| Adenoid removal (adenoidectomy), child under 12
CPT 42830
PRIMARY REMOVAL OF ADENOIDS (YOUNGER THAN 12 YEARS) |
$4,350.00 |
$4,350.00 |
$2,915.32–$9,007.60 |
28% below |
— |
| Anterior cervical discectomy and fusion (ACDF), one level
CPT 22551
ARTHRD ANT NTRBDY CERVICAL |
$8,452.00 |
$8,452.00 |
$5,524.56–$34,880.75 |
56% below |
— |
| Anterior cervical discectomy and fusion (ACDF), one level
CPT 22551
FUSION OF UPPER SPINE BONE WITH REMOVAL OF DISC AND RELEASE OF SPINAL CORD OR NERVE; 1 DISC |
$8,672.00 |
$8,672.00 |
$5,524.56–$34,880.75 |
55% below |
— |
| Appendectomy for a ruptured appendix with abscess or peritonitis
CPT 44960
APPENDECTOMY |
$4,000.00 |
$4,000.00 |
$741.84–$3,140.48 |
30% above |
— |
| Appendectomy, open surgery
CPT 44950
APPENDECTOMY |
$2,524.00 |
$2,524.00 |
$1,724.26–$17,588.40 |
1% above |
— |
| Arthroscopic ACL reconstruction or repair of the knee
CPT 29888
KNEE ARTHROSCOPY/SURGERY |
$9,947.00 |
$9,947.00 |
$5,983.73–$19,714.04 |
18% below |
— |
| Arthroscopic rotator cuff repair of the shoulder
CPT 29827
SHO ARTHRS SRG RT8TR CUF RPR |
$8,527.00 |
$8,527.00 |
$5,140.15–$19,714.04 |
30% below |
— |
| Balloon dilation of the maxillary sinus opening, one side
CPT 31295
NSL/SINS NDSC SURG MAX SINS |
$5,201.00 |
$5,201.00 |
$3,436.20–$19,174.04 |
55% below |
— |
| Botox injections for chronic migraine
CPT 64615
CHEMODENERV MUSC MIGRAINE |
$400.00 |
$400.00 |
$226.23–$833.94 |
37% below |
— |
| Broken ankle (outer ankle bone) treatment without surgery or setting
CPT 27786
TREATMENT OF ANKLE FRACTURE |
$1,195.00 |
$1,195.00 |
$126.72–$670.15 |
218% above |
— |
| Broken foot (metatarsal) treatment without surgery or setting
CPT 28470
TREAT METATARSAL FRACTURE |
$1,195.00 |
$1,195.00 |
$123.99–$670.15 |
180% above |
— |
| Bunion correction with a bone cut near the head of the first metatarsal
CPT 28296
COR HLX VLGS DSTL MTAR OSTEO |
$4,551.00 |
$4,551.00 |
$2,445.58–$8,889.54 |
18% below |
— |
| Bunion correction with removal of part of the big toe joint
CPT 28292
COR HLX VLGS RSC PRX PHLX BS |
$5,255.00 |
$5,255.00 |
$3,232.56–$8,889.54 |
24% below |
— |
| Cardiac catheterization with coronary angiogram
CPT 93458
L HRT ARTERY/VENTRICLE ANGIO |
$14,000.00 |
$14,000.00 |
$3,202.85–$8,807.84 |
20% below |
— |
| Cardioversion, elective (restoring heart rhythm)
CPT 92960
CARDIOVERSION ELECTRIC EXT |
$1,500.00 |
$1,500.00 |
$513.52–$1,795.70 |
2% above |
— |
| Cardioversion, elective (restoring heart rhythm)
CPT 92960
EXTERNAL SHOCK TO HEART TO REGULATE HEART BEAT |
$2,000.00 |
$2,000.00 |
$513.52–$1,795.70 |
36% above |
— |
| Carpal tunnel release, open surgery
CPT 64721
CARPAL TUNNEL SURGERY |
$2,665.70 |
$2,665.70 |
$1,673.58–$5,305.24 |
at median |
— |
| Cataract surgery with lens implant
CPT 66984
XCAPSL CTRC RMVL W/O ECP |
$1,765.00 |
$1,765.00 |
$1,218.26–$6,270.00 |
68% below |
— |
| Cervical biopsy
CPT 57500
BIOPSY OF CERVIX |
$883.00 |
$883.00 |
$456.39–$2,502.36 |
30% above |
— |
| Circumcision by surgical excision, older than 28 days (children and adults)
CPT 54161
REMOVAL OF FORESKIN (OLDER THAN 28 DAYS) |
$4,145.75 |
$4,145.75 |
$1,953.16–$5,679.24 |
22% below |
— |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns
CPT 54150
CIRCUMCISION W/REGIONL BLOCK |
$2,700.00 |
$2,700.00 |
$1,813.77–$5,679.24 |
1402% above |
— |
| Closed treatment of a wrist (distal radius) fracture, no resetting
CPT 25600
CLTX DST RDL FX/EPHYS SEP WO |
$1,195.00 |
$1,195.00 |
$123.99–$670.15 |
255% above |
— |
| Colonoscopy with polyp removal
CPT 45385
REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE |
$970.00 |
$970.00 |
$970.00–$3,251.11 |
58% below |
— |
| Colonoscopy with polyp removal
CPT 45385
COLONOSCOPY W/LESION REMOVAL |
$1,940.00 |
$1,940.00 |
$1,182.22–$3,251.11 |
16% below |
— |
| Colonoscopy with tissue sample
CPT 45380
BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE |
$2,150.00 |
$2,150.00 |
$1,172.20–$3,251.10 |
9% below |
— |
| Colonoscopy, diagnostic
CPT 45378
DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE |
$1,408.75 |
$1,408.75 |
$918.75–$2,526.56 |
44% below |
— |
| Colposcopy with LEEP (loop electrosurgical excision)
CPT 57460
BX OF CERVIX W/SCOPE LEEP |
$1,751.00 |
$1,751.00 |
$1,277.71–$8,794.78 |
16% below |
— |
| Colposcopy with cervical biopsy and scraping of the cervical canal
CPT 57454
BX/CURETT OF CERVIX W/SCOPE |
$1,200.00 |
$1,200.00 |
$217.66–$827.91 |
255% above |
— |
| Complex cataract surgery with lens implant
CPT 66982
XCAPSL CTRC RMVL CPLX WO ECP |
$2,226.00 |
$2,226.00 |
$1,536.18–$6,270.00 |
60% below |
— |
| Coronary stent placement, one artery
CPT 92928
PRQ TCAT PLMT NTRAC ST 1 LES |
$18,000.00 |
$18,000.00 |
$7,289.68–$31,363.80 |
26% below |
— |
| Cystoscopy with ureteral stent placement
CPT 52332
CYSTOSCOPY AND TREATMENT |
$6,040.95 |
$6,040.95 |
$2,962.47–$9,576.85 |
31% below |
— |
| Cystoscopy, diagnostic look inside the bladder and urethra
CPT 52000
CYSTOURETHROSCOPY |
$1,114.00 |
$1,114.00 |
$643.43–$1,894.45 |
33% above |
— |
| Cystoscopy, diagnostic look inside the bladder and urethra
CPT 52000
DIAGNOSTIC EXAM OF BLADDER AND URETHRA USING AN ENDOSCOPE |
$1,614.00 |
$1,614.00 |
$643.43–$1,894.45 |
92% above |
— |
| D&C (dilation and curettage), not related to pregnancy
CPT 58120
DILATION AND SCRAPING OF UTERUS |
$3,044.00 |
$3,044.00 |
$2,101.25–$8,794.78 |
3% above |
— |
| Ear tube placement (tympanostomy) under general anesthesia, one ear
CPT 69436
CREATE EARDRUM OPENING |
$1,610.00 |
$1,610.00 |
$1,052.28–$4,215.42 |
52% below |
— |
| Ear tube placement (tympanostomy) with local anesthesia, one ear
CPT 69433
CREATE EARDRUM OPENING |
$927.00 |
$927.00 |
$450.43–$1,465.28 |
93% above |
— |
| Earwax removal by irrigation (rinsing), one ear
CPT 69209
REMOVE IMPACTED EAR WAX UNI |
$297.00 |
$297.00 |
$58.28–$160.27 |
172% above |
— |
| Earwax removal with instruments, one ear
CPT 69210
REMOVAL OF IMPACTED EAR WAX |
$297.00 |
$297.00 |
$46.97–$160.27 |
267% above |
— |
| Earwax removal with instruments, one ear
CPT 69210
REMOVE IMPACTED EAR WAX UNI |
$670.00 |
$670.00 |
$46.97–$160.27 |
727% above |
— |
| Endometrial biopsy (uterine lining sample) without dilating the cervix
CPT 58100
BIOPSY OF UTERUS LINING |
$876.00 |
$876.00 |
$109.93–$549.26 |
448% above |
— |
| Endoscopic sinus surgery: full ethmoid sinus opening
CPT 31255
NSL/SINS NDSC W/TOT ETHMDCT |
$6,444.00 |
$6,444.00 |
$3,992.71–$19,174.04 |
61% below |
— |
| Endoscopic sinus surgery: opening the frontal sinus
CPT 31276
NSL/SINS NDSC FRNT TISS RMVL |
$4,738.00 |
$4,738.00 |
$3,173.90–$19,174.04 |
73% below |
— |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus
CPT 31256
EXPLORATION MAXILLARY SINUS |
$4,738.00 |
$4,738.00 |
$3,397.66–$10,129.35 |
52% below |
— |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue
CPT 31267
ENDOSCOPY MAXILLARY SINUS |
$2,961.25 |
$2,961.25 |
$2,151.17–$19,174.04 |
83% below |
— |
| Epidural steroid injection, neck or mid back, with imaging guidance
CPT 62321
INJECTION OF SUBSTANCE INTO MIDDLE OR UPPER SPINE CANAL USING IMAGING GUIDANCE |
$2,070.00 |
$2,070.00 |
$333.27–$1,917.77 |
44% above |
— |
| Epidural steroid injection, neck or mid back, with imaging guidance
CPT 62321
NJX INTERLAMINAR CRV/THRC |
$2,185.00 |
$2,185.00 |
$333.27–$1,917.77 |
52% above |
— |
| Facet joint injection, lower back, one level, with imaging guidance
CPT 64493
INJ PARAVERT F JNT L/S 1 LEV |
$1,955.00 |
$1,955.00 |
$835.75–$2,402.98 |
101% above |
— |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm
CPT 49593
REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); 3 CM TO 10 CM; REDUCIBLE |
$5,000.00 |
$5,000.00 |
$2,956.92–$17,588.40 |
44% below |
— |
| First repair of a front abdominal hernia larger than 10 cm
CPT 49595
RPR AA HRN 1ST > 10 RDC |
$6,000.00 |
$6,000.00 |
$2,956.92–$17,588.39 |
59% below |
— |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm
CPT 49591
REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE; EPIGASTRIC; INCISIONAL; VENTRAL; UMBILICAL; SPIGELIAN); ANY APPROACH (IE; OPEN; LAPAROSCOPIC; ROBOTIC); INITIAL; INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS WHEN PERFORMED; TOTAL LENGTH OF DEFECT(S); LESS THAN 3 CM; REDUCIBLE |
$4,413.00 |
$4,413.00 |
$2,956.92–$9,727.41 |
43% below |
— |
| Flexible sigmoidoscopy, diagnostic (lower colon only)
CPT 45330
DIAGNOSTIC EXAM OF LOWER PORTION OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE |
$1,082.00 |
$1,082.00 |
$383.36–$2,526.56 |
7% above |
— |
| Gallbladder removal, laparoscopic
CPT 47562
REMOVAL OF GALLBLADDER USING AN ENDOSCOPE |
$8,271.00 |
$8,271.00 |
$5,436.85–$16,424.79 |
25% below |
— |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery
CPT 47563
REMOVAL OF GALLBLADDER WITH X-RAY STUDY OF BILE DUCTS USING AN ENDOSCOPE |
$6,159.40 |
$6,159.40 |
$4,149.90–$16,424.79 |
11% below |
— |
| Hammertoe correction surgery
CPT 28285
REPAIR OF HAMMERTOE |
$3,399.00 |
$3,399.00 |
$2,445.58–$8,889.54 |
65% above |
— |
| Hemorrhoid banding (rubber band ligation)
CPT 46221
LIGATION OF HEMORRHOID(S) |
$2,162.00 |
$2,162.00 |
$395.41–$2,526.56 |
208% above |
— |
| Hemorrhoidectomy (internal and external), one area
CPT 46255
REMOVAL OF SINGLE EXTERNAL AND INTERNAL HEMORRHOID GROUP |
$3,174.00 |
$3,174.00 |
$2,008.03–$7,541.05 |
22% above |
— |
| Hemorrhoidectomy (internal and external), one area
CPT 46255
REMOVE INT/EXT HEM 1 GROUP |
$12,388.00 |
$12,388.00 |
$2,008.03–$7,541.05 |
376% above |
— |
| Hip replacement after an earlier hip surgery (conversion to total hip)
CPT 27132
TOTAL HIP ARTHROPLASTY |
$9,500.00 |
$9,500.00 |
$5,322.18–$34,880.75 |
40% below |
— |
| Hysterectomy through an abdominal incision (total)
CPT 58150
TOTAL HYSTERECTOMY |
$13,390.00 |
$13,390.00 |
$852.76–$4,715.26 |
at median |
— |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes
CPT 58340
CATHETER FOR HYSTEROGRAPHY |
$340.00 |
$340.00 |
$48.14–$232.66 |
4% above |
— |
| Hysteroscopy with endometrial ablation
CPT 58563
EXAM OF UTERUS WITH DESTRUCTION OF LINING OF UTERUS USING AN ENDOSCOPE |
$5,330.25 |
$5,330.25 |
$3,801.49–$13,590.88 |
55% below |
— |
| Hysteroscopy with uterine lining sampling and/or polyp removal
CPT 58558
BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE |
$3,500.60 |
$3,500.60 |
$2,101.25–$8,794.78 |
16% above |
— |
| IUD insertion (the device itself billed separately)
CPT 58300
INSERT INTRAUTERINE DEVICE |
$1,545.00 |
$1,545.00 |
$120.54–$136.98 |
608% above |
— |
| Incision and drainage of a simple or single skin abscess
CPT 10060
I&D ABSCESS SIMPLE/SINGLE |
$876.00 |
$876.00 |
$156.20–$545.10 |
278% above |
— |
| Incision and drainage of a simple or single skin abscess
CPT 10060
SIMPLE OR SINGLE DRAINAGE OF SKIN ABSCESS |
$936.00 |
$936.00 |
$156.20–$545.10 |
304% above |
— |
| Inguinal (groin) hernia repair, age 5 or older
CPT 49505
REPAIR OF GROIN HERNIA (5 YEARS OR OLDER) |
$2,571.43 |
$2,571.43 |
$2,571.43–$9,727.41 |
36% below |
— |
| Inguinal (groin) hernia repair, age 5 or older
CPT 49505
PRP I/HERN INIT REDUC >5 YR |
$4,031.00 |
$4,031.00 |
$2,691.44–$9,727.41 |
at median |
— |
| Injection into a tendon sheath or ligament (for example trigger finger)
CPT 20550
INJ TENDON SHEATH/LIGAMENT |
$474.00 |
$474.00 |
$226.23–$833.94 |
116% above |
— |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound
CPT 20610
DRAIN/INJ JOINT/BURSA W/O US |
$752.00 |
$752.00 |
$226.23–$833.94 |
157% above |
— |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound
CPT 20610
ASPIRATION AND/OR INJECTION OF FLUID FROM LARGE JOINT |
$1,313.00 |
$1,313.00 |
$226.23–$833.94 |
349% above |
— |
| Insertion of a drug-delivery implant, such as the arm birth control implant
CPT 11981
INSERTION DRUG DLVR IMPLANT |
$375.00 |
$375.00 |
$46.97–$361.46 |
104% above |
— |
| Joint injection or drainage, medium joint (wrist, elbow, ankle)
CPT 20605
DRAIN/INJ JOINT/BURSA W/O US |
$434.00 |
$434.00 |
$226.23–$833.94 |
41% above |
— |
| Joint injection or drainage, small joint (fingers, toes)
CPT 20600
DRAIN/INJ JOINT/BURSA W/O US |
$434.00 |
$434.00 |
$226.23–$833.94 |
50% above |
— |
| Knee arthroscopy with meniscus repair (one side of the knee)
CPT 29882
KNEE ARTHROSCOPY/SURGERY |
$6,118.20 |
$6,118.20 |
$3,232.56–$8,889.54 |
11% below |
— |
| Knee arthroscopy with meniscus trim
CPT 29881
KNEE ARTHROSCOPY/SURGERY |
$5,562.00 |
$5,562.00 |
$3,232.56–$8,889.54 |
19% below |
— |
| Knee arthroscopy with removal of both torn meniscus parts
CPT 29880
KNEE ARTHROSCOPY/SURGERY |
$5,572.00 |
$5,572.00 |
$3,232.56–$8,889.54 |
19% below |
— |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty)
CPT 29877
KNEE ARTHROSCOPY/SURGERY |
$5,408.00 |
$5,408.00 |
$3,232.56–$8,889.54 |
21% below |
— |
| Laparoscopic appendectomy (appendix removal through small cuts)
CPT 44970
LAPAROSCOPY APPENDECTOMY |
$6,503.00 |
$6,503.00 |
$4,149.90–$16,424.79 |
43% above |
— |
| Laparoscopic appendectomy (appendix removal through small cuts)
CPT 44970
REMOVAL OF APPENDIX USING AN ENDOSCOPE |
$7,003.00 |
$7,003.00 |
$4,149.90–$16,424.79 |
54% above |
— |
| Laparoscopic fundoplication (anti-reflux surgery)
CPT 43280
STRENGTHENING OF MUSCLE BETWEEN ESOPHAGUS AND STOMACH BY WRAPPING PART OF STOMACH AROUND ESOPHAGUS USING AN ENDOSCOPE |
$10,174.00 |
$10,174.00 |
$7,022.18–$28,879.65 |
61% below |
— |
| Laparoscopic hysterectomy (uterus 250 g or less)
CPT 58570
TLH UTERUS 250 G OR LESS |
$9,476.00 |
$9,476.00 |
$7,022.18–$28,879.65 |
58% below |
— |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries
CPT 58571
TLH W/T/O 250 G OR LESS |
$10,897.40 |
$10,897.40 |
$7,022.18–$28,879.65 |
48% below |
— |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries
CPT 58571
REMOVAL OF UTERUS; TUBES; AND/OR OVARIES THROUGH ABDOMEN USING AN ENDOSCOPE; 250.0 G OR LESS |
$14,537.40 |
$14,537.40 |
$7,022.18–$28,879.65 |
31% below |
— |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side
CPT 49650
REPAIR OF GROIN HERNIA USING AN ENDOSCOPE |
$7,817.70 |
$7,817.70 |
$4,149.90–$16,424.79 |
40% below |
— |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia
CPT 49651
LAP ING HERNIA REPAIR RECUR |
$9,476.00 |
$9,476.00 |
$3,652.72–$16,424.79 |
37% below |
— |
| Laparoscopic removal of fallopian tubes and/or ovaries
CPT 58661
REMOVAL OF OVARIES AND/OR TUBES USING AN ENDOSCOPE |
$7,699.25 |
$7,699.25 |
$5,391.57–$16,424.79 |
at median |
— |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs
CPT 12031
INTMD RPR S/A/T/EXT 2.5 CM/< |
$356.00 |
$356.00 |
$231.54–$1,104.43 |
12% above |
— |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs
CPT 12031
INTERMEDIATE REPAIR OF WOUND OF SCALP; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS |
$1,666.00 |
$1,666.00 |
$231.54–$1,104.43 |
424% above |
— |
| Left heart catheterization, diagnostic one side
CPT 93452
LEFT HRT CATH W/VENTRCLGRPHY |
$14,000.00 |
$14,000.00 |
$3,202.85–$8,807.84 |
17% below |
— |
| Lower-back epidural injection, with imaging guidance
CPT 62323
INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE |
$2,070.00 |
$2,070.00 |
$190.44–$1,917.77 |
67% above |
— |
| Lower-back epidural injection, with imaging guidance
CPT 62323
NJX INTERLAMINAR LMBR/SAC |
$2,078.00 |
$2,078.00 |
$190.44–$1,917.77 |
67% above |
— |
| Lower-back epidural injection, without imaging guidance
CPT 62322
NJX INTERLAMINAR LMBR/SAC |
$800.00 |
$800.00 |
$546.15–$2,402.98 |
28% below |
— |
| Lower-back nerve root steroid injection, with imaging guidance
CPT 64483
NJX AA&/STRD TFRM EPI L/S 1 |
$2,053.00 |
$2,053.00 |
$621.45–$2,402.98 |
25% above |
— |
| Lumbar discectomy or laminotomy to free a nerve root, one level
CPT 63030
PARTIAL REMOVAL OF SPINE BONE WITH RELEASE OF LOWER SPINAL CORD OR NERVES AND/OR REMOVAL OF DISC |
$8,878.00 |
$8,878.00 |
$5,446.90–$19,714.03 |
40% below |
— |
| Lumbar laminectomy (spinal decompression), one level
CPT 63047
PARTIAL REMOVAL OF SPINE BONE WITH RELEASE OF LOWER SPINAL CORD AND/OR NERVES; 1 SEGMENT |
$8,366.00 |
$8,366.00 |
$5,183.30–$19,714.04 |
43% below |
— |
| Lumbar spinal fusion (posterior), one level
CPT 22612
FUSION OF SPINE IN LOWER BACK |
$3,701.50 |
$3,701.50 |
$3,701.50–$47,636.71 |
80% below |
— |
| Lumbar spinal fusion (posterior), one level
CPT 22612
ARTHRD PST TQ 1NTRSPC LUMBAR |
$7,403.00 |
$7,403.00 |
$4,816.44–$47,636.71 |
61% below |
— |
| Lumpectomy (partial mastectomy)
CPT 19301
PARTIAL MASTECTOMY |
$5,150.00 |
$5,150.00 |
$2,733.34–$10,637.63 |
16% below |
— |
| Mastectomy (total removal of the breast)
CPT 19303
MAST SIMPLE COMPLETE |
$6,077.00 |
$6,077.00 |
$2,740.26–$18,040.33 |
48% below |
— |
| Miscarriage treatment with D&C, first trimester
CPT 59820
CARE OF MISCARRIAGE |
$3,435.05 |
$3,435.05 |
$2,101.25–$8,794.78 |
58% below |
— |
| Miscarriage treatment with D&C, first trimester
CPT 59820
TREATMENT OF MISCARRIAGE DURING FIRST TRIMESTER |
$3,935.05 |
$3,935.05 |
$2,101.25–$8,794.78 |
52% below |
— |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm
CPT 11400
EXC TR-EXT B9+MARG 0.5 CM< |
$567.00 |
$567.00 |
$315.59–$1,923.90 |
97% above |
— |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm
CPT 11440
EXC FACE-MM B9+MARG 0.5 CM/< |
$515.00 |
$515.00 |
$309.39–$1,923.90 |
107% above |
— |
| Nail removal (partial or complete), one nail
CPT 11730
REMOVAL OF NAIL PLATE |
$206.00 |
$206.00 |
$156.20–$545.10 |
3% above |
— |
| Nail removal (partial or complete), one nail
CPT 11730
SIMPLE SEPARATION OF FINGERNAIL OR TOENAIL FROM NAIL BED; FIRST NAIL |
$936.00 |
$936.00 |
$156.20–$545.10 |
367% above |
— |
| Occipital nerve block (injection for headaches)
CPT 64405
INJECTION OF ANESTHETIC AGENT AND/OR STEROID INTO UPPER NECK AND BACK OF HEAD NERVE |
$1,075.00 |
$1,075.00 |
$273.93–$833.94 |
206% above |
— |
| Pacemaker implant (dual chamber)
CPT 33208
INSERTION OF PACEMAKER AND UPPER AND LOWER HEART CHAMBER ELECTRODE |
$19,000.00 |
$19,000.00 |
$8,660.46–$28,396.47 |
49% above |
— |
| Paracentesis with imaging guidance
CPT 49083
ABD PARACENTESIS W/IMAGING |
$1,320.00 |
$1,320.00 |
$687.38–$2,464.14 |
1% below |
— |
| Paracentesis with imaging guidance
CPT 49083
DRAINAGE OF FLUID FROM ABDOMINAL CAVITY USING IMAGING GUIDANCE |
$2,703.00 |
$2,703.00 |
$687.38–$2,464.14 |
103% above |
— |
| Partial knee replacement (one compartment)
CPT 27446
REVISION OF KNEE JOINT |
$13,560.00 |
$13,560.00 |
$9,358.92–$34,880.75 |
15% below |
— |
| Permanent removal of a nail and nail root (partial or complete)
CPT 11750
REMOVAL OF NAIL BED |
$1,666.00 |
$1,666.00 |
$321.71–$1,104.43 |
339% above |
— |
| Prostate removal (prostatectomy), laparoscopic
CPT 55866
LAPS SURG PRST8ECT RPBIC RAD |
$7,725.00 |
$7,725.00 |
$5,508.60–$28,879.65 |
71% below |
— |
| Radiofrequency ablation of facet joint nerves, lower back, one level
CPT 64635
DESTROY LUMB/SAC FACET JNT |
$2,415.00 |
$2,415.00 |
$1,488.95–$5,305.24 |
23% below |
— |
| Removal of a breast lump, open surgery
CPT 19120
REMOVAL OF BREAST LESION |
$4,070.00 |
$4,070.00 |
$2,521.97–$10,637.63 |
33% above |
— |
| Removal of a foreign object under the skin, simple
CPT 10120
INC&RMVL FB SUBQ TISS SMPL |
$336.00 |
$336.00 |
$198.34–$1,104.43 |
4% below |
— |
| Removal of a foreign object under the skin, simple
CPT 10120
REMOVAL OF FOREIGN BODY FROM TISSUE; ACCESSED BENEATH THE SKIN; SIMPLE |
$1,666.00 |
$1,666.00 |
$198.34–$1,104.43 |
376% above |
— |
| Removal of one lobe of the thyroid (lobectomy)
CPT 60220
PARTIAL REMOVAL OF THYROID |
$7,032.00 |
$7,032.00 |
$4,853.77–$16,424.79 |
51% below |
— |
| Screening colonoscopy for a person at average risk (Medicare code)
HCPCS G0121
COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK |
$1,754.00 |
$1,754.00 |
$918.75–$2,526.56 |
30% below |
— |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code)
HCPCS G0105
COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK |
$1,472.00 |
$1,472.00 |
$918.75–$2,526.56 |
38% below |
— |
| Septoplasty to straighten the nasal septum
CPT 30520
RESHAPING OF NASAL CARTILAGE |
$2,250.55 |
$2,250.55 |
$2,250.55–$9,007.60 |
69% below |
— |
| Septoplasty to straighten the nasal septum
CPT 30520
REPAIR OF NASAL SEPTUM |
$4,501.10 |
$4,501.10 |
$2,897.63–$9,007.60 |
38% below |
— |
| Shock-wave lithotripsy to break up kidney stones (from outside the body)
CPT 50590
FRAGMENTING OF KIDNEY STONE |
$11,252.75 |
$11,252.75 |
$3,482.49–$9,576.85 |
28% above |
— |
| Short arm cast (elbow to hand)
CPT 29075
APPLICATION OF FOREARM CAST |
$252.00 |
$252.00 |
$176.18–$759.88 |
15% above |
— |
| Short arm splint (forearm and hand)
CPT 29125
APPLY FOREARM SPLINT |
$169.00 |
$169.00 |
$87.85–$361.46 |
1% above |
— |
| Short arm splint (forearm and hand)
CPT 29125
APPLICATION OF NONMOVEABLE FOREARM TO HAND SPLINT |
$565.00 |
$565.00 |
$87.85–$361.46 |
237% above |
— |
| Short leg cast (below the knee)
CPT 29405
APPLY SHORT LEG CAST |
$1,250.00 |
$1,250.00 |
$176.18–$759.88 |
582% above |
— |
| Short leg splint (calf to foot)
CPT 29515
APPLICATION LOWER LEG SPLINT |
$714.00 |
$714.00 |
$87.85–$441.48 |
252% above |
— |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle)
CPT 29824
SHO ARTHRS SRG DSTL CLAVICLC |
$4,263.00 |
$4,263.00 |
$2,445.58–$8,889.54 |
25% below |
— |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery)
CPT 29826
SHO ARTHRS SRG DECOMPRESSION |
$3,908.52 |
$3,908.52 |
$134.99–$5,533.95 |
37% above |
— |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs
CPT 12001
RPR S/N/AX/GEN/TRNK 2.5CM/< |
$225.00 |
$225.00 |
$85.89–$545.10 |
at median |
— |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs
CPT 12001
SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.5 CM OR LESS |
$936.00 |
$936.00 |
$85.89–$545.10 |
316% above |
— |
| Skin biopsy, punch, one lesion
CPT 11104
PUNCH BX SKIN SINGLE LESION |
$345.00 |
$345.00 |
$401.61–$1,104.43 |
74% above |
— |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm
CPT 11600
EXC TR-EXT MAL+MARG 0.5 CM/< |
$823.00 |
$823.00 |
$530.36–$1,923.90 |
55% above |
— |
| Skin tag removal, up to 15 tags
CPT 11200
RMVL SKIN TAGS UP TO&INC 15 |
$876.00 |
$876.00 |
$67.80–$545.10 |
500% above |
— |
| Spinal tap (lumbar puncture), diagnostic
CPT 62270
DX LMBR SPI PNXR |
$1,000.00 |
$1,000.00 |
$502.37–$1,917.77 |
25% above |
— |
| Spinal tap (lumbar puncture), diagnostic
CPT 62270
REMOVAL OF CEREBROSPINAL FLUID WITH LOWER BACK SPINAL TAP FOR DIAGNOSTIC TEST |
$3,177.00 |
$3,177.00 |
$502.37–$1,917.77 |
298% above |
— |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs
CPT 12002
SIMPLE REPAIR OF SURFACE WOUND OF SCALP; NECK; UNDERARMS; TRUNK; ARMS; OR LEGS; 2.6-7.5 CM |
$936.00 |
$936.00 |
$85.89–$545.10 |
277% above |
— |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair
CPT 12011
RPR F/E/E/N/L/M 2.5 CM/< |
$800.00 |
$800.00 |
$85.89–$545.10 |
199% above |
— |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair
CPT 12011
SIMPLE REPAIR OF SURFACE WOUND OF FACE; EARS; EYELIDS; NOSE; LIPS; OR MOUTH; 2.5 CM OR LESS |
$936.00 |
$936.00 |
$85.89–$545.10 |
250% above |
— |
| TURP (transurethral resection of the prostate)
CPT 52601
REMOVAL OF PROSTATE GLAND USING AN ELECTROCAUTERY KNIFE THROUGH URETHRA WITH CONTROL OF BLEEDING USING AN ENDOSCOPE |
$5,562.00 |
$5,562.00 |
$4,121.92–$14,567.19 |
55% below |
— |
| Thoracentesis with imaging guidance
CPT 32555
ASPIRATION OF FLUID FROM CHEST CAVITY USING IMAGING GUIDANCE |
$1,486.29 |
$1,486.29 |
$566.33–$1,704.29 |
29% above |
— |
| Thoracentesis with imaging guidance
CPT 32555
ASPIRATE PLEURA W/ IMAGING |
$3,290.00 |
$3,290.00 |
$566.33–$1,704.28 |
185% above |
— |
| Tonsil and adenoid removal, age 12 or older
CPT 42821
REMOVAL OF TONSILS AND ADENOID GLANDS (12 YEARS OR OLDER) |
$2,714.00 |
$2,714.00 |
$2,033.09–$9,007.60 |
56% below |
— |
| Tonsil and adenoid removal, child under 12
CPT 42820
REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS) |
$5,347.50 |
$5,347.50 |
$4,011.34–$16,083.26 |
33% below |
— |
| Tonsil removal (tonsillectomy) only, age 12 or older
CPT 42826
REMOVAL OF TONSILS (12 YEARS OR OLDER) |
$2,714.00 |
$2,714.00 |
$2,033.09–$9,007.60 |
61% below |
— |
| Tonsil removal (tonsillectomy) only, child under 12
CPT 42825
REMOVAL OF TONSILS |
$4,350.00 |
$4,350.00 |
$2,859.77–$16,083.26 |
40% below |
— |
| Total hip replacement
CPT 27130
TOTAL HIP ARTHROPLASTY |
$11,087.15 |
$11,087.15 |
$4,668.05–$34,880.75 |
30% below |
— |
| Total knee replacement
CPT 27447
TOTAL KNEE ARTHROPLASTY |
$10,068.25 |
$10,068.25 |
$4,984.17–$34,880.75 |
37% below |
— |
| Total shoulder replacement
CPT 23472
RECONSTRUCT SHOULDER JOINT |
$10,335.00 |
$10,335.00 |
$4,733.41–$47,636.71 |
40% below |
— |
| Total thyroid removal (thyroidectomy)
CPT 60240
REMOVAL OF THYROID |
$9,557.00 |
$9,557.00 |
$5,972.65–$16,424.79 |
37% below |
— |
| Trigger finger release surgery
CPT 26055
INCISE FINGER TENDON SHEATH |
$2,890.00 |
$2,890.00 |
$1,588.61–$4,368.68 |
66% above |
— |
| Trigger point injections, 1 or 2 muscles
CPT 20552
INJ TRIGGER POINT 1/2 MUSCL |
$381.00 |
$381.00 |
$226.23–$833.94 |
152% above |
— |
| Trigger point injections, 1 or 2 muscles
CPT 20552
INJECTION OF TRIGGER POINTS; 1-2 MUSCLES |
$1,313.00 |
$1,313.00 |
$226.23–$833.94 |
767% above |
— |
| Tubal ligation, laparoscopic (tubes sealed by cautery)
CPT 58670
LAPAROSCOPY TUBAL CAUTERY |
$5,390.05 |
$5,390.05 |
$3,370.46–$16,424.79 |
at median |
— |
| Upper endoscopy (EGD) with balloon widening of the esophagus
CPT 43249
BALLOON DILATION OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE; LESS THAN 3.0 CM |
$1,545.00 |
$1,545.00 |
$1,015.20–$5,213.37 |
40% below |
— |
| Upper endoscopy (EGD) with biopsy
CPT 43239
BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE |
$1,463.00 |
$1,463.00 |
$825.14–$2,464.14 |
17% below |
— |
| Upper endoscopy (EGD) with injection into the lining
CPT 43236
UPPR GI SCOPE W/SUBMUC INJ |
$1,082.00 |
$1,082.00 |
$672.13–$2,464.14 |
57% below |
— |
| Upper endoscopy (EGD) with polyp removal by snare
CPT 43251
REMOVAL OF POLYPS OR GROWTHS OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE |
$669.50 |
$669.50 |
$669.50–$5,213.37 |
69% below |
— |
| Upper endoscopy (EGD) with polyp removal by snare
CPT 43251
EGD REMOVE LESION SNARE |
$1,339.00 |
$1,339.00 |
$995.86–$5,213.37 |
38% below |
— |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire
CPT 43248
INSERTION OF GUIDE WIRE WITH DILATION OF ESOPHAGUS USING A FLEXIBLE ENDOSCOPE |
$1,539.85 |
$1,539.85 |
$896.05–$2,464.14 |
at median |
— |
| Upper endoscopy (EGD), diagnostic
CPT 43235
DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE |
$859.05 |
$859.05 |
$859.05–$2,464.14 |
58% below |
— |
| Upper endoscopy (EGD), diagnostic
CPT 43235
EGD DIAGNOSTIC BRUSH WASH |
$1,718.10 |
$1,718.10 |
$896.05–$2,464.14 |
17% below |
— |
| Ureteroscopy with laser stone breaking (lithotripsy)
CPT 52353
CYSTOURETERO W/LITHOTRIPSY |
$5,562.00 |
$5,562.00 |
$4,119.56–$14,567.19 |
55% below |
— |
| Ureteroscopy with laser stone breaking and stent placement
CPT 52356
CYSTO/URETERO W/LITHOTRIPSY |
$11,252.75 |
$11,252.75 |
$4,501.38–$14,567.19 |
10% below |
— |
| Vasectomy, one or both sides, including follow-up semen testing
CPT 55250
REMOVAL OF SPERM DUCT(S) |
$2,500.00 |
$2,500.00 |
$1,942.55–$5,679.24 |
143% above |
— |
| Vasectomy, one or both sides, including follow-up semen testing
CPT 55250
REMOVAL OF SPERM DUCT |
$2,575.00 |
$2,575.00 |
$1,942.55–$5,679.24 |
150% above |
— |
| Wart removal, up to 14 warts
CPT 17110
DESTRUCT B9 LESION 1-14 |
$927.00 |
$927.00 |
$156.20–$545.10 |
354% above |
— |
| Wound debridement, skin and tissue under it, first 20 sq cm
CPT 11042
REMOVAL OF SKIN AND TISSUE; 20.0 SQ CM OR LESS |
$753.00 |
$753.00 |
$324.80–$1,104.43 |
126% above |
— |
| Wound debridement, skin and tissue under it, first 20 sq cm
CPT 11042
DBRDMT SUBQ TIS 1ST 20SQCM/< |
$1,666.00 |
$1,666.00 |
$324.80–$1,104.43 |
400% above |
— |
| Wrist fracture surgery (plate and screws), distal radius
CPT 25607
OPTX DST RD XARTC FX/EPI SEP |
$7,802.00 |
$7,802.00 |
$5,183.30–$19,714.04 |
19% below |
— |