Pennsylvania Bulletin

PA Bulletin, Doc. No. 07-2316a

[37 Pa.B. 6610]
[Saturday, December 15, 2007]

[Continued from previous Web Page]

Procedure Code Procedure Code Description Assistant Surgeon Fee Revision (Billing with Modifier 80) Professional Component Fee Revision (Billing with Modifier 26) Technical Component Fee Revision (Billing with Modifier TC) Billing with No Modifier or Pricing Modifiers U6, U7, U8, U9, SU or TH Billing with NU (New) or RR (Rental) Modifiers

22842 POSTERIOR SEGMENTAL INSTRUMENTATION (EG, PEDICLE FIXATION, DUAL RODS WITH MULTIPLE HOOKS AND SUBLAMINAR WIRES); 3 TO 6 VERTEBRAL SEGMENTS $115.23 N/A N/A $720.21 N/A

22843 POSTERIOR SEGMENTAL INSTRUMENTATION (EG, PEDICLE FIXATION, DUAL RODS WITH MULTIPLE HOOKS AND SUBLAMINAR WIRES); 7 TO 12 VERTEBRAL SEGMENTS $121.48 N/A N/A $759.28 N/A

22844 POSTERIOR SEGMENTAL INSTRUMENTATION (EG, PEDICLE FIXATION, DUAL RODS WITH MULTIPLE HOOKS AND SUBLAMINAR WIRES); 13 OR MORE VERTEBRAL SEGMENTS $149.85 N/A N/A $936.54 N/A

22845 ANTERIOR INSTRUMENTATION; 2 TO 3 VERTEBRAL SEGMENTS $110.17 N/A N/A $688.59 N/A

22847 ANTERIOR INSTRUMENTATION; 8 OR MORE VERTEBRAL SEGMENTS $125.84 N/A N/A $786.51 N/A

22848 PELVIC FIXATION (ATTACHMENT OF CAUDAL END OF INSTRUMENTATION TO PELVIC BONY STRUCTURES) OTHER THAN SACRUM $54.55 N/A N/A $340.92 N/A

23105 ARTHROTOMY; GLENOHUMERAL JOINT, WITH SYNOVECTOMY, WITH OR WITHOUT BIOPSY N/A N/A N/A $563.37 N/A

23106 ARTHROTOMY; STERNOCLAVICULAR JOINT, WITH SYNOVECTOMY, WITH OR WITHOUT BIOPSY N/A N/A N/A $420.81 N/A

23107 ARTHROTOMY, GLENOHUMERAL JOINT, WITH JOINT EXPLORATION, WITH OR WITHOUT REMOVAL OF LOOSE OR FOREIGN BODY $93.91 N/A N/A $586.96 N/A

23210 RADICAL RESECTION FOR TUMOR; SCAPULA $129.85 N/A N/A $811.54 N/A

23921 DISARTICULATION OF SHOULDER; SECONDARY CLOSURE OR SCAR REVISION N/A N/A N/A $387.15 N/A

24100 ARTHROTOMY, ELBOW; WITH SYNOVIAL BIOPSY ONLY N/A N/A N/A $348.12 N/A

24152 RADICAL RESECTION FOR TUMOR, RADIAL HEAD OR NECK $103.47 N/A N/A $646.69 N/A

24153 RADICAL RESECTION FOR TUMOR, RADIAL HEAD OR NECK; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT) N/A N/A N/A $607.06 N/A

24155 RESECTION OF ELBOW JOINT (ARTHRECTOMY) $119.59 N/A N/A $747.43 N/A

24361 ARTHROPLASTY, ELBOW; WITH DISTAL HUMERAL PROSTHETIC REPLACEMENT $143.96 N/A N/A $899.77 N/A

24365 ARTHROPLASTY, RADIAL HEAD $90.93 N/A N/A $568.34 N/A

24366 ARTHROPLASTY, RADIAL HEAD; WITH IMPLANT $97.44 N/A N/A $609.02 N/A

24931 AMPUTATION, ARM THROUGH HUMERUS; WITH IMPLANT $116.86 N/A N/A $730.37 N/A

24935 STUMP ELONGATION, UPPER EXTREMITY N/A N/A N/A $902.19 N/A

25335 CENTRALIZATION OF WRIST ON ULNA (EG, RADIAL CLUB HAND) N/A N/A N/A $868.09 N/A

25574 OPEN TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES, WITH INTERNAL OR EXTERNAL FIXATION; OF RADIUS OR ULNA $85.27 N/A N/A $532.91 N/A

25820 ARTHRODESIS, WRIST; LIMITED, WITHOUT BONE GRAFT (EG, INTERCARPAL OR RADIOCARPAL) $87.80 N/A N/A $548.77 N/A

26030 DRAINAGE OF PALMAR BURSA; MULTIPLE BURSA N/A N/A N/A $427.74 N/A

26125 FASCIECTOMY, PARTIAL PALMAR WITH RELEASE OF SINGLE DIGIT INCLUDING PROXIMAL INTERPHALANGEAL JOINT, WITH OR WITHOUT Z-PLASTY, OTHER LOCAL TISSUE REARRANGEMENT OR SKIN GRAFTING (INCLUDES OBTAINING GRAFT); EACH ADDITIONAL DIGIT (LIST SEPARATELY IN ADDITION TO PRIMARY PROCEDURE) N/A N/A N/A $257.07 N/A

26510 CROSS INTRINSIC TRANSFER, EACH TENDON $90.76 N/A N/A $567.25 N/A

26531 ARTHROPLASTY, METACARPOPHALANGEAL JOINT; WITH PROSTHETIC IMPLANT, EACH JOINT $87.04 N/A N/A $544.03 N/A

26536 ARTHROPLASTY, INTERPHALANGEAL JOINT; WITH PROSTHETIC IMPLANT, EACH JOINT $91.96 N/A N/A $574.77 N/A

26591 REPAIR, INTRINSIC MUSCLES OF HAND, EACH MUSCLE N/A N/A N/A $428.12 N/A

26861 ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR WITHOUT INTERNAL FIXATION; EACH ADDITIONAL INTERPHALANGEAL JOINT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) N/A N/A N/A $97.38 N/A

26863 ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR WITHOUT INTERNAL FIXATION; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT), EACH ADDITIONAL JOINT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) N/A N/A N/A $217.65 N/A

27036 CAPSULECTOMY OR CAPSULOTOMY, HIP, WITH OR WITHOUT EXCISION OF HETEROTOPIC BONE, WITH RELEASE OF HIP FLEXOR MUSCLES (IE, GLUTEUS MEDIUS, GLUTEUS MINIMUS, TENSOR FASCIA LATAE, RECTUS FEMORIS, SARTORIUS, ILIOPSOAS) N/A N/A N/A $885.44 N/A

27054 ARTHROTOMY WITH SYNOVECTOMY, HIP JOINT N/A N/A N/A $598.45 N/A

27071 PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION) (EG, OSTEOMYELITIS OR BONE ABSCESS); DEEP (SUBFASCIAL OR INTRAMUSCULAR) $129.44 N/A N/A $808.98 N/A

27096 INJECTION PROCEDURE FOR SACROILIAC JOINT, ARTHROGRAPHY AND/ OR ANESTHETIC/STEROID N/A N/A N/A $61.46 N/A

27178 OPEN TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; CLOSED MANIPULATION WITH SINGLE OR MULTIPLE PINNING $125.71 N/A N/A $785.69 N/A

27256 TREATMENT OF SPONTANEOUS HIP DISLOCATION (DEVELOPMENTAL, INCLUDING CONGENITAL OR PATHOLOGICAL), BY ABDUCTION, SPLINT OR TRACTION; WITHOUT ANESTHESIA, WITHOUT MANIPULATION N/A N/A N/A $224.03 N/A

27334 ARTHROTOMY, WITH SYNOVECTOMY, KNEE; ANTERIOR OR POSTERIOR N/A N/A N/A $600.95 N/A

27335 ARTHROTOMY, WITH SYNOVECTOMY, KNEE; ANTERIOR AND POSTERIOR INCLUDING POPLITEAL AREA N/A N/A N/A $680.09 N/A

27358 EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF FEMUR; WITH INTERNAL FIXATION (LIST IN ADDITION TO CODE FOR PRIMARY PROCEDURE) $42.70 N/A N/A $266.90 N/A

27396 TRANSPLANT, HAMSTRING TENDON TO PATELLA; SINGLE TENDON $87.23 N/A N/A $545.18 N/A

27400 TRANSFER, TENDON OR MUSCLE, HAMSTRINGS TO FEMUR (EG, EGGEROS TYPE PROCEDURE) $94.82 N/A N/A $592.63 N/A

27425 LATERAL RETINACULAR RELEASE OPEN $62.29 N/A N/A $389.32 N/A

27427 LIGAMENTOUS RECONSTRUCTION (AUGMENTATION) $101.87 N/A N/A $636.67 N/A

27438 ARTHROPLASTY, PATELLA; WITH PROSTHESIS $119.19 N/A N/A $744.93 N/A

27450 OSTEOTOMY, FEMUR, SHAFT OR SUPRACONDYLAR; WITH FIXATION $146.21 N/A N/A $913.81 N/A

27605 TENOTOMY, PERCUTANEOUS, ACHILLES TENDON (SEPARATE PROCEDURE); LOCAL ANESTHESIA N/A N/A N/A $185.88 N/A

27692 TRANSFER OR TRANSPLANT OF SINGLE TENDON (WITH MUSCLE REDIRECTION OR REROUTING); EACH ADDITIONAL TENDON (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) $16.55 N/A N/A $103.43 N/A

27700 ARTHROPLASTY, ANKLE $88.75 N/A N/A $554.71 N/A

27740 ARREST, EPIPHYSEAL (EPIPHYSIODESIS), ANY METHOD, COMBINED, PROXIMAL AND DISTAL TIBIA AND FIBULA $101.56 N/A N/A $634.76 N/A

27742 ARREST, EPIPHYSEAL (EPIPHYSIODESIS), ANY METHOD, COMBINED, PROXIMAL AND DISTAL TIBIA AND FIBULA; AND DISTAL FEMUR $96.80 N/A N/A $605.03 N/A

27756 PERCUTANEOUS SKELETAL FIXATION OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE) (EG, PINS OR SCREWS) $80.06 N/A N/A $500.40 N/A

27871 ARTHRODESIS, TIBIOFIBULAR JOINT, PROXIMAL OR DISTAL $99.13 N/A N/A $619.55 N/A

28088 SYNOVECTOMY, TENDON SHEATH, FOOT; EXTENSOR N/A N/A N/A $278.80 N/A

28110 OSTECTOMY, PARTIAL EXCISION, FIFTH METATARSAL HEAD (BUNIONETTE) (SEPARATE PROCEDURE) N/A N/A N/A $266.46 N/A

28160 HEMIPHALANGECTOMY OR INTERPHALANGEAL JOINT EXCISION, TOE, PROXIMAL END OF PHALANX, EACH N/A N/A N/A $255.30 N/A

28175 RADICAL RESECTION OF TUMOR, BONE; PHALANX OF TOE $57.44 N/A N/A $359.03 N/A

28340 RECONSTRUCTION, TOE, MACRODACTYLY; SOFT TISSUE RESECTION N/A N/A N/A $409.71 N/A

28344 RECONSTRUCTION, TOE(S); POLYDACTYLY $45.27 N/A N/A $282.96 N/A

28345 RECONSTRUCTION, TOE(S); SYNDACTYLY, WITH OR WITHOUT SKIN GRAFT(S), EACH WEB N/A N/A N/A $382.10 N/A

28456 PERCUTANEOUS SKELETAL FIXATION OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS), WITH MANIPULATION, EACH N/A N/A N/A $244.55 N/A

28496 PERCUTANEOUS SKELETAL FIXATION OF FRACTURE GREAT TOE, PHALANX OR PHALANGES, WITH MANIPULATION N/A N/A N/A $199.19 N/A

28530 CLOSED TREATMENT OF SESAMOID FRACTURE N/A N/A N/A $89.62 N/A

28725 ARTHRODESIS; SUBTALAR $117.76 N/A N/A $736.03 N/A

29000 APPLICATION OF HALO TYPE BODY CAST (SEE 20661--20663 FOR INSERTION) N/A N/A N/A $149.17 N/A

29010 APPLICATION OF RISSER JACKET, LOCALIZER, BODY; ONLY N/A N/A N/A $140.50 N/A

29015 APPLICATION OF RISSER JACKET, LOCALIZER, BODY; INCLUDING HEAD N/A N/A N/A $144.44 N/A

29020 APPLICATION OF TURNBUCKLE JACKET, BODY; ONLY N/A N/A N/A $129.75 N/A

29025 APPLICATION OF TURNBUCKLE JACKET, BODY; INCLUDING HEAD N/A N/A N/A $156.41 N/A

29035 APPLICATION OF BODY CAST, SHOULDER TO HIPS N/A N/A N/A $121.77 N/A

29086 APPLICATION, CAST; FINGER (EG, CONTRACTURE) N/A N/A N/A $40.46 N/A

29131 APPLICATION OF FINGER SPLINT; DYNAMIC N/A N/A N/A $28.04 N/A

29200 STRAPPING; THORAX N/A N/A N/A $34.83 N/A

29260 STRAPPING; ELBOW OR WRIST N/A N/A N/A $31.38 N/A

29325 APPLICATION OF HIP SPICA CAST; ONE AND ONE-HALF SPICA OR BOTH LEGS N/A N/A N/A $156.32 N/A

29435 APPLICATION OF PATELLAR TENDON BEARING (PTB) CAST N/A N/A N/A $77.02 N/A

29445 APPLICATION OF RIGID TOTAL CONTACT LEG CAST N/A N/A N/A $101.64 N/A

29520 STRAPPING; HIP N/A N/A N/A $34.89 N/A

29730 WINDOWING OF CAST N/A N/A N/A $40.99 N/A

29819 ARTHROSCOPY, SHOULDER, SURGICAL; WITH REMOVAL OF LOOSE BODY OR FOREIGN BODY $83.93 N/A N/A $524.57 N/A

29820 ARTHROSCOPY, SHOULDER, SURGICAL; SYNOVECTOMY, PARTIAL $77.40 N/A N/A $483.74 N/A

29821 ARTHROSCOPY, SHOULDER, SURGICAL; SYNOVECTOMY, COMPLETE $84.64 N/A N/A $528.97 N/A

29822 ARTHROSCOPY, SHOULDER, SURGICAL; DEBRIDEMENT, LIMITED $82.27 N/A N/A $514.18 N/A

29825 ARTHROSCOPY, SHOULDER, SURGICAL; WITH LYSIS AND RESECTION OF ADHESIONS, WITH OR WITHOUT MANIPULATION $83.82 N/A N/A $523.88 N/A

29834 ARTHROSCOPY, ELBOW, SURGICAL; WITH REMOVAL OF LOOSE BODY OR FOREIGN BODY $70.39 N/A N/A $439.95 N/A

29835 ARTHROSCOPY, ELBOW, SURGICAL; SYNOVECTOMY, PARTIAL $72.05 N/A N/A $450.33 N/A

29836 ARTHROSCOPY, ELBOW, SURGICAL; SYNOVECTOMY, COMPLETE $82.92 N/A N/A $518.23 N/A

29837 ARTHROSCOPY, ELBOW, SURGICAL; DEBRIDEMENT, LIMITED $75.72 N/A N/A $473.27 N/A

29838 ARTHROSCOPY, ELBOW, SURGICAL; DEBRIDEMENT, EXTENSIVE $84.81 N/A N/A $530.08 N/A

29843 ARTHROSCOPY, WRIST, SURGICAL; FOR INFECTION, LAVAGE AND DRAINAGE $67.34 N/A N/A $420.90 N/A

29844 ARTHROSCOPY, WRIST, SURGICAL; SYNOVECTOMY, PARTIAL $70.74 N/A N/A $442.12 N/A

29846 ARTHROSCOPY, WRIST, SURGICAL; EXCISION AND/OR REPAIR OF TRIANGULAR FIBROCARTILAGE AND/OR JOINT DEBRIDEMENT $74.16 N/A N/A $463.48 N/A

29850 ARTHROSCOPICALLY AIDED TREATMENT OF INTERCONDYLAR SPINE(S) AND/OR TUBEROSITY FRACTURE(S) OF THE KNEE, WITH OR WITHOUT MANIPULATION; WITHOUT INTERNAL OR EXTERNAL FIXATION (INCLUDES ARTHROSCOPY) $78.59 N/A N/A $491.21 N/A

29871 ARTHROSCOPY, KNEE, SURGICAL; FOR INFECTION, LAVAGE AND DRAINAGE N/A N/A N/A $453.28 N/A

29873 ARTHROSCOPY, KNEE, SURGICAL; WITH LATERAL RELEASE N/A N/A N/A $455.79 N/A

29874 ARTHROSCOPY, KNEE, SURGICAL; FOR REMOVAL OF LOOSE BODY OR FOREIGN BODY (EG, OSTEOCHONDRITIS DISSECANS FRAGMENTATION, CHONDRAL FRAGMENTATION) $76.15 N/A N/A $475.94 N/A

29875 ARTHROSCOPY, KNEE, SURGICAL; SYNOVECTOMY, LIMITED (EG, PLICA OR SHELF RESECTION) (SEPARATE PROCEDURE) $70.73 N/A N/A $442.07 N/A

29877 ARTHROSCOPY, KNEE, SURGICAL; DEBRIDEMENT/SHAVING OF ARTICULAR CARTILAGE (CHONDROPLASTY) $86.56 N/A N/A $541.00 N/A

29884 ARTHROSCOPY, KNEE, SURGICAL; WITH LYSIS OF ADHESIONS, WITH OR WITHOUT MANIPULATION (SEPARATE PROCEDURE) $86.23 N/A N/A $538.91 N/A

29894 ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), SURGICAL; WITH REMOVAL OF LOOSE BODY OR FOREIGN BODY $74.12 N/A N/A $463.26 N/A

29895 ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), SURGICAL; SYNOVECTOMY, PARTIAL $72.50 N/A N/A $453.11 N/A

29897 ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), SURGICAL; DEBRIDEMENT, LIMITED $76.06 N/A N/A $475.40 N/A

29898 ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), SURGICAL; DEBRIDEMENT, EXTENSIVE $84.65 N/A N/A $529.09 N/A

30150 RHINECTOMY; PARTIAL N/A N/A N/A $706.68 N/A

30160 RHINECTOMY; TOTAL $111.36 N/A N/A $696.01 N/A

30540 REPAIR FISTULA; OROMAXILLARY (COMBINE WITH 31030 IF ANTROTOMY IS INCLUDED) N/A N/A N/A $584.92 N/A

30580 REPAIR FISTULA; OROMAXILLARY (COMBINE WITH 31030 IF ANTROTOMY IS INCLUDED) N/A N/A N/A $446.62 N/A

31233 NASAL/SINUS ENDOSCOPY, DIAGNOSTIC WITH MAXILLARY SINUSOSCOPY (VIA INFERIOR MEATUS OR CANINE FOSSA PUNCTURE) $20.36 N/A N/A $127.22 N/A

31235 NASAL/SINUS ENDOSCOPY, DIAGNOSTIC WITH SPHENOID SINUSOSCOPY (VIA PUNCTURE OF SPHENOIDAL FACE OR CANNULATION OF OSTIUM) $24.28 N/A N/A $151.76 N/A

31239 NASAL/SINUS ENDOSCOPY, SURGICAL; WITH DACRYOCYSTORHINOSTOMY $94.91 N/A N/A $593.21 N/A

31240 NASAL/SINUS ENDOSCOPY, SURGICAL; WITH CONCHA BULLOSA RESECTION $24.12 N/A N/A $150.74 N/A

31255 NASAL/SINUS ENDOSCOPY, SURGICAL; WITH ETHMOIDECTOMY, TOTAL (ANTERIOR AND POSTERIOR) $61.63 N/A N/A $385.21 N/A

31276 NASAL/SINUS ENDOSCOPY, SURGICAL WITH FRONTAL SINUS EXPLORATION, WITH OR WITHOUT REMOVAL OF TISSUE FROM FRONTAL SINUS $97.17 N/A N/A $485.84 N/A

31287 NASAL/SINUS ENDOSCOPY, SURGICAL, WITH SPHENOIDOTOMY $35.39 N/A N/A $221.18 N/A

31288 NASAL/SINUS ENDOSCOPY, SURGICAL, WITH SPHENOIDOTOMY; WITH REMOVAL OF TISSUE FROM THE SPHENOID SINUS $41.06 N/A N/A $256.60 N/A

31292 NASAL/SINUS ENDOSCOPY, SURGICAL; WITH MEDIAL OR INFERIOR ORBITAL WALL DECOMPRESSION $145.64 N/A N/A $910.25 N/A

31293 NASAL/SINUS ENDOSCOPY, SURGICAL; WITH MEDIAL ORBITAL WALL AND INFERIOR ORBITAL WALL DECOMPRESSION $158.58 N/A N/A $991.14 N/A

31511 LARYNGOSCOPY, INDIRECT; WITH REMOVAL OF FOREIGN BODY N/A N/A N/A $114.52 N/A

31512 LARYNGOSCOPY, INDIRECT; WITH REMOVAL OF LESION N/A N/A N/A $119.07 N/A

31513 LARYNGOSCOPY, INDIRECT; WITH VOCAL CORD INJECTION N/A N/A N/A $122.64 N/A

31520 LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; DIAGNOSTIC, NEWBORN N/A N/A N/A $142.85 N/A

31528 LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; WITH DILATION, INITIAL N/A N/A N/A $132.34 N/A

31529 LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; WITH DILATION, SUBSEQUENT N/A N/A N/A $151.39 N/A

31535 LARYNGOSCOPY, DIRECT, OPERATIVE, WITH BIOPSY N/A N/A N/A $177.79 N/A

31536 LARYNGOSCOPY, DIRECT, OPERATIVE, WITH BIOPSY; WITH OPERATING MICROSCOPE OR TELESCOPE N/A N/A N/A $199.50 N/A

31540 LARYNGOSCOPY, DIRECT, OPERATIVE, WITH EXCISION OF TUMOR AND/ OR STRIPPING OF VOCAL CORDS OR EPIGLOTTIS N/A N/A N/A $229.31 N/A

31541 LARYNGOSCOPY, DIRECT, OPERATIVE, WITH EXCISION OF TUMOR AND/ OR STRIPPING OF VOCAL CORDS OR EPIGLOTTIS; WITH OPERATING MICROSCOPE OR TELESCOPE N/A N/A N/A $251.35 N/A

31560 LARYNGOSCOPY, DIRECT, OPERATIVE, WITH ARYTENOIDECTOMY N/A N/A N/A $295.92 N/A

31561 LARYNGOSCOPY, DIRECT, OPERATIVE, WITH ARYTENOIDECTOMY; WITH OPERATING MICROSCOPE OR TELESCOPE N/A N/A N/A $323.48 N/A

31575 LARYNGOSCOPY, FLEXIBLE FIBEROPTIC; DIAGNOSTIC N/A N/A N/A $69.00 N/A

31576 LARYNGOSCOPY, FLEXIBLE FIBEROPTIC; WITH BIOPSY N/A N/A N/A $112.74 N/A

31577 LARYNGOSCOPY, FLEXIBLE FIBEROPTIC; WITH REMOVAL OF FOREIGN BODY N/A N/A N/A $139.43 N/A

31578 LARYNGOSCOPY, FLEXIBLE FIBEROPTIC; WITH REMOVAL OF LESION N/A N/A N/A $152.88 N/A

31595 SECTION RECURRENT LARYNGEAL NERVE, THERAPEUTIC (SEPARATE PROCEDURE), UNILATERAL $106.63 N/A N/A $666.42 N/A

31601 TRACHEOSTOMY, PLANNED (SEPARATE PROCEDURE); UNDER TWO YEARS $38.23 N/A N/A $238.95 N/A

31603 TRACHEOSTOMY, EMERGENCY PROCEDURE; TRANSTRACHEAL N/A N/A N/A $207.99 N/A

31605 TRACHEOSTOMY, EMERGENCY PROCEDURE; CRICOTHYROID MEMBRANE N/A N/A N/A $171.36 N/A

31615 TRACHEOBRONCHOSCOPY THROUGH ESTABLISHED TRACHEOSTOMY INCISION N/A N/A N/A $115.11 N/A

31620 BRONCHOSCOPY N/A N/A N/A $68.19 N/A

31622 BRONCHOSCOPY, RIGID OR FLEXIBLE, WITH OR WITHOUT FLUOROSCOPIC GUIDANCE; DIAGNOSTIC, WITH OR WITHOUT CELL WASHING (SEPARATE PROCEDURE) N/A N/A N/A $135.10 N/A

31623 BRONCHOSCOPY (RIGID OR FLEXIBLE); WITH OR WITHOUT FLUOROSCOPIC GUIDANCE; WITH BRUSHING OR PROTECTED BRUSHINGS N/A N/A N/A $137.01 N/A

31624 BRONCHOSCOPY (RIGID OR FLEXIBLE); WITH OR WITHOUT FLUOROSCOPIC GUIDANCE; WITH BRONCHIAL ALVEOLAR LAVAGE N/A N/A N/A $137.01 N/A

31625 BRONCHOSCOPY, RIGID OR FLEXIBLE, WITH OR WITHOUT FLUOROSCOPIC GUIDANCE; WITH BRONCHIAL OR ENDOBRONCHIAL BIOPSY(S), SINGLE OR MULTIPLE SITES N/A N/A N/A $159.94 N/A

31628 BRONCHOSCOPY, RIGID OR FLEXIBLE, WITH OR WITHOUT FLUOROSCOPIC GUIDANCE; WITH TRANSBRONCHIAL LUNG BIOPSY(S), SINGLE LOBE N/A N/A N/A $178.19 N/A

31629 BRONCHOSCOPY, RIGID OR FLEXIBLE, WITH OR WITHOUT FLUOROSCOPIC GUIDANCE; WITH TRANSBRONCHIAL NEEDLE ASPIRATION BIOPSY(S), TRACHEA, MAIN STEM AND/OR LOBAR BRONCHUS(I) N/A N/A N/A $190.52 N/A

31630 BRONCHOSCOPY, RIGID OR FLEXIBLE, WITH OR WITHOUT FLUOROSCOPIC GUIDANCE; WITH TRACHEAL/BRONCHIAL DILATION OR CLOSED REDUCTION OF FRACTURE N/A N/A N/A $194.76 N/A

31631 BRONCHOSCOPY, RIGID OR FLEXIBLE, WITH OR WITHOUT FLUOROSCOPIC GUIDANCE; WITH PLACEMENT OF TRACHEAL STENT(S) (INCLUDES TRACHEAL/ BRONCHIAL DILATION AS REQUIRED) N/A N/A N/A $215.99 N/A

31632 BRONCHOSCOPY, RIGID OR FLEXIBLE, WITH OR WITHOUT FLUOROSCOPIC GUIDANCE; WITH TRANSBRONCHIAL LUNG BIOPSY(S), EACH ADDITIONAL LOBE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) N/A N/A N/A $50.93 N/A

31633 BRONCHOSCOPY, RIGID OR FLEXIBLE, WITH OR WITHOUT FLUOROSCOPIC GUIDANCE; WITH TRANSBRONCHIAL NEEDLE ASPIRATION BIOPSY(S), EACH ADDITIONAL LOBE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) N/A N/A N/A $62.93 N/A

31635 BRONCHOSCOPY (RIGID OR FLEXIBLE); WITH REMOVAL OF FOREIGN BODY N/A N/A N/A $178.87 N/A

31643 BRONCHOSCOPY, (RIGID OR FLEXIBLE); WITH PLACEMENT OF CATHETER(S) FOR INTRACAVITARY RADIOELEMENT APPLICATION N/A N/A N/A $165.78 N/A

31645 BRONCHOSCOPY, (RIGID OR FLEXIBLE); WITH THERAPEUTIC ASPIRATION OF TRACHEOBRONCHIAL TREE, INITIAL (EG, DRAINAGE OF LUNG ABSCESS) N/A N/A N/A $149.78 N/A

31646 BRONCHOSCOPY, (RIGID OR FLEXIBLE); WITH THERAPEUTIC ASPIRATION OF TRACHEOBRONCHIAL TREE, SUBSEQUENT N/A N/A N/A $130.29 N/A

31656 BRONCHOSCOPY, (RIGID OR FLEXIBLE); WITH INJECTION OF CONTRAST MATERIAL FOR SEGMENTAL BRONCHOGRAPHY (FIBERSCOPE ONLY) N/A N/A N/A $105.47 N/A

31730 TRANSTRACHEAL (PERCUTANEOUS) INTRODUCTION OF NEEDLE WIRE DILATOR/ STENT OR INDWELLING TUBE FOR OXYGEN THERAPY N/A N/A N/A $135.53 N/A

31820 SURGICAL CLOSURE TRACHEOSTOMY OR FISTULA; WITHOUT PLASTIC REPAIR N/A N/A N/A $287.12 N/A

31825 SURGICAL CLOSURE TRACHEOSTOMY OR FISTULA; WITH PLASTIC REPAIR N/A N/A N/A $426.93 N/A

32019 INSERTION OF INDWELLING TUNNELED PLEURAL CATHETER WITH CUFF N/A N/A N/A $209.21 N/A

32020 TUBE THORACOSTOMY WITH OR WITHOUT WATER SEAL (EG, FOR ABSCESS, HEMOTHORAX, EMPYEMA) (SEPARATE PROCEDURE) N/A N/A N/A $167.92 N/A

32400 BIOPSY, PLEURA; PERCUTANEOUS NEEDLE N/A N/A N/A $81.04 N/A

32405 BIOPSY, LUNG OR MEDIASTINUM, PERCUTANEOUS NEEDLE N/A N/A N/A $90.15 N/A

32420 PNEUMOCENTESIS, PUNCTURE OF LUNG FOR ASPIRATION N/A N/A N/A $100.50 N/A

32501 RESECTION AND REPAIR OF PORTION OF BRONCHUS (BRONCHOPLASTY) WHEN PERFORMED AT TIME OF LOBECTOMY OR SEGMENTECTOMY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) $36.88 N/A N/A $230.47 N/A

32601 THORACOSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE); LUNGS AND PLEURAL SPACE, WITHOUT BIOPSY $46.11 N/A N/A $288.19 N/A

32602 THORACOSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE); LUNGS AND PLEURAL SPACE, WITH BIOPSY $50.05 N/A N/A $312.83 N/A

32656 THORACOSCOPY, SURGICAL; WITH PARIETAL PLEURECTOMY $121.88 N/A N/A $761.76 N/A

32657 THORACOSCOPY, SURGICAL; WITH WEDGE RESECTION OF LUNG, SINGLE OR MULTIPLE $119.62 N/A N/A $747.61 N/A

32658 THORACOSCOPY, SURGICAL; WITH REMOVAL OF CLOT OR FOREIGN BODY FROM PERICARDIAL SAC $109.65 N/A N/A $685.33 N/A

32659 THORACOSCOPY, SURGICAL; WITH CREATION OF PERICARDIAL WINDOW OR PARTIAL RESECTION OF PERICARDIAL SAC FOR DRAINAGE $111.24 N/A N/A $695.27 N/A

32660 THORACOSCOPY, SURGICAL; WITH TOTAL PERICARDIECTOMY $155.75 N/A N/A $973.41 N/A

32661 THORACOSCOPY, SURGICAL; WITH EXCISION OF PERICARDIAL CYST, TUMOR OR MASS $122.19 N/A N/A $763.67 N/A

32662 THORACOSCOPY, SURGICAL; WITH EXCISION OF MEDIASTINAL CYST, TUMOR OR MASS $137.24 N/A N/A $857.73 N/A

32664 THORACOSCOPY, SURGICAL; WITH THORACIC SYMPATHECTOMY $128.88 N/A N/A $805.51 N/A

33010 PERICARDIOCENTESIS; INITIAL N/A N/A N/A $109.50 N/A

33011 PERICARDIOCENTESIS; SUBSEQUENT N/A N/A N/A $111.17 N/A

33141 TRANSMYOCARDIAL LASER REVASCULARIZATION, BY THORACOTOMY; PERFORMED AT THE TIME OF OTHER OPEN CARDIAC PROCEDURE(S) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) $24.76 N/A N/A $154.76 N/A

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Procedure Code	Procedure Code Description	Assistant Surgeon Fee Revision (Billing with Modifier 80)	Professional Component Fee Revision (Billing with Modifier 26)	Technical Component Fee Revision (Billing with Modifier TC)	Billing with No Modifier or Pricing Modifiers U6, U7, U8, U9, SU or TH	Billing with NU (New) or RR (Rental) Modifiers
22842	POSTERIOR SEGMENTAL INSTRUMENTATION (EG, PEDICLE FIXATION, DUAL RODS WITH MULTIPLE HOOKS AND SUBLAMINAR WIRES); 3 TO 6 VERTEBRAL SEGMENTS	$115.23	N/A	N/A	$720.21	N/A
22843	POSTERIOR SEGMENTAL INSTRUMENTATION (EG, PEDICLE FIXATION, DUAL RODS WITH MULTIPLE HOOKS AND SUBLAMINAR WIRES); 7 TO 12 VERTEBRAL SEGMENTS	$121.48	N/A	N/A	$759.28	N/A
22844	POSTERIOR SEGMENTAL INSTRUMENTATION (EG, PEDICLE FIXATION, DUAL RODS WITH MULTIPLE HOOKS AND SUBLAMINAR WIRES); 13 OR MORE VERTEBRAL SEGMENTS	$149.85	N/A	N/A	$936.54	N/A
22845	ANTERIOR INSTRUMENTATION; 2 TO 3 VERTEBRAL SEGMENTS	$110.17	N/A	N/A	$688.59	N/A
22847	ANTERIOR INSTRUMENTATION; 8 OR MORE VERTEBRAL SEGMENTS	$125.84	N/A	N/A	$786.51	N/A
22848	PELVIC FIXATION (ATTACHMENT OF CAUDAL END OF INSTRUMENTATION TO PELVIC BONY STRUCTURES) OTHER THAN SACRUM	$54.55	N/A	N/A	$340.92	N/A
23105	ARTHROTOMY; GLENOHUMERAL JOINT, WITH SYNOVECTOMY, WITH OR WITHOUT BIOPSY	N/A	N/A	N/A	$563.37	N/A
23106	ARTHROTOMY; STERNOCLAVICULAR JOINT, WITH SYNOVECTOMY, WITH OR WITHOUT BIOPSY	N/A	N/A	N/A	$420.81	N/A
23107	ARTHROTOMY, GLENOHUMERAL JOINT, WITH JOINT EXPLORATION, WITH OR WITHOUT REMOVAL OF LOOSE OR FOREIGN BODY	$93.91	N/A	N/A	$586.96	N/A
23210	RADICAL RESECTION FOR TUMOR; SCAPULA	$129.85	N/A	N/A	$811.54	N/A
23921	DISARTICULATION OF SHOULDER; SECONDARY CLOSURE OR SCAR REVISION	N/A	N/A	N/A	$387.15	N/A
24100	ARTHROTOMY, ELBOW; WITH SYNOVIAL BIOPSY ONLY	N/A	N/A	N/A	$348.12	N/A
24152	RADICAL RESECTION FOR TUMOR, RADIAL HEAD OR NECK	$103.47	N/A	N/A	$646.69	N/A
24153	RADICAL RESECTION FOR TUMOR, RADIAL HEAD OR NECK; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT)	N/A	N/A	N/A	$607.06	N/A
24155	RESECTION OF ELBOW JOINT (ARTHRECTOMY)	$119.59	N/A	N/A	$747.43	N/A
24361	ARTHROPLASTY, ELBOW; WITH DISTAL HUMERAL PROSTHETIC REPLACEMENT	$143.96	N/A	N/A	$899.77	N/A
24365	ARTHROPLASTY, RADIAL HEAD	$90.93	N/A	N/A	$568.34	N/A
24366	ARTHROPLASTY, RADIAL HEAD; WITH IMPLANT	$97.44	N/A	N/A	$609.02	N/A
24931	AMPUTATION, ARM THROUGH HUMERUS; WITH IMPLANT	$116.86	N/A	N/A	$730.37	N/A
24935	STUMP ELONGATION, UPPER EXTREMITY	N/A	N/A	N/A	$902.19	N/A
25335	CENTRALIZATION OF WRIST ON ULNA (EG, RADIAL CLUB HAND)	N/A	N/A	N/A	$868.09	N/A
25574	OPEN TREATMENT OF RADIAL AND ULNAR SHAFT FRACTURES, WITH INTERNAL OR EXTERNAL FIXATION; OF RADIUS OR ULNA	$85.27	N/A	N/A	$532.91	N/A
25820	ARTHRODESIS, WRIST; LIMITED, WITHOUT BONE GRAFT (EG, INTERCARPAL OR RADIOCARPAL)	$87.80	N/A	N/A	$548.77	N/A
26030	DRAINAGE OF PALMAR BURSA; MULTIPLE BURSA	N/A	N/A	N/A	$427.74	N/A
26125	FASCIECTOMY, PARTIAL PALMAR WITH RELEASE OF SINGLE DIGIT INCLUDING PROXIMAL INTERPHALANGEAL JOINT, WITH OR WITHOUT Z-PLASTY, OTHER LOCAL TISSUE REARRANGEMENT OR SKIN GRAFTING (INCLUDES OBTAINING GRAFT); EACH ADDITIONAL DIGIT (LIST SEPARATELY IN ADDITION TO PRIMARY PROCEDURE)	N/A	N/A	N/A	$257.07	N/A
26510	CROSS INTRINSIC TRANSFER, EACH TENDON	$90.76	N/A	N/A	$567.25	N/A
26531	ARTHROPLASTY, METACARPOPHALANGEAL JOINT; WITH PROSTHETIC IMPLANT, EACH JOINT	$87.04	N/A	N/A	$544.03	N/A
26536	ARTHROPLASTY, INTERPHALANGEAL JOINT; WITH PROSTHETIC IMPLANT, EACH JOINT	$91.96	N/A	N/A	$574.77	N/A
26591	REPAIR, INTRINSIC MUSCLES OF HAND, EACH MUSCLE	N/A	N/A	N/A	$428.12	N/A
26861	ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR WITHOUT INTERNAL FIXATION; EACH ADDITIONAL INTERPHALANGEAL JOINT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)	N/A	N/A	N/A	$97.38	N/A
26863	ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR WITHOUT INTERNAL FIXATION; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT), EACH ADDITIONAL JOINT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)	N/A	N/A	N/A	$217.65	N/A
27036	CAPSULECTOMY OR CAPSULOTOMY, HIP, WITH OR WITHOUT EXCISION OF HETEROTOPIC BONE, WITH RELEASE OF HIP FLEXOR MUSCLES (IE, GLUTEUS MEDIUS, GLUTEUS MINIMUS, TENSOR FASCIA LATAE, RECTUS FEMORIS, SARTORIUS, ILIOPSOAS)	N/A	N/A	N/A	$885.44	N/A
27054	ARTHROTOMY WITH SYNOVECTOMY, HIP JOINT	N/A	N/A	N/A	$598.45	N/A
27071	PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION) (EG, OSTEOMYELITIS OR BONE ABSCESS); DEEP (SUBFASCIAL OR INTRAMUSCULAR)	$129.44	N/A	N/A	$808.98	N/A
27096	INJECTION PROCEDURE FOR SACROILIAC JOINT, ARTHROGRAPHY AND/ OR ANESTHETIC/STEROID	N/A	N/A	N/A	$61.46	N/A
27178	OPEN TREATMENT OF SLIPPED FEMORAL EPIPHYSIS; CLOSED MANIPULATION WITH SINGLE OR MULTIPLE PINNING	$125.71	N/A	N/A	$785.69	N/A
27256	TREATMENT OF SPONTANEOUS HIP DISLOCATION (DEVELOPMENTAL, INCLUDING CONGENITAL OR PATHOLOGICAL), BY ABDUCTION, SPLINT OR TRACTION; WITHOUT ANESTHESIA, WITHOUT MANIPULATION	N/A	N/A	N/A	$224.03	N/A
27334	ARTHROTOMY, WITH SYNOVECTOMY, KNEE; ANTERIOR OR POSTERIOR	N/A	N/A	N/A	$600.95	N/A
27335	ARTHROTOMY, WITH SYNOVECTOMY, KNEE; ANTERIOR AND POSTERIOR INCLUDING POPLITEAL AREA	N/A	N/A	N/A	$680.09	N/A
27358	EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF FEMUR; WITH INTERNAL FIXATION (LIST IN ADDITION TO CODE FOR PRIMARY PROCEDURE)	$42.70	N/A	N/A	$266.90	N/A
27396	TRANSPLANT, HAMSTRING TENDON TO PATELLA; SINGLE TENDON	$87.23	N/A	N/A	$545.18	N/A
27400	TRANSFER, TENDON OR MUSCLE, HAMSTRINGS TO FEMUR (EG, EGGEROS TYPE PROCEDURE)	$94.82	N/A	N/A	$592.63	N/A
27425	LATERAL RETINACULAR RELEASE OPEN	$62.29	N/A	N/A	$389.32	N/A
27427	LIGAMENTOUS RECONSTRUCTION (AUGMENTATION)	$101.87	N/A	N/A	$636.67	N/A
27438	ARTHROPLASTY, PATELLA; WITH PROSTHESIS	$119.19	N/A	N/A	$744.93	N/A
27450	OSTEOTOMY, FEMUR, SHAFT OR SUPRACONDYLAR; WITH FIXATION	$146.21	N/A	N/A	$913.81	N/A
27605	TENOTOMY, PERCUTANEOUS, ACHILLES TENDON (SEPARATE PROCEDURE); LOCAL ANESTHESIA	N/A	N/A	N/A	$185.88	N/A
27692	TRANSFER OR TRANSPLANT OF SINGLE TENDON (WITH MUSCLE REDIRECTION OR REROUTING); EACH ADDITIONAL TENDON (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)	$16.55	N/A	N/A	$103.43	N/A
27700	ARTHROPLASTY, ANKLE	$88.75	N/A	N/A	$554.71	N/A
27740	ARREST, EPIPHYSEAL (EPIPHYSIODESIS), ANY METHOD, COMBINED, PROXIMAL AND DISTAL TIBIA AND FIBULA	$101.56	N/A	N/A	$634.76	N/A
27742	ARREST, EPIPHYSEAL (EPIPHYSIODESIS), ANY METHOD, COMBINED, PROXIMAL AND DISTAL TIBIA AND FIBULA; AND DISTAL FEMUR	$96.80	N/A	N/A	$605.03	N/A
27756	PERCUTANEOUS SKELETAL FIXATION OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE) (EG, PINS OR SCREWS)	$80.06	N/A	N/A	$500.40	N/A
27871	ARTHRODESIS, TIBIOFIBULAR JOINT, PROXIMAL OR DISTAL	$99.13	N/A	N/A	$619.55	N/A
28088	SYNOVECTOMY, TENDON SHEATH, FOOT; EXTENSOR	N/A	N/A	N/A	$278.80	N/A
28110	OSTECTOMY, PARTIAL EXCISION, FIFTH METATARSAL HEAD (BUNIONETTE) (SEPARATE PROCEDURE)	N/A	N/A	N/A	$266.46	N/A
28160	HEMIPHALANGECTOMY OR INTERPHALANGEAL JOINT EXCISION, TOE, PROXIMAL END OF PHALANX, EACH	N/A	N/A	N/A	$255.30	N/A
28175	RADICAL RESECTION OF TUMOR, BONE; PHALANX OF TOE	$57.44	N/A	N/A	$359.03	N/A
28340	RECONSTRUCTION, TOE, MACRODACTYLY; SOFT TISSUE RESECTION	N/A	N/A	N/A	$409.71	N/A
28344	RECONSTRUCTION, TOE(S); POLYDACTYLY	$45.27	N/A	N/A	$282.96	N/A
28345	RECONSTRUCTION, TOE(S); SYNDACTYLY, WITH OR WITHOUT SKIN GRAFT(S), EACH WEB	N/A	N/A	N/A	$382.10	N/A
28456	PERCUTANEOUS SKELETAL FIXATION OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS), WITH MANIPULATION, EACH	N/A	N/A	N/A	$244.55	N/A
28496	PERCUTANEOUS SKELETAL FIXATION OF FRACTURE GREAT TOE, PHALANX OR PHALANGES, WITH MANIPULATION	N/A	N/A	N/A	$199.19	N/A
28530	CLOSED TREATMENT OF SESAMOID FRACTURE	N/A	N/A	N/A	$89.62	N/A
28725	ARTHRODESIS; SUBTALAR	$117.76	N/A	N/A	$736.03	N/A
29000	APPLICATION OF HALO TYPE BODY CAST (SEE 20661--20663 FOR INSERTION)	N/A	N/A	N/A	$149.17	N/A
29010	APPLICATION OF RISSER JACKET, LOCALIZER, BODY; ONLY	N/A	N/A	N/A	$140.50	N/A
29015	APPLICATION OF RISSER JACKET, LOCALIZER, BODY; INCLUDING HEAD	N/A	N/A	N/A	$144.44	N/A
29020	APPLICATION OF TURNBUCKLE JACKET, BODY; ONLY	N/A	N/A	N/A	$129.75	N/A
29025	APPLICATION OF TURNBUCKLE JACKET, BODY; INCLUDING HEAD	N/A	N/A	N/A	$156.41	N/A
29035	APPLICATION OF BODY CAST, SHOULDER TO HIPS	N/A	N/A	N/A	$121.77	N/A
29086	APPLICATION, CAST; FINGER (EG, CONTRACTURE)	N/A	N/A	N/A	$40.46	N/A
29131	APPLICATION OF FINGER SPLINT; DYNAMIC	N/A	N/A	N/A	$28.04	N/A
29200	STRAPPING; THORAX	N/A	N/A	N/A	$34.83	N/A
29260	STRAPPING; ELBOW OR WRIST	N/A	N/A	N/A	$31.38	N/A
29325	APPLICATION OF HIP SPICA CAST; ONE AND ONE-HALF SPICA OR BOTH LEGS	N/A	N/A	N/A	$156.32	N/A
29435	APPLICATION OF PATELLAR TENDON BEARING (PTB) CAST	N/A	N/A	N/A	$77.02	N/A
29445	APPLICATION OF RIGID TOTAL CONTACT LEG CAST	N/A	N/A	N/A	$101.64	N/A
29520	STRAPPING; HIP	N/A	N/A	N/A	$34.89	N/A
29730	WINDOWING OF CAST	N/A	N/A	N/A	$40.99	N/A
29819	ARTHROSCOPY, SHOULDER, SURGICAL; WITH REMOVAL OF LOOSE BODY OR FOREIGN BODY	$83.93	N/A	N/A	$524.57	N/A
29820	ARTHROSCOPY, SHOULDER, SURGICAL; SYNOVECTOMY, PARTIAL	$77.40	N/A	N/A	$483.74	N/A
29821	ARTHROSCOPY, SHOULDER, SURGICAL; SYNOVECTOMY, COMPLETE	$84.64	N/A	N/A	$528.97	N/A
29822	ARTHROSCOPY, SHOULDER, SURGICAL; DEBRIDEMENT, LIMITED	$82.27	N/A	N/A	$514.18	N/A
29825	ARTHROSCOPY, SHOULDER, SURGICAL; WITH LYSIS AND RESECTION OF ADHESIONS, WITH OR WITHOUT MANIPULATION	$83.82	N/A	N/A	$523.88	N/A
29834	ARTHROSCOPY, ELBOW, SURGICAL; WITH REMOVAL OF LOOSE BODY OR FOREIGN BODY	$70.39	N/A	N/A	$439.95	N/A
29835	ARTHROSCOPY, ELBOW, SURGICAL; SYNOVECTOMY, PARTIAL	$72.05	N/A	N/A	$450.33	N/A
29836	ARTHROSCOPY, ELBOW, SURGICAL; SYNOVECTOMY, COMPLETE	$82.92	N/A	N/A	$518.23	N/A
29837	ARTHROSCOPY, ELBOW, SURGICAL; DEBRIDEMENT, LIMITED	$75.72	N/A	N/A	$473.27	N/A
29838	ARTHROSCOPY, ELBOW, SURGICAL; DEBRIDEMENT, EXTENSIVE	$84.81	N/A	N/A	$530.08	N/A
29843	ARTHROSCOPY, WRIST, SURGICAL; FOR INFECTION, LAVAGE AND DRAINAGE	$67.34	N/A	N/A	$420.90	N/A
29844	ARTHROSCOPY, WRIST, SURGICAL; SYNOVECTOMY, PARTIAL	$70.74	N/A	N/A	$442.12	N/A
29846	ARTHROSCOPY, WRIST, SURGICAL; EXCISION AND/OR REPAIR OF TRIANGULAR FIBROCARTILAGE AND/OR JOINT DEBRIDEMENT	$74.16	N/A	N/A	$463.48	N/A
29850	ARTHROSCOPICALLY AIDED TREATMENT OF INTERCONDYLAR SPINE(S) AND/OR TUBEROSITY FRACTURE(S) OF THE KNEE, WITH OR WITHOUT MANIPULATION; WITHOUT INTERNAL OR EXTERNAL FIXATION (INCLUDES ARTHROSCOPY)	$78.59	N/A	N/A	$491.21	N/A
29871	ARTHROSCOPY, KNEE, SURGICAL; FOR INFECTION, LAVAGE AND DRAINAGE	N/A	N/A	N/A	$453.28	N/A
29873	ARTHROSCOPY, KNEE, SURGICAL; WITH LATERAL RELEASE	N/A	N/A	N/A	$455.79	N/A
29874	ARTHROSCOPY, KNEE, SURGICAL; FOR REMOVAL OF LOOSE BODY OR FOREIGN BODY (EG, OSTEOCHONDRITIS DISSECANS FRAGMENTATION, CHONDRAL FRAGMENTATION)	$76.15	N/A	N/A	$475.94	N/A
29875	ARTHROSCOPY, KNEE, SURGICAL; SYNOVECTOMY, LIMITED (EG, PLICA OR SHELF RESECTION) (SEPARATE PROCEDURE)	$70.73	N/A	N/A	$442.07	N/A
29877	ARTHROSCOPY, KNEE, SURGICAL; DEBRIDEMENT/SHAVING OF ARTICULAR CARTILAGE (CHONDROPLASTY)	$86.56	N/A	N/A	$541.00	N/A
29884	ARTHROSCOPY, KNEE, SURGICAL; WITH LYSIS OF ADHESIONS, WITH OR WITHOUT MANIPULATION (SEPARATE PROCEDURE)	$86.23	N/A	N/A	$538.91	N/A
29894	ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), SURGICAL; WITH REMOVAL OF LOOSE BODY OR FOREIGN BODY	$74.12	N/A	N/A	$463.26	N/A
29895	ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), SURGICAL; SYNOVECTOMY, PARTIAL	$72.50	N/A	N/A	$453.11	N/A
29897	ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), SURGICAL; DEBRIDEMENT, LIMITED	$76.06	N/A	N/A	$475.40	N/A
29898	ARTHROSCOPY, ANKLE (TIBIOTALAR AND FIBULOTALAR JOINTS), SURGICAL; DEBRIDEMENT, EXTENSIVE	$84.65	N/A	N/A	$529.09	N/A
30150	RHINECTOMY; PARTIAL	N/A	N/A	N/A	$706.68	N/A
30160	RHINECTOMY; TOTAL	$111.36	N/A	N/A	$696.01	N/A
30540	REPAIR FISTULA; OROMAXILLARY (COMBINE WITH 31030 IF ANTROTOMY IS INCLUDED)	N/A	N/A	N/A	$584.92	N/A
30580	REPAIR FISTULA; OROMAXILLARY (COMBINE WITH 31030 IF ANTROTOMY IS INCLUDED)	N/A	N/A	N/A	$446.62	N/A
31233	NASAL/SINUS ENDOSCOPY, DIAGNOSTIC WITH MAXILLARY SINUSOSCOPY (VIA INFERIOR MEATUS OR CANINE FOSSA PUNCTURE)	$20.36	N/A	N/A	$127.22	N/A
31235	NASAL/SINUS ENDOSCOPY, DIAGNOSTIC WITH SPHENOID SINUSOSCOPY (VIA PUNCTURE OF SPHENOIDAL FACE OR CANNULATION OF OSTIUM)	$24.28	N/A	N/A	$151.76	N/A
31239	NASAL/SINUS ENDOSCOPY, SURGICAL; WITH DACRYOCYSTORHINOSTOMY	$94.91	N/A	N/A	$593.21	N/A
31240	NASAL/SINUS ENDOSCOPY, SURGICAL; WITH CONCHA BULLOSA RESECTION	$24.12	N/A	N/A	$150.74	N/A
31255	NASAL/SINUS ENDOSCOPY, SURGICAL; WITH ETHMOIDECTOMY, TOTAL (ANTERIOR AND POSTERIOR)	$61.63	N/A	N/A	$385.21	N/A
31276	NASAL/SINUS ENDOSCOPY, SURGICAL WITH FRONTAL SINUS EXPLORATION, WITH OR WITHOUT REMOVAL OF TISSUE FROM FRONTAL SINUS	$97.17	N/A	N/A	$485.84	N/A
31287	NASAL/SINUS ENDOSCOPY, SURGICAL, WITH SPHENOIDOTOMY	$35.39	N/A	N/A	$221.18	N/A
31288	NASAL/SINUS ENDOSCOPY, SURGICAL, WITH SPHENOIDOTOMY; WITH REMOVAL OF TISSUE FROM THE SPHENOID SINUS	$41.06	N/A	N/A	$256.60	N/A
31292	NASAL/SINUS ENDOSCOPY, SURGICAL; WITH MEDIAL OR INFERIOR ORBITAL WALL DECOMPRESSION	$145.64	N/A	N/A	$910.25	N/A
31293	NASAL/SINUS ENDOSCOPY, SURGICAL; WITH MEDIAL ORBITAL WALL AND INFERIOR ORBITAL WALL DECOMPRESSION	$158.58	N/A	N/A	$991.14	N/A
31511	LARYNGOSCOPY, INDIRECT; WITH REMOVAL OF FOREIGN BODY	N/A	N/A	N/A	$114.52	N/A
31512	LARYNGOSCOPY, INDIRECT; WITH REMOVAL OF LESION	N/A	N/A	N/A	$119.07	N/A
31513	LARYNGOSCOPY, INDIRECT; WITH VOCAL CORD INJECTION	N/A	N/A	N/A	$122.64	N/A
31520	LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; DIAGNOSTIC, NEWBORN	N/A	N/A	N/A	$142.85	N/A
31528	LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; WITH DILATION, INITIAL	N/A	N/A	N/A	$132.34	N/A
31529	LARYNGOSCOPY DIRECT, WITH OR WITHOUT TRACHEOSCOPY; WITH DILATION, SUBSEQUENT	N/A	N/A	N/A	$151.39	N/A
31535	LARYNGOSCOPY, DIRECT, OPERATIVE, WITH BIOPSY	N/A	N/A	N/A	$177.79	N/A
31536	LARYNGOSCOPY, DIRECT, OPERATIVE, WITH BIOPSY; WITH OPERATING MICROSCOPE OR TELESCOPE	N/A	N/A	N/A	$199.50	N/A
31540	LARYNGOSCOPY, DIRECT, OPERATIVE, WITH EXCISION OF TUMOR AND/ OR STRIPPING OF VOCAL CORDS OR EPIGLOTTIS	N/A	N/A	N/A	$229.31	N/A
31541	LARYNGOSCOPY, DIRECT, OPERATIVE, WITH EXCISION OF TUMOR AND/ OR STRIPPING OF VOCAL CORDS OR EPIGLOTTIS; WITH OPERATING MICROSCOPE OR TELESCOPE	N/A	N/A	N/A	$251.35	N/A
31560	LARYNGOSCOPY, DIRECT, OPERATIVE, WITH ARYTENOIDECTOMY	N/A	N/A	N/A	$295.92	N/A
31561	LARYNGOSCOPY, DIRECT, OPERATIVE, WITH ARYTENOIDECTOMY; WITH OPERATING MICROSCOPE OR TELESCOPE	N/A	N/A	N/A	$323.48	N/A
31575	LARYNGOSCOPY, FLEXIBLE FIBEROPTIC; DIAGNOSTIC	N/A	N/A	N/A	$69.00	N/A
31576	LARYNGOSCOPY, FLEXIBLE FIBEROPTIC; WITH BIOPSY	N/A	N/A	N/A	$112.74	N/A
31577	LARYNGOSCOPY, FLEXIBLE FIBEROPTIC; WITH REMOVAL OF FOREIGN BODY	N/A	N/A	N/A	$139.43	N/A
31578	LARYNGOSCOPY, FLEXIBLE FIBEROPTIC; WITH REMOVAL OF LESION	N/A	N/A	N/A	$152.88	N/A
31595	SECTION RECURRENT LARYNGEAL NERVE, THERAPEUTIC (SEPARATE PROCEDURE), UNILATERAL	$106.63	N/A	N/A	$666.42	N/A
31601	TRACHEOSTOMY, PLANNED (SEPARATE PROCEDURE); UNDER TWO YEARS	$38.23	N/A	N/A	$238.95	N/A
31603	TRACHEOSTOMY, EMERGENCY PROCEDURE; TRANSTRACHEAL	N/A	N/A	N/A	$207.99	N/A
31605	TRACHEOSTOMY, EMERGENCY PROCEDURE; CRICOTHYROID MEMBRANE	N/A	N/A	N/A	$171.36	N/A
31615	TRACHEOBRONCHOSCOPY THROUGH ESTABLISHED TRACHEOSTOMY INCISION	N/A	N/A	N/A	$115.11	N/A
31620	BRONCHOSCOPY	N/A	N/A	N/A	$68.19	N/A
31622	BRONCHOSCOPY, RIGID OR FLEXIBLE, WITH OR WITHOUT FLUOROSCOPIC GUIDANCE; DIAGNOSTIC, WITH OR WITHOUT CELL WASHING (SEPARATE PROCEDURE)	N/A	N/A	N/A	$135.10	N/A
31623	BRONCHOSCOPY (RIGID OR FLEXIBLE); WITH OR WITHOUT FLUOROSCOPIC GUIDANCE; WITH BRUSHING OR PROTECTED BRUSHINGS	N/A	N/A	N/A	$137.01	N/A
31624	BRONCHOSCOPY (RIGID OR FLEXIBLE); WITH OR WITHOUT FLUOROSCOPIC GUIDANCE; WITH BRONCHIAL ALVEOLAR LAVAGE	N/A	N/A	N/A	$137.01	N/A
31625	BRONCHOSCOPY, RIGID OR FLEXIBLE, WITH OR WITHOUT FLUOROSCOPIC GUIDANCE; WITH BRONCHIAL OR ENDOBRONCHIAL BIOPSY(S), SINGLE OR MULTIPLE SITES	N/A	N/A	N/A	$159.94	N/A
31628	BRONCHOSCOPY, RIGID OR FLEXIBLE, WITH OR WITHOUT FLUOROSCOPIC GUIDANCE; WITH TRANSBRONCHIAL LUNG BIOPSY(S), SINGLE LOBE	N/A	N/A	N/A	$178.19	N/A
31629	BRONCHOSCOPY, RIGID OR FLEXIBLE, WITH OR WITHOUT FLUOROSCOPIC GUIDANCE; WITH TRANSBRONCHIAL NEEDLE ASPIRATION BIOPSY(S), TRACHEA, MAIN STEM AND/OR LOBAR BRONCHUS(I)	N/A	N/A	N/A	$190.52	N/A
31630	BRONCHOSCOPY, RIGID OR FLEXIBLE, WITH OR WITHOUT FLUOROSCOPIC GUIDANCE; WITH TRACHEAL/BRONCHIAL DILATION OR CLOSED REDUCTION OF FRACTURE	N/A	N/A	N/A	$194.76	N/A
31631	BRONCHOSCOPY, RIGID OR FLEXIBLE, WITH OR WITHOUT FLUOROSCOPIC GUIDANCE; WITH PLACEMENT OF TRACHEAL STENT(S) (INCLUDES TRACHEAL/ BRONCHIAL DILATION AS REQUIRED)	N/A	N/A	N/A	$215.99	N/A
31632	BRONCHOSCOPY, RIGID OR FLEXIBLE, WITH OR WITHOUT FLUOROSCOPIC GUIDANCE; WITH TRANSBRONCHIAL LUNG BIOPSY(S), EACH ADDITIONAL LOBE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)	N/A	N/A	N/A	$50.93	N/A
31633	BRONCHOSCOPY, RIGID OR FLEXIBLE, WITH OR WITHOUT FLUOROSCOPIC GUIDANCE; WITH TRANSBRONCHIAL NEEDLE ASPIRATION BIOPSY(S), EACH ADDITIONAL LOBE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)	N/A	N/A	N/A	$62.93	N/A
31635	BRONCHOSCOPY (RIGID OR FLEXIBLE); WITH REMOVAL OF FOREIGN BODY	N/A	N/A	N/A	$178.87	N/A
31643	BRONCHOSCOPY, (RIGID OR FLEXIBLE); WITH PLACEMENT OF CATHETER(S) FOR INTRACAVITARY RADIOELEMENT APPLICATION	N/A	N/A	N/A	$165.78	N/A
31645	BRONCHOSCOPY, (RIGID OR FLEXIBLE); WITH THERAPEUTIC ASPIRATION OF TRACHEOBRONCHIAL TREE, INITIAL (EG, DRAINAGE OF LUNG ABSCESS)	N/A	N/A	N/A	$149.78	N/A
31646	BRONCHOSCOPY, (RIGID OR FLEXIBLE); WITH THERAPEUTIC ASPIRATION OF TRACHEOBRONCHIAL TREE, SUBSEQUENT	N/A	N/A	N/A	$130.29	N/A
31656	BRONCHOSCOPY, (RIGID OR FLEXIBLE); WITH INJECTION OF CONTRAST MATERIAL FOR SEGMENTAL BRONCHOGRAPHY (FIBERSCOPE ONLY)	N/A	N/A	N/A	$105.47	N/A
31730	TRANSTRACHEAL (PERCUTANEOUS) INTRODUCTION OF NEEDLE WIRE DILATOR/ STENT OR INDWELLING TUBE FOR OXYGEN THERAPY	N/A	N/A	N/A	$135.53	N/A
31820	SURGICAL CLOSURE TRACHEOSTOMY OR FISTULA; WITHOUT PLASTIC REPAIR	N/A	N/A	N/A	$287.12	N/A
31825	SURGICAL CLOSURE TRACHEOSTOMY OR FISTULA; WITH PLASTIC REPAIR	N/A	N/A	N/A	$426.93	N/A
32019	INSERTION OF INDWELLING TUNNELED PLEURAL CATHETER WITH CUFF	N/A	N/A	N/A	$209.21	N/A
32020	TUBE THORACOSTOMY WITH OR WITHOUT WATER SEAL (EG, FOR ABSCESS, HEMOTHORAX, EMPYEMA) (SEPARATE PROCEDURE)	N/A	N/A	N/A	$167.92	N/A
32400	BIOPSY, PLEURA; PERCUTANEOUS NEEDLE	N/A	N/A	N/A	$81.04	N/A
32405	BIOPSY, LUNG OR MEDIASTINUM, PERCUTANEOUS NEEDLE	N/A	N/A	N/A	$90.15	N/A
32420	PNEUMOCENTESIS, PUNCTURE OF LUNG FOR ASPIRATION	N/A	N/A	N/A	$100.50	N/A
32501	RESECTION AND REPAIR OF PORTION OF BRONCHUS (BRONCHOPLASTY) WHEN PERFORMED AT TIME OF LOBECTOMY OR SEGMENTECTOMY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)	$36.88	N/A	N/A	$230.47	N/A
32601	THORACOSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE); LUNGS AND PLEURAL SPACE, WITHOUT BIOPSY	$46.11	N/A	N/A	$288.19	N/A
32602	THORACOSCOPY, DIAGNOSTIC (SEPARATE PROCEDURE); LUNGS AND PLEURAL SPACE, WITH BIOPSY	$50.05	N/A	N/A	$312.83	N/A
32656	THORACOSCOPY, SURGICAL; WITH PARIETAL PLEURECTOMY	$121.88	N/A	N/A	$761.76	N/A
32657	THORACOSCOPY, SURGICAL; WITH WEDGE RESECTION OF LUNG, SINGLE OR MULTIPLE	$119.62	N/A	N/A	$747.61	N/A
32658	THORACOSCOPY, SURGICAL; WITH REMOVAL OF CLOT OR FOREIGN BODY FROM PERICARDIAL SAC	$109.65	N/A	N/A	$685.33	N/A
32659	THORACOSCOPY, SURGICAL; WITH CREATION OF PERICARDIAL WINDOW OR PARTIAL RESECTION OF PERICARDIAL SAC FOR DRAINAGE	$111.24	N/A	N/A	$695.27	N/A
32660	THORACOSCOPY, SURGICAL; WITH TOTAL PERICARDIECTOMY	$155.75	N/A	N/A	$973.41	N/A
32661	THORACOSCOPY, SURGICAL; WITH EXCISION OF PERICARDIAL CYST, TUMOR OR MASS	$122.19	N/A	N/A	$763.67	N/A
32662	THORACOSCOPY, SURGICAL; WITH EXCISION OF MEDIASTINAL CYST, TUMOR OR MASS	$137.24	N/A	N/A	$857.73	N/A
32664	THORACOSCOPY, SURGICAL; WITH THORACIC SYMPATHECTOMY	$128.88	N/A	N/A	$805.51	N/A
33010	PERICARDIOCENTESIS; INITIAL	N/A	N/A	N/A	$109.50	N/A
33011	PERICARDIOCENTESIS; SUBSEQUENT	N/A	N/A	N/A	$111.17	N/A
33141	TRANSMYOCARDIAL LASER REVASCULARIZATION, BY THORACOTOMY; PERFORMED AT THE TIME OF OTHER OPEN CARDIAC PROCEDURE(S) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)	$24.76	N/A	N/A	$154.76	N/A

[37 Pa.B. 6610][Saturday, December 15, 2007]

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[37 Pa.B. 6610]
[Saturday, December 15, 2007]