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TITLE 11. Insurance |
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Subchapter A. Life, Accident and Health Insurance |
Part 52. Minimum Standards for Form, Content and Sale of Health Insurance, Including Standards of Full and Fair Disclosure |
Sec. 52.80. State of New York Certified Surgical Fee Schedule
Latest version.
- The following schedule of relative values for surgery, with $6 applied to each unit of value, shall constitute the State of New York Certified Surgical Fee Schedule:INTEGUMENTARY SYSTEMSkin, Mucous Membrane, Subcutaneous and Areolar Tissues
Value Incision 0101 Incision and drainage of infected or noninfected sebaceous cyst2.0 (2nd lesion 50%; each additional lesion 25%) 0102 Incision and drainage of furuncle2.0 0103 Acne surgery; marsupialization, opening, or removal of multiple milia, comedones, cysts, pustules, etc.1.5 0108 Incision and drainage of carbuncle, suppurative hidradenitis and other cutaneous or subcutaneous abscesses simple2.0 0109 extensiveby report 0115 Drainage of pilonidal cyst2.0 0125 Drainage of onychia or paronychia2.0 0126 multiple or complicatedby report 0130 Incision and removal of foreign body, subcutaneous tissues, simple2.0 0131 complicated byby report 0140 Drainage of hematoma, simple2.0 0141 complicatedby report 0145 Puncture aspiration of abscess or hematoma1.0 Excision Debridement (for abrasions and burns see 0164, 0330–0334, 0351–0356.) 0160 Debridement of extensively eczematized or infected skin up to 10% of the body surface2.0 0161 for each additional 10% of body surface, add1.0 0162 Debridement of nails, any method, five or less2.0 0163 for each additional five or major portion thereof1.0 0164 Debridement of abrasionsby report Excision and Simple Closure—(Not reconstructive surgery; for reconstructive surgery see "Repair—Complex.") (For electro–surgical methods see 0401, et seq.) 0171 Biopsy; excision of skin, subcutaneous tissue or mucous membrane for biopsy (including simple closure) (independent procedure)3.0 Excision (including simple closure) of BENIGN cicatricial, fibrous, inflammatory, congenital, cystic, etc., lesions of skin, subcutaneous tissue or mucous membrane; one (see appropriate size below.) 0175 lesiondiameterup to¼inch4.0 0176 lesiondiameter¼to½5.0 0177 lesiondiameter½to¾6.0 0178 lesiondiametermore than¾inch or complicatedby report Excision (including simple closure) or treatment by any other method except radiation) of MALIGNANT lesions of skin or mucous membrane (except melanoma) to include local anesthesia. Trunk, arms or legs: 0188 lesion diameter up to¼inch6.0 0189 lesiondiameter¼to½inch8.0 0190 lesiondiameter½to¾inch10.0 Face, scalp, ears, neck, hands, feet, genitalia: 0191 lesiondiameterup to¼inch10.0 0192 lesiondiameterup to½inch15.0 0193 lesiondiameter½to¾inch20.0 Eyelids, nose, lips, mucous membrane: 0194 lesiondiameterup to¼inch15.0 0195 lesiondiameter¼to½inch20.0 0196 lesiondiameter½to¾inch25.0 0197 Lesions over¾inch, complicated or unusually locatedby report 0225 Avulsion, nail, partial, or complete, simple2.0 0228 Excision of nail or nail matrix, partial or complete, e.g., ingrown or deformed nail for permanent removal10.0 0238 Excision of pilonidal cyst or sinus30.0 Miscellaneous lesions (use appropriate procedure number and state diagnosis.) Hemangioma (see 0175–0178, 0260–0324.) Hidradenitis (see 0108, 0175–0178, 0260–0324.) Lipoma (see 0175–0178, 0260–0324.) Lymph node dissection (see 2651–2672.) Melanoma (see 0188–0197, 0260–0324.) Ulcer–vascular or inflammatory (see 0175–0178, 0260–0324.) Introduction 0242 Injection, intralesional (up to and including seven lesions)2.0 0243 more than seven3.0 Repair—Simple 0251 Wounds, recent, up to 2½inches2.0 0252 for each additional inch add1.0 REPAIR—COMPLEX (e.g., reconstructive surgery, complicated wound closure, skin grafts, etc.). The following values (0260–0324) are to be applied in situations requiring unusual and time–consuming techniques of repair to obtain the maximum functional and cosmetic result. Unless otherwise noted, the stated values include the creation of the defect and necessary preparation for repair, or the debridemnet and repair of complicated laceration (excluding 0251, 0252.) Excision and/or repair by direct closure of lesion or laceration resulting in a LINEAR REPAIR: 0260 up to½inch, forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet8.0 0261 eyelids, nose, ears and lips10.0 (See also 0290–0294, 2737–2746.) (For other areas see 0175–0178, 0188–0197, 0251–0252.) 0262 ½inch to 1 inch, trunk7.0 0263 scalp, arms and legs10.0 0264 forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet14.0 0265 eyelids, nose, ears and lips17.0 (See also 0290–0294, 2737–2746.) 0266 1 inch to 3 inches, trunk15.0 0267 scalp, arms and legs22.0 0268 forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet30.0 0269 eyelids, none, ears and lips40.0 (See also 0290–0294, 2737–2746.) 0270 Unusual, complicated or over 3 inch linear repairby report Excision and/or repair by adjacent tissue transfer or rearrangement (e.g., Z–plasty, rotation flap, advanced flap, double pedicle flap, etc.): 0275 for defect up to 1 square inch, trunk20.0 0276 scalp, arms and legs30.0 0277 forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet40.0 0278 eyelids, nose, ears and lips50.0 0279 defect size between 1 square inch and 3 square inches, trunk30.0 0280 scalp, arms and legs40.0 0281 forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet50.0 0282 eyelids, nose, ears and lips60.0 0283 more than 3 square inches, unusual or complicatedby report Eyelid, full thickness, excision and repair:0290 by advancement flaps, up to¼eyelid margin37.0 0291 over¼of eyelid margin50.0 0292 by transfer flaps of tarso–conjunctivea from opposing eyelid, up to/3of eyelid50.0 0293 total eyelid, one or more stages, lower lid75.0 0294 upper lid85.0 SKIN GRAFTS—The value is to be determined on the basis of size and location of defect (recipient area) and type of graft. Unless otherwise noted, these values include creation and/or surgical preparation of the defect, obtaining and placing of the graft, and the care of the donor site. 0300 Pinch, split or full thickness skin to cover small ulcer, tip of digit or other minimal open area (except on face, use 0301–0304) up to defect size¾inch diameter5.0 (Values for items 0301–0304 include simple debridement of granulations or recent avulsions. When the recipient area for grafting is created by surgical excision of essentially intact skin, scar or other lesion (including subcutaneous tissue) add 50% to the calculated value for the graft. This includes primary or delayed application of the graft.) 0301 Split skin graft, up to 16 square inches (except 0300), trunk, scalp, arms, legs, hands and feet (except multiple digits)25.0 0302 each additional 16 square inches or part thereof5.0 0303 face, neck, ears, genitalia or multiple digits38.0 0304 each additional 16 square inches or part thereof7.0 0308 Full thickness, free, up to 3 square inches, including direct closure of donor site, trunk20.0 0309 scalp, arms and legs30.0 0310 forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet40.0 0311 eyelids, nose, ears and lips50.0 (For each additional 3 square inches in the above procedures, add 50% of area value.) Values for following items (0312–0323) do NOT include extensive immobilizing; for plaster casts see 1851–1890 for values for these services. 0312 Pedicle flap, direct flap, direct or tubed, (including direct closure of donor site) trunk20.0 0313 scalp, arms and legs30.0 0314 forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet40.0 0315 eyelids, nose, ears and lips50.0 0316 delay, intermediate transfer or sectioning of pedicle of tubed or direct flap, trunk15.0 0317 scalp, arms and legs22.0 0318 forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet30.0 0319 eyelids, nose, ears and lips37.0 0320 excision of lesion and/or preparation of recipient site and attachment of direct or tubed pedicle flap, trunk30.0 0321 scalp, arms and legs45.0 0322 forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet60.0 0323 eyelids, nose, ears and lips75.0 (Revision, defatting or rearranging of transferred pedicle or flap skin graft, see 0260–0283 inclusive.) 0324 Composite graft (full thickness of external ear or nasal ala)25.0 0325 Derma–fat–fascia–graft (except to breast–0484)45.0 0330 Abrasion of skin, total face, for removal of scars, tattoos, etc. primary60.0 0331 secondary, total face30.0 0333 regional (¼face, cheeks, chin, forehead or elsewhere) primary15.0 0334 secondary, regional7.5 0335 Rhytidectomy, lower eyelids60.0 0336 upper eyelids40.0 0337 forehead50.0 0338 glabellar frown40.0 0339 cheeks, chin and neck150.0 0340 Facial nerve paralysis, free fascia grafts100.0 0341 re-animation–muscle transfers120.0 (For nerve transfers, decompression or suture, see 5350, 6002, 6003.) BURNS—List percentage of body surface involved and depth of burn. Does not include skin grafts 0351 Initial treatment, first degree, where no more than local treatment necessary1.5 0352 Dressings, initial or subsequent under anesthesia, small4.0 0353 under anesthesia, large or with major debridement, per hour10.0 0354 without anesthesia, small, office or hospital2.0 0355 without anesthesia, medium (whole face or whole extremity, etc.)3.0 0356 without anesthesia, large (more than one extremity, etc.)4.0 Destruction 0401 Electro–surgical destruction with or without surgical curettement of facial nevi, leukoplakia, actinic or senile keratoses, or keratoacanthomas, to include local anesthesia, one lesion3.0 (50% for each additional lesion up to a total of three; over three, each additional lesion 25%.) 0402 complicated lesion(s)by report 0403 Electro–surgical destruction (except 0401 and 0402) or chemocautery (Mono–, Bi–, Tricholoracetic acid, phenol, etc.) or cryocautery (liquid N2, CO2, etc.) of benign or pre–malignant lesions of skin or mucous membrane (except 0405 and 0406) with or without curettement one lesion2.0 (50% for second lesion; over two, each additional lesion 25%.) 0404 complicated lesion(s)by report flat (plane, juvenile) warts, up to fifteen2.0 (Retreatment same as routine office visit.) 0406 Electro–surgical destruction of multiple fibro–cutaneous tags, up to fifteen2.0 0408 Chemosurgery, (Mohs type technique), malignancies of skin, includes removal of growth and microscopic delineation of margins and base,first stage—fulguration and application of chemicals20.0 0409 each subsequent treatment, up to five sections5.0 0410 each additional section over five1.0 0411 Cryotherapy—(CO2slush, liquid N2)1.5 0412 Electrolysis epilation, each½hour3.0 Breast Incision 0430 Puncture aspiration of cyst2.0 0431 Mastotomy with exploration or drainage of abscess, deep10.0 Excision 0441 Biopsy of breast15.0 0444 Excision of cyst, fibro–adenoma or other benign tumor, aberrant breast tissue, duct lesion (including gynecomastia) or nipple lesion (including any other partial mastectomy) male or female, unilateral15.0 0445 bilateral25.0 0446 Excision of chest wall tumor involving ribs70.0 0447 Excision of chest wall tumor involving ribs plus plastic reconstruction100.0 0457 Complete (simple) mastectomy30.0 0470 Radical mastectomy, including breast, pectoral muscles and axillary lymph nodes70.0 0481 Mammoplasty, plastic operation on breasts, reduction or repositioning, bilateral, one stage150.0 0482 two stageby report 0483 augmentation, prosthetic, unilateral75.0 0484 bilateral100.0 0485 derma–fat fascia, unilateral100.0 MUSCULOSKELETAL SYSTEM Listed values include the application of first cast or traction device only. Incision 0501 Aspiration or curette biopsy of bone marrow3.0 0502 Needle (trocar) biopsy vertebra10.0 0506 Incision of superficial soft tissue abscess secondary to osteomyelitis2.0 0507 deep or complicatedby report 0513 Sequestrectomy for osteomyelitis or bone abscessby report 0516 Removal of metal band, plate, screw or nail (independent procedure)15.0 (For pins, etc., see 0598, 0599.) OSTEOTOMY—Cutting, division or transection of bone, with or without internal fixation 0526 Clavicle40.0 0527 Humerus50.0 0529 Radius40.0 0530 Ulna40.0 0531 Femur, neck, under age 880.0 0532 over age 8100.0 0533 subtrochanteric80.0 0534 supracondylar70.0 0536 Tibia55.0 0537 Smaller bones (fibula, metacarpals, metatarsals, etc.)30.0 0538 Correction of bowlegs or knock–knees, unilateral50.0 0539 bilateral75.0 (For iliac osteotomy, see 1341, 1342.) 0540 Multiple osteotomies, single bones for realignment on intrameduliary rod, Scofield type procedure, humerus50.0 0541 radius or ulna50.0 0542 femur100.0 0543 tibia75.0 Excision 0549 Biopsy bone, radius, ulna, fibula, skull, sternum10.0 0550 humerus, pelvis, femur, tibia20.0 0551 vertebra40.0 (For needle biopsy, see 0502.) (Value of biopsy done preceding definitive surgery is 50 percent of listed value.) 0552 Claviculectomy, partial35.0 0553 total65.0 0554 Astragalectomy55.0 0556 Excision of head of radius35.0 0557 Carpectomy30.0 0560 Coccygectomy30.0 0561 Patellectomy or hemipatellectomy50.0 0563 Metatarsectomy25.0 0566 Excision of chondroma, osteochondroma, or exostosis; humerus, pelvis, femur, tibia, radius, fibula, ulna40.0 0567 small bones25.0 0568 Excision of bone cyst, simple, large bones40.0 0569 small bones25.0 (With autogenous bone graft, add 10.0 units to 0568, 0569.) 0576 Partial ostectomy; partial excision of bone, craterization, guttering or saucerization of bone; diaphysectomy; humerus, pelvis, femur, tibia, fibula, radius, ulna50.0 0577 small bones25.0 0578 Excision of tumor of mandible without replacement75.0 (For replacement see 0619.) 0580 Radical resection of bones for tumor with bone graft; scapula, humerus, pelvis, femur, tibia100.0 0581 other bones65.0 Introduction (For associated procedures, see Fractures.) 0591 Insertion of wire, pin, caliper or tongs (independent procedure)5.0 0598 Removal buried wire or pin (independent procedure)2.0 0599 Removal of caliper or tongs (independent procedure)1.0 Repair 0611 Osteoplasty; shortening of bone, femur, tibia, humerus100.0 0612 radius, ulna65.0 0613 other bones45.0 0614 lengthing of bone100.0 0616 mandible for prognathism or micrognathism, one or two stages100.0 BONE OR CARTILAGE GRAFT—Osteoperiosteal graft, periosteal graft, or cartilage graft. Includes obtaining and placing of graft. Unless otherwise indicated, values are for autogenous grafts. When non–autogenous material is used, reduce value by 5.0 units. 0617 Bone graft; femur, tibia, humerus100.0 0618 radius, ulna65.0 0619 skull or significant portion of mandible100.0 0620 other bones, including chin, nose, malar prominences45.0 0621 Cartilage graft, autogenous, to face, nose, ear or skull70.0 Spinal Fusion (For fusion of childgood scoliosis, see 0643, 0644, 0645.) (Items 0634–0642 refer to spinal procedures at one interspace; for each additional interspace, add 10%) 0634 Spinal fusion, cervical region, posterior technique90.0 0635 anterior technique80.0 0636 thoracic region, posterior or posterior-lateral technique90.0 0637 interbody technique, anterior, lateral or posterior100.0 0638 lumbar region, posterior or posterior–laterial technique90.0 (For interbody technique, anterior see 0642.) 0639 Spinal fusion with removal of intervertebral disc, cervical region, posterior, technique120.0 0640 anterior interbody technique80.0 0641 lumbar or thoracic region, posterior, posterior–lateral, or posterior interbody technique120.0 0642 anterior interbody technique100.0 0643 Spinal fusion for scoliosis, child or young adult (less than 18 years of age), up to and including five interspaces120.0 0644 Harrington rod technique150.0 0645 Halo technique150.0 (For adult scoliotic fusion see 0634–0642.) 0647 Scapulopexy65.0 0648 Patellapexy50.0 0649 Pectus excavatum, infants, plastic repair25.0 0650 Pectus excavatum (major) plastic repair90.0 0654 Epiphyseal–diaphyseal fusion; epiphyseal arrest; epiphysiodesis or stapling; femur55.0 0655 tibia and fibula, proximal or distal55.0 0656 combined distal femur and proximal tibia and fibula (knee)75.0 0657 combined proximal and distal, tibia and fibula75.0 0658 combined distal femur and proximal and distal tibia and fibula100.0 0660 Hemi–epiphyseal arrest (e.g., for genu varus or genu valgus) distal femur45.0 (For removal and reinsertion of staples at same operation, use values listed above.) (For removal of staples only, 50% of listed values.) (Free of bone adhesions, callus or synostosis, independent procedure, see Ostectomy.) Fractures Skull 0681 Skull, non–operativeSv. ¶* (Depressed with operation, see 5018, 5020.) Facial Bones 0685 Nasal, simple or compound, no reductionSv. ¶ 0686 uncomplicated (digital) closed reduction5.0 0687 complicated (instrumental) closed reduction10.0 0688 open reduction, uncomplicated25.0 0689 complicated with either internal and/or external skeletal fixation40.0 0690 with concomitant open reduction of fractured septum60.0 0691 Malar, simple or compound, no reductionSv. ¶ 0692 closed reduction (including towel clip technique)5.0 0693 depressed, open reduction30.0 0694 complicated, depressed, open reduction with internal skeletal fixation and multiple surgical approaches65.0 0698 Maxilla, simple or compound, no reductionSv. ¶ 0699 closed reduction, with wiring of teeth30.0 0701 open reduction, with wiring of teeth and/or local fixation50.0 0702 complicated, open reduction, fixation by head cap, multiple surgical approaches, internal fixation, wiring teeth, etcby report (For antral approach, see 1988.) 0703 Mandible, simple or compound, no reductionSv. ¶ 0704 closed reduction and wiring of teeth30.0 0705 open reduction with or without wiring of teeth50.0 0706 skeletal pinning with external fixation40.0 Spine and Trunk 0720 Vertebral process, one or moreSv. ¶ 0721 Vertebral body, one or more not requiring reductionSv. ¶ 0722 requiring reduction30.0 0732 Sacrum, simple not requiring reductionSv. ¶ 0733 compound or complexby report 0735 Coccyx, simple, not requiring reductionSv. ¶ 0736 compound or complicatedby report 0740 Clavicle, simple, no reductionSv. ¶ 0741 simple, closed reduction15.0 0742 compound, including uncomplicated soft tissue closure20.0 0743 simple or compound, open reduction40.0 0747 Scapula, simple, no reductionSv. ¶ 0748 simple or compound, open reduction55.0 0756 Sternum, simpleSv. ¶ 0757 compound or complicatedby report 0761 Ribs, simpleSv. ¶ 0762 compound or complicatedby report Pelvis (Illum, Ischlum, Pubis) 0767 Fracture, simple, no reductionSv. ¶ 0768 complicated, closed reductionby report 0771 compound, open reduction75.0 0772 Acetabulum, with or without other fractures of pelvis, simple, no reductionSv. ¶ 0773 central, with displacement, requiring closed reduction55.0 0775 simple or compound, open reduction75.0 Upper Extremity 0778 Humerus, surgical neck, simple, not requiring reductionSv. ¶ 0780 requiring manipulative reduction30.0 0781 compound, with uncomplicated soft tissue closure35.0 0782 simple or compound, open reduction50.0 0783 shaft, simple, not requiring reductionSv. ¶ 0784 simple, closed reduction25.0 0785 compound, with uncomplicated soft tissue closure30.0 0786 simple or compound, open reduction45.0 0787 simple or compound, open reduction, skeletal pinning with external fixation40.0 0788 supracondylar or dicondylar, not requiring reductionSv. ¶ 0789 closed reduction25.0 0790 compound, with uncomplicated soft tissue closure30.0 0791 simple or compound, open reduction50.0 0792 medial or lateral condyle, simple, not requiring reductionSv. ¶ 0793 closed reduction20.0 0794 compound, with uncomplicated soft tissue closure25.0 0795 simple or compound, open reduction40.0 0796 Elbow, proximal end of ulna with dislocation of radial head simple, (Monteggia fracture) closed reduction20.0 0797 simple or compound, open reduction (See also 1292.)55.0 0798 Radius, head, simple, no reductionSv. ¶ 0799 closed reduction15.0 0800 compound, with uncomplicated soft tissue closure20.0 0801 simple or compound, open reduction or excision (See also 0556.)35.0 0802 shaft, simple, no reductionSv. ¶ 0803 simple, closed reduction20.0 0804 compound, with uncomplicated soft tissue closure25.0 0805 simple or compound, open reduction40.0 0806 distal end (e.g., Colle's type), simple, no reductionSv. ¶ 0807 closed reduction15.0 0808 with severe comminution and impaction, closed reduction20.0 0809 simple or compound, open reduction40.0 0810 skeletal pinning, with external fixation30.0 0811 Ulna, proximal end, olecranon process, simple, no reductionSv. ¶ 0812 compound, with uncomplicated soft tissue closure25.0 0813 simple or compound, open reduction and/or resection40.0 0814 shaft, simple, no reductionSv. ¶ 0815 closed reduction20.0 0816 compound, with uncomplicated soft tissue closure25.0 0817 simple or compound, open reduction40.0 0818 skeletal pinning with external fixation30.0 0820 Radius and ulna shaft, simple, no reductionSv. ¶ 0821 simple, closed reduction25.0 0822 compound, with uncomplicated soft tissue closure30.0 0823 simple compound, open reduction50.0 0824 skeletal pinning with external fixation40.0 (For Colle's fracture see 0806–0810.) 0827 Carpal bones, one or more, simple reductionSv. ¶ 0830 simple or compound, open reduction35.0 0840 Metacarpal, simple, no reductionSv. ¶ 0842 one, simple or compound, closed reduction with uncomplicated soft tissue closure10.0 0843 more than one, simple or compound, closed reduction, with uncomplicated soft tissue closure12.5 0844 one or more, simple or compound, open reduction30.0 0848 skeletal pinning with external fixation25.0 0852 Phalanx or phalanges, finger, proximal, middle or thumb, simple, no reductionSv. ¶ 0853 closed reduction7.5 0854 compound, with uncomplicated soft tissue closure10.0 0855 simple or compound, open reduction20.0 0856 Phalanx or phalanges, distal, simple, no reductionSv. ¶ 0857 simple or compound, closed reduction with uncomplicated soft tissue closure5.0 0858 simple or compound, open reduction12.5 Lower Extremity 0865 Femur, neck, simple, no reductionSv. ¶ 0866 with fixation or traction50.0 0867 simple or compound, open reduction80.0 0868 multiple pinning, with or without external fixation80.0 0869 treatment with replacement prosthesis80.0 0872 intertrochanteric, simple, no reductionSv. ¶ 0873 with fixation or traction45.0 0874 simple or compound, open reduction80.0 0877 slipped epiphysis, no reduction, treatment by traction, bed rest or cast applicationSv. ¶ 0878 open reduction, single or multiple pinning or bone graft80.0 0879 reconstruction100.0 0880 shaft, including supracondylar, simple, no reductionSv. ¶ 0881 simple, closed reduction40.0 0882 compound, with uncomplicated soft tissue closure45.0 0883 simple or compound, open reduction80.0 0884 skeletal pinning with external fixation60.0 0885 distal end, medial or lateral condyle, simple, no reductionSv. ¶ 0886 condyle or condyles, simple, closed reduction35.0 0887 simple or compound, open reduction60.0 0889 Patella, simple, no reductionSv. ¶ 0890 compound, with uncomplicated soft tissue closure25.0 0891 simple or compound, open reduction50.0 0893 Tibia, proximal end, tibial plateaus, condyle, condyles or intercondylar spines, simple, no reductionSv. ¶ 0894 closed reduction25.0 0895 compound, with uncomplicated soft tissue closure30.0 0896 simple or compound, open reduction55.0 0901 shaft, simple, no reductionSv. ¶ 0902 closed reduction25.0 0903 compound, with uncomplicated soft tissue closure30.0 0904 simple or compounded, open reduction50.0 0905 simple or compound, open or "blind" insertion of intramedullary rod (e.g., Lottes nail)50.0 0907 distal end, malleolus, simple, no reductionSv. ¶ 0908 simple, closed reduction15.0 0909 compound, with uncomplicated soft tissue closure20.0 0910 simple or compound, open reduction40.0 0914 Fibula, shaft, simple, no reductionSv. ¶ 0915 compound, with uncomplicated soft tissue closure20.0 0916 simple or compound, open reduction30.0 0920 distal end, malleolus, simple, no reductionSv. ¶ 0921 closed reduction15.0 0922 compound, with uncomplicated soft tissue closure20.0 0923 simple or compound, open reduction40.0 0925 Tibia and fibula, shafts, simple, no reductionSv. ¶ 0926 closed reduction30.0 0927 compound, with uncomplicated soft tissue closure35.0 0928 simple or compound, open reduction60.0 0930 skeletal pinning with external fixation40.0 0932 Ankle, bimalleolar (including Potts) simple, no reductionSv. ¶ 0933 simple, closed reduction25.0 0934 compound, with uncomplicated soft tissue closure30.0 0935 simple or compound, open reduction50.0 0937 trimalleolar, simple, no reductionSv. ¶ 0938 closed reduction30.0 0940 compound, with uncomplicated soft tissue closure35.0 0941 simple or compound, open reduction60.0 0943 Tarsal (except astragalus and os calcis) one or more, simple, no reductionSv. ¶ 0944 closed reduction10.0 0945 compound, with uncomplicated soft tissue closure15.0 0946 simple or compound, open reduction30.0 0954 Astragalus, simple, no reductionSv. ¶ 0955 simple, closed reduction20.0 0956 compound, with uncomplicated soft tissue closure25.0 0957 simple or compound, open reduction55.0 0960 Os calcis, simple, no reductionSv. ¶ 0961 closed reduction20.0 0962 compound, with uncomplicated soft tissue closure25.0 0963 simple or compound, open reduction50.0 0964 skeletal pinning with external fixation40.0 0966 Metatarsal, simple, no reductionSv. ¶ 0967 closed reduction10.0 0968 compound, with uncomplicated soft tissue closure15.0 0970 simple or compound, open reduction25.0 0975 Phalanx or phalanges, great toe, simple, no reductionSv. ¶ 0976 simple, closed reduction5.0 0977 simple or compound, open reduction15.0 0979 other than great toe, simple, no reductionSv. ¶ 0981 closed reduction5.0 0982 simple or compound, open reduction12.5 Joints Incision ARTHROTOMY or capsulotomy with exploration, drainage, or removal of loose body, e.g., osteochondritis of foreign body. 1001 Shoulder50.0 1002 Elbow50.0 1003 Wrist40.0 1005 Other joints of upper extremity30.0 1006 Finger, one15.0 1007 Hip70.0 1008 Knee50.0 (For miniscectomy, see 1082.) 1010 Ankle50.0 1013 Other joints of lower extremity30.0 1020 Toe, great toe15.0 1026 other10.0 1044 Arthrocentesis; puncture for aspiration of hemarthrosis, initial3.0 1045 subsequent2.0 1046 puncture for aspiration of joint effusion (not traumatic), or injection of medication, initial or subsequent2.0 1050 Sesamoid bone, excision, one or more, unilateral15.0 Excision ARTHRECTOMY—Excision of joint (See also Arthrodesis.) 1065 Temporomandibular joint, unilateral75.0 1074 Excision of intervertebral disc90.0 (See also 5208–5211.) (With spinal fusion, see 0639–0642.) (For laminectomy for spondylolisthesis, see 5225.) 1082 Meniscectomy: excision of semilunar cartilage of knee joint50.0 1085 temporomandibular joint75.0 1093 Synovectomy elbow70.0 1101 hip80.0 1102 knee70.0 1103 ankle50.0 Introduction 1131 Injection procedure for arthography3.0 Repair ARTHROPLASTY—Plastic or reconstructive operation on joint, any type unless otherwise specified. 1141 Shoulder (See also 1200, 1201.)80.0 1142 Elbow80.0 1143 Wrist80.0 1144 Finger, one joint30.0 1148 Hip, cup100.0 1149 replacement prosthesis, primary for fracture80.0 1150 secondary reconstruction100.0 (For acetabuloplasty, either 1148 or 1150, add 25% to listed values.) 1151 Knee100.0 1152 Ankle75.0 1154 Toe, one joint20.0 1159 Metatarsal—phalangeal joint; bunion operation, Silver type20.0 1160 Keller, McBride, etc., types30.0 1162 Joplin type35.0 1163 Club foot corrective procedure, medial release, Brockman type30.0 ARTHRODESIS—Fusion of joint (For spine see 0634–0645.) 1166 Shoulder90.0 1167 Elbow70.0 1168 Wrist60.0 1170 Finger, thumb, one joint20.0 1175 Hip100.0 1176 Knee80.0 1177 Ankle70.0 1178 Toe, one or more joints15.0 1179 Hammer toe operation, one toe (e.g.,inter–phalangeal fusion, filleting, phalanectomy)20.0 1183 Tarsal joints, one or more (e.g.,Grice procedure)50.0 1184 Other joints, lower extremity40.0 1185 Foot, triple arthrodesis, unilateral under age 14 years50.0 1186 over age 14 years60.0 With tendon transplantation see 1585, 1586 Suture CAPSULORRAPHY OR RECONSTRUCTION 1200 Shoulder, suture or repair of joint capsule for recurrent dislocation (independent procedure), Putti–Platt, Magnusen types70.0 1201 Bankart type80.0 1206 Patella (See also 0561, 1352, 1632.)60.0 1211 Knee, suture of a torn, ruptured or severed collateral ligament55.0 1212 suture of a torn, ruptured or severed cruciate ligament55.0 1213 suture of torn, ruptured or severed collateral and cruciate ligaments75.0 1214 reconstruction of a collateral or cruciate ligament65.0 1215 both collateral or cruciate ligaments85.0 1216 Ankle, reconstruction of a collateral ligament, ankle45.0 1217 both ligaments60.0 1218 Hand, reconstruction, metacarpophalangeal or interphalangeal ligaments35.0 Manipulation Manipulation of joint under general anesthesia, including application of fixation apparatus (dislocation excluded). (For club feet and turnbuckle casts, see section on cast.) 1221 Shoulder5.0 1222 Elbow4.0 1223 Wrist4.0 1224 Digits, one or more, under anesthesia, where no other surgical procedure is performed2.5 1226 Hip6.0 1227 Knee5.0 1228 Ankle4.0 1232 Spine6.0 Dislocations 1251 Temporomandibular, simple, closed reduction, initial5.0 1252 subsequent1.0 1255 Vertebra, cervical, simple, closed reduction, using tractionSv. ¶ 1256 closed reduction with anesthesia55.0 1262 thoracic, simple, closed reduction with anesthesia55.0 1264 simple or compound, open reduction100.0 1267 lumbar, simple, closed reduction with anesthesia55.0 1270 simple or compound, open reduction100.0 1273 Clavicle, sternoclavicular, simple, no reductionSv. ¶ 1274 closed reduction with anesthesia10.0 1275 simple or compound, open reduction40.0 1278 acromioclavicular, simple, no reductionSv. ¶ 1279 closed reduction with anesthesia10.0 1281 simple or compound, open reduction40.0 1284 Shoulder (humerus), simple, closed reduction without anesthesiaSv. ¶ 1285 with anesthesia5.0 1286 simple or compound, open reduction55.0 1290 Elbow, simple, closed reduction5.0 1291 compound, with uncomplicated soft tissue closure25.0 1292 simple or compound, open reduction55.0 1295 Wrist, carpal, one bone, simple, closed reduction5.0 1296 compound, with uncomplicated soft tissue closure25.0 1297 simple or compound, open reduction45.0 1298 more than one bone, simple, closed reduction7.0 1300 compound, with uncomplicated soft tissue closure25.0 1301 simple or compound, open reduction45.0 1304 Metacarpal, one bone, simple, closed reduction3.0 1305 compound, with uncomplicated soft tissue closure10.0 1306 simple or compound, open reduction20.0 1315 Finger, one, one or more joints, simple, closed reduction3.0 1316 compound, with uncomplicated soft tissue closure7.5 1317 simple or compound, open reduction15.0 1326 Thumb, simple, closed reduction4.0 1327 compound, with uncomplicated soft tissue closure10.0 1328 simple or compound, open reduction20.0 1332 Hip (femur), simple, closed reduction20.0 1334 simple or compound, open reduction60.0 1338 congenital, abduction splinting or traction in any formSv. ¶ 1339 congenital, closed reduction with anesthesia20.0 1340 congenital, open reduction and replacement of femoral head in acetabulum60.0 1341 iliac or acetabular osteotomy, (e.g.,Pemberton or Salter type), under age 880.0 1342 over age 8100.0 (For dislocated or slipped femoral head epiphyses, see 0877–0879.) 1344 Knee (femoral–tibial joint), simple, closed reduction20.0 1345 compound, with uncomplicated soft tissue closure25.0 1346 simple or compound, open reduction60.0 1350 Patella, simple, closed reduction3.0 1351 compound, with uncomplicated soft tissue closure15.0 1352 simple or compound, open reduction (with or without partial or total patellectomy)50.0 (See also 0561, 1206 and 1632.) 1354 Distal tibial–fibular joint (ankle mortise), open reduction and fixation45.0 1355 Ankle, simple, closed reduction10.0 1356 compound, with uncomplicated soft tissue closure25.0 1357 simple or compound, open reduction50.0 1361 Tarsal, simple, closed reduction10.0 1362 compound, with uncomplicated soft tissue closure17.5 1363 simple or compound, open reduction45.0 1371 Astragalo–tarsal, simple, closed reduction10.0 1372 compound, with uncomplicated soft tissue closure17.5 1373 simple or compound, open reduction45.0 1376 Metatarsal, one bone, simple, closed reduction7.0 1377 compound, with uncomplicated soft tissue closure12.0 1378 simple or compound, open reduction25.0 1385 Toe, one, simple, closed reduction2.0 1386 compound, with uncomplicated soft tissue closure7.0 1387 simple or compound, open reduction15.0 1391 multiple joints and/or toes, simple, closed reduction7.0 1392 compound, with uncomplicated soft tissue closure12.0 1393 simple or compound, open reduction20.0 Bursae Incision 1401 Drainage of infected bursa3.0 1406 Removal of subdeltoid calcium deposits25.0 1410 Removal of subtrochanteric calcium deposits30.0 1413 Needle puncture of bursa, with or without aspiration, injection or irregation, initial or subsequent2.0 Excision 1430 Radical excision of bursa, hand, wrist or forearm, (i.e.,tenosynovitis fungosa, Tbc., and other granulomas)50.0 1431 Excision of bursa, olecranon20.0 1433 prepatellar20.0 1435 subacromial (subdeltoid)25.0 1436 peritrochanteric, femur30.0 (For popliteal see 1562.) Muscles Incision 1450 Removal of foreign body in muscle, with anesthesiaby report 1454 Division of scalenus anticus, without resection of cervical rib35.0 1456 with resection of cervical rib50.0 1458 Division of sternocleidomastoid for torticollis open operation35.0 1460 Muscle biopsy, superficial5.0 1462 deep10.0 Suture 1495 Suture of ruptured diaphragm, chronic, transabdominal70.0 1496 transthoracic or combined80.0 1497 acute, traumaticby report (For other specific muscles, see 1633, 1640, 1654.) Tendons, Tendon Sheaths and Fascia Incision 1511 Drainage of tendon sheath, acute suppurative tenosynovitis, one digit3.0 1514 single palmar and/or ulnar or radial bursa30.0 1515 multiple or complicatedby report 1517 Injection of medication, tendon sheath2.0 1519 Incision of fibrous sheath of tendon for stenosing tenosynovitis, including freeing of tendons or removal of foreign body20.0 1531 Division of iliotibial band, open operation30.0 1534 Stripping of ilium (Soutter operation)40.0 Tenotomy 1535 Tenotomy, subcutaneous, corrective, single digit5.0 1536 multiple digits7.5 1537 adductor, hip10.0 1538 open, elbow to shoulder, single20.0 1539 multiple25.0 1540 elbow to wrist, single15.0 1541 multiple25.0 1542 knee to hip, single30.0 1543 multiple40.0 1544 knee to thigh, single15.0 1545 multiple30.0 Excision 1550 Excision of lesion of tendon or fibrous sheath, or ganglion, digits only10.0 1553 in other locations15.0 (For radical excision of bursa, forearm, i.e., tenosynovitis fungosa, Tbc., and other granulomas, see 1430.) 1562 Excision of synovial cyst of popliteal space (Baker's cyst)30.0 1570 Fasciotomy, palmar plantar, subcutaneous10.0 1573 Fasciectomy, for Dupuytren's contracture, partial30.0 1574 radical, including finger extensions and vertical bands50.0 Repair Includes necessary initial dressing (including cast and/or splint application.) 1580 Repair or suture of an extensor tendon, primary or late, hand or foot, distal to wrist or ankle12.0 1582 forearm or leg18.0 1583 Repair or suture of a flexor tendon, primary or late, finger, hand or forearm foot or leg30.0 1585 Transfer, transplant or free tendon graft, distal to elbow, or distal to knee, single40.0 1586 multiple50.0 1587 elbow to shoulder or knee to hip, single50.0 1588 multiple60.0 1589 Tenolysis, single25.0 1590 multiple (any number through same incision)30.0 1591 Lengthening or shortening of tendon (e.g.Achilles' tendon)30.0 (Retrieve or reroute tendon through separate incision, add 25 percent of appropriate fee.) 1593 Multiple tendons and/or other structures through same incision or woundby report 1612 Free fascial graft for reconstruction of tendon pulley or gliding surface, etc.15.0 1616 Abdominal fascial transplants, bilateral (Lowman type procedure)75.0 (For free fascial graft to face see 0340.) 1618 Fascia lata transplants, otherby report 1632 Patellar (extensor mechanism) advancement, with or without patellectomy60.0 1633 Ruptured quadirceps insertion45.0 1635 Ruptured Achilles' tendon from insertion at heel45.0 1639 Ruptured long head of biceps, proximal35.0 1640 Ruptured biceps tendon from insertion at elbow45.0 1641 Flexor–plasty, elbow (e.g., Steindler type advancement or extensor release)30.0 1654 Repair ruptured supraspinatus tendon or musculotendinous cuff shoulder, acute50.0 1655 Repair of complete shoulder cuff avulsion, chronic70.0 Extremities Incision 1681 Drainage of felon, superficial2.0 1682 in hospital5.0 (For drainage of single or multiple infected spaces of hand, lumbrical, hypothenar, thenar, middle palmar, etc. with or without tendon sheath involvement, see 1514, 1515.) Amputation UPPER EXTREMITY: 1701 Interthoracoscapular100.0 1703 Disarticulation of shoulder75.0 1705 Arm through humerus40.0 1708 Forearm, through radius and ulna40.0 1709 Open (Guillotine) arm35.0 1710 secondary closure or minor scar revision5.0 1711 reamputation40.0 1713 Cineplasty, complete procedure75.0 1718 Disarticulation through wrist or amputation of hand through metacarpal bones40.0 1725 Metacarpal, with finger or thumb, one, with or without split or Wolff graft, or skin–plasty and/or tenodesis, with or without resection of digital nerves30.0 1737 Digit (finger or thumb), any joint or phalanx, one, with or without split or Wolff graft, or skin–plasty and/or tenodesis, with or without resection of digital nerves15.0 LOWER EXTREMITY: 1745 Interpelviabdominalby report 1748 Disarticulation of hip80.0 1750 Disarticulation of knee40.0 1752 Thigh, through femur, including supracondylar60.0 1760 open (Guillotine)50.0 1761 secondary closure or minor revision5.0 1763 reamputation60.0 1767 Leg, through tibia and fibula50.0 1771 open (Guillotine)40.0 1772 secondary closure or minor revision5.0 1774 re-amputation50.0 1778 Ankle (Syme, Pirogoff types), with skin–plasty and resection of nerves50.0 1782 Midtarsal35.0 1785 Foot, transmetatarsal35.0 1788 Metatarsal with toe, with or without split or Wolff graft, or skin–plasty and/or tenodesis, with or without resection of digital nerves25.0 1802 Toe, one, with or without split or Wolff graft, or skin–plasty and/or tenodesis, with or without resection of digital nerves10.0 1803 more than one15.0 Repair 1811 Freeing of web fingers, with flaps35.0 1815 with skin graft45.0 1816 complexby report Plaster Casts (Independent Procedure Only) (Excluding Cost of Materials) 1840 Club–foot castwith molding or manipulation, long or short leg, under age of 24 months, single2.0 1841 bilateral3.5 (If over age 24 months, see casts, general.) 1842 Wedgingclub–foot castsingle1.0 1843 bilateral1.5 (For children 10 years of age or under, reduce listed values 1851–1890 by 30%.) 1851 Molded plaster to forearm (splint)2.0 1854 Elbow to fingers (short arm)2.0 1856 Hand and wrist (gauntlet)2.0 1860 Shoulder to hand (full arm)3.0 1862 Shoulder spica6.0 1863 Thigh–foot, molded splint3.0 1864 Leg–foot, molded splint2.0 1865 Ankle (foot to midleg) (short leg)3.0 1867 Knee (foot to thigh) (long leg)4.0 1871 Ambulatory leg cast (walking boot cast)3.5 1878 Hip spica, unilateral7.0 1882 bilateral8.0 1884 Body, shoulder to hips8.0 1885 including head10.0 1886 Risser jacket, localizer, body only12.5 1887 including head15.0 1888 Turnbuckle jacket, body only for scoliosis12.5 1889 including head15.0 1890 "Halo" type fixation and cast20.0 1891 Unna boot2.0 1896 large, (e.g., long leg, shoulder or hip spica, Minerva, Calot jacket, turnbuckle, etc.)2.0 1897 Repair of spica, body cast or jacket3.0 (For change of cast, unit value will be that of application only.) RESPIRATORY SYSTEM Nose Incision 1901 Drainage of nasal abscess or hematoma2.0 1905 Drainage of septal abscess or hematoma2.5 Excision 1911 Biopsy, soft tissue, nose3.0 1916 Excision of nasal polyp(s) one or more, unilateral or bilateral, one or more stages, office7.0 1917 complicated, requiring hospitalization20.0 (For excision of nasopharyngeal fibroma, see 3006.) 1924 Excision or surgical planning of skin of nose for rhinophyma35.0 1928 Submucous resection, classic, nasal septum30.0 (For septoplasty, see 1952.) 1935 Resection of inferior turbinate (submucous), complete or partial, unilateral or bilateral (independent procedure)15.0 Endoscopy 1941 Removal of intranasal foreign body by rhinoscopy2.0 1942 by lateral rhinotomyby report Repair See also Repair–Complex 0260–0324, and 0620, 0621.) 1950 Rhinoplasty, lateral and alar cartilages and/or elevation of nasal tip40.0 1951 complete, external parts including bony pyramid, lateral and alar cartilages, and/or elevation of nasal tip80.0 1952 including major septal repair90.0 1953 secondary minor revision15.0 (For total or major partial reconstruction, see 0260–0324, 0620, 0621.) (For nasal bridge collapse, bone or cartilage graft, see 0620, 0621.) 1954 Septoplasty, (not 1928) independent procedure40.0 1959 Repair choanal altresia, intranasal10.0 1960 transpalantine60.0 1961 Lysis of synechia2.0 1962 Repair of oromaxillary fistulaby report 1963 with radical antrotomy50.0 1964 Repair oronasal fistula20.0 1965 Reconstruction, functional, of the internal nose40.0 Destruction 1966 Cauterization of turbinates, unilateral or bilateral (independent procedure)2.0 Manipulation (For reduction of fracture, see 0685–0690.) 1971 Nasal hemorrhage, anterior, control of, unilateral or bilateral, with or without cauterization or anterior packs2.0 1973 posterior, with cauterzation or posterior nasal packs, with or without anterior pack, initial10.0 1974 subsequent2.0 1978 by ligation of anterior ethmoidal artery30.0 Accessory Sinuses Incision 1981 Antrum lavage. puncture or natural ostium, unilateral2.0 1982 bilateral3.0 1983 Antroscopy4.0 1985 Antrotomy, intranasal, unilateral15.0 1986 bilateral25.0 1988 Radical (Caldwell–Luc), unilateral50.0 1989 bilateral65.0 1991 Sphenoid sinusotomy30.0 1992 Frontal sinusotomy, external, simple (trephine operation)20.0 1993 transorbital, unilateral40.0 1994 radical, obliterative60.0 1995 Combined external frontal, ethmoidal and sphenoidal sinusotomy, unilateral80.0 Excision 2006 Ethmoidectomy, intranasal or external, unilateral30.0 2017 Maxillectomy, unilateral, with or without orbital exenteration and/or lateral rhinotomy100.0 2019 Hypophisectomy, transeptal70.0 (See also 5130.) Larynx Incision 2041 Laryngofissure with removal of tumor or laryngocele60.0 2042 Thyrotomy, diagnostic35.0 2043 for laryngeal web, two stage, with Keel insertion, (McNaught type)90.0 2044 for laryngeal stenosis with graft or core mold, including tracheotomyby report Excision 2051 Laryngectomy, without neck dissection100.0 2054 with neck dissection140.0 2055 Hemilaryngectomy60.0 2056 Arytenoidectomy, external approach (See also 2084.)70.0 2057 Epiglottidectomy, external approach60.0 2058 endoral approach25.0 Introduction 2060 Injection procedure for bronchography, indirect method3.0 2061 with insertion of catheter, (independent procedure)4.0 2062 Endotracheal intubation, emergency procedure5.0 Endoscopy 2070 Laryngoscopy, indirect with biopsy4.0 2071 direct, diagnostic (independent procedure)10.0 2072 operative, including foreign body removal30.0 2073 with biopsy15.0 2074 including excision of tumor25.0 2075 with Lynch suspension30.0 2084 Endoscopic arytenoidectomy50.0 Trachea and Bronchi Incision 2101 Tracheotomy (independent procedure)20.0 2102 Tracheal fenestration50.0 Endoscopy 2111 Bronchoscopy, diagnostic15.0 2113 with biopsy20.0 2117 with removal of foreign body25.0 2120 with excision of tumor25.0 2121 with therapeutic aspiration of bronchus15.0 2122 with drainage of lung abscess or cavity, initial15.0 2123 with injection of contrast media15.0 2124 subsequent10.0 2126 Catheterization for bronchospirometry (independent procedure) (exclusive of gas analysis)10.0 2127 Tracheal aspiration (independent procedure) under direct vision10.0 2128 indirect1.0 Repair 2131 Tracheoplasty: plastic operation on trachea, cervicalby report 2132 intrathoracicby report 2133 Bronchoplasty, graft repairby report 2134 excision of stenosis and anastomosisby report 2135 with lobectomy and anastomosisby report Suture 2141 Tracheorrhaphy: suture of external tracheal wound or injury, depending on structure and extent of injury, cervicalby report 2142 intrathoracicby report 2144 Closure of tracheostomy or tracheal fistula25.0 2147 Closure of tracheo–esophageal fistula90.0 2148 complicatedby report Incision 2151 Thoracotomy, exploratory, including biopsy50.0 2152 including control of hemorrhage and/or repair of lung fistula75.0 2153 for postoperative complications75.0 2154 with open drainage of empyema cavity by rib resection (independent procedure)40.0 2155 with cyst removal75.0 2157 with closed drainage of empyema cavity; tube drainage with negative pressure (independent procedure), in hospital5.0 2160 with removal of intrapleural foreign body or fibrin body70.0 2161 with cardiac massageby report 2163 with open intrapleural pneumonolysis (See also 2207.)75.0 2170 Pneumonotomy, with open drainage of pulmonary abscess or cyst60.0 2173 with removal of foreign body from lung75.0 2177 Decortication, pulmonary, total100.0 2180 Pneumonocentesis: puncture of lung for aspiration biopsy5.0 2183 Thoracentesis: puncture of pleural cavity for aspiration, initial or subsequent3.0 Excision 2191 Pneumonectomy, total100.0 2193 Lobectomy, total, subtotal or segmental100.0 2194 with concomitant decortication125.0 2195 Wedge resection, single or multiple80.0 2196 Pulmonary resection with concomitant thoracoplasty150.0 2197 Pleurectomy, any type (independent procedure)50.0 Endoscopy 2201 Thoracoscopy, exploratory (independent procedure)20.0 2204 with biopsy20.0 2207 Closed intrapleural pneumonolysis30.0 Surgical Collapse Therapy Thoracoplasty 2211 Extrapleural resection of ribs, any type, first stage60.0 2212 second stage30.0 2213 third stage30.0 2217 Extrapleural pneumonolysis, including associated filling or packing procedures60.0 2218 Extraperiosteal pneumonolysis, including associated filling or packing procedures70.0 2221 Pneumothorax: intrapleural injection of air, initial5.0 2222 subsequent2.0 CARDIOVASCULAR SYSTEM Heart and Pericardium Values for principal surgeon only. Incision 2301 Cardiotomy, exploratory (includes removal of foreign body)100.0 2305 Pericardiotomy with exploration, drainage or removal of foreign body100.0 2309 pericardiocentesis, initial5.0 2310 subsequent4.0 2311 Blalock–Hanlon procedure (creation of atrial–septal defect) (closed)150.0 Excision 2316 Pericardiectomy, extensive120.0 2317 Excision intracardiac tumor200.0 2319 Infundibular stenosisby report Introduction Listed values include usual preassessment of clinical problem and recording of intracardiac pressures. 2330 Catheterization of heart, including recording of intracardiac pressures where indicated (independent procedure) right35.0 2331 left, percutaneous15.0 2332 trans–septal20.0 2333 retrograde20.0 2334 combined left and right45.0 2335 final evaluation and report only5.0 Suture 2337 Cardiorrhaphy: suture of heart wound or injury100.0 Repair 2340 Aortic valve, valvotomy (commissurotomy) (closed)150.0 2341 valvuloplasty for stenosis or insufficiency (open)200.0 2342 replacement (open)200.0 2343 Pulmonic valve, valvotomy (commissurotomy) (closed)150.0 2344 valvotomy; infundibular stenosis (open)200.0 2345 Mitral valve, valvotomy (commissurotomy) (closed)140.0 2346 valvuloplasty for stenosis or insufficiency (open)200.0 2347 replacement (open)200.0 2348 Tricuspid valveby report 2349 Coronary endarterectomy, myocardial revascularization by implantation or anastomosis100.0 2350 Myocardial aneurysm200.0 2351 Atrial septal defect (secundum type; endocardial cushion defect) (open)180.0 2352 Ventricular septal defect (open)180.0 2353 Tetralogy of Fallot (with or without previous shunt) (open)200.0 2354 Aortic sinus of Valsalva fistula (open)200.0 2355 Repair anomaleus pulmonary venous connection, total (open)200.0 2356 Insert internal pacemaker with myocardial electrodes, initial100.0 2357 replacement or repair30.0 2358 Pervenous or transvenous insertion of a pacemaker and subcutaneous implantation of a battery50.0 2359 Subcutaneous implantation of a battery (used with code 2330, right heart catheterization, currently in fee schedule)18.75 Arteries and Veins Incision Arteriotomy — With removal of embolus: 2373 Trunk80.0 2374 Neck60.0 2375 Extremity60.0 Phlebotomy — With removal of thrombus: 2380 Trunk70.0 2381 Extremity45.0 Excision 2390 Thromboendarterectomy, abdominal aorta and iliac arteries and/or femoral arteries150.0 2392 femoral and/or popliteal arteries120.0 2394 carotid artery120.0 2400 Excision and graft or bypass graft of arch of aortaby report 2404 Excision and graft, thoracic aorta150.0 2408 abdominal aorta150.0 2412 extremity120.0 2420 Excision of arteriovenous fistula (See also 2474.)by report Introduction 2441 Venopuncture, withdrawal of venous blood, intravenous injection (femoral, internal or external jugular or sagittal sinus) for diagnostic study or introduction of intravenous therapy, up to three years of age2.0 2442 scalp vein, for fluid therapy or indirect transfusion, up to three years of age3.0 2443 Exposure of and incision into vein ("cutdown") for fluid therapy or indirect transfusion, under one year of age4.0 2445 Blood transfusion, indirect method2.0 2446 replacement type, infant, initial or subsequent30.0 2448 direct method5.0 2450 "push" transfusion, given under two years of age5.0 2454 Injection of sclerosing solution into vein of leg, one1.0 2455 two or more injections, same leg2.0 Repair 2460 Repair aneurysm of aorta, lateral repair150.0 2464 dissecting ("window" operation)150.0 2466 Banding of pulmonary artery100.0 2472 Repair of aortic arch anomalies (vascular ring)120.0 2473 Repair of atrial septal defect200.0 2474 Repair of arterio–venous fistula, plastic procedureby report (For aortic anastomosis, see also 2400–2408, 2472.) 2475 Excision of coarctation of aorta with primary anastomosis (See also 2400–2408.)150.0 2478 Pulmonary–subclavian anastomosis, Potts150.0 2482 Blalock120.0 2486 Pulmonary–superiorcaval anastomosis, Glenn150.0 2487 Baffes procedure: inferior cava to left atrium–right pulmonary vein to right antrium150.0 2490 Portocaval anastomosis100.0 2496 Splenorenal anastomosis100.0 Suture 2511 Arteriorrhaphy: suture of wound or injury of artery (independent procedure), trunk60.0 2512 extremity30.0 2515 Phleborrhaphy: suture of wound or injury of vein (independent procedure), trunk60.0 2516 extremity20.0 2520 Ligation and division of ductus arteriosus100.0 2522 Ligation of carotid artery40.0 2525 Ligation and division of inferior vena cava60.0 2526 Ligation of femoral vein25.0 2530 Ligation and division of common iliac vein50.0 2558 Ligation and division of long saphenous vein at saphenofemoral junction, with or without retrograde injection or distal interruptions20.0 2561 Ligation and division and complete stripping of long or short saphenous veins, unilateral30.0 2562 bilateral50.0 2563 long and short saphenous veins, unilateral40.0 2565 bilateral60.0 2576 Ligation and division of short saphenous vein at saphenopopliteal junction (independent procedure)12.5 2581 minor varicose vein of leg, initial5.0 2585 subsequent3.0 Hemodialysis–Related Surgical Procedures 2590 Insertion of initial arterio–venous shunt (Including revisions during 21 follow–up days)50.0 2591 Revision of either arterial or venous cannula31.25 2592 Construction of arterio–venous fistula50.0 HEMIC AND LYMPHATIC SYSTEMS Spleen Excision 2601 Splenectomy60.0 Introduction 2610 Injection procedure for splenoportography10.0 Lymph Nodes and Lymphatic Channels Incision 2631 Drainage of lymph node abscess or lymphadenitis, simple3.0 2632 extensiveby report Excision 2641 Biopsy or excision of lymph node (independent procedure) (except 2642)5.0 2642 anterior scalene15.0 Radical Lymphadenectomy (Radical resection of lymph nodes): 2651 Supra–hyoid, unilateral50.0 2652 bilateral60.0 2655 Cervical (complete), unilateral80.0 2658 Axilla50.0 2671 Groin, superficial50.0 2672 deep, with common iliac dissection80.0 2673 Retroperitoneal, extensive, including pelvic, aortic and renal dissection100.0 Introduction 2676 Injection procedure for lymph–angiography, unilateral10.0 2677 bilateral15.0 MEDIASTINUM Incision 2680 Mediastinotomy with exploration or drainage, cervical approach40.0 2681 transthoracic80.0 2683 Foreign body removal, cervical approach70.0 2684 transthoracic80.0 Excision 2691 Excision of mediastinal cyst80.0 2693 Excision of mediastinal tumor100.0 2696 Ligation or repair, thoracic duct75.0 DIGESTIVE SYSTEM Mouth Incision 2701 Drainage of sublingual abscess2.0 2705 Drainage of Ludwig's angina8.0 Lips Excision (For excision of mucocele see 0175–0178 or 0260–0269.) (For excision of small lesion of lip see 0175–0178 or 0260–0269.) 2737 Vermilionectomy ("lip peel")40.0 2739 Transverse wedge excision, lip25.0 2743 V–excision of large lesion of lip up to one–half lip25.0 2746 Resection of more than one–half lip without plastic closure25.0 (With plastic closure, primary or secondary see 0260–0324.) Repair (Cheiloplasty) 2754 Plastic repair of cleft lip, primary, unilateral70.0 2758 bilateral, one stage90.0 2759 bilateral, two stages, per stage60.0 (For secondary, local revision, unilateral or bilateral see 0260–0324.) 2762 Plastic repair (secondary) of unilateral cleft lip by recreation of defect and reclosure70.0 2765 Plastic repair (secondary) of bilateral harelip by recreation of defect and reclosure—per major stage60.0 (For plastic or reconstruction operation on lip see also 0260–0324.) Tongue Incision (Glossotomy) 2771 Drainage of lingual abscess2.0 Excision (Glossectomy) 2781 Biopsy of tongue, anterior third3.0 2782 posterior two–thirds5.0 2785 Partial glossectomy or hemiglossectomy40.0 2787 Complete or total glossectomy70.0 Repair (Glossoplasty) (For plastic repair of tongue see 0260–0324.) Suture (Glossorrhaphy) (For suture of injury see 0251, 0260–0270.) Teeth and Gums Incision 2815 Drainage of alveolar abscess, acute with cellulitis, intraoral2.0 2820a General anesthesia for multiple extractions in hospital Palate and Uvula Incision 2871 Incision and drainage of abscess of palate2.0 Excision 2881 Biopsy of palate3.0 (For excision of local lesion of palate see 0175–0196, 0260–0270) (For graft or flap closure see 0275–0283, 0300–0304) 2885 Resection of palate or extensive excision of lesion of palate40.0 (For resection of palate with reconstruction see 0277–0283, 0312–0323.) 2887 Uvulectomy: excision of uvula3.0 Repair 2890 Palatoplasty: plastic operation for cleft palate, partial60.0 2892 complete, including alveolar ridge80.0 2895 major revision60.0 2897 secondary lengthening procedure70.0 2898 attachment pharyngeal flap60.0 2899 alveolar ridge, anterior palate defect30.0 (For secondary minor revision see 0260–0270, 0277–0283.) Suture For suture of palate injury see 0260–0270, 0277–0283.) Salivary Glands and Ducts Incision 2911 Drainage of parotid abscess5.0 2912 Drainage of submaxillary abscess5.0 2914 Sialolithotomy, submaxillary or parotid, uncomplicated3.0 2915 Sialolithotomy, submaxillary, complicated10.0 2916 Sialolithotomy, parotid extraoral25.0 Excision 2921 Biopsy of salivary gland5.0 2927 Excision of parotid tumor or gland, superficial without nerve dissection20.0 2928 with nerve dissection60.0 2934 Excision of parotid gland, total, with dissection of facial nerve70.0 2937 with sacrifice of facial nerve60.0 2938 Excision of submaxillary tumor and/or gland40.0 Repair (Sialodochoplasty) 2941 Plastic repair of salivary duct, simple35.0 2942 complicatedby report Introduction 2945 Injection procedure for sialography1.0 Suture 2951 Closure of salivary fistula40.0 Manipulation 2961 Dilation of salivary duct; ptyalectasis1.0 Pharynx, Adenoids and Tonsils Incision 2970 Drainage of peritonsillar abscess3.0 2971 Drainage of retropharyngeal or parapharyngeal abscess, intraoral10.0 2973 external approachby report Excision 2981 Biopsy of oropharynx3.0 2982 hypopharynx5.0 2983 nasopharynx5.0 (For larynx, see 2070 or 2073.) 2984 Excision of pharyngoesophageal diverticulum, single stage50.0 2985 multiple stages60.0 2989 Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues15.0 2990 extending beneath subcutaneous tissues50.0 2992 Tonsillectomy, with or without adenoidectomy, under age 18 years15.0 2993 18 years or over20.0 2994 Adenoidectomy (independent procedure), primary or secondary10.0 3000 Excision of tonsil tag(s), hospital10.0 3002 office6.0 3004 Excision of lingual tonsil (independent procedure)10.0 3005 Excision of nasopharyngeal fibromaby report Suture 3006 Suture of wound or injury of pharynxby report Repair 3011 Pharyngoplasty: plastic or reconstructive operation on pharynxby report (For pharyngeal flap, see 2898.) Esophagus Incision 3031 Esophagotomy, cervical60.0 3032 for removal of foreign body, cervical60.0 3033 thoracic80.0 Excision 3043 Esophagectomy: resection of esophagus, transpleural or extrapleural (upper two–thirds)120.0 3045 Esophagogastrectomy, combined thoraco–abdominal120.0 3046 Local excision, end–to–end anastomosis90.0 Endoscopy 3051 Esophagoscopy, diagnostic15.0 3053 with insertion of radioactive substance20.0 3055 with biopsy20.0 3057 with foreign body removal25.0 3061 with dilation, direct20.0 3063 subsequent dilation15.0 (See also 3092, 3095.) Repair 3071 Esophagoplasty: plastic repair or reconstruction of esophagusby report 3072 Esophagogastrostomy (cardioplasty)80.0 3073 Esophagomyotomy (Heller type)80.0 3074 Esophagoduodenostomy (including total gastrectomy)100.0 3075 Esophagojejunostomy, including total gastrectomy100.0 3076 Esophagostomy: fistulization of esophagus, external60.0 Suture 3077 Direct ligation of esophageal varices80.0 3081 Suture of esophageal wound, injury or rupture, cervical approachby report 3083 transthoracic70.0 3086 Closure of esophagostomy or other external esophageal fistula, cervical45.0 3087 thoracic70.0 Manipulation 3092 Dilation of esophagus by sound, bougie or bag, indirect, initial5.0 3095 subsequent3.0 (For direct see 3061 and 3063.) Stomach Incision 3101 Gastrotomy with exploration or foreign body removal50.0 3105 Pyloromyotomy: cutting of pyloric muscle (Fredet–Ramstedt type operation)50.0 Excision 3111 Biopsy by laparotomy50.0 3112 Local excision of ulcer or tumor60.0 3114 Total gastrectomy100.0 3115 Subtotal or hemi–gastrectomy, without vagotomy80.0 3116 with vagotomy90.0 3117 Vagotomy and pylorplasty70.0 (See also 3131.) Endoscopy (independent procedure) 3121 Gastroscopy, diagnostic15.0 3123 with biopsy15.0 Suture 3131 Pyloroplasty50.0 3133 Gastroduodenostomy60.0 3135 Gastrojejunostomy60.0 3136 with vagotomy75.0 3137 Gastrostomy40.0 3141 Gastrorrhaphy: suture of perforated duodenal or gastric ulcer, wound or injury50.0 3144 Revision of gastroduodenal anatomosis (gastroduodenostomy) with reconstruction, without vagotomy90.0 3145 with vagotomy100.0 3146 Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, without vagotomy90.0 3147 with vagotomy100.0 3153 Closure of gastrostomy, surgical40.0 Intestines (Except Rectum) Incision 3161 Enterotomy with exploration or foreign body removal, small bowel60.0 3162 large bowel65.0 3166 Exteriorization of intestine (Mikulicz resection of colon, with or without crushing of spur)70.0 Excision 3171 Excision of one or more lesions of small or large bowel not requiring anastomosis, exteriorization or fistulization, single enterotomy60.0 3172 multiple enterotomies70.0 3174 Enterectomy: resection of small intestine with anastomosis70.0 3176 with enterostomy70.0 3178 Colectomy, partial resection of large intestine in two stages, including first stage colostomy or cecostomy100.0 3179 Colectomy, partial, with anastomosis with or without concomitant proximal colostomy80.0 3180 total, with ileostomy or ilioproctostomy110.0 3181 with proctectomy and ileostomy120.0 3191 Enteroenterostomy; anastomosis of intestine60.0 ENTEROSTOMY — External fistulization of intestines (independent procedure): 3193 small bowel (ileostomy or jejunostomy)50.0 3195 large bowel, (colostomy or cecostomy)50.0 3197 small or large bowel, for ulcerative colitis75.0 3200 Reduction of volvulus, intussusception, internal hernia, by laparotomy60.0 3203 Revision of colostomy, simple, (release of superficial scar)5.0 3204 complicated (reconstruction in depth)25.0 Destruction 3211 Enterolysis (freeing of intestinal adhesion)40.0 3212 with acute bowel obstruction60.0 3213 Intestinal plication (Noble type)60.0 Suture 3220 Suture of intestine (enterorrhaphy), large or small, for perforated ulcer, wound, injury or rupture, single60.0 3221 multipleby report 3222 Suture of intestine with colostomy70.0 3225 Closure of enterostomy, large or small intestine40.0 3227 Closure of fecal fistulaby report Meckel's Diverticulum and the Mesentery Excision 3231 Excision of Meckel's diverticulum (diverticulectomy)50.0 3235 Excision of lesion of mesentery50.0 (With bowel resection, see 3174.) Suture 3241 Suture of mesentery40.0 Appendix Incision 3251 Incision and drainage of appendicular abscess, transabdominal30.0 Excision 3261 Appendectomy40.0 Rectum Incision 3282 Transrectal drainage of pelvic abscess15.0 3283 Incision and drainage of deep supralevator, pelvirectal or retrorectal abscess20.0 (See also 3357, 3358.) Excision 3291 Complete proctectomy, combined abdomino–perineal, one or two stages100.0 3292 Complete proctectomy for congenital megacolon (Swenson type procedure)100.0 3294 Excision of rextal procidentia, with anastomosis, perineal approach60.0 3295 abdominal and perineal approach100.0 3296 Division of stricture in rectum20.0 3298 Perineal excision of primary or recurrent malignant tumor (Kraske type)80.0 3299 Local excision of extensive villous papilloma of rectum40.0 Endoscopy (independent procedure) 3310 Proctosigmoidoscopy, diagnostic, initial3.0 3311 subsequent2.0 3312 with biopsy, initial5.0 3313 subsequent for same lesion3.0 3314 with removal of papilloma or polyp, initial7.0 3315 subsequent for same lesion5.0 3316 with removal of multiple papillomas or polyps9.0 3317 complicatedby report 3318 Endoscopic control of hemmorrhageby report 3319 Endoscopic removal of foreign body, anus or rectumby report Repair 3320 Proctoplasty, for stenosis40.0 3321 for prolapse of mucous membrane40.0 3322 Perirectal injection of sclerosing solution for prolapse, in hospital10.0 3323 Proctopexy for prolapse, abdominal approach60.0 3325 Proctopexy combined with sigmoid resection, abdominal approach90.0 Suture 3331 Closure of rectovesical fistula60.0 (See also 3965.) 3333 Closure of rectourethral fistula70.0 (See also 4026.) 3335 Closure of rectovaginal fistula60.0 (When a colostomy is part of the above procedures, add 10 units.) Manipulation 3341 Reduction of procidentia (independent procedure)2.0 Anus Incision 3351 Fistulotomy or fistulectomy, subcutaneous10.0 3352 submuscular40.0 3353 complex or multipleby report 3354 second stage10.0 3355 Remove seton, office2.0 3356 Incision and drainage of ischiorectal abscess (independent procedure)10.0 3357 Incision and drainage, perianal abscess (See also 3283.)2.0 3358 Incision and drainage of ischiorectal abscess with fistulotomy or fistulectomy, submuscular (See also 3283.)40.0 3364 Sphincterotomy, anal: division of anal sphincter (independent procedure)5.0 Excision 3371 Fissurectomy, with or without sphincterotomy20.0 3372 Cryptectomy, single, office5.0 3373 multiple, hospital procedure30.0 3374 Papillectomy or excision of single tab (independent procedure), office3.0 3375 Excision of external hemorrhoidal tags and/or multple papillae, office5.0 3377 Hemorrhoidectomy, external, complete20.0 3380 internal and external30.0 3381 radical (Buie or amputative type)40.0 3382 Fistulotomy or fistulectomy, submuscular, and hemorrhoidectomy40.0 3386 Fissurectomy and hemorrhoidectomy30.0 3392 Enucleation or excision of external thrombotic hemorrhoid3.0 Introduction 3401 Hemorrhoids, injection of sclerosing solution2.0 Endoscopy (independent procedure) 3411 Anoscopy, diagnostic with or without biopsy1.0 (For with removal of foreign body see 3319.) (For control of hemorrhage, endoscopic, see 3318.) Repair 3420 Anoplasty: plastic operation for stricture40.0 3421 infant, minor thin septum5.0 3422 Construction of anus for congenital absence, perineal approach50.0 3423 combined abdominal and perineal approach80.0 3425 Sphincteroplasty, anal, for incontinence40.0 3426 muscle transplantby report 3427 Thiersch procedure for incontinence and/or prolapse25.0 Destruction 3433 Condyloma, single or multiple, internal and external, in hospital20.0 3434 external, electrodesiccation, initial3.0 3435 subsequent2.0 Liver Incision 3456 Aspiration biopsy of liver5.0 Excision 3464 Hepatectomy, partial: resection of liver80.0 Repair 3471 Marsupialization of cyst or abscess of liver70.0 Suture 3481 Hepatorrhaphy: suture of liver wound or injury60.0 Biliary Tract Incision 3491 Hepaticotomy or hepaticostomy with exploration, drainage or removal of calculus70.0 3495 Choledochotomy or choledochostomy with exploration, drainage or removal of calculus, with or without cholecystotomy70.0 3500 Duodenocholedochotomy: transduodenal choledocholithotomy80.0 3501 Transduodenal sphincterotomy80.0 3504 Cholecystotomy or cholecystostomy with exploration, drainage or removal of calculus50.0 Introduction 3509 Injection procedure for percutaneous trans–hepatic cholangiography (independent procedure)10.0 Excision 3515 Cholecystectomy60.0 3517 with open exploration of common duct70.0 Repair 3518 Exploration for congenital atresia of bile ducts50.0 3519 Direct anastomosis of gallbladder and gastrointestinal tract65.0 3520 Roux–en–y anastomosis of gallbladder and gastrointestinal tract65.0 3521 Direct anastomosis of extrahepatic biliary ducts and gastrointestinal tract75.0 3522 Roux–en–y anastomosis of extrahepatic biliary ducts and gastrointestinal tract85.0 3523 Plastic reconstruction of extrahepatic biliary ducts with end–to–end anastomosis80.0 Pancreas Incision 3541 Abdominal drainage of pancreatitis50.0 3544 Removal of calculus70.0 Excision 3550 Pancreatectomy, subtotal80.0 3551 subtotal (Whipple type)140.0 3552 140.0 3553 Pancreatico–jejunostomy80.0 Repair 3565 Marsupialization of cyst of pancreas60.0 3566 Internal direct anastomosis of cyst to gastrointestinal tract70.0 3567 Roux–en–y internal anastomosis, cyst to gastrointestinal tract80.0 Abdomen, Peritoneum and Omentum Incision 3571 Exploratory laparotomy: exploratory celiotomy40.0 3573 Drainage of peritoneal abscess or localized peritonitis exclusive of appendicular abscess40.0 3575 Subdiaphragmatic or subphrenic abscess50.0 3578 Retroperitoneal abscess40.0 3588 Peritoneocentesis: abdominal paracentesis, initial4.0 3590 subsequent3.0 Excision 3591 Trans–peritoneal excision of intra–abdominal or retroperitoneal tumors or cysts70.0 Endoscopy 3595 Peritoneoscopy15.0 Introduction 3611 Pneumoperitoneum: intraperitoneal injection of air, initial4.0 3612 subsequent2.0 3614 Injection procedure for retroperitoneal pneumography, unilateral or bilateral (independent procedure)5.0 3615 Injection procedure for pelvic pneumography (independent procedure)4.0 (See also 4462.) Repair Hernioplasty, Herniorrhaphy, Herniotomy: 3631 Inguinal, unilateral35.0 3633 with orchiectomy40.0 3634 with excision of hydrocele40.0 3635 recurrent40.0 3646 Femoral, unilateral35.0 3651 recurrent45.0 3661 Ventral, incisional45.0 3662 recurrent50.0 3663 Epigastric35.0 3664 recurrent45.0 3665 Umbilical, under age five years30.0 3666 over age five years35.0 3667 Omphalocele, in newborn, one stage40.0 3668 Gross type procedure, first stage50.0 3669 second stage50.0 (For diaphragmatic hernia, see 1495, 1496.) Suture 3734 Secondary suture of abdominal wall for evisceration or disruption20.0 (For suture of ruptured diaphragm, see 1495, 1496.) URINARY SYSTEM Kidney Incision 3802 Drainage of perirenal abscess (independent procedure)50.0 3808 Nephrotomy with drainage: nephrostomy80.0 3811 Nephrolithotomy, removal of calculus80.0 3812 large (staghorn) calculus90.0 3813 Division or transection of aberrant renal vessels (independent procedure)70.0 3815 Pyelotomy with exploration70.0 3816 Pyelotomy with drainage, pyelostomy70.0 3817 Pyelotomy with removal of calculus; pyelolithotomy; pelviolithotomy70.0 Excision 3820 Renal biopsy, trochar or needle5.0 3821 Nephrectomy, including partial ureterectomy80.0 3822 with total ureterectomy through same or separate incision100.0 3824 Heminephrectomy100.0 3827 Excision of cyst of kidney70.0 3829 Aspiration or injection of renal cyst or renal pelvis5.0 Introduction (For perirenal insufflation, unilateral or bilateral, see 3614.) Repair 3831 Pyeloplasty: plastic operation on renal pelvis with or without plastic operation on ureter or nephropexy80.0 3835 Nephropexy: fixation or suspension of kidney (independent procedure)70.0 Suture 3841 Nephrorrhaphy: suture of kidney wound or injury80.0 3845 Closure of nephrostomy, pyelostomy or other renal fistula (e.g., renocolic fistula)80.0 3846 Symphysiotomy for horseshoe kidney100.0 Transplant 3850 Kidney transplant125.0 Ureter Incision 3851 Ureterotomy with exploration or drainage (independent procedure)70.0 3857 Ureterolithotomy, upper three quarters of ureter70.0 3858 lower one quarter80.0 Excision 3861 Ureterectomy, with bladder cuff (independent procedure)80.0 Repair 3871 Ureteroplasty: plastic operation on ureter (stricture)80.0 3872 Ureterolysis, with or without repositioning of ureter, unilateral70.0 3873 bilateral90.0 3874 Ureteropyelostomy: anastomosis of ureter and renal pelvis80.0 3875 Ureteroureterostomy80.0 3876 Ureteroneocystostomy: anastomosis of ureter to bladder, unilateral80.0 3877 bilateral100.0 3880 Ureteroenterostomy: anastomosis of ureter to intestine, unilateral80.0 3881 bilateral100.0 3884 Ureterostomy: transplantation of ureter to skin, unilateral70.0 3885 bilateral90.0 Suture 3891 Ureterorrhaphy: suture of ureter (independent procedure)80.0 3895 Closure of fistula of ureterby report Bladder Incision 3900 Aspiration of bladder by needle or trochar5.0 3902 with insertion of suprapubic catheter10.0 3904 Cystotomy or cystostomy with fulguration60.0 3905 Cystotomy with drainage; cystostomy50.0 3907 Cystotomy with removal of calculus (cystolithotomy) without vesical neck resection50.0 3908 Drainage of perivesical or prevesical space abscess50.0 Excision 3911 Cystectomy, partial70.0 3912 with re-implantation of ureter into bladder (ureteroneocystostomy)80.0 3913 complete100.0 3914 radical with ureteral transplants120.0 3915 with ureteral–ileo conduit140.0 3918 Transurethral resection, vesical neck, female or child (See also 4321.)50.0 3919 Cystotomy for excision of vesical neck (independent procedure)60.0 3920 Excision of bladder diverticulum (independent procedure)70.0 3922 Excision of bladder tumor (See also 3904.)60.0 3924 Transurethral resection of bladder tumors, large (For small tumors, see 3936, 3937.)60.0 Introduction 3926 Bladder irrigation, simple, lavage and/or instillation1.0 3927 Injection procedure for cystography or urethro–cystography1.0 Cystoscopy (independent procedure): 3930 Diagnostic, office, initial5.0 3931 subsequent within 30 days3.0 3932 with ureteral catheterization8.0 3933 hospital8.0 3934 with ureteral catheterization15.0 (For Howard or Stamey type renal function test see 3948.) 3935 With biopsy10.0 3936 With fulguration or treatment of minor (less than 0.5 cm.) lesion, with or without biopsy10.0 3937 With fulguration of small bladder tumors (0.5 cm. to 2 cm.) (For larger tumors, see 3924.)25.0 3938 With subsequent fulguration of bladder tumor10.0 3939 With insertion of radioactive substance, with or without biopsy or fulguration30.0 3940 With dilatation of bladder for interstitial cystitis, general anesthesia15.0 3942 With ureteral meatotomy20.0 3943 With resection of fulguration of ureterocele20.0 3944 With removal of foreign body from urethra or bladder20.0 3945 With removal of calculus from ureter30.0 3946 With manipulation of ureteral calculus, primary20.0 3947 subsequent10.0 3948 Differential quantitative and chemical renal function test (e.g., Howard or Stamey type)Destruction 3951 Litholaplaxy: crushing of calculus in bladder and removal of fragments50.0 Repair 3952 Cystoplasty; plastic operation on bladder (anterior Y–plasty, vesical fundus resection, etc.) any procedure80.0 Suture 3961 Cystorrhaphy: suture of bladder wound, injury or rupture60.0 3963 Closure of cycstostomy (independent procedure)30.0 3965 Closure of vesicovaginal, vesicouterine, or vesicoenteric fistula (See also 3331.)60.0 Urethra Incision 3971 Urethrotomy, external (independent procedure) anterior10.0 3973 perineal, external25.0 3977 Meatotomy: cutting of meatus (independent procedure)3.0 3978 Drainage of deep periurethral abscess, hospital10.0 3979 Drainage of simple perineal urinary extravasation (independent procedure), uncomplicated15.0 3980 complicated, with or without diversion of urinary stream50.0 (See also 3908.) Excision (For excision or fulguration of urethral caruncle, see 4437.) 3987 Excision or fulguration of carcinoma of urethraby report 3991 Excision or diverticulum of urethra (independent procedure)50.0 3994 Excision of fulguration of urethral polyps, distal¾inch of urethra5.0 (For posterior urethra, see 4006.) Endoscopy 4000 Urethroscopy, diagnostic5.0 4001 with removal of calculus or foreign body20.0 4004 with internal urethrotomy20.0 4006 with fulguration of posterior urethra10.0 4008 subsequent, within 30 days5.0 Repair 4011 Urethroplasty: plastic operation on urethra (except 4132 and 4135)by report Suture 4021 Urethrorrhaphy: suture of urethral wound or injuryby report 4023 Closure of urethrostomy or fistula of urethra (independent procedure)30.0 4025 Closure of urethrovaginal fistula50.0 4026 Closure of urethrorectal fistula (See also 3333.)70.0 Manipulation 4031 Dilation of urethral stricture by passage of sound, initial, male3.0 4032 subsequent within 30 days1.5 4033 Dilation of urethral stricture by passage of filiform and follower, male5.0 4034 subsequent within 30 days2.5 4035 Passage of filiform and follower for acute vesical retention, male5.0 4036 Dilation of female urethra including suppository and/or installation2.0 4037 subsequent within 30 days1.0 MALE GENITAL SYSTEM Penis Incision 4101 Dorsal or lateral "slit" of prepuce (independent procedure)3.0 Excision 4111 Biopsy of penis (independent procedure)3.0 4114 Amputation of penis, partial40.0 4115 complete60.0 4116 radical100.0 (For local excision of lesion of penis, see Integumentary System.) 4122 Circumcision, clamp procedure, newborn3.0 4123 except newborn5.0 4124 surgical excision other than clamp or dorsal slit, any age (except newborn)10.0 (For excision or fulguration of warts, see 0403, 0405.) Repair 4131 Plastic operation on penis for hypospadias, straightening of chordee30.0 (For urethroplasty for hypospadias, see 0260 to 0324.) 4134 Plastic operation on penis for injuryby report 4135 Plastic operation on penis for epispadias with exstrophy of bladderby report 4136 Plastic operation for penile epispadias distal to external sphincter50.0 Testis Excision 4140 Biopsy, needle (independent procedure)2.0 4141 incisional (independent procedure)10.0 4143 Orchiectomy, simple unilateral20.0 4144 bilateral30.0 4145 with superficial inguinal node dissection, unilateral50.0 (For radical retroperitoneal node dissection, see 2673.) Repair 4152 Reduction of torsion of testis by surgical means30.0 4153 with fixation of contralateral testis45.0 4154 Fixation of contralateral testis (independent procedure)20.0 4156 Orchiopexy, any type, with or without hernia repair50.0 4157 second stage (Torek type)10.0 (For orchiectomy with repair of hernia, see 3633.) Epididymis Incision 4161 Drainage of abscess of epididymis3.0 Excision 4171 Biopsy of epididymis, needle2.0 4172 Exploration of epididymis with or without biopsy10.0 4174 Excision of spermatocele with or without epididymectomy30.0 4176 Epididymectomy, unilateral30.0 Repair 4181 Epididymovasostomy (anastomosis of epididymis to vas deferens), unilateral40.0 4182 bilateral50.0 Tunica Vaginalis Incision 4191 Puncture aspiration of hydrocele with or without injection of medication2.0 4200 Repair of hydrocele (Bottle type)20.0 4201 Excision of hydrocele, unilateral30.0 4202 with hernia repair40.0 Scrotum Incision 4211 Drainage of scrotal abscess2.0 4215 Removal of foreign body in scrotumby report Excision (For local excision of lesion of skin of scrotum, see 0175–0197, 0260–0270.) 4224 Resection of scrotumby report 4227 Scrotoplasty; plastic operation on scrotumby report Vas Deferens Incision 4231 Vasotomy: incision or transection of vas, unilateral or bilateral (independent procedure)15.0 Excision 4241 Vasectomy, unilateral or bilateral (independent procedure)15.0 Repair 4251 Vasovasostomy unilateral30.0 4252 bilateral40.0 Suture 4261 Ligation (percutaneous of vas deferens (independent procedure)5.0 Spermatic Cord Excision 4271 Excision of hydrocele of spermatic cord (independent procedure), unilateral30.0 4275 Excision of varicocele (independent procedure), unilateral30.0 4278 with hernia repair40.0 Seminal Vesicles Incision 4281 Vesiculotomy, unilateralby report Excision 4291 Vesiculectomy80.0 Prostate Incision 4300 Biopsy, prostate, needle, single or multiple5.0 4301 incisional, perineal approach30.0 4302 transrectal20.0 4303 Prostatotomy: external drainage of prostatic abscess30.0 4304 Prostatolithotomy: removal of prostatic calculus (independent procedure)70.0 Excision 4311 Prostatectomy, perineal, subtotal80.0 4313 radical100.0 4316 suprapubic, one or two stages80.0 4318 retropubic80.0 4319 radical100.0 Endoscopy 4321 Transurethral resection of prostate, including control of postoperative bleeding, complete (See also 3918.)80.0 FEMALE GENITAL SYSTEM Vulva and Introitus Incision 4403 Incision and drainage, abscess of vulva5.0 4405 Incision and drainage of Bartholin's gland abscess, unilateral5.0 Excision 4421 Biopsy of vulva (independent procedure)3.0 (For local excision or fulguration of lesion(s) of external genitalia, see 0175–0197, 0260–0324, 0401–0406.) 4423 Vulvectomy, complete, bilateral55.0 4424 partial, less than 80% of vulvar area40.0 4425 radical, including unilateral regional lymph nodes100.0 4426 including bilateral regional lymph nodes150.0 4428 Clitoridotomy: circumcision, female7.5 4429 Clitoridectomy10.0 4431 Hymenectomy, partial excision of hymen10.0 4433 Excision of Bartholin's gland or cyst20.0 4434 Marsupialization or cautery destruction of Bartholin's gland or cyst15.0 4436 Excision or fulguration of Skene's glands7.0 4437 Excision or fulguration of urethral caruncle7.0 (For excision of urethral diverticulum see 3991.) (For excision or fulguration of urethral carcinoma see 3987.) Repair 4441 Episioplasty: plastic repair of vulva (non–obstetrical)20.0 4443 Plastic operation on urethral sphincter, vaginal approach30.0 4445 Plastic repair of urethra for mucosal prolapse (independent procedure)by report 4447 Plastic repair of urethrocele (independent procedure)30.0 Suture (For eposiorrhaphy or episioperineorrhaphy: for recent injury of vulva and/or perineum [nonobstetrical], see 4480.) Vagina Incision 4461 Colpotomy with exploration or drainage of pelvic abscess15.0 4462 Colpocentesis (independent procedure)4.0 4463 Puncture and aspiration of cul de sac3.0 4471 Biopsy of vaginal mucosa (independent procedure)3.0 (For excision and/or fulguration of local lesion(s) see 0175–0197, 0401–0406.) 4473 Colpocleisis, complete obliteration of vagina50.0 4475 Le Fort type35.0 4477 Excision of vaginal septumby report Introduction 4478 Irrigation and/or application of any medicament for treatment of bacterial, parasitic or fungoid disease1.0 Repair 4479 Colporrhaphy: suture of injury of vagina (nonobstetrical)by report 4480 Colpoperineorrhaphy: suture of injury of vagina and/or perineum (nonobstetrical)by report 4481 Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele (independent procedure)35.0 4484 Posterior colporrhaphy, repair of rectocele (independent procedure)30.0 4485 with perineoplasty or perineorrhaphy35.0 4488 Combined anterior–posterior colporrhaphy50.0 4492 Urethral suspension, abdominal approach (Marshall–Marchetti type)40.0 4493 Repair of enterocele (independent procedure) abdominal approach45.0 4494 vaginal approach45.0 4495 Colpopexy, abdominal approach45.0 4497 Construction of artificial vagina (vaginal atresia or absence) with or without graftby report (For closure of vaginal fistulae, see 3335, 3965, 4025.) Manipulation 4511 Dilation of vagina under anesthesia2.0 4512 Pelvic examination under anesthesia2.0 Endoscopy 4521 Culdoscopy (independent procedure)15.0 Oviduct Incision 4531 Transection of Fallopian tube, unilateral or bilateral, abdominal or vaginal approach40.0 4532 post–partum, during same hospitalization30.0 Excision 4541 Salpingectomy, complete or partial, unilateral or bilateral (independent procedure)45.0 4545 Salpingo–oophorectomy, complete or partial, unilateral or bilateral (independent procedure)45.0 4551 Salpingoplasty, unilateral or bilateral (independent procedure)50.0 Ovary Incision 4561 Drainage of ovarian cyst, vaginal approach, unilateral or bilateral25.0 4562 abdominal approach, unilateral or bilateral40.0 4564 Drainage of ovarian abscess, vaginal approach20.0 4565 abdominal approach40.0 Excision 4566 Biopsy of ovary, unilateral or bilateral (independent procedure)45.0 4568 Partial oophorectomy, bilateral or unilateral45.0 Cervix Uteri Excision (For radical surgical procedures, see 4620, 4626.) 4571 Biopsy or local excision of lesion, with or without fulguration, quadrant biopsy (independent procedure)3.0 4572 Cauterization of cervix, office3.0 4573 Biopsy of cervix, circumferential (cone) with or without dilation and curettage, with or without Sturmdorff type repair20.0 4575 Trachelectomy: cervicectomy: amputation of cervix (independent procedure)20.0 4577 total excision of cervical stump, with or without pelvic floor repair, abdominal approach50.0 4578 vaginal approach60.0 Introduction *4581 Insertion of any hemostatic agent for control of hemorrhage (independent procedure)3.0 (For insertion of any radioactive material, see 7615.) 4583 Insertion of intracervical or intrauterine device3.0 Repair 4585 Tracheloplasty: surgical repair of incompetent cervix, loop type8.0 4586 Shirodkar type20.0 4587 Trachelorrhaphy, plastic repair of uterine cervix, vaginal approachby report Manipulation 4588 Dilation of cervical canal, instrumental (independent procedure)3.0 4589 Dilation and curettement of cervical canal15.0 Corpus Uteri Excision 4610 Endometrial biopsy (independent procedure)3.0 4612 Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical)15.0 4613 Myomectomy: excision of fibroid tumor of uterus (independent procedure, nonobstetrical)50.0 4614 Total hysterectomy (corpus and cervix) with or without tubes, and/or ovaries, one or both60.0 4618 Supracervical hysterectomy: subtotal hysterectomy, with or without tubes, and/or ovaries, one or both55.0 4620 Radical hysterectomy for cancer including regional lymph nodes100.0 4626 plus removal of bladder and ureteral transplantations and/or abdominoperineal resection of rectum and colon and colostomy or any combination thereofby report 4631 Vaginal hysterectomy60.0 4632 with plastic repair of vagina, anterior and/or posterior colporrhaphy70.0 4634 with repair of enterocele75.0 Introduction *4675 Insufflation of uterus and tubes with air or CO*3.0 *4676 Injection procedure for hystero–salpingography*3.0 Repair 4683 Uterine suspension with or without shortening of round ligaments (independent procedure)40.0 4684 with presacral sympathectomy45.0 4685 with interposition operation, with or without pelvic floor repair50.0 4690 with shortening of endopelvic fascia: parametrial fixation with or without pelvic floor repair (Manchester type)50.0 4692 with shortening of sacro–uterine ligaments50.0 4694 Hysterosalpingostomy: anastomosis of tubes of uterus50.0 4695 Hysterorrhaphy: repair of ruptured uterus (nonobstetrical)40.0 Perineum Excision 4710 Biopsy of perineum (independent procedure)3.0 (For excision of local lesion see 0175–0178, 0260–0324.) Incision *4720 Incision and drainage of perineal abscess (nonobstetrical)*3.0 Repair 4731 Perincoplasty: repair of perineum (independent procedure)15.0 4735 third degree laceration, old (independent procedure)40.0 (Also see 4441, 4480.) 4742 Perineorrhaphy, postpartum, by other than delivering physician20.0 4745 Repair of perineal fistula25.0 (For repair of recent injury of perineum, nonobstetrical, see 4480.) MATERNITY (Fees for all maternity procedures include prenatal and postpartum care unless otherwise specified.) Incision 4801 Classic cesarean section50.0 4802 Low cervical (lower uterine segment) cesarean section50.0 4803 Cesarean section and hysterectomy, total or subtotal60.0 4804 Extraperitoneal cesarean section60.0 Excision 4809 Hysterotomy induced abortion50.0 4811 Ectopic pregnancy, tubal, requiring salpingectomy and/or oophorectomy, abdominal or vaginal approach50.0 4812 ovarian, requiring oophorectomyby report 4815 Hysterotomy, abdominal, for removal of hydatidiform mole45.0 Manipulation 4821 Total obstetrical care including antepartum care, obstetrical delivery and postpartum care (with or without low forceps, and/or episiotomy)35.0 4822 Obstetrical delivery (with or without low forceps, and/or episiotomy) and including hospital postpartum care20.0 4823 Antepartum care only (independent procedure)Sv.‡ 4824 Postpartum care only (independent procedure)Sv.‡ 4841 Amniocentesis, diagnostic5.0 4842 Amniocentesis with hypertonic solution including terminal curettage, induced abortion40.0 4843 Dilation and curettage, and/or suction, induced abortion20.0 4850 Abortion, first trimester, completed medicallySv.‡ 4851 (incomplete) completed surgically, (dilataion and curettage)15.0 4853 second trimester, completed medicallySv.‡ 4854 (incomplete) completed surgically, (dilatation and curettage)15.0 4856 missed, first or second trimester, completed medically or surgicallyby report 4858 incomplete, septic, requiring dilatation and curettage and additional careby report 4870 Dilatation and curettage of uterus for postpartum bleeding15.0 ENDOCRINE SYSTEM Thyroid Gland Incision 4904 Incision and drainage of thyroglossal cyst (infected)3.0 Excision 4911 Local excision of small cyst or adenoma of thyroid40.0 4912 Total thyroid lobectomy, unilateral50.0 4914 Thyroidectomy, total or complete70.0 4917 subtotal or partial60.0 4924 total or subtotal for malignancy with radical neck dissection100.0 4925 total or subtotal for malignancy with limited neck dissection80.0 4937 secondary, unilateral60.0 4938 bilateral70.0 4941 Excision of thyroglossal duct, cyst or sinus45.0 Parathyroid, Thymus, Pituitary, Pineal, Adrenal Glands and Carotid Body (For hypophysectomy, see 2019 and 5130.) Excision 4971 Parathyroidectomy or exploration of parathyroid70.0 4972 with mediastinal exploration with or without splitting of sternum90.0 4985 Adrenalectomy, transabdominal, lumbar or dorsal, unilateral80.0 4986 bilateral, one stage100.0 4987 two stages120.0 4989 Biopsy adrenal, unilateral60.0 4990 bilateral70.0 4993 Excision of carotid body tumor, with excision of carotid artery100.0 4994 without excision of carotid artery70.0 NERVOUS SYSTEM Skull, Meninges and Brain CRANIOTOMY FOLLOWING TRAUMA: Incision 5001 Burr holes, unilateral, exploratory for subdural puncture, not followed by surgery30.0 5002 multiple, bilateral, not followed by surgery50.0 5003 Evacuation of hematoma, subdural, extradural, or intracerebral by burr holes only90.0 5004 requiring craniotomy100.0 5012 Removal of foreign body from brain100.0 Excision 5015 Removal of brain scarby report Repair 5018 Elevation of depressed skull fracture, simple75.0 5020 with debridement of brain and repair of dura100.0 5022 Cranioplasty for skull defect, bone, metal or plastic100.0 5024 Repair of dura by graft, including repair for cerebrospinal rhinorrhea100.0 CRANIOTOMY FOR NON–TRAUMATIC CAUSES: Incision 5101 Burr holes, exploratory or ventricular puncture, not followed by surgery30.0 5102 Ventricular puncture through previous burr holes or fontanelle5.0 5106 Craniotomy for drainage of brain abscess75.0 5108 Subsequent tapping (aspiration) abscess in operating room10.0 5110 at bedside5.0 5112 Suboccipital craniectomy for tractotomy or section of 5th, 8th, 9th or other cranial nerves125.0 5113 Intratemporal (mastoid) craniectomy for decompression, neurolysis or excision of acoustic nerve tumor100.0 5114 Craniotomy for surgery of sensory root of grasserian ganglion100.0 5116 Craniotomy for lobotomy, unilateral40.0 5117 bilateral60.0 5119 Craniotomy for orbital decompression, unilateral100.0 5121 Cisternal puncture (independent procedure)3.0 5122 Subdural tap through fontanelle (infant)3.0 Excision (For trans–septal hypophysectomy see 2019.) 5130 Osteoplastic craniotomy for excision of brain tumor, abscess, or cyst, supratentorial125.0 5132 Suboccipital craniectomy for brain tumor150.0 5134 Osteoplastic craniotomy for arteriovenous malformationby report 5136 Osteoplastic craniotomy for obliteration of aneurysm150.0 5140 Craniotomy for pallidectomy, any method, including localizing techniques, single or multiple stages100.0 5144 for topectomy100.0 5146 for excision of choroid plexus50.0 5148 Craniectomy for osteomyelitis of skullby report Introduction 5152 Burr holes with ventriculography, not followed by surgery30.0 5153 followed by surgery20.0 5154 Ventriculography through fontanelle or previous burr holes10.0 5155 Ventricular puncture with introduction of dye and recovery by spinal puncture12.0 5159 Injection procedure for pneumoencephalography10.0 Repair 5160 Ventriculocisternostomy100.0 5162 Repair of encephaloceleby report 5166 Ventriculoauricular shunt100.0 5167 replacement or irrigation of obstructed valve90.0 5168 replacement or irrigation of ventricular catheter30.0 5169 removal of shunt in toto without replacement30.0 5170 Ventriculo–auricular–peritoneal–pleural–uretera l shunt100.0 5171 co–surgeon80.0 5174 Craniectomy for craniostenosis, single suture75.0 5175 multiple sutures100.0 Spine and Spinal Cord Incision 5190 Laminectomy for decompression of the spinal cord and nerve roots (See also 5208–5210, 5225.)100.0 5192 Cordotomy, cervico–dorsal100.0 5194 Rhizotomy75.0 5198 Spinal puncture, lumbar, simple (independent procedure)2.0 5199 diagnostic, initial, with study of hydrodynamics4.0 (Add one unit to value assigned to 5198 and 5199 if patient is under 4 years.) Excision 5206 Laminectomy for lesion of spinal cord or meninges100.0 5208 Laminotomy for removal of intervertebral discs, cervical90.0 5209 thoracic90.0 5210 lumbar90.0 5211 Excision of intervertebral discs, anterior approach, cervical80.0 (See also 0634–0642.) Introduction 5214 Injection procedure for myelography10.0 5216 for discography10.0 Repair 5225 Laminectomy for spondylolisthesis (See also 5190.)100.0 5227 Repair of meningocele75.0 5229 Repair of meningomyelocele90.0 5231 Lumbar subarachnoid–peritoneal–ureteral shunt80.0 5232 co–surgeon75.0 5233 Application crutchfield tongs or other skeletal traction device5.0 Peripheral Nerves, Other Extracranial Nerves and Ganglia Incision (For transection of trigeminal or glossopharyngeal nerves, see 5112, 5114.) 5252 Phrenic nerve transection or avulsion15.0 5255 Transection, spinal nerve40.0 5257 Transection, occipital nerve40.0 Excision (For excision of tender scar, skin and subcutaneous tissues with or without tiny neuroma, see 0175, 0178, 0265, 0266.) 5273 Excision of surgically identifiable neuroma of cutaneous nerve8.0 5274 digital nerve, one or both, same digit10.0 5275 hand or foot, one (add 10 percent each additional)15.0 5276 arm or leg25.0 5277 Avulsion infraorbital nerve20.0 5280 Stoefel's neurectomy40.0 5282 Obturator neurectomy40.0 Introduction 5290 Alcohol injection, subarachnoid5.0 5294 2nd or 3rd branch of trigeminal nerve7.5 5295 under x–ray control (excluding x–ray charge)10.0 Nerve Block 5298 Paravertebral block, lumbar or thoracic5.0 5300 Sympathetic block (cervical)5.0 5302 Stellate ganglion5.0 5311 Brachial plexus block5.0 5312 Intercostal nerves3.0 5313 Lumbar, sacral and coccygeal nerves5.0 5314 Pudendal nerve5.0 5315 Splanchnic nerves5.0 5316 Ilioinguinal and iliohypogastric nerves5.0 5317 Sciatic nerve3.0 5318 Phrenic nerve3.0 5319 Other peripheral nerves3.0 Repair NEURORRHAPHY—suture of nerve. Primary 5320 Digital, one (add 25 percent each additional nerve)15.0 5822 Hand or foot (except motor thenar or ulnar motor)20.0 5323 Motor thenar or ulnar motor30.0 5325 Arm or leg (except sciatic)40.0 5326 Sciaticby report 5328 Brachial or lumbar plexusby report 5330 Cranial, extra–cranial75.0 (For facial nerve, see 6002, 6003.) Secondary or delayed anastomosis or reanastomosis including local advancement to overcome gap. (Add 25 percent to primary repair.) Secondary or delayed anastomosis involving additional procedures such as nerve graft and/or rerouting of nerve to overcome gapby report (See 6003 for facial nerve.) NEUROPLASTIES: plastic procedure on intact nerve. 5335 Freeing nerve from scar, including internal and external lysis and transposition away from scarred area, digital, one or both15.0 5337 hand or foot20.0 5339 arm or leg (except sciatic)40.0 5340 sciaticby report 5341 brachial or lumbar plexusby report 5343 cranial, extra–cranial75.0 (For facial nerve, see 6002, 6003.) 5345 Transplantation ulnar nerve, elbow (independent procedure) (includes neurolysis)25.0 5347 Median nerve decompression at carpal tunnel, simple30.0 (If complex, see also 1550, 1553.) NEURO–ANASTOMOSIS to establish other than normal anatomical continuity. 5350 Spinal accessory–facial, hypoglossal–facial, spinal accessory–hypoglossal, etc.75.0 Vegetative Nervous System Excision SYMPATHECTOMIES: 5371 Cervical, unilateral60.0 5372 bilateral80.0 5375 Cervico–thoracic (Smithwicke type, supra– and infra–diaphragmatic), unilateral70.0 5376 bilateral, concomitant or delayed100.0 5381 Lumbar, unilateral55.0 5382 bilateral75.0 5385 Splanchnicectomy (Peet type) unilateral65.0 5386 bilateral80.0 5390 Presacral neurectomy, hypogastric plexus50.0 Eyeball Incision 5420 Goniotomy50.0 Excision 5421 Enucleation of eyeball with or without sphere implant40.0 5422 with integrated implant50.0 5424 Secondary implantation of integrated implant60.0 5427 Evisceration of eyeball40.0 5428 with implantation in scleral shell50.0 5431 Suture of eyeball for wound or injuryby report Cornea Incision 5441 Keratotomy, any type10.0 5443 Paracentesis of cornea10.0 5445 Removal of foreign body from surface of cornea2.0 5448 under slit lamp3.0 Excision 5451 Keratectomy, partial30.0 5452 complete40.0 5457 Pterygium25.0 Introduction 5461 Tattoo of cornea, mechanical or chemical30.0 5465 Curettage and cauterization of corneal ulcer5.0 5466 Iontophoresis of corneal ulcer5.0 Repair 5471 Keratoplasty, (corneal transplant) lamellar100.0 5472 partial or complete, penetrating110.0 Suture 5481 Suture of perforated corneaby report Scelera Incision 5491 Sclerotomy, operative incision, with removal of intraocular foreign body (with or without magnet)50.0 5492 with removal of foreign body from anterior chamber (with or without magnet)50.0 5495 Sclerotomy, posterior30.0 5496 Aspiration of anterior chamber, diagnostic4.0 Excision 5501 Sclerectomy for glaucoma, with scissors, punch or trephination60.0 5503 Scleral resection100.0 Introduction 5511 Irrigation and/or air injection into anterior chamber15.0 Suture 5521 Suture of sclera for wound or injuryby report Iris and Ciliary Body Incision 5531 Iridotomy20.0 5532 with transfixion of iris; iris bombe20.0 5534 Iridotomy—performed with photocoagulator10.0 Excision 5541 Excision of lesion of iris60.0 5542 and/or ciliary body (iridocylectomy)80.0 5544 Iridectomy; basal, optical or preliminary50.0 5546 peripheral50.0 Repair 5552 Iridodialysis40.0 5561 Repair of prolapsed iris with suture of perforated sclera or corneaby report Manipulation 5571 Iridenclesis or comparable procedure50.0 Destruction 5580 Diathermy of the ciliary body; cyclodiathermy30.0 5582 Cyclodialysis50.0 Crystalline Lens Incision 5601 Discission (needling of lens), initial20.0 5602 subsequent10.0 5603 Aspiration of lens material for congenital cataract, one or more stages60.0 Excision 5611 Extraction of lens, intracapsular, extracapsular or linear, unilateral80.0 5616 Removal of dislocated lens80.0 Vitreous Introduction 5622 Transplantation of vitreous50.0 Retina Repair 5630 Reattachment of retina, electrocoagulation, scleral resection, buckling or partial tubing100.0 5631 encircling tube, initial100.0 5632 subsequentby report 5633 Removal of encirclng tube40.0 5634 Reattachment of retina, light coagulation of retinal break(s), one or more stages during same period of hospitalization40.0 5635 with drainage of subretinal fluid50.0 5636 Light coagulation of retina for tumor, Eales disease, etc., initial40.0 5637 subsequent20.0 Ocular Muscles Incision, Excision and Repair 5641 Any type of muscle operation involving one or more muscles in one or both eyes done in one stage60.0 5647 Muscle transplant (Hummelscheim type, etc.70.0 Orbit Incision 5651 Orbitomy with exploration60.0 5652 with drainage of intraorbital abscess60.0 5653 with removal of intraorbital foreign body60.0 5662 Excision of benign lesion of orbit, requiring bone flap90.0 5664 Exenteration or evisceration of orbital contents with or without graft60.0 5665 including orbital boneby report Introduction 5671 Orbital injection of alcohol for hemorrhagic glaucoma or intractable pain10.0 Repair (For plastic repair of orbit, see 0260–0324, 0619–0621.) Eyelids Incision 5691 Blepharotomy with drainage of abscess of eyelid2.0 5692 with drainage of Meibomian glands; hordeolum (stye)2.0 Excision (For blepharectomy, see 0175–0197, 0260–0324,) 5702 Excision or incision of Meibomian gland (chalazion), single5.0 5703 multiple, same lid6.0 5704 multiple, different lids7.0 (For excision of lesion of eyelid, malignant, see 0194–0197, 0260-0324.) 5712 Epilation, electrolysis4.0 (For excision of xantholasma, 0175–0178, 0260-0324.) Repair (Blepharoplasty: plastic repair of eyelid with or without graft, any type, see 0251, 0252, 0260–0324.) (Canthoplasty: plastic repair of canthus, see 0251, 0252, 0260-0324.) (Plastic restoration of eyebrow, by graft, see 0308–0324.) (Tarsoplasty: plastic repair of tarsal cartilage, see 0261-0275.) (Reposition of ciliary base, see 0260-0324.) 5727 Blepharoptosis repair, superior rectus, levator, or frontalis methods, unilateral60.0 5728 fascia sling method40.0 5729 lid suture method25.0 5730 Cautery puncture for entropion or ectropion5.0 5731 Ectropion repair (e.g.,Kuhnt–Szymanowski type)40.0 5732 Entropion repair (e.g.,Wheeler type)40.0 Suture (Blepharorrhaphy: suture of eyelid, see 0251, 0261–0269.) (Tarsorrhaphy: suture of tarsal cartilage see 0251, 0261–0269.) (Canthorrhaphy: suture of palpebral fissure of canthus, see 0251, 0261–0269.) Conjunctiva Incision 5741 Removal of foreign body from surface of conjunctiva1.0 5742 embedded in conjunctiva2.0 5743 Suture of conjunctiva5.0 Excision 5751 Biopsy of conjunctiva5.0 5753 Excision of lesion of conjunctiva,e.g.,cyst5.0 (For epithelioma, see 0175–0196, 0261–0269.) For nevus see 0175–0196, 0261–0269.) Repair 5760 Conjunctivoplasty, free graft using conjunctiva50.0 5762 using buccal mucous membrane60.0 5774 Flap operation of corneal ulcer20.0 5775 Flap operation: "flapping" of conjunctiva for perforating injuries or operative wound20.0 (For repair of symblepharon without graft, see 0175–0178, 0260–0276.) Lacrimal Tract Incision 5801 Drainage of lacrimal gland (abscess)10.0 5803 Drainage of lacrimal sac, (dacryocystotomy or dacryocystostomy)7.5 Excision 5811 Excision of lacrimal gland (dacryoadenectomy)50.0 5813 Excision of lacrimal sac (dacryocystectomy)50.0 5815 Excision of lacrimal gland tumor60.0 Introduction 5821 Catheterization of nasolacrimal duct with implantation of tube or stent10.0 5823 Injection procedure for dacryocystography3.0 Repair 5831 Plastic operation on canaliculiby report 5833 Dacryocystorrhinostomy: fistulization of lacrimal sac into nasal cavity, with or without anterior ethmoidectomy70.0 5835 Closure of punctum by cautery4.0 Manipulation 5841 Dilation of punctum2.0 5843 Probing of nasolocrimal duct3.0 5846 Probing and/or irrigation of canaliculus*2.0 EAR External Ear Incision 5901 Drainage of abscess or hematoma of auricle, simple2.0 5902 complicated, including suppurative chondritisby report 5905 Drainage of abscess of external auditory canal2.0 Excision 5911 Biopsy of ear3.0 (For local destruction or excision of lesion of ear, see 0175–0197.) (For plastic closure see 0260–0324.) 5916 Excision; ear, partial, simple repair10.0 5917 Complete amputation, auricle20.0 5920 Excision; osteoma, external canal, simple5.0 5923 Excision of exostosis of external auditory canal, endaural or post–aural approach, complicated50.0 5924 Radical excision of malignant lesion of external auditory canalby report 5926 with neck dissectionby report Endoscopy 5931 Otoscopy with removal of foreign body in external auditory canal2.0 Repair (Otolasty: plastic operation on ear, see 0260–0324.) (Reconstruction of ear with graft of skin plus cartilage, bone or other implant, see 0260–0324, 0620 and 0621.) 5947 Otoplasty, of cartilage ("lop–ear"), with or without reduction in size, unilateral50.0 5948 bilateral70.0 5949 Reconstruct external auditory canal for congenital astresia, single stage100.0 Suture (For suture of wound or injury of ear, see 0251, 0252, 0260–0270.) Middle Ear Introduction 5955 Eustachian tube catheterization and insufflation, unilateral or bilateral1.5 Incision 5961 Myringotomy; tympanotomy; plicotomy, with or without Eustachian inflation and/or aspiration3.0 5962 Tympanotomy, diagnostic, exploratory for middle ear exposure50.0 5963 with insertion of tube for serous otitis media, unilateral5.0 5964 with insertion of collar button tube for muco–serous otitis media, unilateral or bilateral25.0 5968 Tympanolysis, transtympanic80.0 Excision 5971 Mastoidectomy, simple50.0 5972 Mastoidectomy, modified radical or radical, without skin graft80.0 5975 with skin graft90.0 5980 Petrous apicectomy including radical mastoidectomyby report 5982 Removal of middle ear polyp10.0 Repair 5990 Revision of radical mastoidectomy, with or without skin graft90.0 5991 Patching tympanic membrane, with or without cauterization2.0 5992 Myringoplasty, uncomplicated80.0 5993 Tympanoplasty without mastoidectomy (may include change in contours of external auditory canal and be combined with middle ear, including ossicular chain construction and/or attic surgery), post auricular or endaural approach100.0 5994 Typanoplasty with mastoidectomy120.0 5996 Incudo–stapedial arthrodesis, with or without graft70.0 5997 Stapes mobilization, primary or secondary70.0 5998 Stapedectomy with insertion of prosthetic stapes with fenestration of the oval window100.0 5999 Mastoid obliteration80.0 Suture 6001 Closure of fistula, mastoid (independent procedure)25.0 6002 Decompression, intratemporal, facial nerve, with or without neurolysis100.0 (See also 5330.) 6003 Suture and/or graft, facial nerve, intratemporal120.0 Internal Ear Incision 6011 Labyrinthotomy, any type100.0 6012 Fenestration of semicircular canal100.0 6014 Revision of fenestration operation60.0 Excision 6021 Labyrinthectomy100.0
Notation
*
Value is to be calculated as the sum of the various services rendered (e.g., hospital visit, application of cast or splint, detention with patient, office visit, etc.).