IN FULL TRANSPARENCY

STAR ER has always practiced full transparency in billing. Accordingly, we support HB2041 and are pleased to share our full chargemaster list below.

We know that the cost of healthcare is complicated and often a stressful part of a patient’s experience. We encourage you to understand your insurance policy, including deductibles and co-pays, and ask any questions that arise at the time of your visit or at any point in the billing process by contacting our financial office at (806) 701- 4141.

  • Prices below are based on the most current chargemaster as of 1/1/19 and many times are adjusted to reflect lower allowed amounts by insurance or in relation to self-pay rates.
  • Existing Network contracts determine final charges and often result in substantially lower billing and total prices. STAR ER does not balance bill and never charges more than any insurance plan allows after processing the claims. That does not negate your deductible or out-of-pocket expenses pre-determined by you and your insurance company.
  • Emergency Physician fees are not included in the rates below; however,  STAR ER does not have added consulting fees or fees for other specialty services outside STAR emergency Physicians.
View Rate Comparison With Area Hospitals
Charge CodeDescriptionFee ($)
10040Acne surgery (eg, marsupialization, opening or removal of multiple milia, comedones, cysts, pustules)885.8
10060Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single972.88
10061Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple1808.15
10080Incision and drainage of pilonidal cyst; simple1849
10081Incision and drainage of pilonidal cyst; complicated1739.35
10120Incision and removal of foreign body, subcutaneous tissues; simple1047.05
10121Incision and removal of foreign body, subcutaneous tissues; complicated1879.1
10140Incision and drainage of hematoma, seroma or fluid collection3762.5
10160Puncture aspiration of abscess, hematoma, bulla, or cyst1075
11000Debridement of extensive eczematous or infected skin; up to 10% of body surface215
11042Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less1075
11043Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less1147.03
11055Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion196.73
11200Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions342.93
11305Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less282.73
11400Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.5 cm or less479.45
11401Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.6 to 1.0 cm585.88
11402Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 1.1 to 2.0 cm654.68
11403Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 2.1 to 3.0 cm754.65
11404Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 3.1 to 4.0 cm857.85
11406Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter over 4.0 cm1231.95
11420Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less479.45
11421Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm621.35
11422Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm693.38
11423Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm811.63
11424Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm937.4
11426Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm1349.13
11440Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.5 cm or less524.6
11441Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.6 to 1.0 cm670.8
11442Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 1.1 to 2.0 cm752.5
11443Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 2.1 to 3.0 cm900.85
11444Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 3.1 to 4.0 cm1141.65
11446Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter over 4.0 cm1570.58
11601Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.6 to 1.0 cm909.45
11720Debridement of nail(s) by any method(s); 1 to 5125.78
11730Avulsion of nail plate, partial or complete, simple; single548.25
11732Avulsion of nail plate, partial or complete, simple; each additional nail plate (List separately in addition to code for primary procedure)180.6
11740Evacuation of subungual hematoma332.18
11750Excision of nail and nail matrix, partial or complete (eg, ingrown or deformed nail), for permanent removal1766.23
11760Repair of nail bed1574.88
11765Wedge excision of skin of nail fold (eg, for ingrown toenail)999.75
11770Excision of pilonidal cyst or sinus; simple767.55
12001Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.5 cm or less548.25
12002Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.6 cm to 7.5 cm600.93
12004Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm747.13
12005Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 12.6 cm to 20.0 cm1011.58
12006Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 20.1 cm to 30.0 cm1227.65
12007Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); over 30.0 cm1524.35
12011Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less567.6
12013Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm635.33
12014Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm807.33
12015Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm1005.13
12016Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm1364.18
12017Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 20.1 cm to 30.0 cm1557.68
12018Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm1761.93
12031Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.5 cm or less1543.7
12032Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.6 cm to 7.5 cm1961.88
12034Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 7.6 cm to 12.5 cm2085.5
12035Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 12.6 cm to 20.0 cm2446.7
12041Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less1579.18
12042Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.6 cm to 7.5 cm2016.7
12044Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 7.6 cm to 12.5 cm2177.95
12045Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 12.6 cm to 20.0 cm2732.65
12051Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less1732.9
12052Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm2053.25
12053Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm2200.53
12055Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm3076.65
13100Repair, complex, trunk; 1.1 cm to 2.5 cm1290
13101Repair, complex, trunk; 2.6 cm to 7.5 cm1631.85
13102Repair, complex, trunk; each additional 5 cm or less (List separately in addition to code for primary procedure)445.05
13120Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm2388.65
13121Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm2704.7
13122Repair, complex, scalp, arms, and/or legs; each additional 5 cm or less (List separately in addition to code for primary procedure)869.68
13131Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 1.1 cm to 2.5 cm1482.43
13132Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 2.6 cm to 7.5 cm2400.48
13133Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; each additional 5 cm or less (List separately in addition to code for primary procedure)704.13
13151Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm1681.3
13152Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm2322
15850Removal of sutures under anesthesia (other than local), same surgeon364.43
15851Removal of sutures under anesthesia (other than local), other surgeon384.85
16000Initial treatment, first degree burn, when no more than local treatment is required287.03
16020Dressings and/or debridement of partial-thickness burns, initial or subsequent; small (less than 5% total body surface area)552.55
16025Dressings and/or debridement of partial-thickness burns, initial or subsequent; medium (eg, whole face or whole extremity, or 5% to 10% total body surface area)612.75
16030Dressings and/or debridement of partial-thickness burns, initial or subsequent; large (eg, more than 1 extremity, or greater than 10% total body surface area)733.15
16036Escharotomy; each additional incision (List separately in addition to code for primary procedure)365.5
17000Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); first lesion327.88
17003Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); second through 14 lesions, each (List separately in addition to code for first lesion)33.33
17004Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses), 15 or more lesions720.25
17110Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions445.05
17250Chemical cauterization of granulation tissue (ie, proud flesh)303.15
20103Exploration of penetrating wound (separate procedure); extremity2308.03
20520Removal of foreign body in muscle or tendon sheath; simple787.98
20550Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar "fascia")239.73
20552Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)790.13
20553Injection(s); single or multiple trigger point(s), 3 or more muscles250.48
20600Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidance225.75
20605Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance244.03
20610Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance790.13
21310Closed treatment of nasal bone fracture without manipulation790.13
21315Closed treatment of nasal bone fracture; without stabilization1077.15
21320Closed treatment of nasal bone fracture; with stabilization1026.63
21400Closed treatment of fracture of orbit, except blowout; without manipulation1359.88
21480Closed treatment of temporomandibular dislocation; initial or subsequent639.63
21800Closed treatment of rib fracture, uncomplicated, each494.5
23500Closed treatment of clavicular fracture; without manipulation857.85
23505Closed treatment of clavicular fracture; with manipulation1397.5
23540Closed treatment of acromioclavicular dislocation; without manipulation1316.45
23570Closed treatment of scapular fracture; without manipulation911.6
23600Closed treatment of proximal humeral (surgical or anatomical neck) fracture; without manipulation1271.73
23605Closed treatment of proximal humeral (surgical or anatomical neck) fracture; with manipulation, with or without skeletal traction3291.65
23650Closed treatment of shoulder dislocation, with manipulation; without anesthesia2900.35
23655Closed treatment of shoulder dislocation, with manipulation; requiring anesthesia1584.55
23930Incision and drainage, upper arm or elbow area; deep abscess or hematoma1430.83
24200Removal of foreign body, upper arm or elbow area; subcutaneous552.55
24500Closed treatment of humeral shaft fracture; without manipulation1391.05
24530Closed treatment of supracondylar or transcondylar humeral fracture, with or without intercondylar extension; without manipulation1492.1
24560Closed treatment of humeral epicondylar fracture, medial or lateral; without manipulation1250.23
24565Closed treatment of humeral epicondylar fracture, medial or lateral; with manipulation3762.5
24576Closed treatment of humeral condylar fracture, medial or lateral; without manipulation1313.65
24600Treatment of closed elbow dislocation; without anesthesia1465.23
24605Treatment of closed elbow dislocation; requiring anesthesia2743.4
24640Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation953.53
24650Closed treatment of radial head or neck fracture; without manipulation1012.65
24655Closed treatment of radial head or neck fracture; with manipulation2805.75
24670Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid process[es]); without manipulation1134.13
24800Arthrodesis, elbow joint; local3377.65
25028Incision and drainage, forearm and/or wrist; deep abscess or hematoma2112.38
25500Closed treatment of radial shaft fracture; without manipulation1041.68
25505Closed treatment of radial shaft fracture; with manipulation4353.23
25530Closed treatment of ulnar shaft fracture; without manipulation1007.28
25560Closed treatment of radial and ulnar shaft fractures; without manipulation1059.95
25565Closed treatment of radial and ulnar shaft fractures; with manipulation4353.75
25600Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; without manipulation1039.53
25605Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; with manipulation2281.15
25622Closed treatment of carpal scaphoid (navicular) fracture; without manipulation1180.35
25630Closed treatment of carpal bone fracture (excluding carpal scaphoid [navicular]); without manipulation, each bone1201.85
25650Closed treatment of ulnar styloid fracture1255.6
26010Drainage of finger abscess; simple1012.65
26011Drainage of finger abscess; complicated (eg, felon)1529.73
26415Excision of extensor tendon, with implantation of synthetic rod for delayed tendon graft, hand or finger, each rod2915.4
26600Closed treatment of metacarpal fracture, single; without manipulation, each bone1114.78
26605Closed treatment of metacarpal fracture, single; with manipulation, each bone1256.68
26607Closed treatment of metacarpal fracture, with manipulation, with external fixation, each bone1813.53
26670Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; without anesthesia1323.33
26700Closed treatment of metacarpophalangeal dislocation, single, with manipulation; without anesthesia1266.35
26720Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; without manipulation, each1859.75
26725Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; with manipulation, with or without skin or skeletal traction, each3060.53
26742Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; with manipulation, each1475.98
26750Closed treatment of distal phalangeal fracture, finger or thumb; without manipulation, each1864.05
26755Closed treatment of distal phalangeal fracture, finger or thumb; with manipulation, each2757.38
26770Closed treatment of interphalangeal joint dislocation, single, with manipulation; without anesthesia2581.08
26775Closed treatment of interphalangeal joint dislocation, single, with manipulation; requiring anesthesia1512.53
27301Incision and drainage, deep abscess, bursa, or hematoma, thigh or knee region2703.63
27501Closed treatment of supracondylar or transcondylar femoral fracture with or without intercondylar extension, without manipulation2076.9
27508Closed treatment of femoral fracture, distal end, medial or lateral condyle, without manipulation2132.8
27520Closed treatment of patellar fracture, without manipulation1264.2
27560Closed treatment of patellar dislocation; without anesthesia1497.48
27620Arthrotomy, ankle, with joint exploration, with or without biopsy, with or without removal of loose or foreign body1923.18
27650Repair, primary, open or percutaneous, ruptured Achilles tendon;2810.05
27750Closed treatment of tibial shaft fracture (with or without fibular fracture); without manipulation1364.18
27752Closed treatment of tibial shaft fracture (with or without fibular fracture); with manipulation, with or without skeletal traction2186.55
27760Closed treatment of medial malleolus fracture; without manipulation1313.65
27780Closed treatment of proximal fibula or shaft fracture; without manipulation1183.58
27786Closed treatment of distal fibular fracture (lateral malleolus); without manipulation1248.08
27808Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); without manipulation1307.2
27810Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); with manipulation1914.58
27818Closed treatment of trimalleolar ankle fracture; with manipulation1972.63
27824Closed treatment of fracture of weight bearing articular portion of distal tibia (eg, pilon or tibial plafond), with or without anesthesia; without manipulation1245.93
27840Closed treatment of ankle dislocation; without anesthesia1475.98
28190Removal of foreign body, foot; subcutaneous983.63
28192Removal of foreign body, foot; deep1875.88
28400Closed treatment of calcaneal fracture; without manipulation982.55
28430Closed treatment of talus fracture; without manipulation926.65
28470Closed treatment of metatarsal fracture; without manipulation, each2094.1
28490Closed treatment of fracture great toe, phalanx or phalanges; without manipulation639.63
28495Closed treatment of fracture great toe, phalanx or phalanges; with manipulation689.08
28510Closed treatment of fracture, phalanx or phalanges, other than great toe; without manipulation, each639.63
28515Closed treatment of fracture, phalanx or phalanges, other than great toe; with manipulation, each639.63
28540Closed treatment of tarsal bone dislocation, other than talotarsal; without anesthesia201.32
28630Closed treatment of metatarsophalangeal joint dislocation; without anesthesia606.3
28660Closed treatment of interphalangeal joint dislocation; without anesthesia449.35
29049Application, cast; figure-of-eight561.13
29085Application, cast; hand and lower forearm (gauntlet)316.8
29105Application of long arm splint (shoulder to hand)604.15
29125Application of short arm splint (forearm to hand); static325.73
29126Application of short arm splint (forearm to hand); dynamic405.5
29130Application of finger splint; static (foam)325.73
29131Application of finger splint; dynamic372.24
29240Strapping; shoulder (eg, Velpeau)237.58
29260Strapping; elbow or wrist363.03
29280Strapping; hand or finger190.08
29505Application of long leg splint (thigh to ankle or toes)440.75
29515Application of short leg splint (calf to foot)508.48
29530Strapping; knee211.78
29540Strapping; ankle and/or foot (Do not report 29540 in conjunction with 29581)163.15
29550Strapping; toes146.2
29580Strapping; Unna boot39.6
29700Removal or bivalving; gauntlet, boot or body cast258
29799Unlisted procedure, casting or strapping409.85
30300Removal foreign body, intranasal; office type procedure906.23
30901Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method434.3
30903Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method794.43
30905Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial985.78
31500Intubation, endotracheal, emergency procedure624.58
31505Laryngoscopy, indirect; diagnostic (separate procedure)342.93
31525Laryngoscopy direct, with or without tracheoscopy; diagnostic, except newborn1646.9
31575Laryngoscopy, flexible; diagnostic342.93
31720Catheter aspiration (separate procedure); nasotracheal228.98
32551Tube thoracostomy, includes connection to drainage system (eg, water seal), when performed, open (separate procedure)3171.25
36000Introduction of needle or intracatheter, vein119.33
36410Venipuncture, age 3 years or older, necessitating the skill of a physician or other qualified health care professional (separate procedure), for diagnostic or therapeutic purposes (not to be used for routine venipuncture)87.08
36415Collection of venous blood by venipuncture58.05
36416Collection of capillary blood specimen (eg, finger, heel, ear stick)65.58
36556Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older3171.25
36569Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump; age 5 years or older1114.78
36575Repair of tunneled or non-tunneled central venous access catheter, without subcutaneous port or pump, central or peripheral insertion site675.1
36591Collection of blood specimen from a completely implantable venous access device96.75
36592Collection of blood specimen using established central or peripheral catheter, venous, not otherwise specified106.43
37195Thrombolysis, cerebral, by intravenous infusion591.25
40650Repair lip, full thickness; vermilion only1701.73
40652Repair lip, full thickness; up to half vertical height1994.13
40654Repair lip, full thickness; over one-half vertical height, or complex2348.88
40830Closure of laceration, vestibule of mouth; 2.5 cm or less997.6
40831Closure of laceration, vestibule of mouth; over 2.5 cm or complex1151.33
41250Repair of laceration 2.5 cm or less; floor of mouth and/or anterior two-thirds of tongue959.98
41800Drainage of abscess, cyst, hematoma from dentoalveolar structures949.23
42330Sialolithotomy; submandibular (submaxillary), sublingual or parotid, uncomplicated, intraoral1151.33
42700Incision and drainage abscess; peritonsillar1536.18
42809Removal of foreign body from pharynx708.43
43752Naso- or oro-gastric tube placement, requiring physician's skill and fluoroscopic guidance (includes fluoroscopy, image documentation and report)187.05
43753Gastric intubation and aspiration(s) therapeutic, necessitating physician's skill (eg, for gastrointestinal hemorrhage), including lavage if performed225.75
43760Change of gastrostomy tube, percutaneous, without imaging or endoscopic guidance1505
43999Unlisted procedure, stomach704.13
45005Incision and drainage of submucosal abscess, rectum1028.78
46040Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure)3020.75
46050Incision and drainage, perianal abscess, superficial992.23
46083Incision of thrombosed hemorrhoid, external741.75
46230Excision of multiple external papillae or tags, anus1056.73
46320Excision of thrombosed hemorrhoid, external559
46500Injection of sclerosing solution, hemorrhoids422.48
46600Anoscopy; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)334.33
46608Anoscopy; with removal of foreign body884.73
49580Repair umbilical hernia, younger than age 5 years; reducible1380.3
49585Repair umbilical hernia, age 5 years or older; reducible1835.03
51700Bladder irrigation, simple, lavage and/or instillation334.33
51701Insertion of non-indwelling bladder catheter (eg, straight catheterization for residual urine)338.63
51702Insertion of temporary indwelling bladder catheter; simple (eg, Foley)338.63
51703Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/balloon)617.05
51798Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging89.23
54700Incision and drainage of epididymis, testis and/or scrotal space (eg, abscess or hematoma)1224.43
55100Drainage of scrotal wall abscess1224.43
56405Incision and drainage of vulva or perineal abscess470.85
56420Incision and drainage of Bartholin's gland abscess534.28
57415Removal of impacted vaginal foreign body (separate procedure) under anesthesia (other than local)690.15
62270Spinal puncture, lumbar, diagnostic1757.63
64400Injection, anesthetic agent; trigeminal nerve, any division or branch790.13
64402Injection, anesthetic agent; facial nerve470.85
64405Injection, anesthetic agent; greater occipital nerve352.6
64450Injection, anesthetic agent; other peripheral nerve or branch1757.63
65205Removal of foreign body, external eye; conjunctival superficial463.33
65210Removal of foreign body, external eye; conjunctival embedded (includes concretions), subconjunctival, or scleral nonperforating557.93
65220Removal of foreign body, external eye; corneal, without slit lamp1064.25
65222Removal of foreign body, external eye; corneal, with slit lamp309.6
67700Blepharotomy, drainage of abscess, eyelid1027.7
68040Expression of conjunctival follicles (eg, for trachoma)268.75
69000Drainage external ear, abscess or hematoma; simple742.83
69020Drainage external auditory canal, abscess941.7
69200Removal foreign body from external auditory canal; without general anesthesia497.73
69205Removal foreign body from external auditory canal; with general anesthesia426.78
69209Removal impacted cerumen using irrigation/lavage, unilateral334.33
69210Removal impacted cerumen requiring instrumentation, unilateral251.55
70030Radiologic examination, eye, for detection of foreign body121.48
70100Radiologic examination, mandible; partial, less than 4 views261.23
70110Radiologic examination, mandible; complete, minimum of 4 views387
70130Radiologic examination, mastoids; complete, minimum of 3 views per side234.35
70140Radiologic examination, facial bones; less than 3 views204.25
70150Radiologic examination, facial bones; complete, minimum of 3 views1404.1
70160Radiologic examination, nasal bones, complete, minimum of 3 views734.45
70200Radiologic examination; orbits, complete, minimum of 4 views306.38
70210Radiologic examination, sinuses, paranasal, less than 3 views127.93
70220Radiologic examination, sinuses, paranasal, complete, minimum of 3 views734.45
70250Radiologic examination, skull; less than 4 views1404.1
70260Radiologic examination, skull; complete, minimum of 4 views313.9
70320Radiologic examination, teeth; complete, full mouth187.05
70330Radiologic examination, temporomandibular joint, open and closed mouth; bilateral374.1
70360Radiologic examination; neck, soft tissue734.45
70450Computed tomography, head or brain; without contrast material1404.1
70460Computed tomography, head or brain; with contrast material(s)2988.41
70470Computed tomography, head or brain; without contrast material, followed by contrast material(s) and further sections2988.41
70480Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material1591
70481Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s)2988.41
70482Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material, followed by contrast material(s) and further sections3180.93
70486Computed tomography, maxillofacial area; without contrast material1591
70487Computed tomography, maxillofacial area; with contrast material(s)2988.41
70488Computed tomography, maxillofacial area; without contrast material, followed by contrast material(s) and further sections2897.13
70490Computed tomography, soft tissue neck; without contrast material1591
70491Computed tomography, soft tissue neck; with contrast material(s)2988.41
70492Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections2988.41
70496Computed tomographic angiography, head, with contrast material(s), including noncontrast images, if performed, and image postprocessing2988.41
70498Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing3672.2
71010Radiologic examination, chest; single view, frontal146.2
71020Radiologic examination, chest, 2 views, frontal and lateral;201.03
71022Radiologic examination, chest, 2 views, frontal and lateral; with oblique projections197.8
71030Radiologic examination, chest, complete, minimum of 4 views;197.8
71035Radiologic examination, chest, special views (eg, lateral decubitus, Bucky studies)150.5
71045Radiologic examination, chest; single view734.45
71046Radiologic examination, chest; 2 views734.45
71047Radiologic examination, chest; 3 views233.28
71048Radiologic examination, chest; 4 or more views271.98
71100Radiologic examination, ribs, unilateral; 2 views734.45
71101Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views1404.1
71110Radiologic examination, ribs, bilateral; 3 views387
71111Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views222.53
71120Radiologic examination; sternum, minimum of 2 views734.45
71130Radiologic examination; sternoclavicular joint or joints, minimum of 3 views161.25
71250Computed tomography, thorax; without contrast material1591
71260Computed tomography, thorax; with contrast material(s)2988.41
71270Computed tomography, thorax; without contrast material, followed by contrast material(s) and further sections2988.41
71275Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if performed, and image postprocessing3516.33
72020Radiologic examination, spine, single view, specify level204.25
72040Radiologic examination, spine, cervical; 2 or 3 views734.45
72050Radiologic examination, spine, cervical; 4 or 5 views1404.1
72052Radiologic examination, spine, cervical; 6 or more views387
72070Radiologic examination, spine; thoracic, 2 views1404.1
72072Radiologic examination, spine; thoracic, 3 views387
72074Radiologic examination, spine; thoracic, minimum of 4 views387
72080Radiologic examination, spine; thoracolumbar junction, minimum of 2 views153.73
72100Radiologic examination, spine, lumbosacral; 2 or 3 views1404.1
72110Radiologic examination, spine, lumbosacral; minimum of 4 views387
72114Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views308.53
72120Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views387
72125Computed tomography, cervical spine; without contrast material1591
72126Computed tomography, cervical spine; with contrast material5396.22
72127Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections1942.53
72128Computed tomography, thoracic spine; without contrast material1591
72129Computed tomography, thoracic spine; with contrast material2257.5
72130Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections2847.68
72131Computed tomography, lumbar spine; without contrast material1591
72132Computed tomography, lumbar spine; with contrast material5396.22
72133Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections2811.13
72170Radiologic examination, pelvis; 1 or 2 views1404.1
72190Radiologic examination, pelvis; complete, minimum of 3 views173.08
72191Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing3672.2
72192Computed tomography, pelvis; without contrast material1404.1
72193Computed tomography, pelvis; with contrast material(s)2988.41
72194Computed tomography, pelvis; without contrast material, followed by contrast material(s) and further sections2721.9
72202Radiologic examination, sacroiliac joints; 3 or more views359.05
72220Radiologic examination, sacrum and coccyx, minimum of 2 views734.45
73000Radiologic examination; clavicle, complete734.45
73010Radiologic examination; scapula, complete1404.1
73020Radiologic examination, shoulder; 1 view734.45
73030Radiologic examination, shoulder; complete, minimum of 2 views734.45
73050Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction156.95
73060Radiologic examination; humerus, minimum of 2 views734.45
73070Radiologic examination, elbow; 2 views734.45
73080Radiologic examination, elbow; complete, minimum of 3 views734.45
73090Radiologic examination; forearm, 2 views734.45
73092Radiologic examination; upper extremity, infant, minimum of 2 views121.48
73100Radiologic examination, wrist; 2 views734.45
73110Radiologic examination, wrist; complete, minimum of 3 views734.45
73120Radiologic examination, hand; 2 views1404.1
73130Radiologic examination, hand; minimum of 3 views734.45
73140Radiologic examination, finger(s), minimum of 2 views734.45
73200Computed tomography, upper extremity; without contrast material1591
73201Computed tomography, upper extremity; with contrast material(s)1536.18
73202Computed tomography, upper extremity; without contrast material, followed by contrast material(s) and further sections1959.73
73502Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views734.45
73510Radiologic examination, hip, unilateral; complete, minimum of 2 views405.28
73520Radiologic examination, hips, bilateral, minimum of 2 views of each hip, including anteroposterior view of pelvis169.85
73550Radiologic examination, femur, 2 views197.8
73552Radiologic examination, femur; minimum 2 views734.45
73560Radiologic examination, knee; 1 or 2 views734.45
73562Radiologic examination, knee; 3 views734.45
73564Radiologic examination, knee; complete, 4 or more views1404.1
73590Radiologic examination; tibia and fibula, 2 views734.45
73592Radiologic examination; lower extremity, infant, minimum of 2 views124.7
73600Radiologic examination, ankle; 2 views734.45
73610Radiologic examination, ankle; complete, minimum of 3 views734.45
73620Radiologic examination, foot; 2 views734.45
73630Radiologic examination, foot; complete, minimum of 3 views734.45
73650Radiologic examination; calcaneus, minimum of 2 views734.45
73660Radiologic examination; toe(s), minimum of 2 views734.45
73700Computed tomography, lower extremity; without contrast material1591
73701Computed tomography, lower extremity; with contrast material(s)2988.41
73702Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections1964.03
73706Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing2988.41
74000Radiologic examination, abdomen; single anteroposterior view158.03
74010Radiologic examination, abdomen; anteroposterior and additional oblique and cone views648.23
74018Radiologic examination, abdomen; 1 view734.45
74019Radiologic examination, abdomen; 2 views1404.1
74020Radiologic examination, abdomen; complete, including decubitus and/or erect views281.65
74021Radiologic examination, abdomen; 3 or more views1404.1
74022Radiologic examination, abdomen; complete acute abdomen series, including supine, erect, and/or decubitus views, single view chest1404.1
74150Computed tomography, abdomen; without contrast material1404.1
74160Computed tomography, abdomen; with contrast material(s)2233.85
74170Computed tomography, abdomen; without contrast material, followed by contrast material(s) and further sections2627.3
74174Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if performed, and image postprocessing3535.68
74175Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and image postprocessing3672.2
74176Computed tomography, abdomen and pelvis; without contrast material2899.73
74177Computed tomography, abdomen and pelvis; with contrast material(s)2988.41
74178Computed tomography, abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions3504.5
74190Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation380.55
74410Urography, infusion, drip technique and/or bolus technique;483.75
75574Computed tomographic angiography, heart, coronary arteries and bypass grafts (when present), with contrast material, including 3D image postprocessing (including evaluation of cardiac structure and morphology, assessment of cardiac function, and evaluatio3230.38
76010Radiologic examination from nose to rectum for foreign body, single view, child121.48
763763D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; not requiring image postprocessing on an independent works496.65
76512Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non-quantitative A-scan)1404.1
76536Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation955.68
76645Ultrasound, breast(s) (unilateral or bilateral), real time with image documentation724.55
76700Ultrasound, abdominal, real time with image documentation; complete1404.1
76705Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)1404.1
76770Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete977.18
76775Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited369.8
76801Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; single or first gestation1404.1
76802Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal approach; each additional gestation (List separately in addition to code for primary procedure)756.8
76805Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, after first trimester (> or = 14 weeks 0 days), transabdominal approach; single or first gestation983.63
76815Ultrasound, pregnant uterus, real time with image documentation, limited (eg, fetal heart beat, placental location, fetal position and/or qualitative amniotic fluid volume), 1 or more fetuses1404.1
76817Ultrasound, pregnant uterus, real time with image documentation, transvaginal1404.1
76830Ultrasound, transvaginal1404.1
76856Ultrasound, pelvic (nonobstetric), real time with image documentation; complete1404.1
76857Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles)1404.1
76870Ultrasound, scrotum and contents1404.1
76882Ultrasound, limited, joint or other nonvascular extremity structure(s) (eg, joint space, peri-articular tendon[s], muscle[s], nerve[s], other soft tissue structure[s], or soft tissue mass[es]), real-time with image documentation1404.1
76942Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation2702.61
77777Interstitial radiation source application; intermediate2543.45
78630Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography1360.95
80047Basic metabolic panel (Calcium, ionized) This panel must include the following: Calcium, ionized (82330) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium (84132) Sodium (84295) Urea Nitrogen (BUN) (84520)258
80048Basic metabolic panel (Calcium, total) This panel must include the following: Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium (84132) Sodium (84295) Urea nitrogen (BUN) (84520)123.45
80050General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated (85027) and388.08
80051Electrolyte panel This panel must include the following: Carbon dioxide (bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295)102.4
80053Comprehensive metabolic panel154.2
80061Lipid panel This panel must include the following: Cholesterol, serum, total (82465) Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) (83718) Triglycerides (84478)195.47
80074Acute hepatitis panel This panel must include the following: Hepatitis A antibody (HAAb), IgM antibody (86709) Hepatitis B core antibody (HBcAb), IgM antibody (86705) Hepatitis B surface antigen (HBsAg) (87340) Hepatitis C antibody (86803)695.43
80076Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alanine amino (ALT) (SGPT) (84460) Transferase, aspartate am110.73
80100Drug screen, qualitative; multiple drug classes chromatographic method, each procedure95.68
80101Drug screen, qualitative; single drug class method (eg, immunoassay, enzyme assay), each drug class89.23
80104Drug screen, qualitative; multiple drug classes other than chromatographic method, each procedure95.68
80156Carbamazepine; total197.8
80158Cyclosporine74.18
80160Desipramine93.53
80162Digoxin; total193.81
80164Valproic acid (dipropylacetic acid); total184.9
80166Doxepin98.9
80174Imipramine93.53
80178Lithium89.23
80182Nortriptyline87.08
80184Phenobarbital74.18
80185Phenytoin; total193.46
80194Quinidine74.18
80196Salicylate46.23
80198Theophylline206.46
80202Vancomycin184.9
80299Acetaminophen Level87.08
80305Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay [eg, dipsticks, cups, cards, or cartridges]), includes sample validation when p213.93
80306Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; read by instrument assisted direct optical observation (eg, utilizing immunoassay [eg, dipsticks, cups, cards, or cartridges]), includes sample validation when per212.38
80320Alcohols199.95
80329Analgesics, non-opioid; 1 or 2225.75
81000Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, with microscopy16.13
81001Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy16.13
81002Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; non-automated, without microscopy41.15
81003Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy32.76
81005Urinalysis; qualitative or semiquantitative, except immunoassays12.9
81025Urine pregnancy test, by visual color comparison methods101.81
81050Volume measurement for timed collection, each11.83
82003Acetaminophen130.08
82009Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative25.8
82010Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative119.31
82040Albumin; serum, plasma or whole blood72.25
82043Albumin; urine (eg, microalbumin), quantitative39.78
82055Alcohol (ethanol); any specimen except breath59.13
82075Alcohol (ethanol), breath70.95
82085Aldolase65.58
82103Alpha-1-antitrypsin; total87.08
82105Alpha-fetoprotein (AFP); serum74.18
82108Aluminum164.48
82128Amino acids; multiple, qualitative, each specimen89.23
82131Amino acids; single, quantitative, each specimen110.73
82150Amylase94.6
82164Angiotensin I - converting enzyme (ACE)95.68
82232Beta-2 microglobulin106.43
82247Bilirubin; total73.2
82248Bilirubin; direct68.8
82270Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening (ie, patient was provided 3 cards or single triple card for consecutive collection)22.58
82272Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening50.02
82274Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations104.28
82306Vitamin D; 25 hydroxy, includes fraction(s), if performed368.73
82310Calcium; total34.4
82330Calcium; ionized87.08
82360Calculus; quantitative analysis, chemical82.78
82374Carbon dioxide (bicarbonate)33.33
82378Carcinoembryonic antigen (CEA)124.7
82390Ceruloplasmin70.95
82397Chemiluminescent assay191.35
82435Chloride; blood30.1
82465Cholesterol, serum or whole blood, total27.95
82480Cholinesterase; serum50.53
82482Cholinesterase; RBC50.53
82491Chromatography, quantitative, column (eg, gas liquid or HPLC); single analyte not elsewhere specified, single stationary and mobile phase245.1
82533Cortisol; total237.92
82540Creatine30.1
82550Creatine kinase (CK), (CPK); total95.07
82553Creatine kinase (CK), (CPK); MB fraction only168.62
82565Creatinine; blood74.85
82570Creatinine; other source34.4
82575Creatinine; clearance61.28
82607Cyanocobalamin (Vitamin B-12);74.18
82626Dehydroepiandrosterone (DHEA)164.48
82670Estradiol378.4
82671Estrogens; fractionated208.55
82672Estrogens; total139.75
82677Estriol156.95
82690Ethchlorvynol89.23
82728Ferritin185.98
82746Folic acid; serum74.18
82747Folic acid; RBC112.88
82784Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each59.13
82800Gases, blood, pH only183.83
82803Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation);308.28
82805Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation); with O2 saturation, by direct measurement, except pulse oximetry931.46
82810Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry204.25
82945Glucose, body fluid, other than blood57.35
82947Glucose; quantitative, blood (except reagent strip)57.35
82948Glucose; blood, reagent strip59.6
82962Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically for home use38.79
82977Glutamyltransferase, gamma (GGT)105.12
83001Gonadotropin; follicle stimulating hormone (FSH)251.55
83002Gonadotropin; luteinizing hormone (LH)250.48
83015Heavy metal (eg, arsenic, barium, beryllium, bismuth, antimony, mercury); qualitative, any number of analytes120.4
83036Hemoglobin; glycosylated (A1C)141.78
83090Homocysteine110.73
83516Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; qualitative or semiquantitative, multiple step method75.25
83540Iron87.08
83550Iron binding capacity118.25
83605Lactate (lactic acid)155.97
83615Lactate dehydrogenase (LD), (LDH);88.1
83630Lactoferrin, fecal; qualitative126.85
83655Lead79.55
83690Lipase100.63
83718Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol)39.78
83719Lipoprotein, direct measurement; VLDL cholesterol75.25
83721Lipoprotein, direct measurement; LDL cholesterol129
83735Magnesium97.79
83835Metanephrines37.63
83872Mucin, synovial fluid (Ropes test)26.88
83874Myoglobin188.61
83880Natriuretic peptide495.47
83970Parathormone (parathyroid hormone)266.6
84035Phenylketones, qualitative80.63
84075Phosphatase, alkaline;75.56
84100Phosphorus inorganic (phosphate);65.58
84119Porphyrins, urine; qualitative37.63
84132Potassium; serum, plasma or whole blood62.35
84144Progesterone283.8
84146Prolactin125.78
84152Prostate specific antigen (PSA); complexed (direct measurement)249.4
84153Prostate specific antigen (PSA); total120.4
84155Protein, total, except by refractometry; serum, plasma or whole blood53.57
84156Protein, total, except by refractometry; urine68.8
84157Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid)49.45
84166Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, CSF)260.27
84295Sodium; serum, plasma or whole blood65.58
84402Testosterone; free164.48
84403Testosterone; total351.53
84425Thiamine (Vitamin B-1)137.6
84436Thyroxine; total46.23
84439Thyroxine; free131.61
84443Thyroid stimulating hormone (TSH)245.37
84450Transferase; aspartate amino (AST) (SGOT)75.56
84460Transferase; alanine amino (ALT) (SGPT)77.34
84466Transferrin79.55
84478Triglycerides37.63
84479Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR)94.36
84480Triiodothyronine T3; total (TT-3)207.06
84481Triiodothyronine T3; free247.38
84484Troponin, quantitative147.46
84520Urea nitrogen; quantitative57.71
84550Uric acid; blood65.98
84681C-peptide303.9
84702Gonadotropin, chorionic (hCG); quantitative219.83
84703Gonadotropin, chorionic (hCG); qualitative109.85
84999Unlisted chemistry procedure176.3
85007Blood count; blood smear, microscopic examination with manual differential WBC count12.9
85009Blood count; manual differential WBC count, buffy coat50.53
85014Blood count; hematocrit (Hct)34.65
85018Blood count; hemoglobin (Hgb)34.65
85025Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count113.4
85027Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count)94.36
85032Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each232.2
85044Blood count; reticulocyte, manual25.8
85045Blood count; reticulocyte, automated58.3
85049Blood count; platelet, automated23.65
85240Clotting; factor VIII (AHG), 1-stage74.18
85250Clotting; factor IX (PTC or Christmas)74.18
85300Clotting inhibitors or anticoagulants; antithrombin III, activity78.48
85348Coagulation time; other methods13.98
85378Fibrin degradation products, D-dimer; qualitative or semiquantitative47.3
85379Fibrin degradation products, D-dimer; quantitative148.52
85380Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for venous thromboembolism), qualitative or semiquantitative47.3
85384Fibrinogen; activity54.83
85610Prothrombin time;57.35
85651Sedimentation rate, erythrocyte; non-automated23.65
85652Sedimentation rate, erythrocyte; automated39.38
85730Thromboplastin time, partial (PTT); plasma or whole blood81.7
86000Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky Mountain spotted fever, scrub typhus), each antigen23.65
86003Allergen specific IgE; quantitative or semiquantitative, crude allergen extract, each33.33
86038Antinuclear antibodies (ANA);55.9
86039Antinuclear antibodies (ANA); titer72.03
86060Antistreptolysin 0; titer47.3
86140C-reactive protein;75.56
86141C-reactive protein; high sensitivity (hsCRP)83.85
86147Cardiolipin (phospholipid) antibody, each Ig class137.6
86156Cold agglutinin; screen44.08
86157Cold agglutinin; titer53.75
86277Growth hormone, human (HGH), antibody103.2
86308Heterophile antibodies; screening75.56
86309Heterophile antibodies; titer43
86316Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 549), each133.3
86318Immunoassay for infectious agent antibody, qualitative or semiquantitative, single step method (eg, reagent strip)213.91
86325Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration70.95
86376Microsomal antibodies (eg, thyroid or liver-kidney), each197.8
86403Particle agglutination; screen, each antibody137.6
86430Rheumatoid factor; qualitative77.4
86431Rheumatoid factor; quantitative25.8
86480Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon91.38
86490Skin test; coccidioidomycosis27.95
86510Skin test; histoplasmosis27.95
86580Skin test; tuberculosis, intradermal78.48
86592Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART)62.32
86609Antibody; bacterium, not elsewhere specified83.85
86611Antibody; Bartonella33.33
86617Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot or immunoblot)209.63
86618Antibody; Borrelia burgdorferi (Lyme disease)232.2
86631Antibody; Chlamydia172.65
86635Antibody; Coccidioides33.33
86644Antibody; cytomegalovirus (CMV)93.53
86658Antibody; enterovirus (eg, coxsackie, echo, polio)113.95
86663Antibody; Epstein-Barr (EB) virus, early antigen (EA)83.85
86664Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA)207.48
86674Antibody; Giardia lamblia199.95
86677Antibody; Helicobacter pylori211.79
86694Antibody; herpes simplex, non-specific type test93.53
86695Antibody; herpes simplex, type 1178.45
86696Antibody; herpes simplex, type 2261.23
86701Antibody; HIV-1120.4
86703Antibody; HIV-1 and HIV-2, single result66.65
86704Hepatitis B core antibody (HBcAb); total164.48
86705Hepatitis B core antibody (HBcAb); IgM antibody161.25
86706Hepatitis B surface antibody (HBsAb)70.95
86708Hepatitis A antibody (HAAb)167.7
86709Hepatitis A antibody (HAAb), IgM antibody152.65
86710Antibody; influenza virus87.08
86713Antibody; Legionella93.53
86735Antibody; mumps116.1
86747Antibody; parvovirus96.75
86756Antibody; respiratory syncytial virus188.14
86759Antibody; rotavirus215.57
86762Antibody; rubella93.53
86765Antibody; rubeola83.85
86777Antibody; Toxoplasma93.53
86778Antibody; Toxoplasma, IgM173.08
86787Antibody; varicella-zoster110.73
86788Antibody; West Nile virus, IgM110.73
86789Antibody; West Nile virus63.43
86800Thyroglobulin antibody215
86803Hepatitis C antibody;193.5
86804Hepatitis C antibody; confirmatory test (eg, immunoblot)98.9
86812HLA typing; A, B, or C (eg, A10, B7, B27), single antigen148.35
86900Blood typing, serologic; ABO41.93
86901Blood typing, serologic; Rh (D)107.5
86906Blood typing, serologic; Rh phenotyping, complete376.04
87040Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate)150.65
87045Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, KIA, LIA), Salmonella and Shigella species127.93
87046Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each plate137.88
87070Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates125.82
87073Culture, bacterial; quantitative, anaerobic with isolation and presumptive identification of isolates, any source except urine, blood or stool25.8
87075Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates138.23
87076Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate109.65
87077Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate61.28
87081Culture, presumptive, pathogenic organisms, screening only;96.73
87086Culture, bacterial; quantitative colony count, urine117.78
87088Culture, bacterial; with isolation and presumptive identification of each isolate, urine109.65
87102Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood)27.95
87103Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood56.98
87110Culture, chlamydia, any source286.05
87116Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any source, with isolation and presumptive identification of isolates78.48
87177Ova and parasites, direct smears, concentration and identification148.35
87186Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration [MIC] or breakpoint), each multi-antimicrobial, per plate117.18
87205Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types62.32
87206Smear, primary source with interpretation; fluorescent and/or acid fast stain for bacteria, fungi, parasites, viruses or cell types27.95
87207Smear, primary source with interpretation; special stain for inclusion bodies or parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses)55.9
87209Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hemotoxylin) for ova and parasites262.4
87210Smear, primary source with interpretation; wet mount for infectious agents (eg, saline, India ink, KOH preps)68.82
87220Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or ectoparasite ova or mites (eg, scabies)58.05
87230Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin)288.18
87252Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect185.98
87255Virus isolation; including identification by non-immunologic method, other than by cytopathic effect (eg, virus specific enzymatic activity)459.03
87265Infectious agent antigen detection by immunofluorescent technique; Bordetella pertussis/parapertussis163.4
87274Infectious agent antigen detection by immunofluorescent technique; Herpes simplex virus type 1163.4
87275Infectious agent antigen detection by immunofluorescent technique; influenza B virus78.48
87276Infectious agent antigen detection by immunofluorescent technique; influenza A virus78.48
87280Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus163.4
87299Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism224.68
87324Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; Clostridium difficile toxin78.48
87328Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; cryptosporidium163.4
87339Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; Helicobacter pylori78.48
87340Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; hepatitis B surface antigen68.8
87400Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; Influenza, A or B, each78.48
87400Infectious agent antigen detection by enzyme immunoassay technique, Influenza A78.48
87400Infectious agent antigen detection by enzyme immunoassay technique, Influenza B78.48
87420Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; respiratory syncytial virus78.48
87425Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; rotavirus224.68
87430Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; Streptococcus, group A163.4
87450Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]), qualitative or semiquantitative; single step method, not otherwise specified, eac61.28
87490Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique292.79
87491Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique512.38
87522Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, quantification, includes reverse transcription when performed275.2
87529Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, amplified probe technique476.23
87530Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification384.85
87590Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique271.98
87591Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique512.38
87621Infectious agent detection by nucleic acid (DNA or RNA); papillomavirus, human, amplified probe technique226.83
87798Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism476.23
87804Infectious agent antigen detection by immunoassay with direct optical observation; Influenza195.7
87807Infectious agent antigen detection by immunoassay with direct optical observation; respiratory syncytial virus175.01
87808Infectious agent antigen detection by immunoassay with direct optical observation; Trichomonas vaginalis180.8
87850Infectious agent antigen detection by immunoassay with direct optical observation; Neisseria gonorrhoeae290.42
87880Infectious agent antigen detection by immunoassay with direct optical observation; Streptococcus, group A195.47
89050Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood68.94
89051Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count74.18
89055Leukocyte assessment, fecal, qualitative or semiquantitative62.32
89060Crystal identification by light microscopy with or without polarizing lens analysis, tissue or any body fluid (except urine)104.41
90471Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)251.55
90472Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); each additional vaccine (single or combination vaccine/toxoid) (List separately in addition to code for primary procedure)125.78
90655Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.25 mL dosage, for intramuscular use139.75
90656Influenza virus vaccine, trivalent (IIV3), split virus, preservative free, 0.5 mL dosage, for intramuscular use44.08
90658Influenza virus vaccine, trivalent (IIV3), split virus, 0.5 mL dosage, for intramuscular use44.08
90700Diphtheria, tetanus toxoids, and acellular pertussis vaccine (DTaP), when administered to individuals younger than 7 years, for intramuscular use184.9
90703Tetanus toxoid adsorbed, for intramuscular use84.93
90714Tetanus and diphtheria toxoids adsorbed (Td), preservative free, when administered to individuals 7 years or older, for intramuscular use106.43
90715Tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap), when administered to individuals 7 years or older, for intramuscular use144.05
90732Pneumococcal polysaccharide vaccine, 23-valent (PPSV23), adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use116.1
92002Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; intermediate, new patient314.98
92081Visual field examination, unilateral or bilateral, with interpretation and report; limited examination (eg, tangent screen, Autoplot, arc perimeter, or single stimulus level automated test, such as Octopus 3 or 7 equivalent)224.68
92551Screening test, pure tone, air only47.3
92552Pure tone audiometry (threshold); air only96.75
92950Cardiopulmonary resuscitation (eg, in cardiac arrest)1884.48
93000Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report106.43
93005Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report81.7
93010Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only49.45
93040Rhythm ECG, 1-3 leads; with interpretation and report72.03
93041Rhythm ECG, 1-3 leads; tracing only without interpretation and report182.75
93042Rhythm ECG, 1-3 leads; interpretation and report only37.63
93880Duplex scan of extracranial arteries; complete bilateral study819.15
93922Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus bidirectional, Doppler waveform recording516
93926Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study524.6
93965Noninvasive physiologic studies of extremity veins, complete bilateral study (eg, Doppler waveform analysis with responses to compression and other maneuvers, phleborheography, impedance plethysmography)523.53
93970Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study840.65
93971Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study923.43
93975Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; complete study704.13
93976Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and/or retroperitoneal organs; limited study462.25
94010Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation145.13
94060Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration553.63
94150Vital capacity, total (separate procedure)103.2
94375Respiratory flow volume loop380.55
94640Pressurized or nonpressurized inhalation treatment for acute airway obstruction for therapeutic purposes and/or for diagnostic purposes such as sputum induction with an aerosol generator, nebulizer, metered dose inhaler or intermittent positive pressure b602
94644Continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour602
94645Continuous inhalation treatment with aerosol medication for acute airway obstruction; each additional hour (List separately in addition to code for primary procedure)125.78
94664Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or IPPB device65.58
94750Pulmonary compliance study (eg, plethysmography, volume and pressure measurements)313.9
94760Noninvasive ear or pulse oximetry for oxygen saturation; single determination33.33
94761Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations (eg, during exercise)51.6
95115Professional services for allergen immunotherapy not including provision of allergenic extracts; single injection44.08
95117Professional services for allergen immunotherapy not including provision of allergenic extracts; 2 or more injections53.75
96360Intravenous infusion, hydration; initial, 31 minutes to 1 hour618.13
96361Intravenous infusion, hydration; each additional hour (List separately in addition to code for primary procedure)150.5
96365Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour690.15
96366Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)187.05
96367Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); additional sequential infusion of a new drug/substance, up to 1 hour (List separately in addition to code for primary procedure)167.7
96368Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); concurrent infusion (List separately in addition to code for primary procedure)176.3
96370Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)68.8
96372Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular251.55
96374Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance/drug564.38
96375Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug (List separately in addition to code for primary procedure)222.53
96376Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of the same substance/drug provided in a facility (List separately in addition to code for primary procedure)87.08
97124Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion)104.28
97597Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound274.13
97598Debridement (eg, high pressure waterjet with/without suction, sharp selective debridement with scissors, scalpel and forceps), open wound, (eg, fibrin, devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical application(s), wound338.63
97802Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes130.08
98925Osteopathic manipulative treatment (OMT); 1-2 body regions involved126.85
99000Handling and/or conveyance of specimen for transfer from the office to a laboratory36.55
99001Handling and/or conveyance of specimen for transfer from the patient in other than an office to a laboratory (distance may be indicated)36.55
99050Services provided in the office at times other than regularly scheduled office hours, or days when the office is normally closed (eg, holidays, Saturday or Sunday), in addition to basic service56.98
99051Service(s) provided in the office during regularly scheduled evening, weekend, or holiday office hours, in addition to basic service36.55
99053After hours service226.83
99058Service(s) provided on an emergency basis in the office, which disrupts other scheduled office services, in addition to basic service106.43
99070Supplies and materials (except spectacles), provided by the physician or other qualified health care professional over and above those usually included with the office visit or other services rendered (list drugs, trays, supplies, or materials provided)264.45
99080Special reports such as insurance forms, more than the information conveyed in the usual medical communications or standard reporting form53.75
99143Moderate sedation services (other than those services described by codes 00100-01999) provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the pre793.35
99144Moderate sedation services (other than those services described by codes 00100-01999) provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the pre793.35
99145Moderate sedation services (other than those services described by codes 00100-01999) provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the pre439.68
99148Moderate sedation services (other than those services described by codes 00100-01999), provided by a physician or other qualified health care professional other than the health care professional performing the diagnostic or therapeutic service that the se793.35
99149Moderate sedation services (other than those services described by codes 00100-01999), provided by a physician or other qualified health care professional other than the health care professional performing the diagnostic or therapeutic service that the se168.78
99150Moderate sedation services (other than those services described by codes 00100-01999), provided by a physician or other qualified health care professional other than the health care professional performing the diagnostic or therapeutic service that the se65.58
99151Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the m860
99155Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; initial 15 min168.78
99173Screening test of visual acuity, quantitative, bilateral22.58
99201Office visit for new patient, straightforward210.7
99202Office visit for new patient, straightforward299.93
99203Office visit for new patient, low complexity.435.38
99204Office visit new patient, comprehensive examination675.1
99205Office visit new patient, comprehensive examination849.25
99211Office visit established patient, minimal.210.7
99212Office visit established patient, problem focused210.7
99213Office visit established patient, expanded problem293.48
99214Office visit established patient, detailed history437.53
99215Office visit established patient, comprehensive591.25
99217Observation care discharge day management (This code is to be utilized to report all services provided to a patient on discharge from outpatient hospital "observation status" if the discharge is on other than the initial date of "observation status." To r303.15
99241Office consultation new or established patient, problem focused215
99242Office consultation new or established patient, problem focused409.58
99243Office consultation new or established patient, detailed556.85
99244Office consultation new or established patient, comprehensive823.45
99245Office consultation new or established patient, complex1007.28
99281Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. Counseling and/or coordination of care317.13
99282Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of low complexity. Counseling and/o779.38
99283Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of moderate complexity. Counseling1402.88
99284Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: A detailed history; A detailed examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with o2520.88
99285Emergency department visit for the evaluation and management of a patient, which requires these 3 key components within the constraints imposed by the urgency of the patient's clinical condition and/or mental status: A comprehensive history; A comprehensi3450.75
99291Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes5122.38
99292Critical care, evaluation and management of the critically ill or critically injured patient; each additional 30 minutes (List separately in addition to code for primary service)1242.7
99354Prolonged evaluation and management or psychotherapy service(s) (beyond the typical service time of the primary procedure) in the office or other outpatient setting requiring direct patient contact beyond the usual service; first hour (List separately in416.03
99355Prolonged evaluation and management or psychotherapy service(s) (beyond the typical service time of the primary procedure) in the office or other outpatient setting requiring direct patient contact beyond the usual service; each additional 30 minutes (Lis416.03
99381Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnos402.05
99382Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnos440.75
99383Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnos439.68
99384Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnos477.3
99385Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnos477.3
99386Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnos557.93
99387Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnos613.83
99391Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diag338.63
99392Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diag378.4
99393Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diag377.33
99394Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diag416.03
99395Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diag417.1
99396Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diag455.8
99397Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diag514.93
99406Smoking and tobacco use cessation counseling visit; intermediate, greater than 3 minutes up to 10 minutes107.5
99407Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes115.03
A0396Als specialized service disposable supplies; esophageal intubation25.8
A4206Syringe with needle, sterile, 1 cc or less, each33.33
A4209Syringe with needle, sterile 5 cc or greater, each12.9
A4212Non-coring needle or stylet with or without catheter18.28
A4213Syringe, sterile, 20 cc or greater, each18.28
A4215Needle, sterile, any size, each38.7
A4216Sterile water, saline and/or dextrose, diluent/flush, 10 ml7.53
A4217Sterile water/saline, 500 ml12.9
A4222Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)367.39
A4248Chlorhexidine containing antiseptic, 1 ml33.33
A4314Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)44.08
A4316Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation87.08
A4320Irrigation tray with bulb or piston syringe, any purpose10.75
A4322Irrigation syringe, bulb or piston, each7.53
A4338Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each70.95
A4344Indwelling catheter, foley type, two-way, all silicone, each82.78
A4351Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each4.3
A4353Intermittent urinary catheter, with insertion supplies26.88
A4358Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each16.13
A4364Adhesive, liquid or equal, any type, per oz - Dermabond47.3
A4390Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each2.15
A4450Tape, non-waterproof, per 18 square inches11.83
A4495Surgical stockings thigh length, each50
A4550Surgical trays87.08
A4556Electrodes, (e.g., apnea monitor), per pair97.51
A4565Slings33.33
A4570Splint87.08
A4590Special casting material (e.g., fiberglass)127.93
A4615Cannula, nasal2.15
A4616Tubing (oxygen), per foot11.83
A4617Mouth piece12.9
A4627Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler46.23
A4649Surgical supply; miscellaneous26.88
A4673Extension line with easy lock connectors, used with dialysis18.37
A4927Gloves, non-sterile, per 1001.08
A4930Gloves, sterile, per pair8.6
A6203Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing13.98
A6204Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing11.83
A6212Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing4.3
A6216Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing4.3
A6219Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing13.98
A6222Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing3.23
A6223Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing8.6
A6250Skin sealants, protectants, moisturizers, ointments, any type, any size36.55
A6260Wound cleansers, any type, any size133.3
A6402Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing3.23
A6407Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard3.23
A6413Adhesive bandage, first-aid type, any size, each8.6
A6445Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard3.24
A6448Light compression bandage, elastic, knitted/woven, width less than three inches, per yard10.75
A6449Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard10.75
A6450Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard32.25
A6453Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard7.53
A6454Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard16.13
A6457Tubular dressing with or without elastic, any width, per linear yard8.6
A7000Canister, disposable, used with suction pump, each18.28
A7002Tubing, used with suction pump, each18.28
A7003Administration set, with small volume nonfiltered pneumatic nebulizer, disposable8.6
A7015Aerosol mask, used with dme nebulizer76.33
A7016Dome and mouthpiece, used with small volume ultrasonic nebulizer168.78
A7040One way chest drain valve25.8
A7041Water seal drainage container and tubing for use with implanted chest tube18.28
A9150Non-prescription drugs26.88
A9273Hot water bottle, ice cap or collar, heat and/or cold wrap, any type49.45
A9284Spirometer, non-electronic, includes all accessories294.55
A9900Miscellaneous dme supply, accessory, and/or service component of another hcpcs code13.98
A9150Neosporin Antibiotic Ointment foil packs26.88
J8499Acet/Tylenol #3 with Codeine, 300mg, Oral8.6
A9150Acet/Tylenol, 120mg, Suppository26.88
A9150Acet/Tylenol, 325 mg, PO26.88
A9150Acetaminophen/Tylenol, 500 mg tablet26.88
J3490Acetaminophen Childrens Oral Suspension44.08
A9150Acetaminophen/Tylenol Elixir, 160mg26.88
J8499Acet/Tylenol w/ Codeine, 12.5mg, Elixer8.6
J3490Acetaminophen Suppository44.08
A9150Activated Charcoal, 25mg with Sorbital, Suspension26.88
J3490Acyclovir 800 mg tablet (Zovirax) PO44.08
J3490Advil Children's Suspension44.08
J3490Advil Infant Drops, 15 ml44.08
A9150Afrin Nasal Spray (Oxymetazoline)26.88
99070Alligator Clamp264.45
99070Alligator Forceps264.45
J8499Alprazolam/Xanax 0.5 mg tab (PO Med)8.6
J3490Ambien 10 mg44.08
99070Ambu / Resuscitation Bag for child264.45
J3490Amidate / Etomidate 2mg, IV44.08
J3490Amlodipine besylate 5 mg tabs44.08
99070Ammonia Capsule264.45
J3490Amoxicillin 125 mg44.08
99070Arm board, for IV stabilization264.45
A9150Aspirin, 325mg, PO26.88
A9150Aspirin Tablet, 81mg PO26.88
J3490Atenolol 25 mg44.08
J8499Ativan/Lorazepam .0.5 mg. PO8.6
J3490Atorvastatin 10mg PO44.08
J8499Augmentin 875 mg tab8.6
J3490Auralgan/ Antipyrine/ Benzocaine Otic Drops44.08
B4081NG TUBING WITH STYLET33.33
J3490Bactrim DS/ Sulfamethoxazole and trimethoprim 800mg/160mg Tablet44.08
J3490Bactroban/ Mupirocin44.08
99070Basin264.45
J3490Benadryl/Diphenhydramine, 25 mg, PO44.08
J3490Benadryl / Diphenhydramine Elixir44.08
J3490Dicyclomine/ Bentyl 10mg (PO Med)44.08
99070Zinc Benzoin264.45
J3490Bicarbonate, 2 ml44.08
99070Surgical Blade - Sterile264.45
J3490Brevital, 500mg, IV44.08
99070Buretrol Tubing264.45
99070Opthalmic / Eye Burr264.45
C1751Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis)65.58
J3490Carafate/Sucralfate 1gm tablet44.08
J3490Cardene, PGBCK IV PREMIX SOD CHLORIDE 20 MG/200ML44.08
99070Cardiac Monitoring/Telemetry264.45
J3490Cardizem/Diltiazem 5mg per vial, IV44.08
J3490Cardizem / Diltiazem 25mg/5ml vial, IV44.08
J3490Carvedilol 25 mg PO44.08
99070Cautery, Micro-temp Fine Tip / Bovie264.45
J3490Cephalexin / Keflex 500MG PO44.08
J3490Cerumenex Ear Wax Remover44.08
J3490Cetacaine Spray44.08
99070Chromic sutures (Gut)264.45
99070Chux, Blue Pad264.45
J3490Cipro 500mg44.08
J3490Cipro Ophthalmic Drops44.08
J3490Clindamycin/Cleocin phosphate, 150 mg, IV/IM44.08
J3490Clindamycin/Cleocin phosphate, 200mg, IV/IM44.08
J8499Clindamycin PO 300 MG16.77
J3490Catapres/Clonidine, 0.1mg PO44.08
J3490Clopidogrel Bisulfate 75 mg44.08
99070Coban/ Co-Flex Bandage264.45
J3490Colace/Docusate44.08
J3490Cortisporin-TC Otic Suspension44.08
99070CT Injector Kit264.45
J3490Cyclogel Ophthalmic Drops44.08
J3490Cyclogyl opthamalgic drops, 1%44.08
J3490Cyclopentolate HCl Ophthalmic Drops, 1%44.08
J3490Debrox, Earwax Removal Kit44.08
J8540Dexamethasone .25 mg PO7.53
J3490Dextrose 50%, 50 ml44.08
J3490Diltiazem 20 mg44.08
J3490Donnatal Elixir, 16.2mg44.08
99070Dressing Change Tray, Sterile264.45
E0114Crutches, underarm, pair, with pads, tips and handgrips124.7
E0116Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each53.75
E0487Spirometer, electronic, includes all accessories27.95
E0585Nebulizer, with compressor and heater36.55
E1812Dynamic knee, extension/flexion device with active resistance control110.73
99070Ear Curette264.45
99070Ear Wick264.45
99070Electrodes for EKG264.45
99070Emesis Basin264.45
99070Epistat Balloon264.45
J3490Erythromycin Eye Ointment44.08
99070Ethilon 3.0 sutures264.45
99070Ethilon 4.0 sutures264.45
99070Ethilon 5.0 sutures264.45
99070Ethilon 6.0 sutures264.45
J3490Eye Wash44.08
J3490Fentanyl, 50mg, IV44.08
J3490Fentanyl, 25 mg, IV44.08
99070Intranasal Fentanyl Kit264.45
J3490Flagyl / Metronidazole, 500mg, PO44.08
J3490Adult-Fleet Enema44.08
J3490Flexerill/Cyclobenzaprine HCI, 10 mg PO44.08
J3490Flomax/Tamsulosin cap 0.5-0.4 mg44.08
J3490Fluconazole 150 MG44.08
J3490Fluor-I-Strip, 9mg, for dialation of the eye44.08
J3490Folic Acid IV44.08
G0008Administration of influenza virus vaccine53.75
G0009Administration of pneumococcal vaccine110.73
G0010Administration of hepatitis b vaccine43
G0101Cervical or vaginal cancer screening; pelvic and clinical breast examination120.4
G0102Prostate cancer screening; digital rectal examination27.95
G0105Colorectal cancer screening; colonoscopy on individual at high risk180.6
G0106Colorectal cancer screening; alternative to g0104, screening sigmoidoscopy, barium enema153.73
G0117Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist155.88
G0120Colorectal cancer screening; alternative to g0105, screening colonoscopy, barium enema.389.15
G0121Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk638.55
G0124Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician79.55
G0130Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel)34.4
G0148Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening210.7
G0168Wound closure utilizing tissue adhesive(s) only250.48
G0180Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imple179.53
G0202Screening mammography, producing direct digital image, bilateral, all views402.05
G0204Diagnostic mammography, producing direct digital image, bilateral, all views455.8
G0206Diagnostic mammography, producing direct digital image, unilateral, all views365.5
G0245Initial physician evaluation and management of a diabetic patient with diabetic sensory neuropathy resulting in a loss of protective sensation (lops) which must include: (1) the diagnosis of lops, (2) a patient history, (3) a physical examination that con210.7
G0268Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing142.98
G0341Percutaneous islet cell transplant, includes portal vein catheterization and infusion1124.45
G0364Bone marrow aspiration performed with bone marrow biopsy through the same incision on the same date of service30.1
G0365Vessel mapping of vessels for hemodialysis access (services for preoperative vessel mapping prior to creation of hemodialysis access using an autogenous hemodialysis conduit, including arterial inflow and venous outflow)39.78
G0378Hospital Observation Service, per 1 hour1864.05
G0380Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or87.08
G0381Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or176.3
G0382Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or308.53
G0383Level 4 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or394.53
G0384Level 5 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or570.83
G0389Ultrasound b-scan and/or real time with image documentation; for abdominal aortic aneurysm (aaa) screening349.38
G0434Drug screen, other than chromatographic; any number of drug classes, by clia waived test or moderate complexity test, per patient encounter95.68
J3490Gentamycin Sulfate Ointment44.08
J3490Gentamycin Opth Drops44.08
J3490Hyoscyamine Sulfate/Anaspas .125mg/5ml, PO44.08
J3490Ibuprofen 10 mg PO Peds44.08
99070Ice/Cold Pack264.45
J3490Imodium/ Loperamide PO44.08
99070Infant Sensor - Pedi Sensor264.45
J3490Integrilin / Eptifibatide, 2mg/ml, 10ml vial44.08
99070IV Pump264.45
J0131Injection, acetaminophen, 10 mg9.68
J0150Injection, adenosine for therapeutic use, 6 mg (not to be used to report any adenosine phosphate compounds, instead use a9270)220.38
J0171Injection, adrenalin, epinephrine, 0.1 mg33.33
J0282Injection, amiodarone hydrochloride, 30 mg106.43
J0290Injection, ampicillin sodium, 500 mg50.53
J0295Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm13.98
J0330Injection, succinylcholine chloride, up to 20 mg36.55
J0360Injection, hydralazine hcl, up to 20 mg49.45
J0456Injection, azithromycin, 500 mg120.4
J0461Injection, atropine sulfate, 0.01 mg24.73
J0475Injection, baclofen, 10 mg25
J0500Injection, dicyclomine hcl, up to 20 mg241.88
J0561Injection, penicillin g benzathine, 100,000 units53.75
J0570Buprenorphine implant, 74.2 mg210.7
J0610Injection, calcium gluconate, per 10 ml131.15
J0690Injection, cefazolin sodium, 500 mg70.95
J0692Injection, cefepime hydrochloride, 500 mg86
J0696Injection, ceftriaxone sodium, per 250 mg68.8
J0698Injection, cefotaxime sodium, per gm53.75
J0702Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg22.58
J0735Injection, clonidine hydrochloride, 1 mg160.18
J0744Injection, ciprofloxacin for intravenous infusion, 200 mg79.55
J0780Injection, prochlorperazine, up to 10 mg, Compazine37.63
J1020Injection, methylprednisolone acetate, 20 mg26.88
J1030Injection, methylprednisolone acetate, 40 mg53.75
J1040Injection, methylprednisolone acetate, 80 mg46.23
J1070Injection, testosterone cypionate, up to 100 mg36.55
J1094Injection, dexamethasone acetate, 1 mg34.4
J1100Injection, dexamethasone sodium phosphate, 1 mg11.83
J1170Injection, hydromorphone, up to 4 mg155.88
J1200Injection, diphenhydramine hcl, up to 50 mg36.55
J1265Injection, dopamine hcl, 40 mg53.75
J1580Injection, garamycin, gentamicin, up to 80 mg26.88
J1610Injection, glucagon hydrochloride, per 1 mg662.9
J1630Injection, haloperidol, up to 5 mg10.75
J1631Injection, haloperidol decanoate, per 50 mg59.13
J1642Injection, heparin sodium, (heparin lock flush), per 10 units11.83
J1644Injection, heparin sodium, per 1000 units44.08
J1650Injection, enoxaparin sodium, 10 mg53.75
J1670Injection, tetanus immune globulin, human, up to 250 units79.55
J1720Injection, hydrocortisone sodium succinate, up to 100 mg43
J1815Injection, insulin, per 5 units44.08
J1885Injection, ketorolac tromethamine, per 15 mg44.08
J1940Injection, furosemide, up to 20 mg36.55
J1956Injection, levofloxacin, 250 mg (Levaquin)131.15
J1980Injection, hyoscyamine sulfate, up to 0.25 mg (Levsin)87.08
J1990Injection, chlordiazepoxide hcl, up to 100 mg15
J2001Injection, lidocaine hcl for intravenous infusion, 10 mg36.55
J2060Injection, lorazepam/Ativan, 2 mg36.55
J2175Injection, meperidine hydrochloride, per 100 mg131.15
J2180Injection, meperidine and promethazine hcl, up to 50 mg4.3
J2250Injection, Versed/midazolam hydrochloride, per 1 mg16.13
J2270Injection, morphine sulfate, up to 10 mg131.15
J2300Injection, nalbuphine hydrochloride, per 10 mg10.75
J2310Injection, Narcan/naloxone hydrochloride, per 1 mg80.63
J2360Injection, Norflex/Orphenadrine citrate, up to 60 mg36.55
J2405Injection, ondansetron hydrochloride, per 1 mg50.53
J2543Injection,Zosyn/Piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams)22.58
J2545Pentamidine isethionate, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 300 mg56.98
J2550Injection, Phenergan/Promethazine hcl, up to 50 mg70.95
J2690Injection, procainamide hcl, up to 1 gm3.23
J2704Injection, propofol, 10 mg23.65
J2765Injection, Metoclopramide hcl, up to 10 mg (Reglan)44.08
J2780Injection, Zantac/Ranitidine hydrochloride, 25 mg36.55
J2920Injection, methylprednisolone sodium succinate, up to 40 mg16.13
J2930Injection, methylprednisolone sodium succinate, up to 125 mg87.08
J2997Injection, alteplase recombinant, 1 mg118.25
J3010Injection, fentanyl citrate, 0.1 mg139.75
J3030Injection,Imitrex/Sumatriptan succinate, 6 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)247.25
J3105Injection, terbutaline sulfate, up to 1 mg50.53
J3250Injection, trimethobenzamide hcl, up to 200 mg15.05
J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg (Kenalog)10.75
J3360Injection, Valium/Diazepam, up to 5 mg44.08
J3370Injection, Vancomycin hcl, 500 mg43
J3410Injection, Atarax/Hydroxyzine hcl, up to 25 mg21.5
J3411Injection, thiamine hcl, 100 mg87.08
J3475Injection, magnesium sulfate, per 500 mg36.55
J3480Injection, potassium chloride, per 2 meq3.23
J3490Unclassified drugs44.08
J7030Infusion, normal saline solution , 1000 cc62.35
J7040Infusion, normal saline solution, sterile (500 ml = 1 unit)41.93
J70425% dextrose/normal saline (500 ml = 1 unit)70.95
J7050Infusion, normal saline solution, 250 cc39.78
J70605% dextrose/water (500 ml = 1 unit)70.95
J7070Infusion, d5w, 1000 cc16.13
J7120Ringers lactate infusion, up to 1000 cc36.55
J7506Prednisone, oral, per 5mg3.23
J7510Prednisolone oral, per 5 mg4.3
J7512Prednisone, immediate release or delayed release, oral, 1 mg3.23
J7609Albuterol, inhalation solution, compounded product, administered through dme, unit dose, 1 mg22.58
J7610Albuterol, inhalation solution, compounded product, administered through dme, concentrated form, 1 mg44.08
J7611Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg16.13
J7612Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 0.5 mg16.13
J7613Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg44.08
J7614Levalbuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 0.5 mg44.08
J7620Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme7.53
J7638Dexamethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram10.75
J7644Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram16.13
J7699Noc drugs, inhalation solution administered through dme38.7
J8499Prescription drug, oral, non chemotherapeutic, nos13.55
J8540Dexamethasone, oral, 0.25 mg7.53
99070Katz Extractor (i.e. for Nasal foreign body)264.45
J3490Kayexalate / Sodium Polystyrene, Susp 15g/6m44.08
J3490KDur / Potassium, 40 meq, oral44.08
J3490Ketamine 10 mg IV/IM44.08
J3490Ketamine, 100 mg/ml, IV/IM44.08
J3490Ketamine, 20 mg, for sedation, IV/IM44.08
J3490Ketamine, 40 mg, IV/IM44.08
J3490Ketamine 5 mg IV/IM44.08
J3490Ketamine, 50 mg, IV/IM44.08
J3490Kexalate, Kionex PO44.08
L0120Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)36.55
L0174Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf41.93
L1830KO; Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf139.75
L1902Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf519.17
L3260Surgical boot/shoe, each44.08
L3650Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf36.55
L3660Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf23.65
L3807Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise65.58
L3908Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf44.08
L3913Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment36.55
L3923Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise729.93
L3980Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment729.93
L3982Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment507.4
L3984Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment507.4
L3999Upper limb orthosis, not otherwise specified36.55
L4350Ankle Brace; Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf (AIR SPLINT)566.53
L4360Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise331.1
L4361Walking boot, pneumatic and/or vacuum, with or without joints167.7
L4386Walking boot, non-pneumatic, with or without joints180.6
J3490Labetalol HCI, 5mg/ml, IV44.08
J3490Lactulose 10mg/15ml44.08
J3490Lasix/Furosemide, 20mg, PO44.08
J3490Levaquin/Levofloxacin, 250 mg tablet (oral)44.08
J3490Levaquin/Levofloxacin, 500mg tablet (oral)44.08
J3490Levaquin 750mg PO44.08
J3490Levophed/Norepinephrine 1MG/ML28.8
J8499Hyoscyamine Sulfate 0.125 mg tablet8.6
J3490Lidocaine 1% with EPI, 20ml, IV44.08
J3490Lidocaine HCL, MDV 1%, 10ml44.08
J3490Lidocaine 2%, 10ml, IV44.08
J3490Lidocaine 2%, 20ml44.08
J3490Lidocaine 2% with EPI44.08
J3490Lidocaine 4%, 250ml, IV44.08
J3490Lidocaine 4%, 50ml, topical solution44.08
J3490Lisinopril 10 mg tab PO44.08
J3490Lomotil, 2.5 mg, oral44.08
J3490Lopressor/Metoprolol Tartrate 25 mg oral44.08
J3490Lopressor/Metoprolol Tartrate 50 mg oral44.08
S5001Lortab 10mg/500mg PO6.45
S5000Loratadine (Claritin) 10 mg PO3.23
J3490Lortab, 7.5/500 mg (oral)44.08
J3490Losartan 50 mg PO44.08
J3490Mylanta/Maalox (oral)44.08
J3490Macrobid 100 mg44.08
J3490Magnesium citrate, 1 bottle44.08
J3490Marcaine/Bupivacaine EPI INJ SDV 10ML .5%37
99070Marcaine / Bupivicaine 0.25% 10 ml SDV264.45
99070Marcaine 0.5%, 50 ml, single vial264.45
99070Mastisol 2/3cc264.45
J3490Meclizine / Dramamine / Antivert, 25 mg, oral44.08
99070Merocel264.45
J3490Metoprolol 50 mg tabs PO44.08
J3490Metoprolol Tartrate / Lopressor, 1mg/ml, IV44.08
J3490Midazolam (Versed) 3mg intranasal36
99070Miller Blade264.45
99070Morgan Lens Delivery Set264.45
99070Morgan Lens Medi Flow264.45
J3490Motrin/Ibuprofen tablet, 200mg, coated (oral)44.08
J3490Motrin / Ibuprofen, Children's Elixir44.08
J3490Mucinex 600 mg44.08
J3490Mucomyst44.08
J3490MVI44.08
99070Nasal Speculum Currette264.45
J3490Neosporin eye drops44.08
J3490Neomycin Hydrocortisone Otic Drops44.08
J3490Neo-Synephrine44.08
99070Nitro Tubing264.45
J3490Nitro-Bid, ointment 2%, 1gm44.08
J3490Nitroglycerin, 0.2mg/250ml, IV44.08
J3490Nitroglycerin paste, 1" strip44.08
J3490Nitroquick SL, 0.4mg tablet44.08
J3490Norco 5/325 mg44.08
J3490Norvasc 5 mg tab44.08
99070Nonrebreather oxygen mask264.45
J3490Normal saline solution / Sodium Chloride, 100 ml44.08
J3490Normal saline 0.9%, 250 ml bottle, for irrigation44.08
99070Oxygen each additional hour264.45
99070Oxygen First Hour264.45
J3490Orapred / Oral Prednisone, for kids44.08
99070Paper tape264.45
99070Pedialyte264.45
J3490Pedi-Fleet Enema, 2.2oz44.08
99070Pelvic Tray (for Female Pelvic Exams)264.45
J3490Famotidine/Pepcid, 10 mg, oral44.08
J3490Famotidine/Pepcid, 20 mg, oral44.08
A9150Pepto Bismol Caplets PO26.88
A9150Pepto Bismol caps PO26.88
J3490Phenegan/Promethazine HCI Rectal Suppository, 12.5 mg44.08
J3490Phenegan/Promethazine HCI Rectal Suppository, 25 mg44.08
J3490Phenergan/Promethazine Suppository 50 mg each44.08
J3490Phenegan/Promethazine HCI, 25 mg, oral44.08
J3490Phenergan/Promethazine HCI, 50 mg, oral44.08
99070Nitrazine ( PH ) test strips264.45
J3490Plavix / Clopidogrel, 75mg, oral44.08
99070Pleur-Evac System Adult Single Use Sterile264.45
J3490Polytrim Opthalmic, Polymyxin44.08
POSTOPPostoperative Recheck (Suture Removal, Wound Recheck, etc)0
J3490Potassium 60mg PO44.08
J3490Potassium Chloride, 10 meq, oral44.08
J3490Potassium Chloride ER, 20 mg, oral44.08
J3490Prelone syrup, less than 1 tsp, oral44.08
99070Primary tubing for IV264.45
99070Prolene 3.0 sutures264.45
99070Prolene 4.0 sutures264.45
99070Prolene 5.0 sutures264.45
99070Prolene 6.0 sutures264.45
J3490Proparacaine HCl / Alcaine Opth Drops44.08
J3490Protonix / Pantoprazole Sodium 40 mg, oral44.08
J3490Proventil Tabs 10 MG oral44.08
J8499Provera Tablet up to 10 mg8.6
99070Pump tubing for IV264.45
J3490Pyridium/Phenazopyridine, 200MG PO44.08
Q0035Cardiokymography66.65
Q0091Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory124.7
Q0111Wet mounts, including preparations of vaginal, cervical or skin specimens77.4
Q0144Azithromycin dihydrate, oral, capsules/powder, 1 gram189.2
Q0163Diphenhydramine hydrochloride, 50 mg, oral,7.53
Q2009Injection, fosphenytoin, 50 mg phenytoin equivalent80.63
Q4005Cast supplies, long arm cast, adult (11 years +), plaster176.3
Q4006Cast supplies, long arm cast, adult (11 years +), fiberglass176.3
Q4007Cast supplies, long arm cast, pediatric (0-10 years), plaster176.3
Q4008Cast supplies, long arm cast, pediatric (0-10 years), fiberglass176.3
Q4009Cast supplies, short arm cast, adult (11 years +), plaster176.3
Q4010Cast supplies, short arm cast, adult (11 years +), fiberglass176.3
Q4011Cast supplies, short arm cast, pediatric (0-10 years), plaster176.3
Q4012Cast supplies, short arm cast, pediatric (0-10 years), fiberglass176.3
Q4014Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass87.08
Q4016Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass87.08
Q4017Cast supplies, long arm splint, adult (11 years +), plaster176.3
Q4018Cast supplies, long arm splint, adult (11 years +), fiberglass176.3
Q4019Cast supplies, long arm splint, pediatric (0-10 years), plaster176.3
Q4020Cast supplies, long arm splint, pediatric (0-10 years), fiberglass176.3
Q4022Cast supplies, short arm splint, adult (11 years +), fiberglass118.25
Q4024Cast supplies, short arm splint, pediatric (0-10 years), fiberglass61.28
Q4029Cast supplies, long leg cast, adult (11 years +), plaster176.3
Q4031Cast supplies, long leg cast, pediatric (0-10 years), plaster176.3
Q4032Cast supplies, long leg cast, pediatric (0-10 years), fiberglass255.85
Q4037Cast supplies, short leg cast, adult (11 years +), plaster176.3
Q4038Cast supplies, short leg cast, adult (11 years +), fiberglass127.93
Q4039Cast supplies, short leg cast, pediatric (0-10 years), plaster176.3
Q4040Cast supplies, short leg cast, pediatric (0-10 years), fiberglass137.6
Q4046Cast supplies, short leg splint, adult (11 years +), fiberglass115.03
Q4048Cast supplies, short leg splint, pediatric (0-10 years), fiberglass176.3
Q4049Finger splint, static44.08
Q9954Oral magnetic resonance contrast agent, per 100 ml612.75
Q9963High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml7.53
Q9965Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml7.53
Q9967Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml7.53
99070Quick Clot264.45
J3490Racemic EPI, 2.25%, inhalation44.08
J8499Reglan up to 10 mg PO8.6
99070Nasal rapid rhino rocket (supplies)264.45
J3490Robaxin44.08
J3490Robitussin44.08
J3490Romazicon/Flumazenil, 0.1mg, IV44.08
S0020Injection, bupivicaine hydrochloride, 30 ml36.55
S0028Injection, famotidine, 20 mg106.43
S0030Injection, metronidazole, 500 mg (Flagyl)87.08
S0039Injection, sulfamethoxazole and trimethoprim, 10 ml36.55
S0077Injection, clindamycin phosphate, 300 mg87.08
S0119Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code)49.45
S0164Injection, pantoprazole sodium, 40 mg292.4
S0630Removal of sutures; by a physician other than the physician who originally closed the wound176.3
S2083Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline704.13
S5000Prescription drug, generic3.23
S5001Prescription drug, brand name6.45
S50115% dextrose in lactated ringer's, 1000 ml4.3
S8120Oxygen contents, gaseous, 1 unit equals 1 cubic foot38.7
S8450Splint, prefabricated, digit (specify digit by use of modifier)41.93
S8451Splint, prefabricated, wrist or ankle79.55
S9088Services provided in an urgent care center (list in addition to code for service)439.68
99070Saline locks for IV264.45
99070Schuknecht Foreign Body Remover264.45
99070Secondary Tubing for IV264.45
99070Silk 0 for sutures264.45
J3490Silvadene Cream 1%, 20gm44.08
J3490Silver Nitrate44.08
J3490Silver Sulfadiazine 1% cream44.08
J8499Skelaxin 800mg PO5.81
J3490Sodium Bicarbonate, 8.4%, 50 ml, 1meq/mL44.08
99070Staples264.45
99070Defibrillator Pad / Stat Pad, F/Zoll PD 1200 ADLT264.45
99070Steri Strips 1/2"264.45
99070Urine strain cup264.45
J3490Succsodonate44.08
99070Surgicel264.45
99070Swab, sterile264.45
J3490Tamiflu44.08
J3490Artificial Tears44.08
99070Tegaderm264.45
J3490Tessalon Perles 20 mg PO44.08
J3490Tetracaine opthalmic drops 5%44.08
J8499Tigan, 100mg suppository8.6
J3490Tobramycin Sulfate Opth Drops44.08
J3490Tobrex44.08
99070Tono Pen Tip264.45
J3490Tranexamic Acid 100mg PO18.21
99070Transpore Tape264.45
99070Trocar Catheter264.45
99070Urine Specimen Cup264.45
J8499Ultram 50 mg PO8.6
99070Urine Collection Hat264.45
V2797Vision supply, accessory and/or service component of another hcpcs vision code44.08
J8499Valium/Diazepam, 10mg tablet (oral)8.6
J8499Valium/Diazepam, 5mg tablet (oral)8.6
J3490Valsartan 80 mg PO44.08
J3490Vasopressin, Mdv 20u/ml 1ml44.08
J3490Enalapril, Vasotec IV med 1 ml44.08
J8499VazoTuss, 10cc, oral8.6
J3490Verapamil 2.5 mg/ml44.08
J3490Vecuronium Bromide, 10mg, IV44.08
99070Vicryl 4.0 for sutures264.45
99070Vicryl 5.0 for sutures264.45
99070Vicryl 6.0 for sutures264.45
J8499Vicodin/Hydrocodone 5/500mg (oral)8.6
A9150Viscous Lidocaine, for topical use26.88
A9150Viscous Lidocaine, 10 ml, PO26.88
99070Word Bartholin Catheter264.45
99070Yankaur Suction264.45
J3490Zantac ( RANITIDINE) 150 mg PO44.08
J8499Zithromax / Azithromycin dihydrate, oral, up to 500 mg8.6
A9150Zyrtec, Oral, 10mg tablet26.88
CPT – 87635COVID-19 Testing (Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), amplified probe technique)427.31

“At Star ER, physicians and staff are dedicated to providing the most up-to-date care in a facility that is second-to-none. Everything we do is patient-centric. Lubbock deserves timely and personal emergency medicine care.”