Pennsylvania Code
Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

• No statutes or acts will be found at this website.

The Pennsylvania Bulletin website includes the following: Rulemakings by State agencies; Proposed Rulemakings by State agencies; State agency notices; the Governor’s Proclamations and Executive Orders; Actions by the General Assembly; and Statewide and local court rules.

PA Bulletin, Doc. No. 07-2316e

[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
63047 LAMINECTOMY, FACETECTOMY AND FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA AND/OR NERVE ROOT(S), (EG, SPINAL OR LATERAL RECESS STENOSIS)), SINGLE VERTEBRAL SEGMENT; LUMBAR $152.25 N/A N/A $951.59 N/A
63048 LAMINECTOMY, FACETECTOMY AND FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA AND/OR NERVE ROOT(S), (EG, SPINAL OR LATERAL RECESS STENOSIS)), SINGLE VERTEBRAL SEGMENT; EACH ADDITIONAL SEGMENT, CERVICAL, THORACIC, OR LUMBAR (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) $31.04 N/A N/A $194.01 N/A
63057 TRANSPEDICULAR APPROACH WITH DECOMPRESSION OF SPINAL CORD, EQUINA AND/OR NERVE ROOT(S) (EG, HERNIATED INTERVERTEBRAL DISK), SINGLE SEGMENT; EACH ADDITIONAL SEGMENT, THORACIC OR LUMBAR (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) $48.03 N/A N/A $300.16 N/A
63066 COSTOVERTEBRAL APPROACH WITH DECOMPRESSION OF SPINAL CORD OR NERVE ROOT(S), (EG, HERNIATED INTERVERTEBRAL DISK), THORACIC; EACH ADDITIONAL SEGMENT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) $29.64 N/A N/A $185.22 N/A
63076 DISKECTOMY, ANTERIOR, WITH DECOMPRESSION OF SPINAL CORD AND/ OR NERVE ROOT(S), INCLUDING OSTEOPHYTECTOMY; CERVICAL, EACH ADDITIONAL INTERSPACE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) $37.21 N/A N/A $232.54 N/A
63078 DISKECTOMY, ANTERIOR, WITH DECOMPRESSION OF SPINAL CORD AND/OR NERVE ROOT(S), INCLUDING OSTEOPHYTECTOMY; THORACIC, EACH ADDITIONAL INTERSPACE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) $29.50 N/A N/A $184.39 N/A
63082 VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, ANTERIOR APPROACH WITH DECOMPRESSION OF SPINAL CORD AND/OR NERVE ROOT(S); CERVICAL, EACH ADDITIONAL SEGMENT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) $40.13 N/A N/A $250.81 N/A
63086 VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, TRANSTHORACIC APPROACH WITH DECOMPRESSION OF SPINAL CORD AND/OR NERVE ROOT(S); THORACIC, EACH ADDITIONAL SEGMENT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) $28.41 N/A N/A $177.54 N/A
63088 VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, COMBINED THORACOLUMBAR APPROACH WITH DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA OR NERVE ROOT(S), LOWER THORACIC OR LUMBAR; EACH ADDITIONAL SEGMENT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) $38.71 N/A N/A $241.95 N/A
63091 VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, TRANSPERITONEAL OR RETROPERITONEAL APPROACH WITH DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA OR NERVE ROOT(S), LOWER THORACIC, LUMBAR OR SACRAL; EACH ADDITIONAL SEGMENT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) $26.43 N/A N/A $165.16 N/A
63308 VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, FOR EXCISION OF INTRASPINAL LESION, SINGLE SEGMENT; EACH ADDITIONAL SEGMENT (LIST SEPARATELY IN ADDITION TO CODES FOR SINGLE SEGMENT) $48.14 N/A N/A $300.86 N/A
63600 CREATION OF LESION OF SPINAL CORD BY STEREOTACTIC METHOD, PERCUTANEOUS, ANY MODALITY (INCLUDING STIMULATION AND/OR RECORDING) N/A N/A N/A $735.14 N/A
63709 REPAIR OF DURAL/CEREBROSPINAL FLUID LEAK OR PSEUDOMENINGOCELE, WITH LAMINECTOMY $150.70 N/A N/A $941.85 N/A
63710 DURAL GRAFT, SPINAL $149.59 N/A N/A $934.92 N/A
63741 CREATION OF SHUNT, LUMBAR, SUBARACHNOID-PERITONEAL, -PLEURAL OR OTHER; PERCUTANEOUS, NOT REQUIRING LAMINECTOMY $83.36 N/A N/A $521.00 N/A
64470 INJECTION, ANESTHETIC AGENT AND/OR STEROID, PARAVERTEBRAL FACET JOINT OR FACET JOINT NERVE; CERVICAL OR THORACIC, SINGLE LEVEL N/A N/A N/A $90.54 N/A
64472 INJECTION, ANESTHETIC AGENT AND/OR STEROID, PARAVERTEBRAL FACET JOINT OR FACET JOINT NERVE; CERVICAL OR THORACIC, EACH ADDITIONAL LEVEL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) N/A N/A N/A $58.01 N/A
64475 INJECTION, ANESTHETIC AGENT AND/OR STEROID, PARAVERTEBRAL FACET JOINT OR FACET JOINT NERVE; LUMBAR OR SACRAL, SINGLE LEVEL N/A N/A N/A $72.38 N/A
64476 INJECTION, ANESTHETIC AGENT AND/OR STEROID, PARAVERTEBRAL FACET JOINT OR FACET JOINT NERVE; LUMBAR OR SACRAL, EACH ADDITIONAL LEVEL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) N/A N/A N/A $43.68 N/A
64479 INJECTION, ANESTHETIC AGENT AND/OR STEROID, TRANSFORAMINAL EPIDURAL; CERVICAL OR THORACIC, SINGLE LEVEL N/A N/A N/A $108.45 N/A
64480 INJECTION, ANESTHETIC AGENT AND/OR STEROID, TRANSFORAMINAL EPIDURAL; CERVICAL OR THORACIC, EACH ADDITIONAL LEVEL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) N/A N/A N/A $71.10 N/A
64483 INJECTION, ANESTHETIC AGENT AND/OR STEROID, TRANSFORAMINAL EPIDURAL; LUMBAR OR SACRAL, SINGLE LEVEL N/A N/A N/A $95.86 N/A
64484 INJECTION, ANESTHETIC AGENT AND/OR STEROID, TRANSFORAMINAL EPIDURAL; LUMBAR OR SACRAL, EACH ADDITIONAL LEVEL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) N/A N/A N/A $60.21 N/A
64517 INJECTION, ANESTHETIC AGENT; SUPERIOR HYPOGASTRIC PLEXUS N/A N/A N/A $106.09 N/A
64555 PERCUTANEOUS IMPLANTATION OF NEUROSTIMULATOR ELECTRODES; PERIPHERAL NERVE (EXCLUDES SACRAL NERVE) N/A N/A N/A $125.92 N/A
64561 PERCUTANEOUS IMPLANTATION OF NEUROSTIMULATOR ELECTRODES; SACRAL NERVE (TRANSFORAMINAL PLACEMENT) N/A N/A N/A $360.85 N/A
64575 INCISION FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES; PERIPHERAL NERVE (EXCLUDES SACRAL NERVE) N/A N/A N/A $252.58 N/A
64585 REVISION OR REMOVAL OF PERIPHERAL NEUROSTIMULATOR ELECTRODES N/A N/A N/A $150.88 N/A
64590 INSERTION OR REPLACEMENT OF PERIPHERAL OR GASTRIC NEUROSTIMULATOR PULSE GENERATOR OR RECEIVER, DIRECT OR INDUCTIVE COUPLING $26.90 N/A N/A $168.15 N/A
64595 REVISION OR REMOVAL OF PERIPHERAL OR GASTRIC NEUROSTIMULATOR PULSE GENERATOR OR RECEIVER N/A N/A N/A $133.39 N/A
64614 CHEMODENERVATION OF MUSCLE(S); EXTREMITY(S) AND/OR TRUNK MUSCLE(S) (EG, FOR DYSTONIA, CEREBRAL PALSY, MULTIPLE SCLEROSIS) N/A N/A N/A $122.92 N/A
64623 DESTRUCTION BY NEUROLYTIC AGENT, PARAVERTEBRAL FACET JOINT NERVE; LUMBAR OR SACRAL, EACH ADDITIONAL LEVEL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) N/A N/A N/A $43.07 N/A
64626 DESTRUCTION BY NEUROLYTIC AGENT, PARAVERTEBRAL FACET JOINT NERVE; CERVICAL OR THORACIC, SINGLE LEVEL N/A N/A N/A $202.50 N/A
64627 DESTRUCTION BY NEUROLYTIC AGENT, PARAVERTEBRAL FACET JOINT NERVE; CERVICAL OR THORACIC, EACH ADDITIONAL LEVEL (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) N/A N/A N/A $50.42 N/A
64681 DESTRUCTION BY NEUROLYTIC AGENT, WITH OR WITHOUT RADIOLOGIC MONITORING; SUPERIOR HYPOGASTRIC PLEXUS N/A N/A N/A $201.33 N/A
64708 NEUROPLASTY, MAJOR PERIPHERAL NERVE, ARM OR LEG; OTHER THAN SPECIFIED $64.44 N/A N/A $402.74 N/A
64714 NEUROPLASTY, MAJOR PERIPHERAL NERVE, ARM OR LEG; LUMBAR PLEXUS $86.67 N/A N/A $541.68 N/A
64722 DECOMPRESSION; UNSPECIFIED NERVE(S) (SPECIFY) $44.53 N/A N/A $278.30 N/A
64726 DECOMPRESSION; PLANTAR DIGITAL NERVE N/A N/A N/A $255.10 N/A
64727 INTERNAL NEUROLYSIS, REQUIRING USE OF OPERATING MICROSCOPE (LIST SEPARATELY IN ADDITION TO CODE FOR NEUROPLASTY) (NEUROPLASTY INCLUDES EXTERNAL NEUROLYSIS) N/A N/A N/A $169.49 N/A
64740 TRANSECTION OR AVULSION OF; LINGUAL NERVE $63.80 N/A N/A $398.76 N/A
64742 TRANSECTION OR AVULSION OF; FACIAL NERVE, DIFFERENTIAL OR COMPLETE $65.70 N/A N/A $410.60 N/A
64752 TRANSECTION OR AVULSION OF; VAGUS NERVE (VAGOTOMY), TRANSTHORACIC $69.02 N/A N/A $431.36 N/A
64760 TRANSECTION OR AVULSION OF; VAGUS NERVE (VAGOTOMY), ABDOMINAL $64.22 N/A N/A $401.39 N/A
64761 TRANSECTION OR AVULSION OF; PUDENDAL NERVE N/A N/A N/A $376.77 N/A
64771 TRANSECTION OR AVULSION OF OTHER CRANIAL NERVE, EXTRADURAL $79.78 N/A N/A $498.63 N/A
64772 TRANSECTION OR AVULSION OF OTHER SPINAL NERVE, EXTRADURAL $76.51 N/A N/A $478.16 N/A
64778 EXCISION OF NEUROMA; DIGITAL NERVE, EACH ADDITIONAL DIGIT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) N/A N/A N/A $168.93 N/A
64787 IMPLANTATION OF NERVE END INTO BONE OR MUSCLE (LIST SEPARATELY IN ADDITION TO NEUROMA EXCISION) $37.16 N/A N/A $232.23 N/A
64795 BIOPSY OF NERVE N/A N/A N/A $170.75 N/A
64832 SUTURE OF DIGITAL NERVE, HAND OR FOOT; EACH ADDITIONAL DIGITAL NERVE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) N/A N/A N/A $313.99 N/A
64859SUTURE OF EACH ADDITIONAL MAJOR PERIPHERAL NERVE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) $38.06 N/A N/A $237.88 N/A
64868 ANASTOMOSIS; FACIAL-HYPOGLOSSAL $147.17 N/A N/A $919.79 N/A
64870 ANASTOMOSIS; FACIAL-PHRENIC $146.24 N/A N/A $914.00 N/A
64872 SUTURE OF NERVE; REQUIRING SECONDARY OR DELAYED SUTURE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY NEURORRHAPHY) $17.84 N/A N/A $111.50 N/A
64874 SUTURE OF NERVE; REQUIRING EXTENSIVE MOBILIZATION OR TRANSPOSITION OF NERVE (LIST SEPARATELY IN ADDITION TO CODE FOR NERVE SUTURE) $26.27 N/A N/A $164.21 N/A
64876 SUTURE OF NERVE; REQUIRING SHORTENING OF BONE OF EXTREMITY (LIST SEPARATELY IN ADDITION TO CODE FOR NERVE SUTURE) $28.85 N/A N/A $180.34 N/A
65125 MODIFICATION OF OCULAR IMPLANT WITH PLACEMENT OR REPLACEMENT OF PEGS (EG, DRILLING RECEPTACLE FOR PROSTHESIS APPENDAGE) (SEPARATE PROCEDURE) N/A N/A N/A $234.00 N/A
65150 REINSERTION OF OCULAR IMPLANT; WITH OR WITHOUT CONJUNCTIVAL GRAFT N/A N/A N/A $485.29 N/A
65410 BIOPSY OF CORNEA N/A N/A N/A $84.67 N/A
65435 REMOVAL OF CORNEAL EPITHELIUM; WITH OR WITHOUT CHEMOCAUTERIZATION (ABRASION, CURETTAGE) N/A N/A N/A $56.64 N/A
65600 MULTIPLE PUNCTURES OF ANTERIOR CORNEA (EG, FOR CORNEAL EROSION, TATTOO) N/A N/A N/A $260.30 N/A
65750 KERATOPLASTY (CORNEAL TRANSPLANT); PENETRATING (IN APHAKIA) N/A N/A N/A $990.94 N/A
65755KERATOPLASTY (CORNEAL TRANSPLANT); PENETRATING (IN PSEUDOPHAKIA) N/A N/A N/A $984.45 N/A
65805PARACENTESIS OF ANTERIOR CHAMBER OF EYE (SEPARATE PROCEDURE); WITH THERAPEUTIC RELEASE OF AQUEOUS N/A N/A N/A $107.63 N/A
65855TRABECULOPLASTY BY LASER SURGERY, ONE OR MORE SESSIONS (DEFINED TREATMENT SERIES) N/A N/A N/A $241.85 N/A
65860SEVERING ADHESIONS OF ANTERIOR SEGMENT, LASER TECHNIQUE (SEPARATE PROCEDURE) $33.53 N/A N/A $209.59 N/A
65900REMOVAL OF EPITHELIAL DOWNGROWTH, ANTERIOR CHAMBER OF EYE N/A N/A N/A $776.83 N/A
66130EXCISION OF LESION, SCLERA N/A N/A N/A $463.27 N/A
66250REVISION OR REPAIR OF OPERATIVE WOUND OF ANTERIOR SEGMENT, ANY TYPE, EARLY OR LATE, MAJOR OR MINOR PROCEDURE N/A N/A N/A $432.48 N/A
66625 IRIDECTOMY, WITH CORNEOSCLERAL OR CORNEAL SECTION; PERIPHERAL FOR GLAUCOMA (SEPARATE PROCEDURE) N/A N/A N/A $343.76 N/A
66700 CILIARY BODY DESTRUCTION; DIATHERMY N/A N/A N/A $312.92 N/A
66720 CILIARY BODY DESTRUCTION; CRYOTHERAPY N/A N/A N/A $332.73 N/A
66740 CILIARY BODY DESTRUCTION; CYCLODIALYSIS N/A N/A N/A $313.64 N/A
66770 DESTRUCTION OF CYST OR LESION IRIS OR CILIARY BODY (NONEXCISIONAL PROCEDURE) N/A N/A N/A $376.15 N/A
66920 REMOVAL OF LENS MATERIAL; INTRACAPSULAR N/A N/A N/A $598.66 N/A
66984 EXTRACAPSULAR CATARACT REMOVAL WITH INSERTION OF INTRAOCULAR LENS PROSTHESIS (ONE STAGE PROCEDURE), MANUAL OR MECHANICAL TECHNIQUE (EG, IRRIGATION AND ASPIRATION OR PHACOEMULSIFICATION) N/A N/A N/A $612.96 N/A
67005 REMOVAL OF VITREOUS, ANTERIOR APPROACH (OPEN SKY TECHNIQUE OR LIMBAL INCISION); PARTIAL REMOVAL N/A N/A N/A $370.92 N/A
67010REMOVAL OF VITREOUS, ANTERIOR APPROACH (OPEN SKY TECHNIQUE OR LIMBAL INCISION); SUBTOTAL REMOVAL WITH MECHANICAL VITRECTOMY N/A N/A N/A $430.33 N/A
67028 INTRAVITREAL INJECTION OF A PHARMACOLOGIC AGENT (SEPARATE PROCEDURE) N/A N/A N/A $138.28 N/A
67036VITRECTOMY, MECHANICAL, PARS PLANA APPROACH $123.27 N/A N/A $770.45 N/A
67107REPAIR OF RETINAL DETACHMENT; SCLERAL BUCKLING (SUCH AS LAMELLAR SCLERAL DISSECTION, IMBRICATION OR ENCIRCLING PROCEDURE), WITH OR WITHOUT IMPLANT, WITH OR WITHOUT CRYOTHERAPY, PHOTOCOAGULATION, AND DRAINAGE OF SUBRETINAL FLUID $154.04 N/A N/A $962.77 N/A
67221DESTRUCTION OF LOCALIZED LESION OF CHOROID (EG, CHOROIDAL NEOVASCULARIZATION); PHOTODYNAMIC THERAPY (INCLUDES INTRAVENOUS INFUSION) N/A N/A N/A $182.42 N/A
67225 DESTRUCTION OF LOCALIZED LESION OF CHOROID (EG, CHOROIDAL NEOVASCULARIZATION); PHOTODYNAMIC THERAPY, SECOND EYE, AT SINGLE SESSION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY EYE TREATMENT) N/A N/A N/A $23.37 N/A
67250 SCLERAL REINFORCEMENT (SEPARATE PROCEDURE); WITHOUT GRAFT N/A N/A N/A $640.51 N/A
67255SCLERAL REINFORCEMENT (SEPARATE PROCEDURE); WITH GRAFT N/A N/A N/A $682.40 N/A
67335PLACEMENT OF ADJUSTABLE SUTURE(S) DURING STRABISMUS SURGERY, INCLUDING POSTOPERATIVE ADJUSTMENT(S) OF SUTURE(S) (LIST SEPARATELY IN ADDITION TO CODE FOR SPECIFIC STRABISMUS SURGERY) N/A N/A N/A $125.80 N/A
67345CHEMODECHEMODENERVATION OF EXTRAOCULAR MUSCLE N/A N/A N/A $173.82 N/A
67415FINE NEEDLE ASPIRATION OF ORBITAL CONTENTS N/A N/A N/A $87.59 N/A
67715CANTHOTOMY (SEPARATE PROCEDURE) N/A N/A N/A $87.76 N/A
67825CORRECTION OF TRICHIASIS; EPILATION BY OTHER THAN FORCEPS (EG, BY ELECTROSURGERY, CRYOTHERAPY, LASER SURGERY) N/A N/A N/A $97.48 N/A
67830CORRECTION OF TRICHIASIS; INCISION OF LID MARGIN N/A N/A N/A $111.51 N/A
67835CORRECTION OF TRICHIASIS; INCISION OF LID MARGIN, WITH FREE MUCOUS MEMBRANE GRAFT N/A N/A N/A $354.65 N/A
67875TEMPORARY CLOSURE OF EYELIDS BY SUTURE (EG, FROST SUTURE) N/A N/A N/A $79.48 N/A
67882CONSTRUCTION OF INTERMARGINAL ADHESIONS, MEDIAN TARSORRHAPHY OR CANTHORRHAPHY; WITH TRANSPOSITION OF TARSAL PLATE N/A N/A N/A $371.03 N/A
67901REPAIR OF BLEPHAROPTOSIS; FRONTALIS MUSCLE TECHNIQUE WITH SUTURE OR OTHER MATERIAL (EG, BANKED FASCIA) N/A N/A N/A $456.93 N/A
67903 REPAIR OF BLEPHAROPTOSIS; (TARSO) LEVATOR RESECTION OR ADVANCEMENT, INTERNAL APPROACH N/A N/A N/A $413.34 N/A
67906REPAIR OF BLEPHAROPTOSIS; SUPERIOR RECTUS TECHNIQUE WITH FASCIAL SLING (INCLUDES OBTAINING FASCIA) N/A N/A N/A $416.48 N/A
67908REPAIR OF BLEPHAROPTOSIS; CONJUNCTIVO-TARSO-MULLEROS MUSCLE-LEVATOR RESECTION (EG, FASANELLA-SERVAT TYPE) N/A N/A N/A $359.43 N/A
67912CORRECTION OF LAGOPHTHALMOS, WITH IMPLANTATION OF UPPER EYELID LID LOAD (EG, GOLD WEIGHT) N/A N/A N/A $403.93 N/A
67914REPAIR OF ECTROPION; SUTURE N/A N/A N/A $234.34 N/A
67916REPAIR OF ECTROPION; EXCISION TARSAL WEDGE N/A N/A N/A $350.77 N/A
67921REPAIR OF ENTROPION; SUTURE N/A N/A N/A $219.13 N/A
67924REPAIR OF ENTROPION; EXTENSIVE (EG, TARSAL STRIP OR CAPSULOPALPEBRAL FASCIA REPAIRS OPERATION) N/A N/A N/A $364.54 N/A
67935SUTURE OF RECENT WOUND, EYELID, INVOLVING LID MARGIN, TARSUS AND/OR PALPEBRAL CONJUNCTIVA DIRECT CLOSURE; FULL THICKNESS N/A N/A N/A $371.06 N/A
67950CANTHOPLASTY (RECONSTRUCTION OF CANTHUS) N/A N/A N/A $383.96 N/A
68200SUBCONJUNCTIVAL INJECTION N/A N/A N/A $28.24 N/A
68320CONJUNCTIVOPLASTY; WITH CONJUNCTIVAL GRAFT OR EXTENSIVE REARRANGEMENT N/A N/A N/A $416.65 N/A
68720 DACRYOCYSTORHINOSTOMY (FISTULIZATION OF LACRIMAL SAC TO NASAL CAVITY) $97.63 N/A N/A $610.18 N/A
69005DRAINAGE EXTERNAL EAR, ABSCESS OR HEMATOMA; COMPLICATED N/A N/A N/A $137.48 N/A
69100BIOPSY EXTERNAL EAR N/A N/A N/A $42.27 N/A
69105BIOPSY EXTERNAL AUDITORY CANAL N/A N/A N/A $56.26 N/A
69120EXCISION EXTERNAL EAR; COMPLETE AMPUTATION N/A N/A N/A $352.98 N/A
69205REMOVAL FOREIGN BODY FROM EXTERNAL AUDITORY CANAL; WITH GENERAL ANESTHESIA N/A N/A N/A $88.81 N/A
69300OTOPLASTY, PROTRUDING EAR, WITH OR WITHOUT SIZE REDUCTION N/A N/A N/A $398.47 N/A
69310RECONSTRUCTION OF EXTERNAL AUDITORY CANAL (MEATOPLASTY) (EG, FOR STENOSIS DUE TO INJURY, INFECTION) (SEPARATE PROCEDURE) N/A N/A N/A $936.38 N/A
69424VENTILATING TUBE REMOVAL REQUIRING GENERAL ANESTHESIA N/A N/A N/A $53.86 N/A
69450TYMPANOLYSIS, TRANSCANAL N/A N/A N/A $445.75 N/A
69501TRANSMASTOID ANTROTOMY (SIMPLE MASTOIDECTOMY) N/A N/A N/A $631.78 N/A
69550EXCISION AURAL GLOMUS TUMOR; TRANSCANAL N/A N/A N/A $897.77 N/A
69620 MYRINGOPLASTY (SURGERY CONFINED TO DRUMHEAD AND DONOR AREA) N/A N/A N/A $424.41 N/A
69660STAPEDECTOMY OR STAPEDOTOMY WITH REESTABLISHMENT OF OSSICULAR CONTINUITY, WITH OR WITHOUT USE OF FOREIGN MATERIAL N/A N/A N/A $805.87 N/A
69801LABYRINTHOTOMY, WITH OR WITHOUT CRYOSURGERY INCLUDING OTHER NONEXCISIONAL DESTRUCTIVE PROCEDURES OR PERFUSION OF VESTIBULOACTIVE DRUGS (SINGLE OR MULTIPLE PERFUSIONS); TRANSCANAL N/A N/A N/A $633.02 N/A
69806ENDOLYMPHATIC SAC OPERATION; WITH SHUNT N/A N/A N/A $821.98 N/A
69990MICROSURGICAL TECHNIQUES, REQUIRING USE OF OPERATING MICROSCOPE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE) N/A N/A N/A $201.82 N/A
70015CISTERNOGRAPHY, POSITIVE CONTRAST, RADIOLOGICAL SUPERVISION AND INTERPRETATION N/A $55.97 No Change $104.56 N/A
70030 RADIOLOGIC EXAMINATION, EYE, FOR DETECTION OF FOREIGN BODY N/A $8.04 No Change $23.01 N/A
70100 RADIOLOGIC EXAMINATION, MANDIBLE; PARTIAL, LESS THAN FOUR VIEWS N/A $8.42 No Change $24.92 N/A
70120RADIOLOGIC EXAMINATION, MASTOIDS; LESS THAN THREE VIEWS PER SIDE N/A $8.42 No Change $24.92 N/A
70130RADIOLOGIC EXAMINATION, MASTOIDS; COMPLETE, MINIMUM OF THREE VIEWS PER SIDE N/A $16.12 No Change $43.62 N/A
70134 RADIOLOGIC EXAMINATION, INTERNAL AUDITORY MEATI, COMPLETE N/A $16.12 No Change $38.62 N/A
70140 RADIOLOGIC EXAMINATION, FACIAL BONES; LESS THAN THREE VIEWS N/A $8.80 No Change $28.80 N/A
70150RADIOLOGIC EXAMINATION, FACIAL BONES; COMPLETE, MINIMUM OF THREE VIEWS N/A $11.76 No Change $34.26 N/A
70170DACRYOCYSTOGRAPHY, NASOLACRIMAL DUCT, RADIOLOGICAL SUPERVISION AND INTERPRETATION N/A $13.96 No Change $40.46 N/A
70190RADIOLOGIC EXAMINATION; OPTIC FORAMINA N/A $9.90 No Change $30.90 N/A
70200RADIOLOGIC EXAMINATION; ORBITS, COMPLETE, MINIMUM OF FOUR VIEWS N/A $12.86 No Change $33.86 N/A
70210RADIOLOGIC EXAMINATION, SINUSES, PARANASAL, LESS THAN THREE VIEWS N/A $8.04 No Change $24.54 N/A
70220RADIOLOGIC EXAMINATION, SINUSES, PARANASAL, COMPLETE, MINIMUM OF THREE VIEWS N/A $11.38 No Change $33.88 N/A
70250RADIOLOGIC EXAMINATION, SKULL; LESS THAN FOUR VIEWS N/A $11.38 No Change $32.38 N/A
70260RADIOLOGIC EXAMINATION, SKULL; COMPLETE, MINIMUM OF FOUR VIEWS N/A $16.12 No Change $43.62 N/A
70320RADIOLOGIC EXAMINATION, TEETH; COMPLETE, FULL MOUTH N/A $10.62 No Change $34.61 N/A
70328RADIOLOGIC EXAMINATION, TEMPOROMANDIBULAR JOINT, OPEN AND CLOSED MOUTH; UNILATERAL N/A $8.42 No Change $24.92 N/A
70336MAGNETIC RESONANCE (EG, PROTON) IMAGING, TEMPOROMANDIBULAR JOINT(S) N/A $68.61 $264.55 $333.16 N/A
70350CEPHALOGRAM, ORTHODONTIC N/A $8.38 No Change $19.28 N/A
70355ORTHOPANTOGRAM N/A $9.52 No Change $27.00 N/A
70380RADIOLOGIC EXAMINATION, SALIVARY GLAND FOR CALCULUS N/A $8.04 No Change $29.04 N/A
70450COMPUTED TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL N/A $39.25 No Change $116.75 N/A
70460COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITH CONTRAST MATERIAL(S) N/A $52.49 No Change $134.00 N/A
70470COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS N/A $59.05 No Change $159.05 N/A
70480COMPUTED TOMOGRAPHY, ORBIT, SELLA OR POSTERIOR FOSSA OR OUTER, MIDDLE OR INNER EAR; WITHOUT CONTRAST MATERIAL N/A $59.43 No Change $173.43 N/A
70481COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA OR POSTERIOR FOSSA OR OUTER, MIDDLE OR INNER EAR; WITH CONTRAST MATERIAL(S) N/A $63.87 No Change $192.87 N/A
70482COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA OR POSTERIOR FOSSA OR OUTER, MIDDLE OR INNER EAR; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS N/A $66.83 No Change $218.83 N/A
70488COMPUTED TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS N/A $65.73 No Change $165.73 N/A
70496COMPUTED TOMOGRAPHIC ANGIOGRAPHY, HEAD, WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS, INCLUDING IMAGE POST-PROCESSING N/A $81.09 No Change $281.29 N/A
70498 COMPUTED TOMOGRAPHIC ANGIOGRAPHY, NECK, WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SECTIONS, INCLUDING IMAGE POST-PROCESSING N/A $81.09 No Change $281.29 N/A
70540MAGNETIC RESONANCE (EG, PROTON) IMAGING, ORBIT, FACE AND/OR NECK; WITHOUT CONTRAST MATERIAL(S) N/A $62.39 No Change $331.39 N/A
70542MAGNETIC RESONANCE (EG, PROTON) IMAGING, ORBIT, FACE AND NECK; WITH CONTRAST MATERIAL(S) N/A $74.91 No Change $382.66 N/A
70543MAGNETIC RESONANCE (EG, PROTON) IMAGING, ORBIT, FACE AND NECK; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES N/A $99.79 $472.77 $572.56 N/A
70544MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; WITHOUT CONTRAST MATERIAL(S) N/A $55.79 No Change $323.20 N/A
70545MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; WITH CONTRAST MATERIAL(S) N/A $55.45 No Change $322.86 N/A
70546MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES N/A $83.33 $473.32 $556.65 N/A
70547MAGNETIC RESONANCE ANGIOGRAPHY, NECK; WITHOUT CONTRAST MATERIAL(S) N/A $55.45 No Change $322.86 N/A
70548MAGNETIC RESONANCE ANGIOGRAPHY, NECK; WITH CONTRAST MATERIAL(S) N/A $55.45 No Change $322.86 N/A
70549MAGNETIC RESONANCE ANGIOGRAPHY, NECK; WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER SEQUENCES N/A No Change $473.32 $556.65 N/A
70551MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITHOUT CONTRAST MATERIAL N/A $68.61 No Change $337.61 N/A

[Continued on next Web Page]


No part of the information on this site may be reproduced for profit or sold for profit.

This material has been drawn directly from the official Pennsylvania Bulletin full text database. Due to the limitations of HTML or differences in display capabilities of different browsers, this version may differ slightly from the official printed version.