| Adenoid removal (adenoidectomy), child under 12
code 42830 |
12 |
$4,350.00 |
$7,224.00 |
| Anterior cervical discectomy and fusion (ACDF), one level
code 22551 |
13 |
$3,315.00 |
$15,889.00 |
| Appendectomy for a ruptured appendix with abscess or peritonitis
code 44960 |
6 |
$1,155.00 |
$4,000.00 |
| Appendectomy, open surgery
code 44950 |
12 |
$845.60 |
$3,741.13 |
| Arthroscopic ACL reconstruction or repair of the knee
code 29888 |
14 |
$1,383.90 |
$12,106.00 |
| Arthroscopic rotator cuff repair of the shoulder
code 29827 |
12 |
$1,653.40 |
$11,190.13 |
| Balloon dilation of the maxillary sinus opening, one side
code 31295 |
11 |
$4,161.20 |
$8,965.50 |
| Botox injections for chronic migraine
code 64615 |
16 |
$63.04 |
$394.50 |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion
code 19081 |
15 |
$1,645.00 |
$3,466.80 |
| Broken ankle (outer ankle bone) treatment without surgery or setting
code 27786 |
23 |
$70.00 |
$386.00 |
| Broken foot (metatarsal) treatment without surgery or setting
code 28470 |
21 |
$70.00 |
$454.00 |
| Bunion correction with a bone cut near the head of the first metatarsal
code 28296 |
15 |
$1,791.00 |
$6,510.00 |
| Bunion correction with removal of part of the big toe joint
code 28292 |
14 |
$1,095.20 |
$5,326.03 |
| Cardiac catheterization with coronary angiogram
code 93458 |
13 |
$8,806.50 |
$15,047.50 |
| Cardioversion, elective (restoring heart rhythm)
code 92960 |
27 |
$196.00 |
$1,484.60 |
| Carpal tunnel release, open surgery
code 64721 |
17 |
$593.60 |
$2,750.00 |
| Cataract surgery with lens implant
code 66984 |
12 |
$1,724.10 |
$4,309.38 |
| Catheter ablation for atrial fibrillation
code 93656 |
11 |
$22,430.85 |
$62,005.00 |
| Cervical biopsy
code 57500 |
16 |
$108.58 |
$883.00 |
| Cesarean delivery, including prenatal and postpartum care
code 59510 |
2 |
$4,671.02 |
$4,963.51 |
| Circumcision by surgical excision, older than 28 days (children and adults)
code 54161 |
15 |
$314.25 |
$5,304.00 |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns
code 54150 |
21 |
$109.23 |
$301.00 |
| Circumcision, surgical, older than a newborn
code 54160 |
9 |
$350.40 |
$1,858.00 |
| Closed treatment of a wrist (distal radius) fracture, no resetting
code 25600 |
27 |
$70.00 |
$341.60 |
| Colonoscopy with endoscopic ultrasound
code 45391 |
6 |
$2,361.60 |
$3,234.00 |
| Colonoscopy with polyp removal
code 45385 |
17 |
$624.40 |
$2,305.60 |
| Colonoscopy with tissue sample
code 45380 |
17 |
$872.00 |
$2,702.40 |
| Colonoscopy, diagnostic
code 45378 |
18 |
$685.00 |
$2,509.00 |
| Colposcopy with LEEP (loop electrosurgical excision)
code 57460 |
16 |
$237.75 |
$2,076.38 |
| Colposcopy with cervical biopsy and scraping of the cervical canal
code 57454 |
17 |
$100.28 |
$385.00 |
| Complex cataract surgery with lens implant
code 66982 |
9 |
$2,226.00 |
$5,599.00 |
| Coronary stent placement, one artery
code 92928 |
13 |
$9,389.10 |
$18,768.96 |
| Cystoscopy with ureteral stent placement
code 52332 |
13 |
$803.00 |
$7,933.00 |
| Cystoscopy, diagnostic look inside the bladder and urethra
code 52000 |
15 |
$206.25 |
$1,114.00 |
| D&C (dilation and curettage), not related to pregnancy
code 58120 |
14 |
$455.20 |
$4,913.43 |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion
code 17000 |
23 |
$25.55 |
$114.19 |
| Ear tube placement (tympanostomy) under general anesthesia, one ear
code 69436 |
14 |
$280.00 |
$3,330.00 |
| Ear tube placement (tympanostomy) with local anesthesia, one ear
code 69433 |
14 |
$357.22 |
$709.71 |
| Earwax removal by irrigation (rinsing), one ear
code 69209 |
23 |
$28.50 |
$111.80 |
| Earwax removal with instruments, one ear
code 69210 |
28 |
$18.00 |
$103.45 |
| Endometrial biopsy (uterine lining sample) without dilating the cervix
code 58100 |
19 |
$43.50 |
$278.96 |
| Endoscopic sinus surgery: full ethmoid sinus opening
code 31255 |
13 |
$525.00 |
$11,453.00 |
| Endoscopic sinus surgery: opening the frontal sinus
code 31276 |
12 |
$647.50 |
$13,030.85 |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus
code 31256 |
12 |
$273.00 |
$7,652.75 |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue
code 31267 |
12 |
$1,480.63 |
$14,057.93 |
| Epidural steroid injection, neck or mid back, with imaging guidance
code 62321 |
24 |
$255.75 |
$1,620.85 |
| Eye injection into the vitreous (intravitreal injection)
code 67028 |
5 |
$927.00 |
$927.00 |
| Facet joint injection, lower back, one level, with imaging guidance
code 64493 |
25 |
$167.25 |
$1,457.26 |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm
code 49593 |
14 |
$770.00 |
$11,808.64 |
| First repair of a front abdominal hernia larger than 10 cm
code 49595 |
12 |
$1,512.00 |
$10,332.00 |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm
code 49591 |
16 |
$525.00 |
$8,373.50 |
| Flexible sigmoidoscopy, diagnostic (lower colon only)
code 45330 |
17 |
$373.00 |
$1,082.00 |
| Gallbladder removal, laparoscopic
code 47562 |
12 |
$1,306.00 |
$12,979.50 |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery
code 47563 |
14 |
$1,420.00 |
$12,415.38 |
| Gallbladder removal, open surgery through a larger incision
code 47600 |
4 |
$280.00 |
$3,630.00 |
| Hammertoe correction surgery
code 28285 |
16 |
$550.44 |
$3,983.05 |
| Hemorrhoid banding (rubber band ligation)
code 46221 |
17 |
$432.90 |
$1,094.40 |
| Hemorrhoidectomy (internal and external), one area
code 46255 |
13 |
$545.30 |
$4,200.00 |
| Hip replacement after an earlier hip surgery (conversion to total hip)
code 27132 |
13 |
$3,330.00 |
$15,889.00 |
| Hysterectomy through an abdominal incision (total)
code 58150 |
12 |
$1,707.20 |
$13,390.00 |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes
code 58340 |
17 |
$143.25 |
$340.00 |
| Hysteroscopy with endometrial ablation
code 58563 |
13 |
$2,548.50 |
$10,966.00 |
| Hysteroscopy with uterine lining sampling and/or polyp removal
code 58558 |
14 |
$1,433.00 |
$4,298.07 |
| IUD insertion (the device itself billed separately)
code 58300 |
22 |
$90.75 |
$300.16 |
| Incision and drainage of a simple or single skin abscess
code 10060 |
30 |
$57.00 |
$284.39 |
| Inguinal (groin) hernia repair, age 5 or older
code 49505 |
15 |
$772.80 |
$8,630.00 |
| Injection into a tendon sheath or ligament (for example trigger finger)
code 20550 |
26 |
$43.00 |
$246.60 |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound
code 20610 |
31 |
$47.96 |
$305.00 |
| Insertion of a drug-delivery implant, such as the arm birth control implant
code 11981 |
21 |
$56.00 |
$188.30 |
| Joint injection or drainage, medium joint (wrist, elbow, ankle)
code 20605 |
30 |
$40.52 |
$261.70 |
| Joint injection or drainage, small joint (fingers, toes)
code 20600 |
31 |
$64.50 |
$298.20 |
| Knee arthroscopy with meniscus repair (one side of the knee)
code 29882 |
13 |
$1,391.00 |
$6,877.00 |
| Knee arthroscopy with meniscus trim
code 29881 |
13 |
$1,097.00 |
$6,877.00 |
| Knee arthroscopy with removal of both torn meniscus parts
code 29880 |
13 |
$1,138.00 |
$6,877.00 |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty)
code 29877 |
13 |
$1,255.00 |
$6,877.00 |
| Laparoscopic Roux-en-Y gastric bypass, standard limb length
code 43644 |
3 |
$2,284.80 |
$9,450.47 |
| Laparoscopic adjustable gastric band placement (Lap-Band)
code 43770 |
5 |
$26,271.00 |
$26,271.00 |
| Laparoscopic appendectomy (appendix removal through small cuts)
code 44970 |
13 |
$500.00 |
$8,070.00 |
| Laparoscopic fundoplication (anti-reflux surgery)
code 43280 |
13 |
$2,118.00 |
$26,271.00 |
| Laparoscopic hysterectomy (uterus 250 g or less)
code 58570 |
11 |
$1,272.60 |
$16,448.87 |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries
code 58571 |
14 |
$1,677.90 |
$14,521.75 |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side
code 49650 |
12 |
$861.00 |
$15,131.00 |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia
code 49651 |
13 |
$1,123.00 |
$15,131.00 |
| Laparoscopic removal of an adjustable gastric band and its port
code 43774 |
13 |
$1,891.40 |
$8,663.00 |
| Laparoscopic removal of fallopian tubes and/or ovaries
code 58661 |
12 |
$1,267.70 |
$11,467.58 |
| Laparoscopic sleeve gastrectomy for weight loss
code 43775 |
8 |
$3,749.20 |
$32,839.00 |
| Laser treatment of clouding after cataract surgery (YAG)
code 66821 |
9 |
$583.94 |
$1,535.00 |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs
code 12031 |
28 |
$92.25 |
$371.15 |
| Left heart catheterization, diagnostic
code 93452 |
12 |
$7,727.25 |
$14,000.00 |
| Lower-back epidural injection, with imaging guidance
code 62323 |
26 |
$234.00 |
$1,395.45 |
| Lower-back epidural injection, without imaging guidance
code 62322 |
16 |
$335.25 |
$1,284.83 |
| Lower-back nerve root steroid injection, with imaging guidance
code 64483 |
25 |
$264.75 |
$1,753.05 |
| Lumbar discectomy or laminotomy to free a nerve root, one level
code 63030 |
13 |
$1,553.30 |
$14,738.00 |
| Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level
code 22633 |
13 |
$2,429.00 |
$17,113.00 |
| Lumbar interbody fusion (PLIF or TLIF), one level
code 22630 |
12 |
$3,036.00 |
$20,834.00 |
| Lumbar laminectomy (spinal decompression), one level
code 63047 |
15 |
$838.40 |
$12,558.00 |
| Lumbar spinal fusion (posterior), one level
code 22612 |
14 |
$2,086.00 |
$16,929.13 |
| Lumpectomy (partial mastectomy)
code 19301 |
14 |
$1,115.80 |
$6,152.28 |
| Mastectomy (total removal of the breast)
code 19303 |
13 |
$1,895.00 |
$10,873.17 |
| Miscarriage treatment with D&C, first trimester
code 59820 |
13 |
$872.00 |
$8,204.82 |
| Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals
code 17311 |
8 |
$594.78 |
$1,686.00 |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm
code 11400 |
23 |
$89.06 |
$334.90 |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm
code 11440 |
21 |
$75.75 |
$342.90 |
| Nail removal (partial or complete), one nail
code 11730 |
30 |
$90.44 |
$206.00 |
| Occipital nerve block (injection for headaches)
code 64405 |
26 |
$92.80 |
$406.20 |
| Open Roux-en-Y gastric bypass through an abdominal incision
code 43846 |
1 |
$8,797.54 |
$8,797.54 |
| Pacemaker implant (dual chamber)
code 33208 |
13 |
$6,199.05 |
$12,726.00 |
| Paracentesis with imaging guidance
code 49083 |
25 |
$190.44 |
$1,357.50 |
| Partial knee replacement (one compartment)
code 27446 |
12 |
$1,974.70 |
$15,889.00 |
| Permanent removal of a nail and nail root (partial or complete)
code 11750 |
28 |
$119.20 |
$510.98 |
| Prostate biopsy
code 55700 |
8 |
$225.07 |
$2,921.13 |
| Prostate removal (prostatectomy), laparoscopic
code 55866 |
10 |
$1,884.40 |
$26,271.00 |
| Radiofrequency ablation of facet joint nerves, lower back, one level
code 64635 |
21 |
$524.25 |
$2,415.00 |
| Removal of a breast lump, open surgery
code 19120 |
16 |
$253.50 |
$3,946.38 |
| Removal of a foreign object under the skin, simple
code 10120 |
30 |
$120.75 |
$342.47 |
| Removal of one lobe of the thyroid (lobectomy)
code 60220 |
13 |
$1,420.00 |
$14,360.76 |
| Screening colonoscopy for a person at average risk (Medicare code)
code G0121 |
17 |
$314.81 |
$2,509.00 |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code)
code G0105 |
15 |
$314.81 |
$2,434.20 |
| Septoplasty to straighten the nasal septum
code 30520 |
14 |
$1,025.50 |
$6,135.00 |
| Shock-wave lithotripsy to break up kidney stones (from outside the body)
code 50590 |
14 |
$3,691.00 |
$8,773.00 |
| Short arm cast (elbow to hand)
code 29075 |
27 |
$70.28 |
$218.40 |
| Short arm splint (forearm and hand)
code 29125 |
29 |
$67.91 |
$200.90 |
| Short leg cast (below the knee)
code 29405 |
26 |
$49.50 |
$237.30 |
| Short leg splint (calf to foot)
code 29515 |
28 |
$39.75 |
$221.00 |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle)
code 29824 |
14 |
$727.20 |
$5,475.38 |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery)
code 29826 |
13 |
$231.70 |
$2,859.00 |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs
code 12001 |
30 |
$61.75 |
$255.05 |
| Skin biopsy, punch, one lesion
code 11104 |
26 |
$73.50 |
$228.45 |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm
code 11600 |
20 |
$81.75 |
$532.97 |
| Skin tag removal, up to 15 tags
code 11200 |
28 |
$31.03 |
$169.46 |
| Spinal tap (lumbar puncture), diagnostic
code 62270 |
26 |
$140.00 |
$842.55 |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs
code 12002 |
28 |
$87.75 |
$299.25 |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair
code 12011 |
27 |
$86.25 |
$286.50 |
| TURP (transurethral resection of the prostate)
code 52601 |
13 |
$1,075.20 |
$8,806.50 |
| Tangential (shave-style) skin biopsy, one lesion
code 11102 |
24 |
$28.00 |
$209.40 |
| Thoracentesis with imaging guidance
code 32555 |
26 |
$196.00 |
$1,155.70 |
| Tonsil and adenoid removal, age 12 or older
code 42821 |
13 |
$406.70 |
$5,156.21 |
| Tonsil and adenoid removal, child under 12
code 42820 |
13 |
$500.80 |
$8,208.00 |
| Tonsil removal (tonsillectomy) only, age 12 or older
code 42826 |
12 |
$2,714.00 |
$6,271.00 |
| Tonsil removal (tonsillectomy) only, child under 12
code 42825 |
10 |
$4,350.00 |
$10,690.13 |
| Total hip replacement
code 27130 |
14 |
$1,871.25 |
$15,889.00 |
| Total knee replacement
code 27447 |
15 |
$2,561.00 |
$15,889.00 |
| Total shoulder replacement
code 23472 |
14 |
$2,889.00 |
$17,113.00 |
| Total thyroid removal (thyroidectomy)
code 60240 |
13 |
$1,152.20 |
$15,131.00 |
| Trigger finger release surgery
code 26055 |
18 |
$644.80 |
$2,062.33 |
| Trigger point injections, 1 or 2 muscles
code 20552 |
30 |
$51.75 |
$179.75 |
| Tubal ligation, laparoscopic (tubes sealed by cautery)
code 58670 |
9 |
$4,974.87 |
$15,131.00 |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion
code 19083 |
19 |
$385.60 |
$2,499.90 |
| Upper endoscopy (EGD) with balloon widening of the esophagus
code 43249 |
18 |
$380.80 |
$2,627.87 |
| Upper endoscopy (EGD) with biopsy
code 43239 |
17 |
$755.00 |
$2,339.58 |
| Upper endoscopy (EGD) with injection into the lining
code 43236 |
14 |
$504.70 |
$2,331.00 |
| Upper endoscopy (EGD) with polyp removal by snare
code 43251 |
16 |
$541.80 |
$2,437.88 |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire
code 43248 |
14 |
$385.00 |
$2,391.50 |
| Upper endoscopy (EGD), diagnostic
code 43235 |
17 |
$528.50 |
$2,145.60 |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall
code 43240 |
7 |
$3,016.00 |
$10,986.00 |
| Ureteroscopy with laser stone breaking (lithotripsy)
code 52353 |
15 |
$532.70 |
$6,230.25 |
| Ureteroscopy with laser stone breaking and stent placement
code 52356 |
14 |
$565.60 |
$11,497.38 |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care
code 59610 |
1 |
$4,952.00 |
$4,952.00 |
| Vaginal delivery, including prenatal and postpartum care
code 59400 |
2 |
$4,369.20 |
$4,565.10 |
| Vasectomy, one or both sides, including follow-up semen testing
code 55250 |
19 |
$299.69 |
$2,500.00 |
| Vein ablation, radiofrequency, first vein
code 36475 |
9 |
$2,916.76 |
$7,280.00 |
| Wart removal, up to 14 warts
code 17110 |
25 |
$28.00 |
$218.30 |
| Wound debridement, skin and tissue under it, first 20 sq cm
code 11042 |
29 |
$75.75 |
$333.45 |
| Wrist fracture surgery (plate and screws), distal radius
code 25607 |
14 |
$1,012.90 |
$9,573.53 |