[39 Pa.B. 2860]
[Saturday, June 6, 2009]
[Continued from previous Web Page]
Procedure Code/
Modifier SU, TH, NU or U7 where indicatedProcedure 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 SU, TH, NU or U731631 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 $213.75 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 $50.49 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 $62.08 31635 Bronchoscopy, rigid or flexible, with or without fluoroscopic guidance; with removal of foreign body N/A N/A N/A $176.15 31643 Bronchoscopy (rigid or flexible); with placement of catheter(s) for intracavitary radioelement application N/A N/A N/A $163.41 31645 Bronchoscopy (rigid or flexible); with therapeutic aspiration of tracheobronchial tree, initial (e.g., drainage of lung abscess) N/A N/A N/A $147.80 31646 Bronchoscopy (rigid or flexible); with therapeutic aspiration of tracheobronchial tree, subsequent N/A N/A N/A $128.44 31656 Bronchoscopy (rigid or flexible); with injection of contrast material for segmental bronchography (fiberscope only) N/A N/A N/A $104.56 31730 Transtracheal (percutaneous) introduction of needle wire dilator/stent or indwelling tube for oxygen therapy N/A N/A N/A $133.39 31825 Surgical closure tracheostomy or fistula; with plastic repair N/A N/A N/A $424.79 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.) $36.84 N/A N/A $230.27 32656 Thoracoscopy, surgical; with parietal pleurectomy $120.32 N/A N/A $752.01 32657 Thoracoscopy, surgical; with wedge resection of lung, single or multiple $118.46 N/A N/A $740.36 32658 Thoracoscopy, surgical; with removal of clot or foreign body from pericardial sac $108.05 N/A N/A $675.34 32659 Thoracoscopy, surgical; with creation of pericardial window or partial resection of pericardial sac for drainage $109.81 N/A N/A $686.30 32660 Thoracoscopy, surgical; with total pericardiectomy $154.46 N/A N/A $965.35 32661 Thoracoscopy, surgical; with excision of pericardial cyst, tumor or mass $120.81 N/A N/A $755.08 32662 Thoracoscopy, surgical; with excision of mediastinal cyst, tumor or mass $135.59 N/A N/A $847.41 32664 Thoracoscopy, surgical; with thoracic sympathectomy $126.49 N/A N/A $790.54 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.) $24.17 N/A N/A $151.04 33207 Insertion or replacement of permanent pacemaker with transvenous electrode(s); ventricular N/A N/A N/A $461.18 33508 Endoscopy, surgical, including video-assisted harvest of vein(s) for coronary artery bypass procedure (List separately in addition to code for primary procedure.) $2.43 N/A N/A $15.19 33924 Ligation and takedown of a systemic-to-pulmonary artery shunt, performed in conjunction with a congenital heart procedure (List separately in addition to code for primary procedure.) $43.70 N/A N/A $273.13 33961 Prolonged extracorporeal circulation for cardiopulmonary insufficiency; each additional 24 hours (List separately in addition to code for primary procedure.) $81.97 N/A N/A $512.33 33968 Removal of intra-aortic balloon assist device, percutaneous N/A N/A N/A $32.18 34101 Embolectomy or thrombectomy, with or without catheter; axillary, brachial, innominate, subclavian artery, by arm incision $93.16 N/A N/A $582.24 34111 Embolectomy or thrombectomy, with or without catheter; radial or ulnar artery, by arm incision $93.05 N/A N/A $581.54 35180 Repair, congenital arteriovenous fistula; head and neck $123.04 N/A N/A $768.99 35188 Repair, acquired or traumatic arteriovenous fistula; head and neck $131.86 N/A N/A $824.11 35190 Repair, acquired or traumatic arteriovenous fistula; extremities $114.47 N/A N/A $715.44 35207 Repair blood vessel, direct; hand, finger $105.65 N/A N/A $660.29 35390 Reoperation, carotid, thromboendarterectomy, more than 1 month after original operation (List separately in addition to code for primary procedure.) $24.99 N/A N/A $156.18 35450 Transluminal balloon angioplasty, open; renal or other visceral artery $79.29 N/A N/A $495.56 35454 Transluminal balloon angioplasty, open; iliac $48.69 N/A N/A $304.34 35456 Transluminal balloon angioplasty, open; femoral-popliteal N/A N/A N/A $368.14 35458 Transluminal balloon angioplasty, open; brachiocephalic trunk or branches, each vessel $75.58 N/A N/A $472.35 35475 Transluminal balloon angioplasty, percutaneous; brachiocephalic trunk or branches, each vessel $73.76 N/A N/A $460.97 35482 Transluminal peripheral atherectomy, open; iliac $53.49 N/A N/A $334.32 35483 Transluminal peripheral atherectomy, open; femoral-popliteal $65.50 N/A N/A $409.39 35484 Transluminal peripheral atherectomy, open; brachiocephalic trunk or branches, each vessel $81.80 N/A N/A $511.28 35485 Transluminal peripheral atherectomy, open; tibioperoneal trunk and branches $76.42 N/A N/A $477.65 35612 Bypass graft, with other than vein; subclavian-subclavian $141.13 N/A N/A $882.09 35642 Bypass graft, with other than vein; carotid-vertebral $155.69 N/A N/A $973.04 35681 Bypass graft; composite, prosthetic and vein (List separately in addition to code for primary procedure.) $12.52 N/A N/A $78.28 35682 Bypass graft; autogenous composite, 2 segments of veins from 2 locations (List separately in addition to code for primary procedure.) $55.82 N/A N/A $348.90 35683 Bypass graft; autogenous composite, 3 or more segments of vein from 2 or more locations (List separately in addition to code for primary procedure.) $65.75 N/A N/A $410.96 35685 Placement of vein patch or cuff at distal anastomosis of bypass graft, synthetic conduit (List separately in addition to code for primary procedure.) $31.41 N/A N/A $196.34 35686 Creation of distal arteriovenous fistula during lower extremity bypass surgery (non-hemodialysis) (List separately in addition to code for primary procedure.) $26.12 N/A N/A $163.23 35691 Transposition and/or reimplantation; vertebral to carotid artery $153.09 N/A N/A $956.82 35700 Reoperation, femoral-popliteal or femoral (popliteal)-anterior tibial, posterior tibial, peroneal artery, or other distal vessels, more than 1 month after original operation (List separately in addition to code for primary procedure.) $23.99 N/A N/A $149.92 35875 Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula) $91.56 N/A N/A $572.25 35901 Excision of infected graft; neck $77.44 N/A N/A $484.03 36120 Introduction of needle or intracatheter; retrograde brachial artery N/A N/A N/A $94.00 36420 Venipuncture, cutdown; younger than age 1 year N/A N/A N/A $44.75 36455 Exchange transfusion, blood; other than newborn N/A N/A N/A $116.11 36460 Transfusion, intrauterine, fetal N/A N/A N/A $319.41 36471 Injection of sclerosing solution; multiple veins, same leg N/A N/A N/A $91.12 36516 Therapeutic apheresis; with extracorporeal selective adsorption or selective filtration and plasma reinfusion N/A N/A N/A $58.58 36555 Insertion of non-tunneled centrally inserted central venous catheter; younger than 5 years of age N/A N/A N/A $117.84 36556 Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older N/A N/A N/A $113.21 36557 Insertion of tunneled centrally inserted central venous catheter, without subcutaneous port or pump; younger than 5 years of age N/A N/A N/A $277.74 36561 Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older $51.09 N/A N/A $319.32 36563 Insertion of tunneled centrally inserted central venous access device with subcutaneous pump N/A N/A N/A $335.47 36565 Insertion of tunneled centrally inserted central venous access device, requiring 2 catheters via 2 separate venous access sites; without subcutaneous port or pump (e.g., Tesio type catheter) N/A N/A N/A $316.18 36566 Insertion of tunneled centrally inserted central venous access device, requiring 2 catheters via 2 separate venous access sites; with subcutaneous port(s) N/A N/A N/A $338.16 36570 Insertion of peripherally inserted central venous access device, with subcutaneous port; younger than 5 years of age N/A N/A N/A $282.89 36576 Repair of central venous access device, with subcutaneous port or pump, central or peripheral insertion site N/A N/A N/A $174.10 36578 Replacement, catheter only, of central venous access device, with subcutaneous port or pump, central or peripheral insertion site N/A N/A N/A $199.32 36582 Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous port, through same venous access N/A N/A N/A $274.21 36583 Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous pump, through same venous access N/A N/A N/A $276.43 36585 Replacement, complete, of a peripherally inserted central venous access device, with subcutaneous port, through same venous access N/A N/A N/A $258.09 36589 Removal of tunneled central venous catheter, without subcutaneous port or pump N/A N/A N/A $130.35 36598 Contrast injection(s) for radiologic evaluation of existing central venous access device, including fluoroscopy, image documentation and report N/A N/A N/A $77.37 36620 Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); percutaneous N/A N/A N/A $47.58 36800 Insertion of cannula for hemodialysis, other purpose (separate procedure); vein to vein N/A N/A N/A $148.57 36810 Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external (Scribner type) N/A N/A N/A $201.22 36815 Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external revision, or closure N/A N/A N/A $138.78 36821 Arteriovenous anastomosis, open; direct, any site (e.g., Cimino type) (separate procedure) N/A N/A N/A $500.61 36825 Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); autogenous graft N/A N/A N/A $545.30 36830 Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); nonautogenous graft (e.g., biological collagen, thermoplastic graft) $99.97 N/A N/A $624.80 36832 Revision, open, arteriovenous fistula; without thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure) $88.16 N/A N/A $551.00 36834 Plastic repair of arteriovenous aneurysm (separate procedure) $92.49 N/A N/A $578.09 36835 Insertion of Thomas shunt (separate procedure) $67.90 N/A N/A $424.39 36860 External cannula declotting (separate procedure); without balloon catheter N/A N/A N/A $93.97 36861 External cannula declotting (separate procedure); with balloon catheter N/A N/A N/A $141.19 36870 Thrombectomy, percutaneous, arteriovenous fistula, autogenous or nonautogenous graft (includes mechanical thrombus extraction and intra-graft thrombolysis) $45.87 N/A N/A $286.70 37207 Transcatheter placement of an intravascular stent(s) (non-coronary vessel), open; initial vessel N/A N/A N/A $415.50 37208 Transcatheter placement of an intravascular stent(s) (non-coronary vessel), open; each additional vessel (List separately in addition to code for primary procedure.) N/A N/A N/A $200.76 37700 Ligation and division of long saphenous vein at saphenofemoral junction, or distal interruptions $37.63 N/A N/A $235.16 38102 Splenectomy; total, en bloc for extensive disease, in conjunction with other procedure (List in addition to code for primary procedure.) $37.28 N/A N/A $233.01 38205 Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogenic N/A N/A N/A $73.66 38206 Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous N/A N/A N/A $74.01 38220 Bone marrow; aspiration only N/A N/A N/A $54.68 38221 Bone marrow; biopsy, needle or trocar N/A N/A N/A $69.82 38240 Bone marrow or blood-derived peripheral stem cell transplantation; allogenic N/A N/A N/A $113.08 38241 Bone marrow or blood-derived peripheral stem cell transplantation; autologous $18.15 N/A N/A $113.42 38381 Suture and/or ligation of thoracic duct; thoracic approach N/C N/A N/A $738.43 38747 Abdominal lymphadenectomy, regional, including celiac, gastric, portal, peripancreatic, with or without para-aortic and vena caval nodes (List separately in addition to code for primary procedure.) $38.05 N/A N/A $237.81 39501 Repair, laceration of diaphragm, any approach $118.90 N/A N/A $743.14 39545 Imbrication of diaphragm for eventration, transthoracic or transabdominal, paralytic or nonparalytic $129.09 N/A N/A $806.81 40510 Excision of lip; transverse wedge excision with primary closure N/A N/A N/A $309.31 40525 Excision of lip; full thickness, reconstruction with local flap (e.g., Estlander or fan) N/A N/A N/A $488.15 40527 Excision of lip; full thickness, reconstruction with cross lip flap (Abbe-Estlander) N/A N/A N/A $578.14 41114 Excision of lesion of tongue with closure; with local tongue flap N/A N/A N/A $556.76 41510 Suture of tongue to lip for micrognathia (Douglas type procedure) N/A N/A N/A $373.92 41825 Excision of lesion or tumor (except listed above), dentoalveolar structures; without repair N/A N/A N/A $115.43 42106 Excision, lesion of palate, uvula; with simple primary closure N/A N/A N/A $158.83 42280 Maxillary impression for palatal prosthesis N/A N/A N/A $93.43 42440 Excision of submandibular (submaxillary) gland $65.33 N/A N/A $408.33 42509 Parotid duct diversion, bilateral (Wilke type procedure); with excision of both submandibular glands N/A N/A N/A $756.80 42510 Parotid duct diversion, bilateral (Wilke type procedure); with ligation of both submandibular (Wharton's) ducts $89.01 N/A N/A $556.34 42900 Suture pharynx for wound or injury N/A N/A N/A $309.43 43020 Esophagotomy, cervical approach, with removal of foreign body $76.52 N/A N/A $478.22 43100 Excision of lesion, esophagus, with primary repair; cervical approach $88.43 N/A N/A $552.66 43200 Esophagoscopy, rigid or flexible; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) N/A N/A N/A $93.47 43300 Esophagoplasty (plastic repair or reconstruction), cervical approach; without repair of tracheoesophageal fistula $88.69 N/A N/A $554.29 43635 Vagotomy when performed with partial distal gastrectomy (List separately in addition to code[s] for primary procedure.) $15.97 N/A N/A $99.82 44015 Tube or needle catheter jejunostomy for enteral alimentation, intraoperative, any method (List separately in addition to primary procedure.) N/A N/A N/A $127.64 44121 Enterectomy, resection of small intestine; each additional resection and anastomosis (List separately in addition to code for primary procedure.) $34.49 N/A N/A $215.59 44139 Mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (List separately in addition to primary procedure.) $17.22 N/A N/A $107.63 44701 Intraoperative colonic lavage (List separately in addition to code for primary procedure.) $23.82 N/A N/A $148.87 44955 Appendectomy; when done for indicated purpose at time of other major procedure (not as separate procedure) (List separately in addition to code for primary procedure.) N/A N/A N/A $74.92 45309 Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by snare technique N/A N/A N/A $84.24 46608 Anoscopy; with removal of foreign body N/A N/A N/A $70.37 46610 Anoscopy; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery N/A N/A N/A $69.28 46611 Anoscopy; with removal of single tumor, polyp, or other lesion by snare technique N/A N/A N/A $73.53 46614 Anoscopy; with control of bleeding (e.g., injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator) N/A N/A N/A $64.33 46615 Anoscopy; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique N/A N/A N/A $91.65 47001 Biopsy of liver, needle; when done for indicated purpose at time of other major procedure (List separately in addition to code for primary procedure.) N/A N/A N/A $92.38 47550 Biliary endoscopy, intraoperative (choledochoscopy) (List separately in addition to code for primary procedure.) N/A N/A N/A $146.93 47560 Laparoscopy, surgical; with guided transhepatic cholangiography, without biopsy $38.00 N/A N/A $237.47 47561 Laparoscopy, surgical; with guided transhepatic cholangiography with biopsy $41.25 N/A N/A $257.79 48400 Injection procedure for intraoperative pancreatography (List separately in addition to code for primary procedure.) N/A N/A N/A $93.50 49322 Laparoscopy, surgical; with aspiration of cavity or cyst (e.g., ovarian cyst) (single or multiple) $51.70 N/A N/A $323.14 49568 Implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection (List separately in addition to code for the incisional or ventral hernia repair.) $37.94 N/A N/A $237.12 49905 Omental flap, intra-abdominal (List separately in addition to code for primary procedure.) $50.47 N/A N/A $315.45 52327 Cystourethroscopy (including ureteral catheterization); with subureteric injection of implant material N/A N/A N/A $254.08 56605 Biopsy of vulva or perineum (separate procedure); one lesion N/A N/A N/A $55.51 56606 Biopsy of vulva or perineum (separate procedure); each separate additional lesion (List separately in addition to code for primary procedure.) N/A N/A N/A $27.40 56820 Colposcopy of the vulva N/A N/A N/A $77.24 56821 Colposcopy of the vulva; with biopsy(s) N/A N/A N/A $105.72 57065 Destruction of vaginal lesion(s); extensive (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery) N/A N/A N/A $154.44 57100 Biopsy of vaginal mucosa; simple (separate procedure) N/A N/A N/A $59.99 57150 Irrigation of vagina and/or application of medicament for treatment of bacterial, parasitic, or fungoid disease N/A N/A N/A $27.05 57420 Colposcopy of the entire vagina, with cervix if present N/A N/A N/A $81.73 57421 Colposcopy of the entire vagina, with cervix if present; with biopsy(s) of vagina/cervix N/A N/A N/A $112.78 57455 Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix N/A N/A N/A $101.68 57456 Colposcopy of the cervix including upper/adjacent vagina; with endocervical curettage N/A N/A N/A $95.01 57460 Colposcopy of the cervix including upper/adjacent vagina; with loop electrode biopsy(s) of the cervix N/A N/A N/A $149.80 57461 Colposcopy of the cervix including upper/adjacent vagina; with loop electrode conization of the cervix N/A N/A N/A $173.53 57522 Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision N/A N/A N/A $217.95 58356 Endometrial cryoablation with ultrasonic guidance, including endometrial curettage, when performed N/A N/A N/A $321.60 58555 Hysteroscopy, diagnostic (separate procedure) N/A N/A N/A $174.27 58605 Ligation or transection of fallopian tube(s), abdominal or vaginal approach, postpartum, unilateral or bilateral, during same hospitalization (separate procedure) $47.73 N/A N/A $298.34 58605-U7 Ligation or transection of fallopian tube(s), abdominal or vaginal approach, postpartum, unilateral or bilateral, during same hospitalization (separate procedure) N/A N/A N/A $298.34 58611-TH Ligation or transection of fallopian tube(s) when done at the time of cesarean delivery or intra-abdominal surgery (not a separate procedure) (List separately in addition to code for primary procedure.) N/A N/A N/A $71.89 58611 Ligation or transection of fallopian tube(s) when done at the time of cesarean delivery or intra-abdominal surgery (not a separate procedure) (List separately in addition to code for primary procedure.) $11.50 N/A N/A $71.89 58615 Occlusion of fallopian tube(s) by device (e.g., band, clip, Falope ring) vaginal or suprapubic approach N/A N/A N/A $230.31 58960 Laparotomy, for staging or restaging of ovarian, tubal or primary peritoneal malignancy (second look), with or without omentectomy, peritoneal washing, biopsy of abdominal and pelvic peritoneum, diaphragmatic assessment with pelvic and limited para-aortic lymphadenectomy $132.32 N/A N/A $827.01 60271 Thyroidectomy, including substernal thyroid; cervical approach $147.99 N/A N/A $924.93 60512 Parathyroid autotransplantation (List separately in addition to code for primary procedure.) $34.71 N/A N/A $216.94 61001 Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; subsequent taps N/A N/A N/A $92.86 61026 Ventricular puncture through previous burr hole, fontanelle, suture or implanted ventricular catheter/reservoir; with injection of medication or other substance for diagnosis or treatment N/A N/A N/A $115.19 61050 Cisternal or lateral cervical (C1-C2) puncture; without injection (separate procedure) N/A N/A N/A $96.71 61107 Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for implanting ventricular catheter, pressure recording device, or other intracerebral monitoring device N/A N/A N/A $289.18 61210 Burr hole(s); for implanting ventricular catheter, reservoir, EEG electrode(s), pressure recording device, or other cerebral monitoring device (separate procedure) N/A N/A N/A $337.05 61550 Craniectomy for craniosynostosis; single cranial suture $123.51 N/A N/A $771.96 61720 Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; globus pallidus or thalamus $159.72 N/A N/A $998.22 62287 Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, any method, single or multiple levels, lumbar (e.g., manual or automated percutaneous discectomy, percutaneous laser discectomy) $78.43 N/A N/A $490.18 62290 Injection procedure for discography, each level; lumbar N/A N/A N/A $152.63 62310 Injection, single (not via indwelling catheter), not including neurolytic substances, with or without contrast (for either localization or epidurography), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), epidural or subarachnoid; cervical or thoracic N/A N/A N/A $89.16 62311 Injection, single (not via indwelling catheter), not including neurolytic substances, with or without contrast (for either localization or epidurography), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), epidural or subarachnoid; lumbar, sacral (caudal) N/A N/A N/A $74.51 62318 Injection, including catheter placement, continuous infusion or intermittent bolus, not including neurolytic substances, with or without contrast (for either localization or epidurography), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), epidural or subarachnoid; cervical or thoracic N/A N/A N/A $91.64 62319 Injection, including catheter placement, continuous infusion or intermittent bolus, not including neurolytic substances, with or without contrast (for either localization or epidurography), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), epidural or subarachnoid; lumbar, sacral (caudal) N/A N/A N/A $84.88 63035 Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, including open and endoscopically-assisted approaches; each additional interspace, cervical or lumbar (List separately in addition to code for primary procedure.) $29.14 N/A N/A $182.11 63057 Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (e.g., herniated intervertebral disc), single segment; each additional segment, thoracic or lumbar (List separately in addition to code for primary procedure.) $47.99 N/A N/A $299.96 63066 Costovertebral approach with decompression of spinal cord or nerve root(s) (e.g., herniated intervertebral disc), thoracic; each additional segment (List separately in addition to code for primary procedure.) $29.40 N/A N/A $183.74 63076 Discectomy, 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.) $37.15 N/A N/A $232.20 63078 Discectomy, 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.) $29.35 N/A N/A $183.43 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.) $40.04 N/A N/A $250.23 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.) $28.18 N/A N/A $176.14 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.) $38.32 N/A N/A $239.47 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.) $26.26 N/A N/A $164.10 63600 Creation of lesion of spinal cord by stereotactic method, percutaneous, any modality (including stimulation and/or recording) N/A N/A N/A $722.50 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 $90.38 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 $57.77 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 $71.69 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 $43.26 64479 Injection, anesthetic agent and/or steroid, transforaminal epidural; cervical or thoracic, single level N/A N/A N/A $107.77 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 $70.34 64483 Injection, anesthetic agent and/or steroid, transforaminal epidural; lumbar or sacral, single level N/A N/A N/A $95.04 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 $59.60 64517 Injection, anesthetic agent; superior hypogastric plexus N/A N/A N/A $104.97 64575 Incision for implantation of neurostimulator electrodes; peripheral nerve (excludes sacral nerve) N/A N/A N/A $250.93 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 $42.94 64626 Destruction by neurolytic agent, paravertebral facet joint nerve; cervical or thoracic, single level N/A N/A N/A $201.96 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 $50.40 64681 Destruction by neurolytic agent, with or without radiologic monitoring; superior hypogastric plexus N/A N/A N/A $194.97 64708 Neuroplasty, major peripheral nerve, arm or leg; other than specified $64.11 N/A N/A $400.71 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 $167.77 64742 Transection or avulsion of; facial nerve, differential or complete $65.38 N/A N/A $408.62 64752 Transection or avulsion of; vagus nerve (vagotomy), transthoracic $68.52 N/A N/A $428.28 64778 Excision of neuroma; digital nerve, each additional digit (List separately in addition to code for primary procedure.) N/A N/A N/A $167.79 64787 Implantation of nerve end into bone or muscle (List separately in addition to neuroma excision.) $36.82 N/A N/A $230.14 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 $311.25 64859 Suture of each additional major peripheral nerve (List separately in addition to code for primary procedure.) $37.59 N/A N/A $234.96 64868 Anastomosis; facial-hypoglossal $146.67 N/A N/A $916.71 64870 Anastomosis; facial-phrenic $145.20 N/A N/A $907.50 64872 Suture of nerve; requiring secondary or delayed suture (List separately in addition to code for primary neurorrhaphy.) $17.50 N/A N/A $109.39 64874 Suture of nerve; requiring extensive mobilization, or transposition of nerve (List separately in addition to code for nerve suture.) $26.11 N/A N/A $163.18 64901 Nerve graft, each additional nerve; single strand (List separately in addition to code for primary procedure.) $87.34 N/A N/A $545.88 65125 Modification of ocular implant with placement or replacement of pegs (e.g., drilling receptacle for prosthesis appendage) (separate procedure) N/A N/A N/A $231.09 65150 Reinsertion of ocular implant; with or without conjunctival graft N/A N/A N/A $471.43 65410 Biopsy of cornea N/A N/A N/A $83.31 65435 Removal of corneal epithelium; with or without chemocauterization (abrasion, curettage) N/A N/A N/A $55.95 65600 Multiple punctures of anterior cornea (e.g., for corneal erosion, tattoo) N/A N/A N/A $259.74 65710 Keratoplasty (corneal transplant); anterior lamellar N/A N/A N/A $865.89 65730 Keratoplasty (corneal transplant); penetrating (except in aphakia or pseudophakia) N/A N/A N/A $961.26 65750 Keratoplasty (corneal transplant); penetrating (in aphakia) N/A N/A N/A $976.29 65755 Keratoplasty (corneal transplant); penetrating (in pseudophakia) N/A N/A N/A $970.38 65805 Paracentesis of anterior chamber of eye (separate procedure); with therapeutic release of aqueous N/A N/A N/A $105.84 65855 Trabeculoplasty by laser surgery, 1 or more sessions (defined treatment series) N/A N/A N/A $236.99 65860 Severing adhesions of anterior segment, laser technique (separate procedure) $32.86 N/A N/A $205.36 65900 Removal of epithelial downgrowth, anterior chamber of eye N/A N/A N/A $764.13 66130 Excision of lesion, sclera N/A N/A N/A $455.74 66225 Repair of scleral staphyloma; with graft N/A N/A N/A $728.26 66250 Revision or repair of operative wound of anterior segment, any type, early or late, major or minor procedure N/A N/A N/A $429.61 66625 Iridectomy, with corneoscleral or corneal section; peripheral for glaucoma (separate procedure) N/A N/A N/A $338.95 66700 Ciliary body destruction; diathermy N/A N/A N/A $309.33 66720 Ciliary body destruction; cryotherapy N/A N/A N/A $329.65 66740 Ciliary body destruction; cyclodialysis N/A N/A N/A $310.02 66770 Destruction of cyst or lesion iris or ciliary body (nonexcisional procedure) N/A N/A N/A $373.27 66820 Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); stab incision technique (Ziegler or Wheeler knife) N/A N/A N/A $320.29 66830 Removal of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid) with corneo-scleral section, with or without iridectomy (iridocapsulotomy, iridocapsulectomy) N/A N/A N/A $555.50 66850 Removal of lens material; phacofragmentation technique (mechanical or ultrasonic) (e.g., phacoemulsification), with aspiration N/A N/A N/A $618.15
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