| Adenoid removal (adenoidectomy), child under 12
code 42830 |
30 |
$3,243.07 |
$4,327.45 |
| Anterior cervical discectomy and fusion (ACDF), one level
code 22551 |
32 |
$3,786.00 |
$14,241.77 |
| Appendectomy for a ruptured appendix with abscess or peritonitis
code 44960 |
13 |
$3,786.00 |
$5,339.00 |
| Appendectomy, open surgery
code 44950 |
31 |
$3,786.00 |
$6,906.53 |
| Arthroscopic ACL reconstruction or repair of the knee
code 29888 |
31 |
$3,786.00 |
$7,807.24 |
| Arthroscopic rotator cuff repair of the shoulder
code 29827 |
31 |
$3,786.00 |
$7,807.24 |
| Balloon dilation of the maxillary sinus opening, one side
code 31295 |
20 |
$3,786.00 |
$6,083.00 |
| Botox injections for chronic migraine
code 64615 |
35 |
$295.19 |
$1,871.20 |
| Breast needle biopsy guided by mammogram (stereotactic), with marker clip, first lesion
code 19081 |
44 |
$548.10 |
$2,977.13 |
| Broken ankle (outer ankle bone) treatment without surgery or setting
code 27786 |
36 |
$190.20 |
$1,288.35 |
| Broken foot (metatarsal) treatment without surgery or setting
code 28470 |
40 |
$138.50 |
$358.80 |
| Bunion correction with a bone cut near the head of the first metatarsal
code 28296 |
21 |
$3,591.33 |
$4,627.00 |
| Bunion correction with removal of part of the big toe joint
code 28292 |
31 |
$3,244.61 |
$4,627.00 |
| Cardiac catheterization with coronary angiogram
code 93458 |
50 |
$1,694.40 |
$4,172.18 |
| Cardioversion, elective (restoring heart rhythm)
code 92960 |
55 |
$342.60 |
$832.95 |
| Carpal tunnel release, open surgery
code 64721 |
32 |
$1,952.77 |
$2,605.71 |
| Cataract surgery with lens implant
code 66984 |
32 |
$2,280.73 |
$3,043.33 |
| Catheter ablation for atrial fibrillation
code 93656 |
34 |
$3,415.70 |
$27,153.82 |
| Cervical biopsy
code 57500 |
50 |
$260.25 |
$1,251.45 |
| Cesarean delivery, including prenatal and postpartum care
code 59510 |
13 |
$3,786.00 |
$5,339.00 |
| Circumcision by surgical excision, older than 28 days (children and adults)
code 54161 |
33 |
$2,020.20 |
$3,786.00 |
| Circumcision with a clamp or device and a numbing nerve block, usually newborns
code 54150 |
43 |
$430.90 |
$4,350.00 |
| Circumcision, surgical, older than a newborn
code 54160 |
28 |
$234.00 |
$3,251.50 |
| Closed treatment of a wrist (distal radius) fracture, no resetting
code 25600 |
38 |
$138.50 |
$1,963.09 |
| Colonoscopy with endoscopic ultrasound
code 45391 |
32 |
$850.50 |
$2,478.48 |
| Colonoscopy with polyp removal
code 45385 |
33 |
$1,179.08 |
$2,070.71 |
| Colonoscopy with tissue sample
code 45380 |
36 |
$1,179.08 |
$1,588.55 |
| Colonoscopy, diagnostic
code 45378 |
37 |
$847.80 |
$1,216.56 |
| Colposcopy with LEEP (loop electrosurgical excision)
code 57460 |
37 |
$1,945.00 |
$4,242.66 |
| Colposcopy with cervical biopsy and scraping of the cervical canal
code 57454 |
43 |
$108.00 |
$520.43 |
| Complex cataract surgery with lens implant
code 66982 |
26 |
$2,280.73 |
$3,439.49 |
| Coronary stent placement, one artery
code 92928 |
36 |
$1,478.50 |
$13,501.17 |
| Cystoscopy with ureteral stent placement
code 52332 |
26 |
$1,160.55 |
$4,602.60 |
| Cystoscopy, diagnostic look inside the bladder and urethra
code 52000 |
45 |
$149.10 |
$824.00 |
| D&C (dilation and curettage), not related to pregnancy
code 58120 |
37 |
$1,500.00 |
$4,243.46 |
| Destruction of a precancerous skin lesion (actinic keratosis), first lesion
code 17000 |
35 |
$19.40 |
$424.00 |
| Ear tube placement (tympanostomy) under general anesthesia, one ear
code 69436 |
22 |
$1,618.59 |
$4,338.73 |
| Ear tube placement (tympanostomy) with local anesthesia, one ear
code 69433 |
24 |
$697.80 |
$3,886.00 |
| Earwax removal by irrigation (rinsing), one ear
code 69209 |
40 |
$37.50 |
$372.02 |
| Earwax removal with instruments, one ear
code 69210 |
53 |
$24.70 |
$279.80 |
| Endometrial biopsy (uterine lining sample) without dilating the cervix
code 58100 |
45 |
$60.15 |
$268.43 |
| Endoscopic sinus surgery: full ethmoid sinus opening
code 31255 |
21 |
$3,786.00 |
$6,311.00 |
| Endoscopic sinus surgery: opening the frontal sinus
code 31276 |
21 |
$3,786.00 |
$6,311.00 |
| Endoscopic sinus surgery: opening the maxillary (cheek) sinus
code 31256 |
21 |
$3,786.00 |
$5,741.00 |
| Endoscopic sinus surgery: opening the maxillary sinus with removal of tissue
code 31267 |
22 |
$3,786.00 |
$6,575.00 |
| Epidural steroid injection, neck or mid back, with imaging guidance
code 62321 |
49 |
$402.60 |
$946.04 |
| Eye injection into the vitreous (intravitreal injection)
code 67028 |
26 |
$331.69 |
$2,264.00 |
| Facet joint injection, lower back, one level, with imaging guidance
code 64493 |
42 |
$197.00 |
$2,840.72 |
| First repair of a front abdominal hernia (such as umbilical) 3 to 10 cm
code 49593 |
31 |
$3,127.71 |
$6,819.30 |
| First repair of a front abdominal hernia larger than 10 cm
code 49595 |
31 |
$3,786.00 |
$6,906.53 |
| First repair of a small front abdominal hernia (e.g. umbilical), under 3 cm
code 49591 |
31 |
$3,529.06 |
$4,627.00 |
| Flexible sigmoidoscopy, diagnostic (lower colon only)
code 45330 |
37 |
$180.00 |
$1,216.56 |
| Gallbladder removal, laparoscopic
code 47562 |
32 |
$3,786.00 |
$6,457.82 |
| Gallbladder removal, laparoscopic, with X-ray of the bile ducts during surgery
code 47563 |
32 |
$3,786.00 |
$6,457.82 |
| Gallbladder removal, open surgery through a larger incision
code 47600 |
13 |
$3,786.00 |
$5,339.00 |
| Hammertoe correction surgery
code 28285 |
32 |
$3,244.61 |
$4,182.08 |
| Hemorrhoid banding (rubber band ligation)
code 46221 |
34 |
$383.40 |
$2,531.28 |
| Hemorrhoidectomy (internal and external), one area
code 46255 |
30 |
$1,920.45 |
$3,625.30 |
| Hip replacement after an earlier hip surgery (conversion to total hip)
code 27132 |
20 |
$2,851.39 |
$5,798.00 |
| Hysterectomy through an abdominal incision (total)
code 58150 |
21 |
$1,637.31 |
$4,881.00 |
| Hysterosalpingogram (HSG): contrast injection to check the fallopian tubes
code 58340 |
39 |
$67.95 |
$464.44 |
| Hysteroscopy with endometrial ablation
code 58563 |
32 |
$634.00 |
$5,468.70 |
| Hysteroscopy with uterine lining sampling and/or polyp removal
code 58558 |
38 |
$356.70 |
$3,990.71 |
| IUD insertion (the device itself billed separately)
code 58300 |
30 |
$115.05 |
$2,734.50 |
| Incision and drainage of a simple or single skin abscess
code 10060 |
54 |
$98.10 |
$344.25 |
| Inguinal (groin) hernia repair, age 5 or older
code 49505 |
22 |
$3,786.00 |
$4,754.19 |
| Injection into a tendon sheath or ligament (for example trigger finger)
code 20550 |
43 |
$168.40 |
$857.43 |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound
code 20610 |
44 |
$109.80 |
$1,065.25 |
| Insertion of a drug-delivery implant, such as the arm birth control implant
code 11981 |
42 |
$35.30 |
$172.00 |
| Joint injection or drainage, medium joint (wrist, elbow, ankle)
code 20605 |
44 |
$137.40 |
$857.43 |
| Joint injection or drainage, small joint (fingers, toes)
code 20600 |
44 |
$93.10 |
$728.72 |
| Knee arthroscopy with meniscus repair (one side of the knee)
code 29882 |
31 |
$3,244.61 |
$4,350.00 |
| Knee arthroscopy with meniscus trim
code 29881 |
22 |
$3,546.08 |
$4,367.60 |
| Knee arthroscopy with removal of both torn meniscus parts
code 29880 |
22 |
$3,545.39 |
$4,470.12 |
| Knee arthroscopy with smoothing of damaged cartilage (chondroplasty)
code 29877 |
30 |
$3,244.61 |
$4,291.71 |
| Laparoscopic Roux-en-Y gastric bypass, standard limb length
code 43644 |
19 |
$2,138.57 |
$5,110.00 |
| Laparoscopic adjustable gastric band placement (Lap-Band)
code 43770 |
31 |
$3,786.00 |
$11,523.76 |
| Laparoscopic appendectomy (appendix removal through small cuts)
code 44970 |
32 |
$3,786.00 |
$6,457.82 |
| Laparoscopic fundoplication (anti-reflux surgery)
code 43280 |
30 |
$3,786.00 |
$11,450.99 |
| Laparoscopic hysterectomy (uterus 250 g or less)
code 58570 |
30 |
$3,786.00 |
$11,450.99 |
| Laparoscopic hysterectomy, uterus 250 g or less, with tubes and/or ovaries
code 58571 |
31 |
$3,786.00 |
$11,523.76 |
| Laparoscopic inguinal (groin) hernia repair, first repair on that side
code 49650 |
21 |
$3,786.00 |
$6,311.00 |
| Laparoscopic inguinal (groin) hernia repair, recurrent hernia
code 49651 |
21 |
$3,786.00 |
$6,311.00 |
| Laparoscopic removal of an adjustable gastric band and its port
code 43774 |
31 |
$3,786.00 |
$4,627.00 |
| Laparoscopic removal of fallopian tubes and/or ovaries
code 58661 |
22 |
$3,786.00 |
$6,343.45 |
| Laparoscopic sleeve gastrectomy for weight loss
code 43775 |
19 |
$1,728.40 |
$4,881.00 |
| Laser treatment of clouding after cataract surgery (YAG)
code 66821 |
32 |
$403.60 |
$709.71 |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs
code 12031 |
44 |
$169.95 |
$1,438.81 |
| Left heart catheterization, diagnostic
code 93452 |
48 |
$1,444.70 |
$3,563.20 |
| Lower-back epidural injection, with imaging guidance
code 62323 |
51 |
$414.40 |
$2,403.56 |
| Lower-back epidural injection, without imaging guidance
code 62322 |
43 |
$227.70 |
$1,979.00 |
| Lower-back nerve root steroid injection, with imaging guidance
code 64483 |
42 |
$303.75 |
$2,993.62 |
| Lumbar discectomy or laminotomy to free a nerve root, one level
code 63030 |
26 |
$1,876.00 |
$5,580.00 |
| Lumbar fusion with interbody cage and posterolateral graft (TLIF), one level
code 22633 |
30 |
$3,786.00 |
$20,226.67 |
| Lumbar interbody fusion (PLIF or TLIF), one level
code 22630 |
30 |
$3,786.00 |
$20,226.67 |
| Lumbar laminectomy (spinal decompression), one level
code 63047 |
31 |
$3,786.00 |
$7,907.11 |
| Lumbar spinal fusion (posterior), one level
code 22612 |
31 |
$3,786.00 |
$20,355.21 |
| Lumpectomy (partial mastectomy)
code 19301 |
21 |
$3,786.00 |
$5,109.67 |
| Mastectomy (total removal of the breast)
code 19303 |
24 |
$3,786.00 |
$7,344.50 |
| Miscarriage treatment with D&C, first trimester
code 59820 |
40 |
$891.30 |
$4,016.80 |
| Mohs surgery for skin cancer, first stage, head, neck, hands, feet or genitals
code 17311 |
26 |
$612.13 |
$1,673.10 |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm
code 11400 |
45 |
$102.00 |
$1,305.00 |
| Mole or benign skin lesion removal (excision), face, ears, eyelids, nose or lips, up to 0.5 cm
code 11440 |
36 |
$600.00 |
$943.95 |
| Nail removal (partial or complete), one nail
code 11730 |
54 |
$40.00 |
$306.05 |
| Occipital nerve block (injection for headaches)
code 64405 |
42 |
$69.60 |
$1,345.00 |
| Open Roux-en-Y gastric bypass through an abdominal incision
code 43846 |
13 |
$1,361.68 |
$5,110.00 |
| Pacemaker implant (dual chamber)
code 33208 |
50 |
$3,786.00 |
$11,588.68 |
| Paracentesis with imaging guidance
code 49083 |
54 |
$380.40 |
$1,212.61 |
| Partial knee replacement (one compartment)
code 27446 |
21 |
$3,786.00 |
$6,311.00 |
| Permanent removal of a nail and nail root (partial or complete)
code 11750 |
54 |
$159.00 |
$572.41 |
| Prostate biopsy
code 55700 |
47 |
$249.90 |
$2,733.47 |
| Prostate removal (prostatectomy), laparoscopic
code 55866 |
31 |
$3,786.00 |
$11,523.76 |
| Radiofrequency ablation of facet joint nerves, lower back, one level
code 64635 |
35 |
$799.80 |
$3,813.00 |
| Removal of a breast lump, open surgery
code 19120 |
26 |
$700.65 |
$5,109.67 |
| Removal of a foreign object under the skin, simple
code 10120 |
51 |
$63.30 |
$544.82 |
| Removal of one lobe of the thyroid (lobectomy)
code 60220 |
31 |
$3,786.00 |
$6,457.82 |
| Screening colonoscopy for a person at average risk (Medicare code)
code G0121 |
23 |
$911.71 |
$1,099.00 |
| Screening colonoscopy, high risk of colorectal cancer (Medicare code)
code G0105 |
23 |
$486.62 |
$1,073.68 |
| Septoplasty to straighten the nasal septum
code 30520 |
31 |
$3,243.07 |
$4,327.45 |
| Shock-wave lithotripsy to break up kidney stones (from outside the body)
code 50590 |
45 |
$2,639.60 |
$4,390.96 |
| Short arm cast (elbow to hand)
code 29075 |
47 |
$79.50 |
$879.00 |
| Short arm splint (forearm and hand)
code 29125 |
37 |
$76.20 |
$768.00 |
| Short leg cast (below the knee)
code 29405 |
45 |
$50.55 |
$654.00 |
| Short leg splint (calf to foot)
code 29515 |
43 |
$80.85 |
$634.05 |
| Shoulder arthroscopy with removal of the end of the collarbone (distal clavicle)
code 29824 |
31 |
$3,244.61 |
$4,627.00 |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery)
code 29826 |
19 |
$3,786.00 |
$5,855.00 |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs
code 12001 |
53 |
$61.60 |
$420.40 |
| Skin biopsy, punch, one lesion
code 11104 |
52 |
$148.80 |
$538.97 |
| Skin cancer removal (excision), body, arms or legs, up to 0.5 cm
code 11600 |
36 |
$703.59 |
$1,000.28 |
| Skin tag removal, up to 15 tags
code 11200 |
52 |
$37.80 |
$486.28 |
| Spinal tap (lumbar puncture), diagnostic
code 62270 |
54 |
$109.30 |
$943.92 |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs
code 12002 |
53 |
$119.80 |
$520.20 |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair
code 12011 |
50 |
$119.80 |
$987.16 |
| TURP (transurethral resection of the prostate)
code 52601 |
31 |
$3,786.00 |
$5,631.74 |
| Tangential (shave-style) skin biopsy, one lesion
code 11102 |
51 |
$114.00 |
$544.82 |
| Thoracentesis with imaging guidance
code 32555 |
44 |
$311.20 |
$1,782.00 |
| Tonsil and adenoid removal, age 12 or older
code 42821 |
30 |
$3,243.07 |
$4,182.46 |
| Tonsil and adenoid removal, child under 12
code 42820 |
32 |
$3,786.00 |
$6,547.81 |
| Tonsil removal (tonsillectomy) only, age 12 or older
code 42826 |
32 |
$3,243.07 |
$4,327.45 |
| Tonsil removal (tonsillectomy) only, child under 12
code 42825 |
30 |
$3,786.00 |
$6,547.81 |
| Total hip replacement
code 27130 |
21 |
$3,786.00 |
$6,311.00 |
| Total knee replacement
code 27447 |
21 |
$3,786.00 |
$6,311.00 |
| Total shoulder replacement
code 23472 |
21 |
$3,786.00 |
$6,311.00 |
| Total thyroid removal (thyroidectomy)
code 60240 |
30 |
$3,786.00 |
$6,457.82 |
| Trigger finger release surgery
code 26055 |
31 |
$1,600.41 |
$2,135.54 |
| Trigger point injections, 1 or 2 muscles
code 20552 |
53 |
$71.10 |
$397.14 |
| Tubal ligation, laparoscopic (tubes sealed by cautery)
code 58670 |
32 |
$1,539.15 |
$6,457.82 |
| Ultrasound-guided breast needle biopsy with marker clip, first lesion
code 19083 |
44 |
$365.30 |
$2,977.13 |
| Upper endoscopy (EGD) with balloon widening of the esophagus
code 43249 |
34 |
$1,142.40 |
$2,531.28 |
| Upper endoscopy (EGD) with biopsy
code 43239 |
36 |
$937.56 |
$1,386.82 |
| Upper endoscopy (EGD) with injection into the lining
code 43236 |
34 |
$716.55 |
$2,534.56 |
| Upper endoscopy (EGD) with polyp removal by snare
code 43251 |
33 |
$1,896.99 |
$2,531.28 |
| Upper endoscopy (EGD) with widening of the esophagus over a guide wire
code 43248 |
34 |
$630.75 |
$1,710.96 |
| Upper endoscopy (EGD), diagnostic
code 43235 |
44 |
$937.56 |
$2,156.55 |
| Upper endoscopy with drainage of a pseudocyst through the stomach wall
code 43240 |
32 |
$1,176.60 |
$6,588.93 |
| Ureteroscopy with laser stone breaking (lithotripsy)
code 52353 |
27 |
$412.90 |
$5,554.87 |
| Ureteroscopy with laser stone breaking and stent placement
code 52356 |
24 |
$2,967.60 |
$6,083.00 |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care
code 59610 |
12 |
$3,786.00 |
$5,224.50 |
| Vaginal delivery, including prenatal and postpartum care
code 59400 |
13 |
$3,786.00 |
$5,339.00 |
| Vasectomy, one or both sides, including follow-up semen testing
code 55250 |
14 |
$2,704.61 |
$5,224.50 |
| Vein ablation, radiofrequency, first vein
code 36475 |
34 |
$748.80 |
$4,861.50 |
| Wart removal, up to 14 warts
code 17110 |
47 |
$37.80 |
$268.89 |
| Wound debridement, skin and tissue under it, first 20 sq cm
code 11042 |
54 |
$74.85 |
$538.97 |
| Wrist fracture surgery (plate and screws), distal radius
code 25607 |
22 |
$2,809.80 |
$6,083.00 |