion22612 C 23.53 16.11 16.11 6.42 090 55.80 Lumbar Spine Fusion22614 C 6.43 3.07 3.07 1.92 ZZZ 55.80 Spine Fusion Extra Segment22630 C 22.09 16.22 16.22 7.49 090 55.80 Lumbar Spine Fusion22632 C 5.22 2.45 2.45 1.73 ZZZ 55.80 Spine Fusion Extra Segment22633 C 27.75 17.93 17.93 8.17 090 55.80 Lumbar Spine Fusion Combined22634 C 8.16 3.88 3.88 2.44 ZZZ 55.80 Spine Fusion Extra Segment22800 C 19.50 14.70 14.70 5.14 090 55.80 Post Fusion Vert Seg22808 C 27.51 18.25 18.25 8.00 090 55.80 Ant Fusion 2-3 Vert Seg22810 C 31.50 19.53 19.53 9.25 090 55.80 Ant Fusion 4-7 Vert Seg22812 C 34.25 22.77 22.77 6.26 090 55.80 Ant Fusion 8/> Vert Seg22818 C 34.33 21.48 21.48 6.68 090 55.80 Kyphectomy 1-2 Segments22819 C 39.38 24.81 24.81 7.31 090 55.80 Kyphectomy 3 Or More22830 C 11.22 9.27 9.27 3.13 090 55.80 Exploration Of Spinal Fusion22840 C 12.52 5.99 5.99 3.69 ZZZ 55.80 Insert Spine Fixation Device22841 D 0.00 0.00 0.00 0.00 XXX 0.00 Insert Spine Fixation Device22842 C 12.56 6.00 6.00 3.76 ZZZ 55.80 Insert Spine Fixation Device22843 C 13.44 6.44 6.44 3.99 ZZZ 55.80 Insert Spine Fixation Device22844 C 16.42 7.97 7.97 4.43 ZZZ 55.80 Insert Spine Fixation Device22845 C 11.94 5.65 5.65 3.74 ZZZ 55.80 Insert Spine Fixation Device22846 C 12.40 5.88 5.88 3.87 ZZZ 55.80 Insert Spine Fixation Device22847 C 13.78 6.90 6.90 2.69 ZZZ 55.80 Insert Spine Fixation Device22848 C 5.99 2.91 2.91 1.60 ZZZ 55.80 Insert Pelv Fixation Device22849 C 19.17 13.20 13.20 5.36 090 55.80 Reinsert Spinal Fixation22850 C 9.82 8.43 8.43 2.79 090 55.80 Remove Spine Fixation Device22852 C 9.37 8.20 8.20 2.64 090 55.80 Remove Spine Fixation Device22853 C 4.25 2.03 2.03 1.27 ZZZ 55.80 Insj Biomechanical Device22854 C 5.50 2.62 2.62 1.66 ZZZ 55.80 Insj Biomechanical Device22855 C 15.86 11.54 11.54 4.79 090 55.80 Remove Spine Fixation Device22856 C 24.05 16.06 16.06 7.55 090 55.80 Cerv Artific Diskectomy22857 C 27.13 18.73 18.73 4.99 090 55.80 Lumbar Artif Diskectomy22858 C 8.40 3.97 3.97 2.56 ZZZ 55.80 Second Level Cer Diskectomy22859 C 5.50 2.62 2.62 1.66 ZZZ 55.80 Insj Biomechanical Device22861 C 33.36 21.10 21.10 10.47 090 55.80 Revise Cerv Artific Disc22862 C 32.63 17.86 17.86 4.45 090 55.80 Revise Lumbar Artif Disc22864 C 29.40 19.29 19.29 11.26 090 55.80 Remove Cerv Artif Disc22865 C 31.75 17.48 17.48 7.15 090 55.80 Remove Lumb Artif Disc22867 C 13.50 10.74 10.74 3.97 090 55.80 Insj Stablj Dev W/Dcmprn22868 C 4.00 1.87 1.87 1.19 ZZZ 55.80 Insj Stablj Dev W/Dcmprn22869 C 7.03 5.24 5.24 0.98 090 55.80 Insj Stablj Dev W/O Dcmprn22870 C 2.34 1.00 1.00 0.28 ZZZ 55.80 Insj Stablj Dev W/O Dcmprn22899 R 0.00 0.00 0.00 0.00 YYY 0.00 Spine Surgery Procedure22900 C 8.32 6.07 6.07 1.85 090 55.80 Exc Abdl Tum Deep < 5 Cm22901 C 10.11 6.78 6.78 2.31 090 55.80 Exc Abdl Tum Deep 5 Cm/>22902 C 4.42 7.42 4.10 1.01 090 55.80 Exc Abd Les Sc < 3 Cm22903 C 6.39 4.82 4.82 1.47 090 55.80 Exc Abd Les Sc 3 Cm/>22904 C 16.69 10.10 10.10 3.70 090 55.80 Radical Resect Abd Tumor22999 R 0.00 0.00 0.00 0.00 YYY 0.00 Abdomen Surgery Procedure23000 C 4.48 10.77 5.03 0.83 090 55.80 Removal Of Calcium Deposits23020 C 9.36 8.67 8.67 1.82 090 55.80 Release Shoulder Joint23030 C 3.47 8.30 3.07 0.66 010 55.80 Drain Shoulder Lesion23031 C 2.79 8.18 2.73 0.47 010 55.80 Drain Shoulder Bursa23035 C 9.16 8.54 8.54 1.78 090 55.80 Drain Shoulder Bone Lesion23040 C 9.75 8.99 8.99 1.90 090 55.80 Exploratory Shoulder Surgery23044 C 7.59 7.15 7.15 1.57 090 55.80 Exploratory Shoulder Surgery23065 C 2.30 3.68 2.15 0.36 010 55.80 Biopsy Shoulder Tissues23066 C 4.30 10.98 5.20 0.90 090 55.80 Biopsy Shoulder Tissues23071 C 5.91 4.86 4.86 1.32 090 55.80 Exc Shoulder Les Sc 3 Cm/>23073 C 10.13 7.72 7.72 2.19 090 55.80 Exc Shoulder Tum Deep 5 Cm/>23075 C 4.21 8.79 4.30 0.90 090 55.80 Exc Shoulder Les Sc < 3 Cm23076 C 7.41 6.59 6.59 1.60 090 55.80 Exc Shoulder Tum Deep < 5 Cm23077 C 17.66 11.22 11.22 3.93 090 55.80 Resect Shoulder Tumor < 5 Cm23078 C 22.55 14.07 14.07 4.86 090 55.80 Resect Shoulder Tumor 5 Cm/>23100 C 6.20 6.97 6.97 1.23 090 55.80 Biopsy Of Shoulder Joint23101 C 5.72 6.25 6.25 1.17 090 55.80 Shoulder Joint Surgery23105 C 8.48 8.25 8.25 1.61 090 55.80 Remove Shoulder Joint Lining23106 C 6.13 6.94 6.94 1.25 090 55.80 Incision Of Collarbone Joint23107 C 8.87 8.40 8.40 1.74 090 55.80 Explore Treat Shoulder Joint23120 C 7.39 7.97 7.97 1.44 090 55.80 Partial Removal Collar Bone23125 C 9.64 8.84 8.84 1.84 090 55.80 Removal Of Collar Bone23130 C 7.77 8.27 8.27 1.58 090 55.80 Remove Shoulder Bone Part23140 C 7.12 7.33 7.33 1.45 090 55.80 Removal Of Bone Lesion23145 C 9.40 8.72 8.72 1.66 090 55.80 Removal Of Bone Lesion23146 C 8.08 8.17 8.17 1.38 090 55.80 Removal Of Bone Lesion23150 C 8.91 8.35 8.35 1.68 090 55.80 Removal Of Humerus Lesion23155 C 10.86 9.83 9.83 2.01 090 55.80 Removal Of Humerus Lesion23156 C 9.11 8.58 8.58 1.77 090 55.80 Removal Of Humerus Lesion23170 C 7.21 7.48 7.48 1.47 090 55.80 Remove Collar Bone Lesion23172 C 7.31 7.53 7.53 1.39 090 55.80 Remove Shoulder Blade Lesion23174 C 10.05 9.79 9.79 1.99 090 55.80 Remove Humerus Lesion23180 C 8.99 8.12 8.12 1.88 090 55.80 Remove Collar Bone Lesion23182 C 8.61 8.67 8.67 1.67 090 55.80 Remove Shoulder Blade Lesion23184 C 9.90 9.28 9.28 1.92 090 55.80 Remove Humerus Lesion23190 C 7.47 7.50 7.50 1.46 090 55.80 Partial Removal Of Scapula23195 C 10.36 9.10 9.10 2.01 090 55.80 Removal Of Head Of Humerus23200 C 22.71 16.39 16.39 4.54 090 55.80 Resect Clavicle Tumor

23210 C 27.21 18.65 18.65 5.40 090 55.80 Resect Scapula Tumor23220 C 30.21 20.08 20.08 6.04 090 55.80 Resect Prox Humerus Tumor23330 C 1.90 5.74 2.50 0.36 010 55.80 Remove Shoulder Foreign Body23333 C 6.00 6.17 6.17 1.10 090 55.80 Remove Shoulder Fb Deep23334 C 15.50 12.29 12.29 3.09 090 55.80 Shoulder Prosthesis Removal23335 C 19.00 14.06 14.06 3.80 090 55.80 Shoulder Prosthesis Removal23350 C 1.00 2.88 0.38 0.09 000 55.80 Injection For Shoulder X-Ray23395 C 18.54 14.87 14.87 3.56 090 55.80 Muscle Transfer Shoulder/Arm23397 C 16.76 12.71 12.71 3.20 090 55.80 Muscle Transfers23400 C 13.87 11.34 11.34 2.32 090 55.80 Fixation Of Shoulder Blade23405 C 8.54 7.66 7.66 1.57 090 55.80 Incision Of Tendon & Muscle23406 C 11.01 9.18 9.18 2.01 090 55.80 Incise Tendon(S) & Muscle(S)23410 C 11.39 10.02 10.02 2.23 090 55.80 Repair Rotator Cuff Acute23412 C 11.93 10.28 10.28 2.32 090 55.80 Repair Rotator Cuff Chronic23415 C 9.23 9.00 9.00 1.88 090 55.80 Release Of Shoulder Ligament23420 C 13.54 11.74 11.74 2.70 090 55.80 Repair Of Shoulder23430 C 10.17 9.30 9.30 1.94 090 55.80 Repair Biceps Tendon23440 C 10.64 9.01 9.01 2.05 090 55.80 Remove/Transplant Tendon23450 C 13.70 10.87 10.87 2.59 090 55.80 Repair Shoulder Capsule23455 C 14.67 11.21 11.21 2.86 090 55.80 Repair Shoulder Capsule23460 C 15.82 12.43 12.43 3.01 090 55.80 Repair Shoulder Capsule23462 C 15.72 11.67 11.67 2.98 090 55.80 Repair Shoulder Capsule23465 C 16.30 12.67 12.67 3.19 090 55.80 Repair Shoulder Capsule23466 C 15.80 13.27 13.27 3.04 090 55.80 Repair Shoulder Capsule23470 C 17.89 13.24 13.24 3.46 090 55.80 Reconstruct Shoulder Joint23472 C 22.13 15.57 15.57 4.23 090 55.80 Reconstruct Shoulder Joint23473 C 25.00 17.00 17.00 4.78 090 55.80 Revis Reconst Shoulder Joint23474 C 27.21 18.11 18.11 5.21 090 55.80 Revis Reconst Shoulder Joint23480 C 11.54 9.79 9.79 2.37 090 55.80 Revision Of Collar Bone23485 C 13.91 10.88 10.88 2.71 090 55.80 Revision Of Collar Bone23490 C 12.16 10.23 10.23 2.28 090 55.80 Reinforce Clavicle23491 C 14.54 11.79 11.79 2.93 090 55.80 Reinforce Shoulder Bones23500 C 2.21 3.65 3.78 0.38 090 55.80 Treat Clavicle Fracture23505 C 3.83 5.61 4.97 0.71 090 55.80 Treat Clavicle Fracture23515 C 9.69 9.13 9.13 1.88 090 55.80 Treat Clavicle Fracture23520 C 2.29 3.97 3.98 0.46 090 55.80 Treat Clavicle Dislocation23525 C 3.79 6.56 5.69 0.77 090 55.80 Treat Clavicle Dislocation23530 C 7.48 7.51 7.51 1.39 090 55.80 Treat Clavicle Dislocation23532 C 8.20 8.12 8.12 1.47 090 55.80 Treat Clavicle Dislocation23540 C 2.36 3.78 3.80 0.40 090 55.80 Treat Clavicle Dislocation23545 C 3.43 5.94 4.96 0.52 090 55.80 Treat Clavicle Dislocation23550 C 7.59 7.34 7.34 1.42 090 55.80 Treat Clavicle Dislocation23552 C 8.82 8.31 8.31 1.68 090 55.80 Treat Clavicle Dislocation23570 C 2.36 3.83 4.04 0.43 090 55.80 Treat Shoulder Blade Fx23575 C 4.23 6.49 5.71 0.82 090 55.80 Treat Shoulder Blade Fx23585 C 14.23 11.22 11.22 2.76 090 55.80 Treat Scapula Fracture23600 C 3.00 5.83 5.28 0.54 090 55.80 Treat Humerus Fracture23605 C 5.06 7.32 6.16 0.95 090 55.80 Treat Humerus Fracture23615 C 12.30 10.75 10.75 2.41 090 55.80 Treat Humerus Fracture23616 C 18.37 13.78 13.78 3.58 090 55.80 Treat Humerus Fracture23620 C 2.55 4.64 4.31 0.46 090 55.80 Treat Humerus Fracture23625 C 4.10 6.06 5.23 0.76 090 55.80 Treat Humerus Fracture23630 C 10.57 9.84 9.84 2.06 090 55.80 Treat Humerus Fracture23650 C 3.53 5.04 4.23 0.53 090 55.80 Treat Shoulder Dislocation23655 C 4.76 5.90 5.90 0.91 090 55.80 Treat Shoulder Dislocation23660 C 7.66 7.61 7.61 1.48 090 55.80 Treat Shoulder Dislocation23665 C 4.66 6.72 5.83 0.87 090 55.80 Treat Dislocation/Fracture23670 C 12.28 10.53 10.53 2.40 090 55.80 Treat Dislocation/Fracture23675 C 6.27 8.32 6.89 1.17 090 55.80 Treat Dislocation/Fracture23680 C 13.15 11.02 11.02 2.57 090 55.80 Treat Dislocation/Fracture23700 C 2.57 2.56 2.56 0.51 010 55.80 Fixation Of Shoulder23800 C 14.73 11.88 11.88 2.89 090 55.80 Fusion Of Shoulder Joint23802 C 18.42 14.86 14.86 3.52 090 55.80 Fusion Of Shoulder Joint23900 C 20.72 15.13 15.13 4.12 090 55.80 Amputation Of Arm & Girdle23920 C 16.23 12.96 12.96 3.28 090 55.80 Amputation At Shoulder Joint23921 C 5.72 6.58 6.58 1.17 090 55.80 Amputation Follow-Up Surgery

23929FECA-S

Energy-R 0.00 0.00 0.00 0.00 YYY 0.00 Shoulder Surgery Procedure23930 C 2.99 6.59 2.56 0.58 010 55.80 Drainage Of Arm Lesion23931 C 1.84 6.03 2.32 0.32 010 55.80 Drainage Of Arm Bursa23935 C 6.38 7.00 7.00 1.23 090 55.80 Drain Arm/Elbow Bone Lesion24000 C 6.08 6.47 6.47 1.16 090 55.80 Exploratory Elbow Surgery24006 C 9.74 8.97 8.97 1.85 090 55.80 Release Elbow Joint24065 C 2.13 4.94 2.32 0.33 010 55.80 Biopsy Arm/Elbow Soft Tissue24066 C 5.35 11.54 5.54 1.17 090 55.80 Biopsy Arm/Elbow Soft Tissue24071 C 5.70 4.74 4.74 1.26 090 55.80 Exc Arm/Elbow Les Sc 3 Cm/>24073 C 10.13 7.70 7.70 2.16 090 55.80 Ex Arm/Elbow Tum Deep 5 Cm/>24075 C 4.24 9.32 4.35 0.89 090 55.80 Exc Arm/Elbow Les Sc < 3 Cm24076 C 7.41 6.73 6.73 1.53 090 55.80 Ex Arm/Elbow Tum Deep < 5 Cm24077 C 15.72 10.83 10.83 3.38 090 55.80 Resect Arm/Elbow Tum < 5 Cm24079 C 20.61 13.21 13.21 4.42 090 55.80 Resect Arm/Elbow Tum 5 Cm/>24100 C 5.07 5.92 5.92 0.98 090 55.80 Biopsy Elbow Joint Lining24101 C 6.30 6.88 6.88 1.20 090 55.80 Explore/Treat Elbow Joint24102 C 8.26 7.93 7.93 1.54 090 55.80 Remove Elbow Joint Lining24105 C 3.78 5.59 5.59 0.75 090 55.80 Removal Of Elbow Bursa24110 C 7.58 7.78 7.78 1.50 090 55.80 Remove Humerus Lesion24115 C 10.12 9.08 9.08 1.83 090 55.80 Remove/Graft Bone Lesion24116 C 12.23 10.14 10.14 2.43 090 55.80 Remove/Graft Bone Lesion24120 C 6.82 7.15 7.15 1.28 090 55.80 Remove Elbow Lesion24125 C 8.14 8.09 8.09 1.66 090 55.80 Remove/Graft Bone Lesion

24126 C 8.62 8.33 8.33 1.57 090 55.80 Remove/Graft Bone Lesion24130 C 6.42 7.01 7.01 1.24 090 55.80 Removal Of Head Of Radius24134 C 10.22 9.24 9.24 2.03 090 55.80 Removal Of Arm Bone Lesion24136 C 8.40 8.07 8.07 1.72 090 55.80 Remove Radius Bone Lesion24138 C 8.50 9.28 9.28 1.69 090 55.80 Remove Elbow Bone Lesion24140 C 9.55 8.86 8.86 1.80 090 55.80 Partial Removal Of Arm Bone24145 C 7.81 7.66 7.66 1.60 090 55.80 Partial Removal Of Radius24147 C 7.84 8.56 8.56 1.54 090 55.80 Partial Removal Of Elbow24149 C 16.22 14.62 14.62 3.02 090 55.80 Radical Resection Of Elbow24150 C 23.46 16.65 16.65 4.72 090 55.80 Resect Distal Humerus Tumor24152 C 19.99 14.91 14.91 3.45 090 55.80 Resect Radius Tumor24155 C 12.09 10.06 10.06 2.32 090 55.80 Removal Of Elbow Joint24160 C 18.63 14.21 14.21 3.62 090 55.80 Remove Elbow Joint Implant24164 C 10.00 8.99 8.99 1.90 090 55.80 Remove Radius Head Implant24200 C 1.81 3.94 1.91 0.27 010 55.80 Removal Of Arm Foreign Body24201 C 4.70 10.13 4.78 0.99 090 55.80 Removal Of Arm Foreign Body24220 C 1.31 3.28 0.52 0.12 000 55.80 Injection For Elbow X-Ray24300 C 4.04 7.29 7.29 0.74 090 55.80 Manipulate Elbow W/Anesth24301 C 10.38 9.20 9.20 2.04 090 55.80 Muscle/Tendon Transfer24305 C 7.62 7.64 7.64 1.33 090 55.80 Arm Tendon Lengthening24310 C 6.12 6.26 6.26 1.05 090 55.80 Revision Of Arm Tendon24320 C 10.86 9.44 9.44 2.00 090 55.80 Repair Of Arm Tendon24330 C 9.79 8.91 8.91 1.93 090 55.80 Revision Of Arm Muscles24331 C 10.95 9.49 9.49 1.80 090 55.80 Revision Of Arm Muscles24332 C 7.91 8.13 8.13 1.62 090 55.80 Tenolysis Triceps24340 C 8.08 7.98 7.98 1.54 090 55.80 Repair Of Biceps Tendon24341 C 9.49 10.12 10.12 1.81 090 55.80 Repair Arm Tendon/Muscle24342 C 10.86 9.41 9.41 2.07 090 55.80 Repair Of Ruptured Tendon24343 C 9.16 9.52 9.52 1.73 090 55.80 Repr Elbow Lat Ligmnt W/Tiss24344 C 15.21 13.42 13.42 2.82 090 55.80 Reconstruct Elbow Lat Ligmnt24345 C 9.16 9.37 9.37 1.72 090 55.80 Repr Elbw Med Ligmnt W/Tissu24346 C 15.21 13.39 13.39 3.00 090 55.80 Reconstruct Elbow Med Ligmnt24357 C 5.44 5.73 5.73 0.79 090 55.80 Repair Elbow Perc24358 C 6.66 7.15 7.15 1.24 090 55.80 Repair Elbow W/Deb Open24359 C 8.98 8.35 8.35 1.68 090 55.80 Repair Elbow Deb/Attch Open24360 C 12.67 10.72 10.72 2.55 090 55.80 Reconstruct Elbow Joint24361 C 14.41 11.71 11.71 2.91 090 55.80 Reconstruct Elbow Joint24362 C 15.32 12.15 12.15 3.14 090 55.80 Reconstruct Elbow Joint24363 C 22.00 15.79 15.79 4.17 090 55.80 Replace Elbow Joint24365 C 8.62 8.06 8.06 1.71 090 55.80 Reconstruct Head Of Radius24366 C 9.36 8.48 8.48 1.76 090 55.80 Reconstruct Head Of Radius24370 C 23.55 16.68 16.68 4.49 090 55.80 Revise Reconst Elbow Joint24371 C 27.50 18.70 18.70 5.17 090 55.80 Revise Reconst Elbow Joint24400 C 11.33 10.16 10.16 2.23 090 55.80 Revision Of Humerus24410 C 15.11 12.32 12.32 3.10 090 55.80 Revision Of Humerus24420 C 13.73 12.31 12.31 2.55 090 55.80 Revision Of Humerus24430 C 15.25 12.20 12.20 2.95 090 55.80 Repair Of Humerus24435 C 14.99 13.10 13.10 2.93 090 55.80 Repair Humerus With Graft24470 C 8.93 8.59 8.59 1.83 090 55.80 Revision Of Elbow Joint24495 C 8.41 11.18 11.18 1.68 090 55.80 Decompression Of Forearm24498 C 12.28 10.25 10.25 2.43 090 55.80 Reinforce Humerus24500 C 3.41 6.19 5.33 0.61 090 55.80 Treat Humerus Fracture24505 C 5.39 7.87 6.46 1.01 090 55.80 Treat Humerus Fracture24515 C 12.12 10.78 10.78 2.37 090 55.80 Treat Humerus Fracture24516 C 12.19 10.18 10.18 2.40 090 55.80 Treat Humerus Fracture24530 C 3.69 6.48 5.52 0.68 090 55.80 Treat Humerus Fracture24535 C 7.11 9.22 7.84 1.35 090 55.80 Treat Humerus Fracture24538 C 9.77 9.74 9.74 2.00 090 55.80 Treat Humerus Fracture24545 C 13.15 11.06 11.06 2.57 090 55.80 Treat Humerus Fracture24546 C 14.91 12.13 12.13 2.91 090 55.80 Treat Humerus Fracture24560 C 2.98 5.81 4.80 0.50 090 55.80 Treat Humerus Fracture24565 C 5.78 8.41 7.13 1.14 090 55.80 Treat Humerus Fracture24566 C 9.06 9.76 9.76 1.85 090 55.80 Treat Humerus Fracture24575 C 9.71 9.50 9.50 1.85 090 55.80 Treat Humerus Fracture24576 C 3.06 6.21 5.16 0.53 090 55.80 Treat Humerus Fracture24577 C 6.01 8.59 7.24 1.20 090 55.80 Treat Humerus Fracture24579 C 11.44 10.40 10.40 2.22 090 55.80 Treat Humerus Fracture24582 C 10.14 11.11 11.11 2.09 090 55.80 Treat Humerus Fracture24586 C 15.78 12.40 12.40 3.05 090 55.80 Treat Elbow Fracture24587 C 15.79 12.40 12.40 3.16 090 55.80 Treat Elbow Fracture24600 C 4.37 5.51 4.55 0.68 090 55.80 Treat Elbow Dislocation24605 C 5.64 6.84 6.84 1.11 090 55.80 Treat Elbow Dislocation24615 C 9.83 8.82 8.82 1.88 090 55.80 Treat Elbow Dislocation24620 C 7.22 7.37 7.37 1.29 090 55.80 Treat Elbow Fracture24635 C 8.80 8.89 8.89 1.70 090 55.80 Treat Elbow Fracture24640 C 1.25 1.53 0.90 0.08 010 55.80 Treat Elbow Dislocation24650 C 2.31 4.74 4.18 0.40 090 55.80 Treat Radius Fracture24655 C 4.62 7.23 6.04 0.81 090 55.80 Treat Radius Fracture24665 C 8.36 8.85 8.85 1.57 090 55.80 Treat Radius Fracture24666 C 9.86 9.35 9.35 1.88 090 55.80 Treat Radius Fracture24670 C 2.69 5.12 4.37 0.47 090 55.80 Treat Ulnar Fracture24675 C 4.91 7.29 6.10 0.92 090 55.80 Treat Ulnar Fracture24685 C 8.37 8.82 8.82 1.62 090 55.80 Treat Ulnar Fracture24800 C 11.41 10.21 10.21 2.17 090 55.80 Fusion Of Elbow Joint24802 C 14.32 11.67 11.67 2.94 090 55.80 Fusion/Graft Of Elbow Joint24900 C 10.18 8.99 8.99 2.04 090 55.80 Amputation Of Upper Arm24920 C 10.13 8.94 8.94 2.09 090 55.80 Amputation Of Upper Arm24925 C 7.30 7.52 7.52 1.49 090 55.80 Amputation Follow-Up Surgery24930 C 10.83 9.28 9.28 2.14 090 55.80 Amputation Follow-Up Surgery24931 C 13.44 10.73 10.73 2.77 090 55.80 Amputate Upper Arm & Implant

24935 C 16.45 13.80 13.80 3.38 090 55.80 Revision Of Amputation24940 C 0.00 0.00 0.00 0.00 090 0.00 Revision Of Upper Arm24999 R 0.00 0.00 0.00 0.00 YYY 0.00 Upper Arm/Elbow Surgery25000 C 3.55 5.49 5.49 0.66 090 55.80 Incision Of Tendon Sheath25001 C 3.79 5.39 5.39 0.70 090 55.80 Incise Flexor Carpi Radialis25020 C 6.06 9.24 9.24 1.13 090 55.80 Decompress Forearm 1 Space25023 C 13.83 15.34 15.34 2.66 090 55.80 Decompress Forearm 1 Space25024 C 10.79 9.55 9.55 2.11 090 55.80 Decompress Forearm 2 Spaces25025 C 17.94 13.42 13.42 3.45 090 55.80 Decompress Forearm 2 Spaces25028 C 5.39 8.67 8.67 1.07 090 55.80 Drainage Of Forearm Lesion25031 C 4.26 4.99 4.99 0.75 090 55.80 Drainage Of Forearm Bursa25035 C 7.65 7.72 7.72 1.44 090 55.80 Treat Forearm Bone Lesion25040 C 7.50 7.28 7.28 1.36 090 55.80 Explore/Treat Wrist Joint25065 C 2.04 4.98 2.30 0.30 010 55.80 Biopsy Forearm Soft Tissues25066 C 4.27 5.22 5.22 0.81 090 55.80 Biopsy Forearm Soft Tissues25071 C 5.91 5.07 5.07 1.25 090 55.80 Exc Forearm Les Sc 3 Cm/>25073 C 7.13 6.82 6.82 1.40 090 55.80 Exc Forearm Tum Deep 3 Cm/>25075 C 3.96 9.33 4.33 0.80 090 55.80 Exc Forearm Les Sc < 3 Cm25076 C 6.74 6.90 6.90 1.25 090 55.80 Exc Forearm Tum Deep < 3 Cm25077 C 12.93 9.82 9.82 2.68 090 55.80 Resect Forearm/Wrist Tum25085 C 5.64 6.23 6.23 1.03 090 55.80 Incision Of Wrist Capsule25100 C 4.02 5.13 5.13 0.80 090 55.80 Biopsy Of Wrist Joint25101 C 4.83 5.88 5.88 0.90 090 55.80 Explore/Treat Wrist Joint25105 C 6.02 6.80 6.80 1.07 090 55.80 Remove Wrist Joint Lining25107 C 7.70 8.61 8.61 1.39 090 55.80 Remove Wrist Joint Cartilage25109 C 6.94 7.27 7.27 1.25 090 55.80 Excise Tendon Forearm/Wrist25110 C 4.04 5.01 5.01 0.77 090 55.80 Remove Wrist Tendon Lesion25111 C 3.53 5.01 5.01 0.67 090 55.80 Remove Wrist Tendon Lesion25112 C 4.67 5.57 5.57 0.89 090 55.80 Reremove Wrist Tendon Lesion25115 C 10.09 9.89 9.89 1.82 090 55.80 Remove Wrist/Forearm Lesion25116 C 7.56 8.37 8.37 1.32 090 55.80 Remove Wrist/Forearm Lesion25118 C 4.51 5.62 5.62 0.81 090 55.80 Excise Wrist Tendon Sheath25119 C 6.21 6.91 6.91 1.09 090 55.80 Partial Removal Of Ulna25120 C 6.27 6.92 6.92 1.11 090 55.80 Removal Of Forearm Lesion25125 C 7.67 7.85 7.85 1.42 090 55.80 Remove/Graft Forearm Lesion25126 C 7.74 7.88 7.88 1.49 090 55.80 Remove/Graft Forearm Lesion25130 C 5.43 6.46 6.46 0.94 090 55.80 Removal Of Wrist Lesion25135 C 7.08 7.55 7.55 1.36 090 55.80 Remove & Graft Wrist Lesion25136 C 6.14 6.82 6.82 1.10 090 55.80 Remove & Graft Wrist Lesion25145 C 6.54 7.03 7.03 1.27 090 55.80 Remove Forearm Bone Lesion25150 C 7.38 7.50 7.50 1.41 090 55.80 Partial Removal Of Ulna25151 C 7.68 7.66 7.66 1.37 090 55.80 Partial Removal Of Radius25170 C 22.21 15.92 15.92 4.44 090 55.80 Resect Radius/Ulnar Tumor25210 C 6.12 6.85 6.85 1.04 090 55.80 Removal Of Wrist Bone25215 C 8.14 8.17 8.17 1.45 090 55.80 Removal Of Wrist Bones25230 C 5.37 6.09 6.09 0.99 090 55.80 Partial Removal Of Radius25240 C 5.31 6.07 6.07 0.93 090 55.80 Partial Removal Of Ulna25246 C 1.45 3.29 0.57 0.14 000 55.80 Injection For Wrist X-Ray25248 C 5.31 5.51 5.51 1.06 090 55.80 Remove Forearm Foreign Body25250 C 6.77 7.13 7.13 1.31 090 55.80 Removal Of Wrist Prosthesis25251 C 9.82 8.92 8.92 1.94 090 55.80 Removal Of Wrist Prosthesis25259 C 4.04 7.25 7.25 0.73 090 55.80 Manipulate Wrist W/Anesthes25260 C 8.04 8.60 8.60 1.46 090 55.80 Repair Forearm Tendon/Muscle25263 C 8.04 8.42 8.42 1.56 090 55.80 Repair Forearm Tendon/Muscle25265 C 10.10 9.59 9.59 1.78 090 55.80 Repair Forearm Tendon/Muscle25270 C 6.17 6.80 6.80 1.09 090 55.80 Repair Forearm Tendon/Muscle25272 C 7.21 7.42 7.42 1.29 090 55.80 Repair Forearm Tendon/Muscle25274 C 8.94 8.59 8.59 1.63 090 55.80 Repair Forearm Tendon/Muscle25275 C 8.96 8.72 8.72 1.57 090 55.80 Repair Forearm Tendon Sheath25280 C 7.39 7.52 7.52 1.28 090 55.80 Revise Wrist/Forearm Tendon25290 C 5.43 6.13 6.13 0.97 090 55.80 Incise Wrist/Forearm Tendon25295 C 6.72 7.15 7.15 1.24 090 55.80 Release Wrist/Forearm Tendon25300 C 9.02 8.99 8.99 1.56 090 55.80 Fusion Of Tendons At Wrist25301 C 8.59 8.33 8.33 1.57 090 55.80 Fusion Of Tendons At Wrist25310 C 8.08 8.29 8.29 1.42 090 55.80 Transplant Forearm Tendon25312 C 9.82 9.05 9.05 1.77 090 55.80 Transplant Forearm Tendon25315 C 10.68 9.35 9.35 2.10 090 55.80 Revise Palsy Hand Tendon(S)25316 C 12.90 10.84 10.84 2.66 090 55.80 Revise Palsy Hand Tendon(S)25320 C 12.75 13.28 13.28 2.29 090 55.80 Repair/Revise Wrist Joint25332 C 11.74 10.35 10.35 2.13 090 55.80 Revise Wrist Joint25335 C 13.39 11.09 11.09 2.76 090 55.80 Realignment Of Hand25337 C 11.73 11.72 11.72 2.16 090 55.80 Reconstruct Ulna/Radioulnar25350 C 9.09 8.65 8.65 1.65 090 55.80 Revision Of Radius25355 C 10.53 9.39 9.39 1.88 090 55.80 Revision Of Radius25360 C 8.74 8.46 8.46 1.64 090 55.80 Revision Of Ulna25365 C 12.91 10.86 10.86 2.48 090 55.80