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 SYSTEM
    Skin, Mucous Membrane, Subcutaneous and Areolar Tissues
    Value
    Incision
    0101
    Incision and drainage of infected or noninfected sebaceous cyst
     
    2.0
    (2nd lesion 50%; each additional lesion 25%)
    0102
    Incision and drainage of furuncle
     
    2.0
    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 simple
     
    2.0
    0109
    extensive
     
    by report
    0115
    Drainage of pilonidal cyst
     
    2.0
    0125
    Drainage of onychia or paronychia
     
    2.0
    0126
    multiple or complicated
     
    by report
    0130
    Incision and removal of foreign body, subcutaneous tissues, simple
     
    2.0
    0131
    complicated by
     
    by report
    0140
    Drainage of hematoma, simple
     
    2.0
    0141
    complicated
     
    by report
    0145
    Puncture aspiration of abscess or hematoma
     
    1.0
    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 surface
     
    2.0
    0161
    for each additional 10% of body surface, add
     
    1.0
    0162
    Debridement of nails, any method, five or less
     
    2.0
    0163
    for each additional five or major portion thereof
     
    1.0
    0164
    Debridement of abrasions
     
    by 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
    lesion
    diameter
    up to
    ¼
    inch
     
    4.0
    0176
    lesion
    diameter
    ¼
    to
    ½
     
    5.0
    0177
    lesion
    diameter
    ½
    to
    ¾
     
    6.0
    0178
    lesion
    diameter
    more than
    ¾
    inch or complicated
     
    by 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 to
    ¼
    inch
     
    6.0
    0189
    lesion
    diameter
    ¼
    to
    ½
    inch
     
    8.0
    0190
    lesion
    diameter
    ½
    to
    ¾
    inch
     
    10.0
    Face, scalp, ears, neck, hands, feet, genitalia:
    0191
    lesion
    diameter
    up to
    ¼
    inch
     
    10.0
    0192
    lesion
    diameter
    up to
    ½
    inch
     
    15.0
    0193
    lesion
    diameter
    ½
    to
    ¾
    inch
     
    20.0
    Eyelids, nose, lips, mucous membrane:
    0194
    lesion
    diameter
    up to
    ¼
    inch
     
    15.0
    0195
    lesion
    diameter
    ¼
    to
    ½
    inch
     
    20.0
    0196
    lesion
    diameter
    ½
    to
    ¾
    inch
     
    25.0
    0197
    Lesions over
    ¾
    inch, complicated or unusually located
     
    by report
    0225
    Avulsion, nail, partial, or complete, simple
     
    2.0
    0228
    Excision of nail or nail matrix, partial or complete, e.g., ingrown or deformed nail for permanent removal
     
    10.0
    0238
    Excision of pilonidal cyst or sinus
     
    30.0
    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 seven
     
    3.0
    Repair—Simple
    0251
    Wounds, recent, up to 2
    ½
    inches
     
    2.0
    0252
    for each additional inch add
     
    1.0
    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 to
    ½
    inch, forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet
     
    8.0
    0261
    eyelids, nose, ears and lips
     
    10.0
    (See also 0290–0294, 2737–2746.)
    (For other areas see 0175–0178, 0188–0197, 0251–0252.)
    0262
    ½
    inch to 1 inch, trunk
     
    7.0
    0263
    scalp, arms and legs
     
    10.0
    0264
    forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet
     
    14.0
    0265
    eyelids, nose, ears and lips
     
    17.0
    (See also 0290–0294, 2737–2746.)
    0266
    1 inch to 3 inches, trunk
     
    15.0
    0267
    scalp, arms and legs
     
    22.0
    0268
    forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet
     
    30.0
    0269
    eyelids, none, ears and lips
     
    40.0
    (See also 0290–0294, 2737–2746.)
    0270
    Unusual, complicated or over 3 inch linear repair
     
    by 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, trunk
     
    20.0
    0276
    scalp, arms and legs
     
    30.0
    0277
    forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet
     
    40.0
    0278
    eyelids, nose, ears and lips
     
    50.0
    0279
    defect size between 1 square inch and 3 square inches, trunk
     
    30.0
    0280
    scalp, arms and legs
     
    40.0
    0281
    forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet
     
    50.0
    0282
    eyelids, nose, ears and lips
     
    60.0
    0283
    more than 3 square inches, unusual or complicated
     
    by report
    Eyelid, full thickness, excision and repair:
     
    0290
    by advancement flaps, up to
    ¼
    eyelid margin
     
    37.0
    0291
    over
    ¼
    of eyelid margin
     
    50.0
    0292
    by transfer flaps of tarso–conjunctivea from opposing eyelid, up to
    /3
    of eyelid
     
    50.0
    0293
    total eyelid, one or more stages, lower lid
     
    75.0
    0294
    upper lid
     
    85.0
    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 size
    ¾
    inch diameter
     
    5.0
    (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 thereof
     
    5.0
    0303
    face, neck, ears, genitalia or multiple digits
     
    38.0
    0304
    each additional 16 square inches or part thereof
     
    7.0
    0308
    Full thickness, free, up to 3 square inches, including direct closure of donor site, trunk
     
    20.0
    0309
    scalp, arms and legs
     
    30.0
    0310
    forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet
     
    40.0
    0311
    eyelids, nose, ears and lips
     
    50.0
    (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) trunk
     
    20.0
    0313
    scalp, arms and legs
     
    30.0
    0314
    forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet
     
    40.0
    0315
    eyelids, nose, ears and lips
     
    50.0
    0316
    delay, intermediate transfer or sectioning of pedicle of tubed or direct flap, trunk
     
    15.0
    0317
    scalp, arms and legs
     
    22.0
    0318
    forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet
     
    30.0
    0319
    eyelids, nose, ears and lips
     
    37.0
    0320
    excision of lesion and/or preparation of recipient site and attachment of direct or tubed pedicle flap, trunk
     
    30.0
    0321
    scalp, arms and legs
     
    45.0
    0322
    forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet
     
    60.0
    0323
    eyelids, nose, ears and lips
     
    75.0
    (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. primary
     
    60.0
    0331
    secondary, total face
     
    30.0
    0333
    regional (
    ¼
    face, cheeks, chin, forehead or elsewhere) primary
     
    15.0
    0334
    secondary, regional
     
    7.5
    0335
    Rhytidectomy, lower eyelids
     
    60.0
    0336
    upper eyelids
     
    40.0
    0337
    forehead
     
    50.0
    0338
    glabellar frown
     
    40.0
    0339
    cheeks, chin and neck
     
    150.0
    0340
    Facial nerve paralysis, free fascia grafts
     
    100.0
    0341
    re-animation–muscle transfers
     
    120.0
    (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 necessary
     
    1.5
    0352
    Dressings, initial or subsequent under anesthesia, small
     
    4.0
    0353
    under anesthesia, large or with major debridement, per hour
     
    10.0
    0354
    without anesthesia, small, office or hospital
     
    2.0
    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 lesion
     
    3.0
    (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 N
    2
    , CO
    2
    , etc.) of benign or pre–malignant lesions of skin or mucous membrane (except 0405 and 0406) with or without curettement one lesion
     
    2.0
    (50% for second lesion; over two, each additional lesion 25%.)
    0404
    complicated lesion(s)
     
    by report
    flat (plane, juvenile) warts, up to fifteen
     
    2.0
    (Retreatment same as routine office visit.)
    0406
    Electro–surgical destruction of multiple fibro–cutaneous tags, up to fifteen
     
    2.0
    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 chemicals
     
    20.0
    0409
    each subsequent treatment, up to five sections
     
    5.0
    0410
    each additional section over five
     
    1.0
    0411
    Cryotherapy—(CO
    2
    slush, liquid N
    2
    )
     
    1.5
    0412
    Electrolysis epilation, each
    ½
    hour
     
    3.0
    Breast
    Incision
    0430
    Puncture aspiration of cyst
     
    2.0
    0431
    Mastotomy with exploration or drainage of abscess, deep
     
    10.0
    Excision
    0441
    Biopsy of breast
     
    15.0
    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, unilateral
     
    15.0
    0445
    bilateral
     
    25.0
    0446
    Excision of chest wall tumor involving ribs
     
    70.0
    0447
    Excision of chest wall tumor involving ribs plus plastic reconstruction
     
    100.0
    0457
    Complete (simple) mastectomy
     
    30.0
    0470
    Radical mastectomy, including breast, pectoral muscles and axillary lymph nodes
     
    70.0
    0481
    Mammoplasty, plastic operation on breasts, reduction or repositioning, bilateral, one stage
     
    150.0
    0482
    two stage
     
    by report
    0483
    augmentation, prosthetic, unilateral
     
    75.0
    0484
    bilateral
     
    100.0
    0485
    derma–fat fascia, unilateral
     
    100.0
    MUSCULOSKELETAL SYSTEM
    Listed values include the application of first cast or traction device only.
    Incision
    0501
    Aspiration or curette biopsy of bone marrow
     
    3.0
    0502
    Needle (trocar) biopsy vertebra
     
    10.0
    0506
    Incision of superficial soft tissue abscess secondary to osteomyelitis
     
    2.0
    0507
    deep or complicated
     
    by report
    0513
    Sequestrectomy for osteomyelitis or bone abscess
     
    by 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
    Clavicle
     
    40.0
    0527
    Humerus
     
    50.0
    0529
    Radius
     
    40.0
    0530
    Ulna
     
    40.0
    0531
    Femur, neck, under age 8
     
    80.0
    0532
    over age 8
     
    100.0
    0533
    subtrochanteric
     
    80.0
    0534
    supracondylar
     
    70.0
    0536
    Tibia
     
    55.0
    0537
    Smaller bones (fibula, metacarpals, metatarsals, etc.)
     
    30.0
    0538
    Correction of bowlegs or knock–knees, unilateral
     
    50.0
    0539
    bilateral
     
    75.0
    (For iliac osteotomy, see 1341, 1342.)
    0540
    Multiple osteotomies, single bones for realignment on intrameduliary rod, Scofield type procedure, humerus
     
    50.0
    0541
    radius or ulna
     
    50.0
    0542
    femur
     
    100.0
    0543
    tibia
     
    75.0
    Excision
    0549
    Biopsy bone, radius, ulna, fibula, skull, sternum
     
    10.0
    0550
    humerus, pelvis, femur, tibia
     
    20.0
    0551
    vertebra
     
    40.0
    (For needle biopsy, see 0502.) (Value of biopsy done preceding definitive surgery is 50 percent of listed value.)
    0552
    Claviculectomy, partial
     
    35.0
    0553
    total
     
    65.0
    0554
    Astragalectomy
     
    55.0
    0556
    Excision of head of radius
     
    35.0
    0557
    Carpectomy
     
    30.0
    0560
    Coccygectomy
     
    30.0
    0561
    Patellectomy or hemipatellectomy
     
    50.0
    0563
    Metatarsectomy
     
    25.0
    0566
    Excision of chondroma, osteochondroma, or exostosis; humerus, pelvis, femur, tibia, radius, fibula, ulna
     
    40.0
    0567
    small bones
     
    25.0
    0568
    Excision of bone cyst, simple, large bones
     
    40.0
    0569
    small bones
     
    25.0
    (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, ulna
     
    50.0
    0577
    small bones
     
    25.0
    0578
    Excision of tumor of mandible without replacement
     
    75.0
    (For replacement see 0619.)
    0580
    Radical resection of bones for tumor with bone graft; scapula, humerus, pelvis, femur, tibia
     
    100.0
    0581
    other bones
     
    65.0
    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, humerus
     
    100.0
    0612
    radius, ulna
     
    65.0
    0613
    other bones
     
    45.0
    0614
    lengthing of bone
     
    100.0
    0616
    mandible for prognathism or micrognathism, one or two stages
     
    100.0
    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, humerus
     
    100.0
    0618
    radius, ulna
     
    65.0
    0619
    skull or significant portion of mandible
     
    100.0
    0620
    other bones, including chin, nose, malar prominences
     
    45.0
    0621
    Cartilage graft, autogenous, to face, nose, ear or skull
     
    70.0
    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 technique
     
    90.0
    0635
    anterior technique
     
    80.0
    0636
    thoracic region, posterior or posterior-lateral technique
     
    90.0
    0637
    interbody technique, anterior, lateral or posterior
     
    100.0
    0638
    lumbar region, posterior or posterior–laterial technique
     
    90.0
    (For interbody technique, anterior see 0642.)
    0639
    Spinal fusion with removal of intervertebral disc, cervical region, posterior, technique
     
    120.0
    0640
    anterior interbody technique
     
    80.0
    0641
    lumbar or thoracic region, posterior, posterior–lateral, or posterior interbody technique
     
    120.0
    0642
    anterior interbody technique
     
    100.0
    0643
    Spinal fusion for scoliosis, child or young adult (less than 18 years of age), up to and including five interspaces
     
    120.0
    0644
    Harrington rod technique
     
    150.0
    0645
    Halo technique
     
    150.0
    (For adult scoliotic fusion see 0634–0642.)
    0647
    Scapulopexy
     
    65.0
    0648
    Patellapexy
     
    50.0
    0649
    Pectus excavatum, infants, plastic repair
     
    25.0
    0650
    Pectus excavatum (major) plastic repair
     
    90.0
    0654
    Epiphyseal–diaphyseal fusion; epiphyseal arrest; epiphysiodesis or stapling; femur
     
    55.0
    0655
    tibia and fibula, proximal or distal
     
    55.0
    0656
    combined distal femur and proximal tibia and fibula (knee)
     
    75.0
    0657
    combined proximal and distal, tibia and fibula
     
    75.0
    0658
    combined distal femur and proximal and distal tibia and fibula
     
    100.0
    0660
    Hemi–epiphyseal arrest (e.g., for genu varus or genu valgus) distal femur
     
    45.0
    (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–operative
     
    Sv. ¶*
    (Depressed with operation, see 5018, 5020.)
    Facial Bones
    0685
    Nasal, simple or compound, no reduction
     
    Sv. ¶
    0686
    uncomplicated (digital) closed reduction
     
    5.0
    0687
    complicated (instrumental) closed reduction
     
    10.0
    0688
    open reduction, uncomplicated
     
    25.0
    0689
    complicated with either internal and/or external skeletal fixation
     
    40.0
    0690
    with concomitant open reduction of fractured septum
     
    60.0
    0691
    Malar, simple or compound, no reduction
     
    Sv. ¶
    0692
    closed reduction (including towel clip technique)
     
    5.0
    0693
    depressed, open reduction
     
    30.0
    0694
    complicated, depressed, open reduction with internal skeletal fixation and multiple surgical approaches
     
    65.0
    0698
    Maxilla, simple or compound, no reduction
     
    Sv. ¶
    0699
    closed reduction, with wiring of teeth
     
    30.0
    0701
    open reduction, with wiring of teeth and/or local fixation
     
    50.0
    0702
    complicated, open reduction, fixation by head cap, multiple surgical approaches, internal fixation, wiring teeth, etc
     
    by report
    (For antral approach, see 1988.)
    0703
    Mandible, simple or compound, no reduction
     
    Sv. ¶
    0704
    closed reduction and wiring of teeth
     
    30.0
    0705
    open reduction with or without wiring of teeth
     
    50.0
    0706
    skeletal pinning with external fixation
     
    40.0
    Spine and Trunk
    0720
    Vertebral process, one or more
     
    Sv. ¶
    0721
    Vertebral body, one or more not requiring reduction
     
    Sv. ¶
    0722
    requiring reduction
     
    30.0
    0732
    Sacrum, simple not requiring reduction
     
    Sv. ¶
    0733
    compound or complex
     
    by report
    0735
    Coccyx, simple, not requiring reduction
     
    Sv. ¶
    0736
    compound or complicated
     
    by report
    0740
    Clavicle, simple, no reduction
     
    Sv. ¶
    0741
    simple, closed reduction
     
    15.0
    0742
    compound, including uncomplicated soft tissue closure
     
    20.0
    0743
    simple or compound, open reduction
     
    40.0
    0747
    Scapula, simple, no reduction
     
    Sv. ¶
    0748
    simple or compound, open reduction
     
    55.0
    0756
    Sternum, simple
     
    Sv. ¶
    0757
    compound or complicated
     
    by report
    0761
    Ribs, simple
     
    Sv. ¶
    0762
    compound or complicated
     
    by report
    Pelvis (Illum, Ischlum, Pubis)
    0767
    Fracture, simple, no reduction
     
    Sv. ¶
    0768
    complicated, closed reduction
     
    by report
    0771
    compound, open reduction
     
    75.0
    0772
    Acetabulum, with or without other fractures of pelvis, simple, no reduction
     
    Sv. ¶
    0773
    central, with displacement, requiring closed reduction
     
    55.0
    0775
    simple or compound, open reduction
     
    75.0
    Upper Extremity
    0778
    Humerus, surgical neck, simple, not requiring reduction
     
    Sv. ¶
    0780
    requiring manipulative reduction
     
    30.0
    0781
    compound, with uncomplicated soft tissue closure
     
    35.0
    0782
    simple or compound, open reduction
     
    50.0
    0783
    shaft, simple, not requiring reduction
     
    Sv. ¶
    0784
    simple, closed reduction
     
    25.0
    0785
    compound, with uncomplicated soft tissue closure
     
    30.0
    0786
    simple or compound, open reduction
     
    45.0
    0787
    simple or compound, open reduction, skeletal pinning with external fixation
     
    40.0
    0788
    supracondylar or dicondylar, not requiring reduction
     
    Sv. ¶
    0789
    closed reduction
     
    25.0
    0790
    compound, with uncomplicated soft tissue closure
     
    30.0
    0791
    simple or compound, open reduction
     
    50.0
    0792
    medial or lateral condyle, simple, not requiring reduction
     
    Sv. ¶
    0793
    closed reduction
     
    20.0
    0794
    compound, with uncomplicated soft tissue closure
     
    25.0
    0795
    simple or compound, open reduction
     
    40.0
    0796
    Elbow, proximal end of ulna with dislocation of radial head simple, (Monteggia fracture) closed reduction
     
    20.0
    0797
    simple or compound, open reduction (See also 1292.)
     
    55.0
    0798
    Radius, head, simple, no reduction
     
    Sv. ¶
    0799
    closed reduction
     
    15.0
    0800
    compound, with uncomplicated soft tissue closure
     
    20.0
    0801
    simple or compound, open reduction or excision (See also 0556.)
     
    35.0
    0802
    shaft, simple, no reduction
     
    Sv. ¶
    0803
    simple, closed reduction
     
    20.0
    0804
    compound, with uncomplicated soft tissue closure
     
    25.0
    0805
    simple or compound, open reduction
     
    40.0
    0806
    distal end (e.g., Colle's type), simple, no reduction
     
    Sv. ¶
    0807
    closed reduction
     
    15.0
    0808
    with severe comminution and impaction, closed reduction
     
    20.0
    0809
    simple or compound, open reduction
     
    40.0
    0810
    skeletal pinning, with external fixation
     
    30.0
    0811
    Ulna, proximal end, olecranon process, simple, no reduction
     
    Sv. ¶
    0812
    compound, with uncomplicated soft tissue closure
     
    25.0
    0813
    simple or compound, open reduction and/or resection
     
    40.0
    0814
    shaft, simple, no reduction
     
    Sv. ¶
    0815
    closed reduction
     
    20.0
    0816
    compound, with uncomplicated soft tissue closure
     
    25.0
    0817
    simple or compound, open reduction
     
    40.0
    0818
    skeletal pinning with external fixation
     
    30.0
    0820
    Radius and ulna shaft, simple, no reduction
     
    Sv. ¶
    0821
    simple, closed reduction
     
    25.0
    0822
    compound, with uncomplicated soft tissue closure
     
    30.0
    0823
    simple compound, open reduction
     
    50.0
    0824
    skeletal pinning with external fixation
     
    40.0
    (For Colle's fracture see 0806–0810.)
    0827
    Carpal bones, one or more, simple reduction
     
    Sv. ¶
    0830
    simple or compound, open reduction
     
    35.0
    0840
    Metacarpal, simple, no reduction
     
    Sv. ¶
    0842
    one, simple or compound, closed reduction with uncomplicated soft tissue closure
     
    10.0
    0843
    more than one, simple or compound, closed reduction, with uncomplicated soft tissue closure
     
    12.5
    0844
    one or more, simple or compound, open reduction
     
    30.0
    0848
    skeletal pinning with external fixation
     
    25.0
    0852
    Phalanx or phalanges, finger, proximal, middle or thumb, simple, no reduction
     
    Sv. ¶
    0853
    closed reduction
     
    7.5
    0854
    compound, with uncomplicated soft tissue closure
     
    10.0
    0855
    simple or compound, open reduction
     
    20.0
    0856
    Phalanx or phalanges, distal, simple, no reduction
     
    Sv. ¶
    0857
    simple or compound, closed reduction with uncomplicated soft tissue closure
     
    5.0
    0858
    simple or compound, open reduction
     
    12.5
    Lower Extremity
    0865
    Femur, neck, simple, no reduction
     
    Sv. ¶
    0866
    with fixation or traction
     
    50.0
    0867
    simple or compound, open reduction
     
    80.0
    0868
    multiple pinning, with or without external fixation
     
    80.0
    0869
    treatment with replacement prosthesis
     
    80.0
    0872
    intertrochanteric, simple, no reduction
     
    Sv. ¶
    0873
    with fixation or traction
     
    45.0
    0874
    simple or compound, open reduction
     
    80.0
    0877
    slipped epiphysis, no reduction, treatment by traction, bed rest or cast application
     
    Sv. ¶
    0878
    open reduction, single or multiple pinning or bone graft
     
    80.0
    0879
    reconstruction
     
    100.0
    0880
    shaft, including supracondylar, simple, no reduction
     
    Sv. ¶
    0881
    simple, closed reduction
     
    40.0
    0882
    compound, with uncomplicated soft tissue closure
     
    45.0
    0883
    simple or compound, open reduction
     
    80.0
    0884
    skeletal pinning with external fixation
     
    60.0
    0885
    distal end, medial or lateral condyle, simple, no reduction
     
    Sv. ¶
    0886
    condyle or condyles, simple, closed reduction
     
    35.0
    0887
    simple or compound, open reduction
     
    60.0
    0889
    Patella, simple, no reduction
     
    Sv. ¶
    0890
    compound, with uncomplicated soft tissue closure
     
    25.0
    0891
    simple or compound, open reduction
     
    50.0
    0893
    Tibia, proximal end, tibial plateaus, condyle, condyles or intercondylar spines, simple, no reduction
     
    Sv. ¶
    0894
    closed reduction
     
    25.0
    0895
    compound, with uncomplicated soft tissue closure
     
    30.0
    0896
    simple or compound, open reduction
     
    55.0
    0901
    shaft, simple, no reduction
     
    Sv. ¶
    0902
    closed reduction
     
    25.0
    0903
    compound, with uncomplicated soft tissue closure
     
    30.0
    0904
    simple or compounded, open reduction
     
    50.0
    0905
    simple or compound, open or "blind" insertion of intramedullary rod (e.g., Lottes nail)
     
    50.0
    0907
    distal end, malleolus, simple, no reduction
     
    Sv. ¶
    0908
    simple, closed reduction
     
    15.0
    0909
    compound, with uncomplicated soft tissue closure
     
    20.0
    0910
    simple or compound, open reduction
     
    40.0
    0914
    Fibula, shaft, simple, no reduction
     
    Sv. ¶
    0915
    compound, with uncomplicated soft tissue closure
     
    20.0
    0916
    simple or compound, open reduction
     
    30.0
    0920
    distal end, malleolus, simple, no reduction
     
    Sv. ¶
    0921
    closed reduction
     
    15.0
    0922
    compound, with uncomplicated soft tissue closure
     
    20.0
    0923
    simple or compound, open reduction
     
    40.0
    0925
    Tibia and fibula, shafts, simple, no reduction
     
    Sv. ¶
    0926
    closed reduction
     
    30.0
    0927
    compound, with uncomplicated soft tissue closure
     
    35.0
    0928
    simple or compound, open reduction
     
    60.0
    0930
    skeletal pinning with external fixation
     
    40.0
    0932
    Ankle, bimalleolar (including Potts) simple, no reduction
     
    Sv. ¶
    0933
    simple, closed reduction
     
    25.0
    0934
    compound, with uncomplicated soft tissue closure
     
    30.0
    0935
    simple or compound, open reduction
     
    50.0
    0937
    trimalleolar, simple, no reduction
     
    Sv. ¶
    0938
    closed reduction
     
    30.0
    0940
    compound, with uncomplicated soft tissue closure
     
    35.0
    0941
    simple or compound, open reduction
     
    60.0
    0943
    Tarsal (except astragalus and os calcis) one or more, simple, no reduction
     
    Sv. ¶
    0944
    closed reduction
     
    10.0
    0945
    compound, with uncomplicated soft tissue closure
     
    15.0
    0946
    simple or compound, open reduction
     
    30.0
    0954
    Astragalus, simple, no reduction
     
    Sv. ¶
    0955
    simple, closed reduction
     
    20.0
    0956
    compound, with uncomplicated soft tissue closure
     
    25.0
    0957
    simple or compound, open reduction
     
    55.0
    0960
    Os calcis, simple, no reduction
     
    Sv. ¶
    0961
    closed reduction
     
    20.0
    0962
    compound, with uncomplicated soft tissue closure
     
    25.0
    0963
    simple or compound, open reduction
     
    50.0
    0964
    skeletal pinning with external fixation
     
    40.0
    0966
    Metatarsal, simple, no reduction
     
    Sv. ¶
    0967
    closed reduction
     
    10.0
    0968
    compound, with uncomplicated soft tissue closure
     
    15.0
    0970
    simple or compound, open reduction
     
    25.0
    0975
    Phalanx or phalanges, great toe, simple, no reduction
     
    Sv. ¶
    0976
    simple, closed reduction
     
    5.0
    0977
    simple or compound, open reduction
     
    15.0
    0979
    other than great toe, simple, no reduction
     
    Sv. ¶
    0981
    closed reduction
     
    5.0
    0982
    simple or compound, open reduction
     
    12.5
    Joints
    Incision
    ARTHROTOMY or capsulotomy with exploration, drainage, or removal of loose body, e.g., osteochondritis of foreign body.
    1001
    Shoulder
     
    50.0
    1002
    Elbow
     
    50.0
    1003
    Wrist
     
    40.0
    1005
    Other joints of upper extremity
     
    30.0
    1006
    Finger, one
     
    15.0
    1007
    Hip
     
    70.0
    1008
    Knee
     
    50.0
    (For miniscectomy, see 1082.)
    1010
    Ankle
     
    50.0
    1013
    Other joints of lower extremity
     
    30.0
    1020
    Toe, great toe
     
    15.0
    1026
    other
     
    10.0
    1044
    Arthrocentesis; puncture for aspiration of hemarthrosis, initial
     
    3.0
    1045
    subsequent
     
    2.0
    1046
    puncture for aspiration of joint effusion (not traumatic), or injection of medication, initial or subsequent
     
    2.0
    1050
    Sesamoid bone, excision, one or more, unilateral
     
    15.0
    Excision
    ARTHRECTOMY—Excision of joint (See also Arthrodesis.)
    1065
    Temporomandibular joint, unilateral
     
    75.0
    1074
    Excision of intervertebral disc
     
    90.0
    (See also 5208–5211.)
    (With spinal fusion, see 0639–0642.)
    (For laminectomy for spondylolisthesis, see 5225.)
    1082
    Meniscectomy: excision of semilunar cartilage of knee joint
     
    50.0
    1085
    temporomandibular joint
     
    75.0
    1093
    Synovectomy elbow
     
    70.0
    1101
    hip
     
    80.0
    1102
    knee
     
    70.0
    1103
    ankle
     
    50.0
    Introduction
    1131
    Injection procedure for arthography
     
    3.0
    Repair
    ARTHROPLASTY—Plastic or reconstructive operation on joint, any type unless otherwise specified.
    1141
    Shoulder (See also 1200, 1201.)
     
    80.0
    1142
    Elbow
     
    80.0
    1143
    Wrist
     
    80.0
    1144
    Finger, one joint
     
    30.0
    1148
    Hip, cup
     
    100.0
    1149
    replacement prosthesis, primary for fracture
     
    80.0
    1150
    secondary reconstruction
     
    100.0
    (For acetabuloplasty, either 1148 or 1150, add 25% to listed values.)
    1151
    Knee
     
    100.0
    1152
    Ankle
     
    75.0
    1154
    Toe, one joint
     
    20.0
    1159
    Metatarsal—phalangeal joint; bunion operation, Silver type
     
    20.0
    1160
    Keller, McBride, etc., types
     
    30.0
    1162
    Joplin type
     
    35.0
    1163
    Club foot corrective procedure, medial release, Brockman type
     
    30.0
    ARTHRODESIS—Fusion of joint (For spine see 0634–0645.)
    1166
    Shoulder
     
    90.0
    1167
    Elbow
     
    70.0
    1168
    Wrist
     
    60.0
    1170
    Finger, thumb, one joint
     
    20.0
    1175
    Hip
     
    100.0
    1176
    Knee
     
    80.0
    1177
    Ankle
     
    70.0
    1178
    Toe, one or more joints
     
    15.0
    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 extremity
     
    40.0
    1185
    Foot, triple arthrodesis, unilateral under age 14 years
     
    50.0
    1186
    over age 14 years
     
    60.0
    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 types
     
    70.0
    1201
    Bankart type
     
    80.0
    1206
    Patella (See also 0561, 1352, 1632.)
     
    60.0
    1211
    Knee, suture of a torn, ruptured or severed collateral ligament
     
    55.0
    1212
    suture of a torn, ruptured or severed cruciate ligament
     
    55.0
    1213
    suture of torn, ruptured or severed collateral and cruciate ligaments
     
    75.0
    1214
    reconstruction of a collateral or cruciate ligament
     
    65.0
    1215
    both collateral or cruciate ligaments
     
    85.0
    1216
    Ankle, reconstruction of a collateral ligament, ankle
     
    45.0
    1217
    both ligaments
     
    60.0
    1218
    Hand, reconstruction, metacarpophalangeal or interphalangeal ligaments
     
    35.0
    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
    Shoulder
     
    5.0
    1222
    Elbow
     
    4.0
    1223
    Wrist
     
    4.0
    1224
    Digits, one or more, under anesthesia, where no other surgical procedure is performed
     
    2.5
    1226
    Hip
     
    6.0
    1227
    Knee
     
    5.0
    1228
    Ankle
     
    4.0
    1232
    Spine
     
    6.0
    Dislocations
    1251
    Temporomandibular, simple, closed reduction, initial
     
    5.0
    1252
    subsequent
     
    1.0
    1255
    Vertebra, cervical, simple, closed reduction, using traction
     
    Sv. ¶
    1256
    closed reduction with anesthesia
     
    55.0
    1262
    thoracic, simple, closed reduction with anesthesia
     
    55.0
    1264
    simple or compound, open reduction
     
    100.0
    1267
    lumbar, simple, closed reduction with anesthesia
     
    55.0
    1270
    simple or compound, open reduction
     
    100.0
    1273
    Clavicle, sternoclavicular, simple, no reduction
     
    Sv. ¶
    1274
    closed reduction with anesthesia
     
    10.0
    1275
    simple or compound, open reduction
     
    40.0
    1278
    acromioclavicular, simple, no reduction
     
    Sv. ¶
    1279
    closed reduction with anesthesia
     
    10.0
    1281
    simple or compound, open reduction
     
    40.0
    1284
    Shoulder (humerus), simple, closed reduction without anesthesia
     
    Sv. ¶
    1285
    with anesthesia
     
    5.0
    1286
    simple or compound, open reduction
     
    55.0
    1290
    Elbow, simple, closed reduction
     
    5.0
    1291
    compound, with uncomplicated soft tissue closure
     
    25.0
    1292
    simple or compound, open reduction
     
    55.0
    1295
    Wrist, carpal, one bone, simple, closed reduction
     
    5.0
    1296
    compound, with uncomplicated soft tissue closure
     
    25.0
    1297
    simple or compound, open reduction
     
    45.0
    1298
    more than one bone, simple, closed reduction
     
    7.0
    1300
    compound, with uncomplicated soft tissue closure
     
    25.0
    1301
    simple or compound, open reduction
     
    45.0
    1304
    Metacarpal, one bone, simple, closed reduction
     
    3.0
    1305
    compound, with uncomplicated soft tissue closure
     
    10.0
    1306
    simple or compound, open reduction
     
    20.0
    1315
    Finger, one, one or more joints, simple, closed reduction
     
    3.0
    1316
    compound, with uncomplicated soft tissue closure
     
    7.5
    1317
    simple or compound, open reduction
     
    15.0
    1326
    Thumb, simple, closed reduction
     
    4.0
    1327
    compound, with uncomplicated soft tissue closure
     
    10.0
    1328
    simple or compound, open reduction
     
    20.0
    1332
    Hip (femur), simple, closed reduction
     
    20.0
    1334
    simple or compound, open reduction
     
    60.0
    1338
    congenital, abduction splinting or traction in any form
     
    Sv. ¶
    1339
    congenital, closed reduction with anesthesia
     
    20.0
    1340
    congenital, open reduction and replacement of femoral head in acetabulum
     
    60.0
    1341
    iliac or acetabular osteotomy, (
    e.g.,
    Pemberton or Salter type), under age 8
     
    80.0
    1342
    over age 8
     
    100.0
    (For dislocated or slipped femoral head epiphyses, see 0877–0879.)
    1344
    Knee (femoral–tibial joint), simple, closed reduction
     
    20.0
    1345
    compound, with uncomplicated soft tissue closure
     
    25.0
    1346
    simple or compound, open reduction
     
    60.0
    1350
    Patella, simple, closed reduction
     
    3.0
    1351
    compound, with uncomplicated soft tissue closure
     
    15.0
    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 fixation
     
    45.0
    1355
    Ankle, simple, closed reduction
     
    10.0
    1356
    compound, with uncomplicated soft tissue closure
     
    25.0
    1357
    simple or compound, open reduction
     
    50.0
    1361
    Tarsal, simple, closed reduction
     
    10.0
    1362
    compound, with uncomplicated soft tissue closure
     
    17.5
    1363
    simple or compound, open reduction
     
    45.0
    1371
    Astragalo–tarsal, simple, closed reduction
     
    10.0
    1372
    compound, with uncomplicated soft tissue closure
     
    17.5
    1373
    simple or compound, open reduction
     
    45.0
    1376
    Metatarsal, one bone, simple, closed reduction
     
    7.0
    1377
    compound, with uncomplicated soft tissue closure
     
    12.0
    1378
    simple or compound, open reduction
     
    25.0
    1385
    Toe, one, simple, closed reduction
     
    2.0
    1386
    compound, with uncomplicated soft tissue closure
     
    7.0
    1387
    simple or compound, open reduction
     
    15.0
    1391
    multiple joints and/or toes, simple, closed reduction
     
    7.0
    1392
    compound, with uncomplicated soft tissue closure
     
    12.0
    1393
    simple or compound, open reduction
     
    20.0
    Bursae
    Incision
    1401
    Drainage of infected bursa
     
    3.0
    1406
    Removal of subdeltoid calcium deposits
     
    25.0
    1410
    Removal of subtrochanteric calcium deposits
     
    30.0
    1413
    Needle puncture of bursa, with or without aspiration, injection or irregation, initial or subsequent
     
    2.0
    Excision
    1430
    Radical excision of bursa, hand, wrist or forearm, (
    i.e.,
    tenosynovitis fungosa, Tbc., and other granulomas)
     
    50.0
    1431
    Excision of bursa, olecranon
     
    20.0
    1433
    prepatellar
     
    20.0
    1435
    subacromial (subdeltoid)
     
    25.0
    1436
    peritrochanteric, femur
     
    30.0
    (For popliteal see 1562.)
    Muscles
    Incision
    1450
    Removal of foreign body in muscle, with anesthesia
     
    by report
    1454
    Division of scalenus anticus, without resection of cervical rib
     
    35.0
    1456
    with resection of cervical rib
     
    50.0
    1458
    Division of sternocleidomastoid for torticollis open operation
     
    35.0
    1460
    Muscle biopsy, superficial
     
    5.0
    1462
    deep
     
    10.0
    Suture
    1495
    Suture of ruptured diaphragm, chronic, transabdominal
     
    70.0
    1496
    transthoracic or combined
     
    80.0
    1497
    acute, traumatic
     
    by report
    (For other specific muscles, see 1633, 1640, 1654.)
    Tendons, Tendon Sheaths and Fascia
    Incision
    1511
    Drainage of tendon sheath, acute suppurative tenosynovitis, one digit
     
    3.0
    1514
    single palmar and/or ulnar or radial bursa
     
    30.0
    1515
    multiple or complicated
     
    by report
    1517
    Injection of medication, tendon sheath
     
    2.0
    1519
    Incision of fibrous sheath of tendon for stenosing tenosynovitis, including freeing of tendons or removal of foreign body
     
    20.0
    1531
    Division of iliotibial band, open operation
     
    30.0
    1534
    Stripping of ilium (Soutter operation)
     
    40.0
    Tenotomy
    1535
    Tenotomy, subcutaneous, corrective, single digit
     
    5.0
    1536
    multiple digits
     
    7.5
    1537
    adductor, hip
     
    10.0
    1538
    open, elbow to shoulder, single
     
    20.0
    1539
    multiple
     
    25.0
    1540
    elbow to wrist, single
     
    15.0
    1541
    multiple
     
    25.0
    1542
    knee to hip, single
     
    30.0
    1543
    multiple
     
    40.0
    1544
    knee to thigh, single
     
    15.0
    1545
    multiple
     
    30.0
    Excision
    1550
    Excision of lesion of tendon or fibrous sheath, or ganglion, digits only
     
    10.0
    1553
    in other locations
     
    15.0
    (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, subcutaneous
     
    10.0
    1573
    Fasciectomy, for Dupuytren's contracture, partial
     
    30.0
    1574
    radical, including finger extensions and vertical bands
     
    50.0
    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 ankle
     
    12.0
    1582
    forearm or leg
     
    18.0
    1583
    Repair or suture of a flexor tendon, primary or late, finger, hand or forearm foot or leg
     
    30.0
    1585
    Transfer, transplant or free tendon graft, distal to elbow, or distal to knee, single
     
    40.0
    1586
    multiple
     
    50.0
    1587
    elbow to shoulder or knee to hip, single
     
    50.0
    1588
    multiple
     
    60.0
    1589
    Tenolysis, single
     
    25.0
    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 wound
     
    by 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, other
     
    by report
    1632
    Patellar (extensor mechanism) advancement, with or without patellectomy
     
    60.0
    1633
    Ruptured quadirceps insertion
     
    45.0
    1635
    Ruptured Achilles' tendon from insertion at heel
     
    45.0
    1639
    Ruptured long head of biceps, proximal
     
    35.0
    1640
    Ruptured biceps tendon from insertion at elbow
     
    45.0
    1641
    Flexor–plasty, elbow (e.g., Steindler type advancement or extensor release)
     
    30.0
    1654
    Repair ruptured supraspinatus tendon or musculotendinous cuff shoulder, acute
     
    50.0
    1655
    Repair of complete shoulder cuff avulsion, chronic
     
    70.0
    Extremities
    Incision
    1681
    Drainage of felon, superficial
     
    2.0
    1682
    in hospital
     
    5.0
    (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
    Interthoracoscapular
     
    100.0
    1703
    Disarticulation of shoulder
     
    75.0
    1705
    Arm through humerus
     
    40.0
    1708
    Forearm, through radius and ulna
     
    40.0
    1709
    Open (Guillotine) arm
     
    35.0
    1710
    secondary closure or minor scar revision
     
    5.0
    1711
    reamputation
     
    40.0
    1713
    Cineplasty, complete procedure
     
    75.0
    1718
    Disarticulation through wrist or amputation of hand through metacarpal bones
     
    40.0
    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 nerves
     
    30.0
    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 nerves
     
    15.0
    LOWER EXTREMITY:
    1745
    Interpelviabdominal
     
    by report
    1748
    Disarticulation of hip
     
    80.0
    1750
    Disarticulation of knee
     
    40.0
    1752
    Thigh, through femur, including supracondylar
     
    60.0
    1760
    open (Guillotine)
     
    50.0
    1761
    secondary closure or minor revision
     
    5.0
    1763
    reamputation
     
    60.0
    1767
    Leg, through tibia and fibula
     
    50.0
    1771
    open (Guillotine)
     
    40.0
    1772
    secondary closure or minor revision
     
    5.0
    1774
    re-amputation
     
    50.0
    1778
    Ankle (Syme, Pirogoff types), with skin–plasty and resection of nerves
     
    50.0
    1782
    Midtarsal
     
    35.0
    1785
    Foot, transmetatarsal
     
    35.0
    1788
    Metatarsal with toe, with or without split or Wolff graft, or skin–plasty and/or tenodesis, with or without resection of digital nerves
     
    25.0
    1802
    Toe, one, with or without split or Wolff graft, or skin–plasty and/or tenodesis, with or without resection of digital nerves
     
    10.0
    1803
    more than one
     
    15.0
    Repair
    1811
    Freeing of web fingers, with flaps
     
    35.0
    1815
    with skin graft
     
    45.0
    1816
    complex
     
    by report
    Plaster Casts (Independent Procedure Only)
    (Excluding Cost of Materials)
    1840
    Club–foot cast
    with molding or manipulation, long or short leg, under age of 24 months, single
     
    2.0
    1841
    bilateral
     
    3.5
    (If over age 24 months, see casts, general.)
    1842
    Wedging
    club–foot cast
    single
     
    1.0
    1843
    bilateral
     
    1.5
    (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 spica
     
    6.0
    1863
    Thigh–foot, molded splint
     
    3.0
    1864
    Leg–foot, molded splint
     
    2.0
    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, unilateral
     
    7.0
    1882
    bilateral
     
    8.0
    1884
    Body, shoulder to hips
     
    8.0
    1885
    including head
     
    10.0
    1886
    Risser jacket, localizer, body only
     
    12.5
    1887
    including head
     
    15.0
    1888
    Turnbuckle jacket, body only for scoliosis
     
    12.5
    1889
    including head
     
    15.0
    1890
    "Halo" type fixation and cast
     
    20.0
    1891
    Unna boot
     
    2.0
    1896
    large, (e.g., long leg, shoulder or hip spica, Minerva, Calot jacket, turnbuckle, etc.)
     
    2.0
    1897
    Repair of spica, body cast or jacket
     
    3.0
    (For change of cast, unit value will be that of application only.)
    RESPIRATORY SYSTEM
    Nose
    Incision
    1901
    Drainage of nasal abscess or hematoma
     
    2.0
    1905
    Drainage of septal abscess or hematoma
     
    2.5
    Excision
    1911
    Biopsy, soft tissue, nose
     
    3.0
    1916
    Excision of nasal polyp(s) one or more, unilateral or bilateral, one or more stages, office
     
    7.0
    1917
    complicated, requiring hospitalization
     
    20.0
    (For excision of nasopharyngeal fibroma, see 3006.)
    1924
    Excision or surgical planning of skin of nose for rhinophyma
     
    35.0
    1928
    Submucous resection, classic, nasal septum
     
    30.0
    (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 rhinoscopy
     
    2.0
    1942
    by lateral rhinotomy
     
    by report
    Repair
    See also Repair–Complex 0260–0324, and 0620, 0621.)
    1950
    Rhinoplasty, lateral and alar cartilages and/or elevation of nasal tip
     
    40.0
    1951
    complete, external parts including bony pyramid, lateral and alar cartilages, and/or elevation of nasal tip
     
    80.0
    1952
    including major septal repair
     
    90.0
    1953
    secondary minor revision
     
    15.0
    (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 procedure
     
    40.0
    1959
    Repair choanal altresia, intranasal
     
    10.0
    1960
    transpalantine
     
    60.0
    1961
    Lysis of synechia
     
    2.0
    1962
    Repair of oromaxillary fistula
     
    by report
    1963
    with radical antrotomy
     
    50.0
    1964
    Repair oronasal fistula
     
    20.0
    1965
    Reconstruction, functional, of the internal nose
     
    40.0
    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 packs
     
    2.0
    1973
    posterior, with cauterzation or posterior nasal packs, with or without anterior pack, initial
     
    10.0
    1974
    subsequent
     
    2.0
    1978
    by ligation of anterior ethmoidal artery
     
    30.0
    Accessory Sinuses
    Incision
    1981
    Antrum lavage. puncture or natural ostium, unilateral
     
    2.0
    1982
    bilateral
     
    3.0
    1983
    Antroscopy
     
    4.0
    1985
    Antrotomy, intranasal, unilateral
     
    15.0
    1986
    bilateral
     
    25.0
    1988
    Radical (Caldwell–Luc), unilateral
     
    50.0
    1989
    bilateral
     
    65.0
    1991
    Sphenoid sinusotomy
     
    30.0
    1992
    Frontal sinusotomy, external, simple (trephine operation)
     
    20.0
    1993
    transorbital, unilateral
     
    40.0
    1994
    radical, obliterative
     
    60.0
    1995
    Combined external frontal, ethmoidal and sphenoidal sinusotomy, unilateral
     
    80.0
    Excision
    2006
    Ethmoidectomy, intranasal or external, unilateral
     
    30.0
    2017
    Maxillectomy, unilateral, with or without orbital exenteration and/or lateral rhinotomy
     
    100.0
    2019
    Hypophisectomy, transeptal
     
    70.0
    (See also 5130.)
    Larynx
    Incision
    2041
    Laryngofissure with removal of tumor or laryngocele
     
    60.0
    2042
    Thyrotomy, diagnostic
     
    35.0
    2043
    for laryngeal web, two stage, with Keel insertion, (McNaught type)
     
    90.0
    2044
    for laryngeal stenosis with graft or core mold, including tracheotomy
     
    by report
    Excision
    2051
    Laryngectomy, without neck dissection
     
    100.0
    2054
    with neck dissection
     
    140.0
    2055
    Hemilaryngectomy
     
    60.0
    2056
    Arytenoidectomy, external approach (See also 2084.)
     
    70.0
    2057
    Epiglottidectomy, external approach
     
    60.0
    2058
    endoral approach
     
    25.0
    Introduction
    2060
    Injection procedure for bronchography, indirect method
     
    3.0
    2061
    with insertion of catheter, (independent procedure)
     
    4.0
    2062
    Endotracheal intubation, emergency procedure
     
    5.0
    Endoscopy
    2070
    Laryngoscopy, indirect with biopsy
     
    4.0
    2071
    direct, diagnostic (independent procedure)
     
    10.0
    2072
    operative, including foreign body removal
     
    30.0
    2073
    with biopsy
     
    15.0
    2074
    including excision of tumor
     
    25.0
    2075
    with Lynch suspension
     
    30.0
    2084
    Endoscopic arytenoidectomy
     
    50.0
    Trachea and Bronchi
    Incision
    2101
    Tracheotomy (independent procedure)
     
    20.0
    2102
    Tracheal fenestration
     
    50.0
    Endoscopy
    2111
    Bronchoscopy, diagnostic
     
    15.0
    2113
    with biopsy
     
    20.0
    2117
    with removal of foreign body
     
    25.0
    2120
    with excision of tumor
     
    25.0
    2121
    with therapeutic aspiration of bronchus
     
    15.0
    2122
    with drainage of lung abscess or cavity, initial
     
    15.0
    2123
    with injection of contrast media
     
    15.0
    2124
    subsequent
     
    10.0
    2126
    Catheterization for bronchospirometry (independent procedure) (exclusive of gas analysis)
     
    10.0
    2127
    Tracheal aspiration (independent procedure) under direct vision
     
    10.0
    2128
    indirect
     
    1.0
    Repair
    2131
    Tracheoplasty: plastic operation on trachea, cervical
     
    by report
    2132
    intrathoracic
     
    by report
    2133
    Bronchoplasty, graft repair
     
    by report
    2134
    excision of stenosis and anastomosis
     
    by report
    2135
    with lobectomy and anastomosis
     
    by report
    Suture
    2141
    Tracheorrhaphy: suture of external tracheal wound or injury, depending on structure and extent of injury, cervical
     
    by report
    2142
    intrathoracic
     
    by report
    2144
    Closure of tracheostomy or tracheal fistula
     
    25.0
    2147
    Closure of tracheo–esophageal fistula
     
    90.0
    2148
    complicated
     
    by report
    Incision
    2151
    Thoracotomy, exploratory, including biopsy
     
    50.0
    2152
    including control of hemorrhage and/or repair of lung fistula
     
    75.0
    2153
    for postoperative complications
     
    75.0
    2154
    with open drainage of empyema cavity by rib resection (independent procedure)
     
    40.0
    2155
    with cyst removal
     
    75.0
    2157
    with closed drainage of empyema cavity; tube drainage with negative pressure (independent procedure), in hospital
     
    5.0
    2160
    with removal of intrapleural foreign body or fibrin body
     
    70.0
    2161
    with cardiac massage
     
    by report
    2163
    with open intrapleural pneumonolysis (See also 2207.)
     
    75.0
    2170
    Pneumonotomy, with open drainage of pulmonary abscess or cyst
     
    60.0
    2173
    with removal of foreign body from lung
     
    75.0
    2177
    Decortication, pulmonary, total
     
    100.0
    2180
    Pneumonocentesis: puncture of lung for aspiration biopsy
     
    5.0
    2183
    Thoracentesis: puncture of pleural cavity for aspiration, initial or subsequent
     
    3.0
    Excision
    2191
    Pneumonectomy, total
     
    100.0
    2193
    Lobectomy, total, subtotal or segmental
     
    100.0
    2194
    with concomitant decortication
     
    125.0
    2195
    Wedge resection, single or multiple
     
    80.0
    2196
    Pulmonary resection with concomitant thoracoplasty
     
    150.0
    2197
    Pleurectomy, any type (independent procedure)
     
    50.0
    Endoscopy
    2201
    Thoracoscopy, exploratory (independent procedure)
     
    20.0
    2204
    with biopsy
     
    20.0
    2207
    Closed intrapleural pneumonolysis
     
    30.0
    Surgical Collapse Therapy
    Thoracoplasty
    2211
    Extrapleural resection of ribs, any type, first stage
     
    60.0
    2212
    second stage
     
    30.0
    2213
    third stage
     
    30.0
    2217
    Extrapleural pneumonolysis, including associated filling or packing procedures
     
    60.0
    2218
    Extraperiosteal pneumonolysis, including associated filling or packing procedures
     
    70.0
    2221
    Pneumothorax: intrapleural injection of air, initial
     
    5.0
    2222
    subsequent
     
    2.0
    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 body
     
    100.0
    2309
    pericardiocentesis, initial
     
    5.0
    2310
    subsequent
     
    4.0
    2311
    Blalock–Hanlon procedure (creation of atrial–septal defect) (closed)
     
    150.0
    Excision
    2316
    Pericardiectomy, extensive
     
    120.0
    2317
    Excision intracardiac tumor
     
    200.0
    2319
    Infundibular stenosis
     
    by 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) right
     
    35.0
    2331
    left, percutaneous
     
    15.0
    2332
    trans–septal
     
    20.0
    2333
    retrograde
     
    20.0
    2334
    combined left and right
     
    45.0
    2335
    final evaluation and report only
     
    5.0
    Suture
    2337
    Cardiorrhaphy: suture of heart wound or injury
     
    100.0
    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 valve
     
    by report
    2349
    Coronary endarterectomy, myocardial revascularization by implantation or anastomosis
     
    100.0
    2350
    Myocardial aneurysm
     
    200.0
    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, initial
     
    100.0
    2357
    replacement or repair
     
    30.0
    2358
    Pervenous or transvenous insertion of a pacemaker and subcutaneous implantation of a battery
     
    50.0
    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
    Trunk
     
    80.0
    2374
    Neck
     
    60.0
    2375
    Extremity
     
    60.0
    Phlebotomy — With removal of thrombus:
    2380
    Trunk
     
    70.0
    2381
    Extremity
     
    45.0
    Excision
    2390
    Thromboendarterectomy, abdominal aorta and iliac arteries and/or femoral arteries
     
    150.0
    2392
    femoral and/or popliteal arteries
     
    120.0
    2394
    carotid artery
     
    120.0
    2400
    Excision and graft or bypass graft of arch of aorta
     
    by report
    2404
    Excision and graft, thoracic aorta
     
    150.0
    2408
    abdominal aorta
     
    150.0
    2412
    extremity
     
    120.0
    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 age
     
    2.0
    2442
    scalp vein, for fluid therapy or indirect transfusion, up to three years of age
     
    3.0
    2443
    Exposure of and incision into vein ("cutdown") for fluid therapy or indirect transfusion, under one year of age
     
    4.0
    2445
    Blood transfusion, indirect method
     
    2.0
    2446
    replacement type, infant, initial or subsequent
     
    30.0
    2448
    direct method
     
    5.0
    2450
    "push" transfusion, given under two years of age
     
    5.0
    2454
    Injection of sclerosing solution into vein of leg, one
     
    1.0
    2455
    two or more injections, same leg
     
    2.0
    Repair
    2460
    Repair aneurysm of aorta, lateral repair
     
    150.0
    2464
    dissecting ("window" operation)
     
    150.0
    2466
    Banding of pulmonary artery
     
    100.0
    2472
    Repair of aortic arch anomalies (vascular ring)
     
    120.0
    2473
    Repair of atrial septal defect
     
    200.0
    2474
    Repair of arterio–venous fistula, plastic procedure
     
    by 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, Potts
     
    150.0
    2482
    Blalock
     
    120.0
    2486
    Pulmonary–superiorcaval anastomosis, Glenn
     
    150.0
    2487
    Baffes procedure: inferior cava to left atrium–right pulmonary vein to right antrium
     
    150.0
    2490
    Portocaval anastomosis
     
    100.0
    2496
    Splenorenal anastomosis
     
    100.0
    Suture
    2511
    Arteriorrhaphy: suture of wound or injury of artery (independent procedure), trunk
     
    60.0
    2512
    extremity
     
    30.0
    2515
    Phleborrhaphy: suture of wound or injury of vein (independent procedure), trunk
     
    60.0
    2516
    extremity
     
    20.0
    2520
    Ligation and division of ductus arteriosus
     
    100.0
    2522
    Ligation of carotid artery
     
    40.0
    2525
    Ligation and division of inferior vena cava
     
    60.0
    2526
    Ligation of femoral vein
     
    25.0
    2530
    Ligation and division of common iliac vein
     
    50.0
    2558
    Ligation and division of long saphenous vein at saphenofemoral junction, with or without retrograde injection or distal interruptions
     
    20.0
    2561
    Ligation and division and complete stripping of long or short saphenous veins, unilateral
     
    30.0
    2562
    bilateral
     
    50.0
    2563
    long and short saphenous veins, unilateral
     
    40.0
    2565
    bilateral
     
    60.0
    2576
    Ligation and division of short saphenous vein at saphenopopliteal junction (independent procedure)
     
    12.5
    2581
    minor varicose vein of leg, initial
     
    5.0
    2585
    subsequent
     
    3.0
    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 cannula
     
    31.25
    2592
    Construction of arterio–venous fistula
     
    50.0
    HEMIC AND LYMPHATIC SYSTEMS
    Spleen
    Excision
    2601
    Splenectomy
     
    60.0
    Introduction
    2610
    Injection procedure for splenoportography
     
    10.0
    Lymph Nodes and Lymphatic Channels
    Incision
    2631
    Drainage of lymph node abscess or lymphadenitis, simple
     
    3.0
    2632
    extensive
     
    by report
    Excision
    2641
    Biopsy or excision of lymph node (independent procedure) (except 2642)
     
    5.0
    2642
    anterior scalene
     
    15.0
    Radical Lymphadenectomy
    (Radical resection of lymph nodes):
    2651
    Supra–hyoid, unilateral
     
    50.0
    2652
    bilateral
     
    60.0
    2655
    Cervical (complete), unilateral
     
    80.0
    2658
    Axilla
     
    50.0
    2671
    Groin, superficial
     
    50.0
    2672
    deep, with common iliac dissection
     
    80.0
    2673
    Retroperitoneal, extensive, including pelvic, aortic and renal dissection
     
    100.0
    Introduction
    2676
    Injection procedure for lymph–angiography, unilateral
     
    10.0
    2677
    bilateral
     
    15.0
    MEDIASTINUM
    Incision
    2680
    Mediastinotomy with exploration or drainage, cervical approach
     
    40.0
    2681
    transthoracic
     
    80.0
    2683
    Foreign body removal, cervical approach
     
    70.0
    2684
    transthoracic
     
    80.0
    Excision
    2691
    Excision of mediastinal cyst
     
    80.0
    2693
    Excision of mediastinal tumor
     
    100.0
    2696
    Ligation or repair, thoracic duct
     
    75.0
    DIGESTIVE SYSTEM
    Mouth
    Incision
    2701
    Drainage of sublingual abscess
     
    2.0
    2705
    Drainage of Ludwig's angina
     
    8.0
    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, lip
     
    25.0
    2743
    V–excision of large lesion of lip up to one–half lip
     
    25.0
    2746
    Resection of more than one–half lip without plastic closure
     
    25.0
    (With plastic closure, primary or secondary see 0260–0324.)
    Repair (Cheiloplasty)
    2754
    Plastic repair of cleft lip, primary, unilateral
     
    70.0
    2758
    bilateral, one stage
     
    90.0
    2759
    bilateral, two stages, per stage
     
    60.0
    (For secondary, local revision, unilateral or bilateral see 0260–0324.)
    2762
    Plastic repair (secondary) of unilateral cleft lip by recreation of defect and reclosure
     
    70.0
    2765
    Plastic repair (secondary) of bilateral harelip by recreation of defect and reclosure—per major stage
     
    60.0
    (For plastic or reconstruction operation on lip see also 0260–0324.)
    Tongue
    Incision (Glossotomy)
    2771
    Drainage of lingual abscess
     
    2.0
    Excision (Glossectomy)
    2781
    Biopsy of tongue, anterior third
     
    3.0
    2782
    posterior two–thirds
     
    5.0
    2785
    Partial glossectomy or hemiglossectomy
     
    40.0
    2787
    Complete or total glossectomy
     
    70.0
    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, intraoral
     
    2.0
    2820aGeneral anesthesia for multiple extractions in hospital
    Palate and Uvula
    Incision
    2871
    Incision and drainage of abscess of palate
     
    2.0
    Excision
    2881
    Biopsy of palate
     
    3.0
    (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 palate
     
    40.0
    (For resection of palate with reconstruction see 0277–0283, 0312–0323.)
    2887
    Uvulectomy: excision of uvula
     
    3.0
    Repair
    2890
    Palatoplasty: plastic operation for cleft palate, partial
     
    60.0
    2892
    complete, including alveolar ridge
     
    80.0
    2895
    major revision
     
    60.0
    2897
    secondary lengthening procedure
     
    70.0
    2898
    attachment pharyngeal flap
     
    60.0
    2899
    alveolar ridge, anterior palate defect
     
    30.0
    (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 abscess
     
    5.0
    2912
    Drainage of submaxillary abscess
     
    5.0
    2914
    Sialolithotomy, submaxillary or parotid, uncomplicated
     
    3.0
    2915
    Sialolithotomy, submaxillary, complicated
     
    10.0
    2916
    Sialolithotomy, parotid extraoral
     
    25.0
    Excision
    2921
    Biopsy of salivary gland
     
    5.0
    2927
    Excision of parotid tumor or gland, superficial without nerve dissection
     
    20.0
    2928
    with nerve dissection
     
    60.0
    2934
    Excision of parotid gland, total, with dissection of facial nerve
     
    70.0
    2937
    with sacrifice of facial nerve
     
    60.0
    2938
    Excision of submaxillary tumor and/or gland
     
    40.0
    Repair (Sialodochoplasty)
    2941
    Plastic repair of salivary duct, simple
     
    35.0
    2942
    complicated
     
    by report
    Introduction
    2945
    Injection procedure for sialography
     
    1.0
    Suture
    2951
    Closure of salivary fistula
     
    40.0
    Manipulation
    2961
    Dilation of salivary duct; ptyalectasis
     
    1.0
    Pharynx, Adenoids and Tonsils
    Incision
    2970
    Drainage of peritonsillar abscess
     
    3.0
    2971
    Drainage of retropharyngeal or parapharyngeal abscess, intraoral
     
    10.0
    2973
    external approach
     
    by report
    Excision
    2981
    Biopsy of oropharynx
     
    3.0
    2982
    hypopharynx
     
    5.0
    2983
    nasopharynx
     
    5.0
    (For larynx, see 2070 or 2073.)
    2984
    Excision of pharyngoesophageal diverticulum, single stage
     
    50.0
    2985
    multiple stages
     
    60.0
    2989
    Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues
     
    15.0
    2990
    extending beneath subcutaneous tissues
     
    50.0
    2992
    Tonsillectomy, with or without adenoidectomy, under age 18 years
     
    15.0
    2993
    18 years or over
     
    20.0
    2994
    Adenoidectomy (independent procedure), primary or secondary
     
    10.0
    3000
    Excision of tonsil tag(s), hospital
     
    10.0
    3002
    office
     
    6.0
    3004
    Excision of lingual tonsil (independent procedure)
     
    10.0
    3005
    Excision of nasopharyngeal fibroma
     
    by report
    Suture
    3006
    Suture of wound or injury of pharynx
     
    by report
    Repair
    3011
    Pharyngoplasty: plastic or reconstructive operation on pharynx
     
    by report
    (For pharyngeal flap, see 2898.)
    Esophagus
    Incision
    3031
    Esophagotomy, cervical
     
    60.0
    3032
    for removal of foreign body, cervical
     
    60.0
    3033
    thoracic
     
    80.0
    Excision
    3043
    Esophagectomy: resection of esophagus, transpleural or extrapleural (upper two–thirds)
     
    120.0
    3045
    Esophagogastrectomy, combined thoraco–abdominal
     
    120.0
    3046
    Local excision, end–to–end anastomosis
     
    90.0
    Endoscopy
    3051
    Esophagoscopy, diagnostic
     
    15.0
    3053
    with insertion of radioactive substance
     
    20.0
    3055
    with biopsy
     
    20.0
    3057
    with foreign body removal
     
    25.0
    3061
    with dilation, direct
     
    20.0
    3063
    subsequent dilation
     
    15.0
    (See also 3092, 3095.)
    Repair
    3071
    Esophagoplasty: plastic repair or reconstruction of esophagus
     
    by report
    3072
    Esophagogastrostomy (cardioplasty)
     
    80.0
    3073
    Esophagomyotomy (Heller type)
     
    80.0
    3074
    Esophagoduodenostomy (including total gastrectomy)
     
    100.0
    3075
    Esophagojejunostomy, including total gastrectomy
     
    100.0
    3076
    Esophagostomy: fistulization of esophagus, external
     
    60.0
    Suture
    3077
    Direct ligation of esophageal varices
     
    80.0
    3081
    Suture of esophageal wound, injury or rupture, cervical approach
     
    by report
    3083
    transthoracic
     
    70.0
    3086
    Closure of esophagostomy or other external esophageal fistula, cervical
     
    45.0
    3087
    thoracic
     
    70.0
    Manipulation
    3092
    Dilation of esophagus by sound, bougie or bag, indirect, initial
     
    5.0
    3095
    subsequent
     
    3.0
    (For direct see 3061 and 3063.)
    Stomach
    Incision
    3101
    Gastrotomy with exploration or foreign body removal
     
    50.0
    3105
    Pyloromyotomy: cutting of pyloric muscle (Fredet–Ramstedt type operation)
     
    50.0
    Excision
    3111
    Biopsy by laparotomy
     
    50.0
    3112
    Local excision of ulcer or tumor
     
    60.0
    3114
    Total gastrectomy
     
    100.0
    3115
    Subtotal or hemi–gastrectomy, without vagotomy
     
    80.0
    3116
    with vagotomy
     
    90.0
    3117
    Vagotomy and pylorplasty
     
    70.0
    (See also 3131.)
    Endoscopy (independent procedure)
    3121
    Gastroscopy, diagnostic
     
    15.0
    3123
    with biopsy
     
    15.0
    Suture
    3131
    Pyloroplasty
     
    50.0
    3133
    Gastroduodenostomy
     
    60.0
    3135
    Gastrojejunostomy
     
    60.0
    3136
    with vagotomy
     
    75.0
    3137
    Gastrostomy
     
    40.0
    3141
    Gastrorrhaphy: suture of perforated duodenal or gastric ulcer, wound or injury
     
    50.0
    3144
    Revision of gastroduodenal anatomosis (gastroduodenostomy) with reconstruction, without vagotomy
     
    90.0
    3145
    with vagotomy
     
    100.0
    3146
    Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, without vagotomy
     
    90.0
    3147
    with vagotomy
     
    100.0
    3153
    Closure of gastrostomy, surgical
     
    40.0
    Intestines (Except Rectum)
    Incision
    3161
    Enterotomy with exploration or foreign body removal, small bowel
     
    60.0
    3162
    large bowel
     
    65.0
    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 enterotomy
     
    60.0
    3172
    multiple enterotomies
     
    70.0
    3174
    Enterectomy: resection of small intestine with anastomosis
     
    70.0
    3176
    with enterostomy
     
    70.0
    3178
    Colectomy, partial resection of large intestine in two stages, including first stage colostomy or cecostomy
     
    100.0
    3179
    Colectomy, partial, with anastomosis with or without concomitant proximal colostomy
     
    80.0
    3180
    total, with ileostomy or ilioproctostomy
     
    110.0
    3181
    with proctectomy and ileostomy
     
    120.0
    3191
    Enteroenterostomy; anastomosis of intestine
     
    60.0
    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 colitis
     
    75.0
    3200
    Reduction of volvulus, intussusception, internal hernia, by laparotomy
     
    60.0
    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 obstruction
     
    60.0
    3213
    Intestinal plication (Noble type)
     
    60.0
    Suture
    3220
    Suture of intestine (enterorrhaphy), large or small, for perforated ulcer, wound, injury or rupture, single
     
    60.0
    3221
    multiple
     
    by report
    3222
    Suture of intestine with colostomy
     
    70.0
    3225
    Closure of enterostomy, large or small intestine
     
    40.0
    3227
    Closure of fecal fistula
     
    by report
    Meckel's Diverticulum and the Mesentery
    Excision
    3231
    Excision of Meckel's diverticulum (diverticulectomy)
     
    50.0
    3235
    Excision of lesion of mesentery
     
    50.0
    (With bowel resection, see 3174.)
    Suture
    3241
    Suture of mesentery
     
    40.0
    Appendix
    Incision
    3251
    Incision and drainage of appendicular abscess, transabdominal
     
    30.0
    Excision
    3261
    Appendectomy
     
    40.0
    Rectum
    Incision
    3282
    Transrectal drainage of pelvic abscess
     
    15.0
    3283
    Incision and drainage of deep supralevator, pelvirectal or retrorectal abscess
     
    20.0
    (See also 3357, 3358.)
    Excision
    3291
    Complete proctectomy, combined abdomino–perineal, one or two stages
     
    100.0
    3292
    Complete proctectomy for congenital megacolon (Swenson type procedure)
     
    100.0
    3294
    Excision of rextal procidentia, with anastomosis, perineal approach
     
    60.0
    3295
    abdominal and perineal approach
     
    100.0
    3296
    Division of stricture in rectum
     
    20.0
    3298
    Perineal excision of primary or recurrent malignant tumor (Kraske type)
     
    80.0
    3299
    Local excision of extensive villous papilloma of rectum
     
    40.0
    Endoscopy (independent procedure)
    3310
    Proctosigmoidoscopy, diagnostic, initial
     
    3.0
    3311
    subsequent
     
    2.0
    3312
    with biopsy, initial
     
    5.0
    3313
    subsequent for same lesion
     
    3.0
    3314
    with removal of papilloma or polyp, initial
     
    7.0
    3315
    subsequent for same lesion
     
    5.0
    3316
    with removal of multiple papillomas or polyps
     
    9.0
    3317
    complicated
     
    by report
    3318
    Endoscopic control of hemmorrhage
     
    by report
    3319
    Endoscopic removal of foreign body, anus or rectum
     
    by report
    Repair
    3320
    Proctoplasty, for stenosis
     
    40.0
    3321
    for prolapse of mucous membrane
     
    40.0
    3322
    Perirectal injection of sclerosing solution for prolapse, in hospital
     
    10.0
    3323
    Proctopexy for prolapse, abdominal approach
     
    60.0
    3325
    Proctopexy combined with sigmoid resection, abdominal approach
     
    90.0
    Suture
    3331
    Closure of rectovesical fistula
     
    60.0
    (See also 3965.)
    3333
    Closure of rectourethral fistula
     
    70.0
    (See also 4026.)
    3335
    Closure of rectovaginal fistula
     
    60.0
    (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, subcutaneous
     
    10.0
    3352
    submuscular
     
    40.0
    3353
    complex or multiple
     
    by report
    3354
    second stage
     
    10.0
    3355
    Remove seton, office
     
    2.0
    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 sphincterotomy
     
    20.0
    3372
    Cryptectomy, single, office
     
    5.0
    3373
    multiple, hospital procedure
     
    30.0
    3374
    Papillectomy or excision of single tab (independent procedure), office
     
    3.0
    3375
    Excision of external hemorrhoidal tags and/or multple papillae, office
     
    5.0
    3377
    Hemorrhoidectomy, external, complete
     
    20.0
    3380
    internal and external
     
    30.0
    3381
    radical (Buie or amputative type)
     
    40.0
    3382
    Fistulotomy or fistulectomy, submuscular, and hemorrhoidectomy
     
    40.0
    3386
    Fissurectomy and hemorrhoidectomy
     
    30.0
    3392
    Enucleation or excision of external thrombotic hemorrhoid
     
    3.0
    Introduction
    3401
    Hemorrhoids, injection of sclerosing solution
     
    2.0
    Endoscopy (independent procedure)
    3411
    Anoscopy, diagnostic with or without biopsy
     
    1.0
    (For with removal of foreign body see 3319.)
    (For control of hemorrhage, endoscopic, see 3318.)
    Repair
    3420
    Anoplasty: plastic operation for stricture
     
    40.0
    3421
    infant, minor thin septum
     
    5.0
    3422
    Construction of anus for congenital absence, perineal approach
     
    50.0
    3423
    combined abdominal and perineal approach
     
    80.0
    3425
    Sphincteroplasty, anal, for incontinence
     
    40.0
    3426
    muscle transplant
     
    by report
    3427
    Thiersch procedure for incontinence and/or prolapse
     
    25.0
    Destruction
    3433
    Condyloma, single or multiple, internal and external, in hospital
     
    20.0
    3434
    external, electrodesiccation, initial
     
    3.0
    3435
    subsequent
     
    2.0
    Liver
    Incision
    3456
    Aspiration biopsy of liver
     
    5.0
    Excision
    3464
    Hepatectomy, partial: resection of liver
     
    80.0
    Repair
    3471
    Marsupialization of cyst or abscess of liver
     
    70.0
    Suture
    3481
    Hepatorrhaphy: suture of liver wound or injury
     
    60.0
    Biliary Tract
    Incision
    3491
    Hepaticotomy or hepaticostomy with exploration, drainage or removal of calculus
     
    70.0
    3495
    Choledochotomy or choledochostomy with exploration, drainage or removal of calculus, with or without cholecystotomy
     
    70.0
    3500
    Duodenocholedochotomy: transduodenal choledocholithotomy
     
    80.0
    3501
    Transduodenal sphincterotomy
     
    80.0
    3504
    Cholecystotomy or cholecystostomy with exploration, drainage or removal of calculus
     
    50.0
    Introduction
    3509
    Injection procedure for percutaneous trans–hepatic cholangiography (independent procedure)
     
    10.0
    Excision
    3515
    Cholecystectomy
     
    60.0
    3517
    with open exploration of common duct
     
    70.0
    Repair
    3518
    Exploration for congenital atresia of bile ducts
     
    50.0
    3519
    Direct anastomosis of gallbladder and gastrointestinal tract
     
    65.0
    3520
    Roux–en–y anastomosis of gallbladder and gastrointestinal tract
     
    65.0
    3521
    Direct anastomosis of extrahepatic biliary ducts and gastrointestinal tract
     
    75.0
    3522
    Roux–en–y anastomosis of extrahepatic biliary ducts and gastrointestinal tract
     
    85.0
    3523
    Plastic reconstruction of extrahepatic biliary ducts with end–to–end anastomosis
     
    80.0
    Pancreas
    Incision
    3541
    Abdominal drainage of pancreatitis
     
    50.0
    3544
    Removal of calculus
     
    70.0
    Excision
    3550
    Pancreatectomy, subtotal
     
    80.0
    3551
    subtotal (Whipple type)
     
    140.0
    3552
     
    140.0
    3553
    Pancreatico–jejunostomy
     
    80.0
    Repair
    3565
    Marsupialization of cyst of pancreas
     
    60.0
    3566
    Internal direct anastomosis of cyst to gastrointestinal tract
     
    70.0
    3567
    Roux–en–y internal anastomosis, cyst to gastrointestinal tract
     
    80.0
    Abdomen, Peritoneum and Omentum
    Incision
    3571
    Exploratory laparotomy: exploratory celiotomy
     
    40.0
    3573
    Drainage of peritoneal abscess or localized peritonitis exclusive of appendicular abscess
     
    40.0
    3575
    Subdiaphragmatic or subphrenic abscess
     
    50.0
    3578
    Retroperitoneal abscess
     
    40.0
    3588
    Peritoneocentesis: abdominal paracentesis, initial
     
    4.0
    3590
    subsequent
     
    3.0
    Excision
    3591
    Trans–peritoneal excision of intra–abdominal or retroperitoneal tumors or cysts
     
    70.0
    Endoscopy
    3595
    Peritoneoscopy
     
    15.0
    Introduction
    3611
    Pneumoperitoneum: intraperitoneal injection of air, initial
     
    4.0
    3612
    subsequent
     
    2.0
    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, unilateral
     
    35.0
    3633
    with orchiectomy
     
    40.0
    3634
    with excision of hydrocele
     
    40.0
    3635
    recurrent
     
    40.0
    3646
    Femoral, unilateral
     
    35.0
    3651
    recurrent
     
    45.0
    3661
    Ventral, incisional
     
    45.0
    3662
    recurrent
     
    50.0
    3663
    Epigastric
     
    35.0
    3664
    recurrent
     
    45.0
    3665
    Umbilical, under age five years
     
    30.0
    3666
    over age five years
     
    35.0
    3667
    Omphalocele, in newborn, one stage
     
    40.0
    3668
    Gross type procedure, first stage
     
    50.0
    3669
    second stage
     
    50.0
    (For diaphragmatic hernia, see 1495, 1496.)
    Suture
    3734
    Secondary suture of abdominal wall for evisceration or disruption
     
    20.0
    (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: nephrostomy
     
    80.0
    3811
    Nephrolithotomy, removal of calculus
     
    80.0
    3812
    large (staghorn) calculus
     
    90.0
    3813
    Division or transection of aberrant renal vessels (independent procedure)
     
    70.0
    3815
    Pyelotomy with exploration
     
    70.0
    3816
    Pyelotomy with drainage, pyelostomy
     
    70.0
    3817
    Pyelotomy with removal of calculus; pyelolithotomy; pelviolithotomy
     
    70.0
    Excision
    3820
    Renal biopsy, trochar or needle
     
    5.0
    3821
    Nephrectomy, including partial ureterectomy
     
    80.0
    3822
    with total ureterectomy through same or separate incision
     
    100.0
    3824
    Heminephrectomy
     
    100.0
    3827
    Excision of cyst of kidney
     
    70.0
    3829
    Aspiration or injection of renal cyst or renal pelvis
     
    5.0
    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 nephropexy
     
    80.0
    3835
    Nephropexy: fixation or suspension of kidney (independent procedure)
     
    70.0
    Suture
    3841
    Nephrorrhaphy: suture of kidney wound or injury
     
    80.0
    3845
    Closure of nephrostomy, pyelostomy or other renal fistula (e.g., renocolic fistula)
     
    80.0
    3846
    Symphysiotomy for horseshoe kidney
     
    100.0
    Transplant
    3850
    Kidney transplant
     
    125.0
    Ureter
    Incision
    3851
    Ureterotomy with exploration or drainage (independent procedure)
     
    70.0
    3857
    Ureterolithotomy, upper three quarters of ureter
     
    70.0
    3858
    lower one quarter
     
    80.0
    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, unilateral
     
    70.0
    3873
    bilateral
     
    90.0
    3874
    Ureteropyelostomy: anastomosis of ureter and renal pelvis
     
    80.0
    3875
    Ureteroureterostomy
     
    80.0
    3876
    Ureteroneocystostomy: anastomosis of ureter to bladder, unilateral
     
    80.0
    3877
    bilateral
     
    100.0
    3880
    Ureteroenterostomy: anastomosis of ureter to intestine, unilateral
     
    80.0
    3881
    bilateral
     
    100.0
    3884
    Ureterostomy: transplantation of ureter to skin, unilateral
     
    70.0
    3885
    bilateral
     
    90.0
    Suture
    3891
    Ureterorrhaphy: suture of ureter (independent procedure)
     
    80.0
    3895
    Closure of fistula of ureter
     
    by report
    Bladder
    Incision
    3900
    Aspiration of bladder by needle or trochar
     
    5.0
    3902
    with insertion of suprapubic catheter
     
    10.0
    3904
    Cystotomy or cystostomy with fulguration
     
    60.0
    3905
    Cystotomy with drainage; cystostomy
     
    50.0
    3907
    Cystotomy with removal of calculus (cystolithotomy) without vesical neck resection
     
    50.0
    3908
    Drainage of perivesical or prevesical space abscess
     
    50.0
    Excision
    3911
    Cystectomy, partial
     
    70.0
    3912
    with re-implantation of ureter into bladder (ureteroneocystostomy)
     
    80.0
    3913
    complete
     
    100.0
    3914
    radical with ureteral transplants
     
    120.0
    3915
    with ureteral–ileo conduit
     
    140.0
    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 instillation
     
    1.0
    3927
    Injection procedure for cystography or urethro–cystography
     
    1.0
    Cystoscopy (independent procedure):
    3930
    Diagnostic, office, initial
     
    5.0
    3931
    subsequent within 30 days
     
    3.0
    3932
    with ureteral catheterization
     
    8.0
    3933
    hospital
     
    8.0
    3934
    with ureteral catheterization
     
    15.0
    (For Howard or Stamey type renal function test see 3948.)
    3935
    With biopsy
     
    10.0
    3936
    With fulguration or treatment of minor (less than 0.5 cm.) lesion, with or without biopsy
     
    10.0
    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 tumor
     
    10.0
    3939
    With insertion of radioactive substance, with or without biopsy or fulguration
     
    30.0
    3940
    With dilatation of bladder for interstitial cystitis, general anesthesia
     
    15.0
    3942
    With ureteral meatotomy
     
    20.0
    3943
    With resection of fulguration of ureterocele
     
    20.0
    3944
    With removal of foreign body from urethra or bladder
     
    20.0
    3945
    With removal of calculus from ureter
     
    30.0
    3946
    With manipulation of ureteral calculus, primary
     
    20.0
    3947
    subsequent
     
    10.0
    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 fragments
     
    50.0
    Repair
    3952
    Cystoplasty; plastic operation on bladder (anterior Y–plasty, vesical fundus resection, etc.) any procedure
     
    80.0
    Suture
    3961
    Cystorrhaphy: suture of bladder wound, injury or rupture
     
    60.0
    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) anterior
     
    10.0
    3973
    perineal, external
     
    25.0
    3977
    Meatotomy: cutting of meatus (independent procedure)
     
    3.0
    3978
    Drainage of deep periurethral abscess, hospital
     
    10.0
    3979
    Drainage of simple perineal urinary extravasation (independent procedure), uncomplicated
     
    15.0
    3980
    complicated, with or without diversion of urinary stream
     
    50.0
    (See also 3908.)
    Excision
    (For excision or fulguration of urethral caruncle, see 4437.)
    3987
    Excision or fulguration of carcinoma of urethra
     
    by report
    3991
    Excision or diverticulum of urethra (independent procedure)
     
    50.0
    3994
    Excision of fulguration of urethral polyps, distal
    ¾
    inch of urethra
     
    5.0
    (For posterior urethra, see 4006.)
    Endoscopy
    4000
    Urethroscopy, diagnostic
     
    5.0
    4001
    with removal of calculus or foreign body
     
    20.0
    4004
    with internal urethrotomy
     
    20.0
    4006
    with fulguration of posterior urethra
     
    10.0
    4008
    subsequent, within 30 days
     
    5.0
    Repair
    4011
    Urethroplasty: plastic operation on urethra (except 4132 and 4135)
     
    by report
    Suture
    4021
    Urethrorrhaphy: suture of urethral wound or injury
     
    by report
    4023
    Closure of urethrostomy or fistula of urethra (independent procedure)
     
    30.0
    4025
    Closure of urethrovaginal fistula
     
    50.0
    4026
    Closure of urethrorectal fistula (See also 3333.)
     
    70.0
    Manipulation
    4031
    Dilation of urethral stricture by passage of sound, initial, male
     
    3.0
    4032
    subsequent within 30 days
     
    1.5
    4033
    Dilation of urethral stricture by passage of filiform and follower, male
     
    5.0
    4034
    subsequent within 30 days
     
    2.5
    4035
    Passage of filiform and follower for acute vesical retention, male
     
    5.0
    4036
    Dilation of female urethra including suppository and/or installation
     
    2.0
    4037
    subsequent within 30 days
     
    1.0
    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, partial
     
    40.0
    4115
    complete
     
    60.0
    4116
    radical
     
    100.0
    (For local excision of lesion of penis, see Integumentary System.)
    4122
    Circumcision, clamp procedure, newborn
     
    3.0
    4123
    except newborn
     
    5.0
    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 chordee
     
    30.0
    (For urethroplasty for hypospadias, see 0260 to 0324.)
    4134
    Plastic operation on penis for injury
     
    by report
    4135
    Plastic operation on penis for epispadias with exstrophy of bladder
     
    by report
    4136
    Plastic operation for penile epispadias distal to external sphincter
     
    50.0
    Testis
    Excision
    4140
    Biopsy, needle (independent procedure)
     
    2.0
    4141
    incisional (independent procedure)
     
    10.0
    4143
    Orchiectomy, simple unilateral
     
    20.0
    4144
    bilateral
     
    30.0
    4145
    with superficial inguinal node dissection, unilateral
     
    50.0
    (For radical retroperitoneal node dissection, see 2673.)
    Repair
    4152
    Reduction of torsion of testis by surgical means
     
    30.0
    4153
    with fixation of contralateral testis
     
    45.0
    4154
    Fixation of contralateral testis (independent procedure)
     
    20.0
    4156
    Orchiopexy, any type, with or without hernia repair
     
    50.0
    4157
    second stage (Torek type)
     
    10.0
    (For orchiectomy with repair of hernia, see 3633.)
    Epididymis
    Incision
    4161
    Drainage of abscess of epididymis
     
    3.0
    Excision
    4171
    Biopsy of epididymis, needle
     
    2.0
    4172
    Exploration of epididymis with or without biopsy
     
    10.0
    4174
    Excision of spermatocele with or without epididymectomy
     
    30.0
    4176
    Epididymectomy, unilateral
     
    30.0
    Repair
    4181
    Epididymovasostomy (anastomosis of epididymis to vas deferens), unilateral
     
    40.0
    4182
    bilateral
     
    50.0
    Tunica Vaginalis
    Incision
    4191
    Puncture aspiration of hydrocele with or without injection of medication
     
    2.0
    4200
    Repair of hydrocele (Bottle type)
     
    20.0
    4201
    Excision of hydrocele, unilateral
     
    30.0
    4202
    with hernia repair
     
    40.0
    Scrotum
    Incision
    4211
    Drainage of scrotal abscess
     
    2.0
    4215
    Removal of foreign body in scrotum
     
    by report
    Excision
    (For local excision of lesion of skin of scrotum, see 0175–0197, 0260–0270.)
    4224
    Resection of scrotum
     
    by report
    4227
    Scrotoplasty; plastic operation on scrotum
     
    by 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 unilateral
     
    30.0
    4252
    bilateral
     
    40.0
    Suture
    4261
    Ligation (percutaneous of vas deferens (independent procedure)
     
    5.0
    Spermatic Cord
    Excision
    4271
    Excision of hydrocele of spermatic cord (independent procedure), unilateral
     
    30.0
    4275
    Excision of varicocele (independent procedure), unilateral
     
    30.0
    4278
    with hernia repair
     
    40.0
    Seminal Vesicles
    Incision
    4281
    Vesiculotomy, unilateral
     
    by report
    Excision
    4291
    Vesiculectomy
     
    80.0
    Prostate
    Incision
    4300
    Biopsy, prostate, needle, single or multiple
     
    5.0
    4301
    incisional, perineal approach
     
    30.0
    4302
    transrectal
     
    20.0
    4303
    Prostatotomy: external drainage of prostatic abscess
     
    30.0
    4304
    Prostatolithotomy: removal of prostatic calculus (independent procedure)
     
    70.0
    Excision
    4311
    Prostatectomy, perineal, subtotal
     
    80.0
    4313
    radical
     
    100.0
    4316
    suprapubic, one or two stages
     
    80.0
    4318
    retropubic
     
    80.0
    4319
    radical
     
    100.0
    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 vulva
     
    5.0
    4405
    Incision and drainage of Bartholin's gland abscess, unilateral
     
    5.0
    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, bilateral
     
    55.0
    4424
    partial, less than 80% of vulvar area
     
    40.0
    4425
    radical, including unilateral regional lymph nodes
     
    100.0
    4426
    including bilateral regional lymph nodes
     
    150.0
    4428
    Clitoridotomy: circumcision, female
     
    7.5
    4429
    Clitoridectomy
     
    10.0
    4431
    Hymenectomy, partial excision of hymen
     
    10.0
    4433
    Excision of Bartholin's gland or cyst
     
    20.0
    4434
    Marsupialization or cautery destruction of Bartholin's gland or cyst
     
    15.0
    4436
    Excision or fulguration of Skene's glands
     
    7.0
    4437
    Excision or fulguration of urethral caruncle
     
    7.0
    (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 approach
     
    30.0
    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 abscess
     
    15.0
    4462
    Colpocentesis (independent procedure)
     
    4.0
    4463
    Puncture and aspiration of cul de sac
     
    3.0
    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 vagina
     
    50.0
    4475
    Le Fort type
     
    35.0
    4477
    Excision of vaginal septum
     
    by report
    Introduction
    4478
    Irrigation and/or application of any medicament for treatment of bacterial, parasitic or fungoid disease
     
    1.0
    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 perineorrhaphy
     
    35.0
    4488
    Combined anterior–posterior colporrhaphy
     
    50.0
    4492
    Urethral suspension, abdominal approach (Marshall–Marchetti type)
     
    40.0
    4493
    Repair of enterocele (independent procedure) abdominal approach
     
    45.0
    4494
    vaginal approach
     
    45.0
    4495
    Colpopexy, abdominal approach
     
    45.0
    4497
    Construction of artificial vagina (vaginal atresia or absence) with or without graft
     
    by report
    (For closure of vaginal fistulae, see 3335, 3965, 4025.)
    Manipulation
    4511
    Dilation of vagina under anesthesia
     
    2.0
    4512
    Pelvic examination under anesthesia
     
    2.0
    Endoscopy
    4521
    Culdoscopy (independent procedure)
     
    15.0
    Oviduct
    Incision
    4531
    Transection of Fallopian tube, unilateral or bilateral, abdominal or vaginal approach
     
    40.0
    4532
    post–partum, during same hospitalization
     
    30.0
    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 bilateral
     
    25.0
    4562
    abdominal approach, unilateral or bilateral
     
    40.0
    4564
    Drainage of ovarian abscess, vaginal approach
     
    20.0
    4565
    abdominal approach
     
    40.0
    Excision
    4566
    Biopsy of ovary, unilateral or bilateral (independent procedure)
     
    45.0
    4568
    Partial oophorectomy, bilateral or unilateral
     
    45.0
    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, office
     
    3.0
    4573
    Biopsy of cervix, circumferential (cone) with or without dilation and curettage, with or without Sturmdorff type repair
     
    20.0
    4575
    Trachelectomy: cervicectomy: amputation of cervix (independent procedure)
     
    20.0
    4577
    total excision of cervical stump, with or without pelvic floor repair, abdominal approach
     
    50.0
    4578
    vaginal approach
     
    60.0
    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 device
     
    3.0
    Repair
    4585
    Tracheloplasty: surgical repair of incompetent cervix, loop type
     
    8.0
    4586
    Shirodkar type
     
    20.0
    4587
    Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach
     
    by report
    Manipulation
    4588
    Dilation of cervical canal, instrumental (independent procedure)
     
    3.0
    4589
    Dilation and curettement of cervical canal
     
    15.0
    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 both
     
    60.0
    4618
    Supracervical hysterectomy: subtotal hysterectomy, with or without tubes, and/or ovaries, one or both
     
    55.0
    4620
    Radical hysterectomy for cancer including regional lymph nodes
     
    100.0
    4626
    plus removal of bladder and ureteral transplantations and/or abdominoperineal resection of rectum and colon and colostomy or any combination thereof
     
    by report
    4631
    Vaginal hysterectomy
     
    60.0
    4632
    with plastic repair of vagina, anterior and/or posterior colporrhaphy
     
    70.0
    4634
    with repair of enterocele
     
    75.0
    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 sympathectomy
     
    45.0
    4685
    with interposition operation, with or without pelvic floor repair
     
    50.0
    4690
    with shortening of endopelvic fascia: parametrial fixation with or without pelvic floor repair (Manchester type)
     
    50.0
    4692
    with shortening of sacro–uterine ligaments
     
    50.0
    4694
    Hysterosalpingostomy: anastomosis of tubes of uterus
     
    50.0
    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 physician
     
    20.0
    4745
    Repair of perineal fistula
     
    25.0
    (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 section
     
    50.0
    4802
    Low cervical (lower uterine segment) cesarean section
     
    50.0
    4803
    Cesarean section and hysterectomy, total or subtotal
     
    60.0
    4804
    Extraperitoneal cesarean section
     
    60.0
    Excision
    4809
    Hysterotomy induced abortion
     
    50.0
    4811
    Ectopic pregnancy, tubal, requiring salpingectomy and/or oophorectomy, abdominal or vaginal approach
     
    50.0
    4812
    ovarian, requiring oophorectomy
     
    by report
    4815
    Hysterotomy, abdominal, for removal of hydatidiform mole
     
    45.0
    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 care
     
    20.0
    4823
    Antepartum care only (independent procedure)
     
    Sv.‡
    4824
    Postpartum care only (independent procedure)
     
    Sv.‡
    4841
    Amniocentesis, diagnostic
     
    5.0
    4842
    Amniocentesis with hypertonic solution including terminal curettage, induced abortion
     
    40.0
    4843
    Dilation and curettage, and/or suction, induced abortion
     
    20.0
    4850
    Abortion, first trimester, completed medically
     
    Sv.‡
    4851
    (incomplete) completed surgically, (dilataion and curettage)
     
    15.0
    4853
    second trimester, completed medically
     
    Sv.‡
    4854
    (incomplete) completed surgically, (dilatation and curettage)
     
    15.0
    4856
    missed, first or second trimester, completed medically or surgically
     
    by report
    4858
    incomplete, septic, requiring dilatation and curettage and additional care
     
    by report
    4870
    Dilatation and curettage of uterus for postpartum bleeding
     
    15.0
    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 thyroid
     
    40.0
    4912
    Total thyroid lobectomy, unilateral
     
    50.0
    4914
    Thyroidectomy, total or complete
     
    70.0
    4917
    subtotal or partial
     
    60.0
    4924
    total or subtotal for malignancy with radical neck dissection
     
    100.0
    4925
    total or subtotal for malignancy with limited neck dissection
     
    80.0
    4937
    secondary, unilateral
     
    60.0
    4938
    bilateral
     
    70.0
    4941
    Excision of thyroglossal duct, cyst or sinus
     
    45.0
    Parathyroid, Thymus, Pituitary, Pineal, Adrenal Glands and Carotid Body
    (For hypophysectomy, see 2019 and 5130.)
    Excision
    4971
    Parathyroidectomy or exploration of parathyroid
     
    70.0
    4972
    with mediastinal exploration with or without splitting of sternum
     
    90.0
    4985
    Adrenalectomy, transabdominal, lumbar or dorsal, unilateral
     
    80.0
    4986
    bilateral, one stage
     
    100.0
    4987
    two stages
     
    120.0
    4989
    Biopsy adrenal, unilateral
     
    60.0
    4990
    bilateral
     
    70.0
    4993
    Excision of carotid body tumor, with excision of carotid artery
     
    100.0
    4994
    without excision of carotid artery
     
    70.0
    NERVOUS SYSTEM
    Skull, Meninges and Brain
    CRANIOTOMY FOLLOWING TRAUMA:
    Incision
    5001
    Burr holes, unilateral, exploratory for subdural puncture, not followed by surgery
     
    30.0
    5002
    multiple, bilateral, not followed by surgery
     
    50.0
    5003
    Evacuation of hematoma, subdural, extradural, or intracerebral by burr holes only
     
    90.0
    5004
    requiring craniotomy
     
    100.0
    5012
    Removal of foreign body from brain
     
    100.0
    Excision
    5015
    Removal of brain scar
     
    by report
    Repair
    5018
    Elevation of depressed skull fracture, simple
     
    75.0
    5020
    with debridement of brain and repair of dura
     
    100.0
    5022
    Cranioplasty for skull defect, bone, metal or plastic
     
    100.0
    5024
    Repair of dura by graft, including repair for cerebrospinal rhinorrhea
     
    100.0
    CRANIOTOMY FOR NON–TRAUMATIC CAUSES:
    Incision
    5101
    Burr holes, exploratory or ventricular puncture, not followed by surgery
     
    30.0
    5102
    Ventricular puncture through previous burr holes or fontanelle
     
    5.0
    5106
    Craniotomy for drainage of brain abscess
     
    75.0
    5108
    Subsequent tapping (aspiration) abscess in operating room
     
    10.0
    5110
    at bedside
     
    5.0
    5112
    Suboccipital craniectomy for tractotomy or section of 5th, 8th, 9th or other cranial nerves
     
    125.0
    5113
    Intratemporal (mastoid) craniectomy for decompression, neurolysis or excision of acoustic nerve tumor
     
    100.0
    5114
    Craniotomy for surgery of sensory root of grasserian ganglion
     
    100.0
    5116
    Craniotomy for lobotomy, unilateral
     
    40.0
    5117
    bilateral
     
    60.0
    5119
    Craniotomy for orbital decompression, unilateral
     
    100.0
    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, supratentorial
     
    125.0
    5132
    Suboccipital craniectomy for brain tumor
     
    150.0
    5134
    Osteoplastic craniotomy for arteriovenous malformation
     
    by report
    5136
    Osteoplastic craniotomy for obliteration of aneurysm
     
    150.0
    5140
    Craniotomy for pallidectomy, any method, including localizing techniques, single or multiple stages
     
    100.0
    5144
    for topectomy
     
    100.0
    5146
    for excision of choroid plexus
     
    50.0
    5148
    Craniectomy for osteomyelitis of skull
     
    by report
    Introduction
    5152
    Burr holes with ventriculography, not followed by surgery
     
    30.0
    5153
    followed by surgery
     
    20.0
    5154
    Ventriculography through fontanelle or previous burr holes
     
    10.0
    5155
    Ventricular puncture with introduction of dye and recovery by spinal puncture
     
    12.0
    5159
    Injection procedure for pneumoencephalography
     
    10.0
    Repair
    5160
    Ventriculocisternostomy
     
    100.0
    5162
    Repair of encephalocele
     
    by report
    5166
    Ventriculoauricular shunt
     
    100.0
    5167
    replacement or irrigation of obstructed valve
     
    90.0
    5168
    replacement or irrigation of ventricular catheter
     
    30.0
    5169
    removal of shunt in toto without replacement
     
    30.0
    5170
    Ventriculo–auricular–peritoneal–pleural–uretera l shunt
     
    100.0
    5171
    co–surgeon
     
    80.0
    5174
    Craniectomy for craniostenosis, single suture
     
    75.0
    5175
    multiple sutures
     
    100.0
    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–dorsal
     
    100.0
    5194
    Rhizotomy
     
    75.0
    5198
    Spinal puncture, lumbar, simple (independent procedure)
     
    2.0
    5199
    diagnostic, initial, with study of hydrodynamics
     
    4.0
    (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 meninges
     
    100.0
    5208
    Laminotomy for removal of intervertebral discs, cervical
     
    90.0
    5209
    thoracic
     
    90.0
    5210
    lumbar
     
    90.0
    5211
    Excision of intervertebral discs, anterior approach, cervical
     
    80.0
    (See also 0634–0642.)
    Introduction
    5214
    Injection procedure for myelography
     
    10.0
    5216
    for discography
     
    10.0
    Repair
    5225
    Laminectomy for spondylolisthesis (See also 5190.)
     
    100.0
    5227
    Repair of meningocele
     
    75.0
    5229
    Repair of meningomyelocele
     
    90.0
    5231
    Lumbar subarachnoid–peritoneal–ureteral shunt
     
    80.0
    5232
    co–surgeon
     
    75.0
    5233
    Application crutchfield tongs or other skeletal traction device
     
    5.0
    Peripheral Nerves, Other Extracranial Nerves and Ganglia
    Incision
    (For transection of trigeminal or glossopharyngeal nerves, see 5112, 5114.)
    5252
    Phrenic nerve transection or avulsion
     
    15.0
    5255
    Transection, spinal nerve
     
    40.0
    5257
    Transection, occipital nerve
     
    40.0
    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 nerve
     
    8.0
    5274
    digital nerve, one or both, same digit
     
    10.0
    5275
    hand or foot, one (add 10 percent each additional)
     
    15.0
    5276
    arm or leg
     
    25.0
    5277
    Avulsion infraorbital nerve
     
    20.0
    5280
    Stoefel's neurectomy
     
    40.0
    5282
    Obturator neurectomy
     
    40.0
    Introduction
    5290
    Alcohol injection, subarachnoid
     
    5.0
    5294
    2nd or 3rd branch of trigeminal nerve
     
    7.5
    5295
    under x–ray control (excluding x–ray charge)
     
    10.0
    Nerve Block
    5298
    Paravertebral block, lumbar or thoracic
     
    5.0
    5300
    Sympathetic block (cervical)
     
    5.0
    5302
    Stellate ganglion
     
    5.0
    5311
    Brachial plexus block
     
    5.0
    5312
    Intercostal nerves
     
    3.0
    5313
    Lumbar, sacral and coccygeal nerves
     
    5.0
    5314
    Pudendal nerve
     
    5.0
    5315
    Splanchnic nerves
     
    5.0
    5316
    Ilioinguinal and iliohypogastric nerves
     
    5.0
    5317
    Sciatic nerve
     
    3.0
    5318
    Phrenic nerve
     
    3.0
    5319
    Other peripheral nerves
     
    3.0
    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 motor
     
    30.0
    5325
    Arm or leg (except sciatic)
     
    40.0
    5326
    Sciatic
     
    by report
    5328
    Brachial or lumbar plexus
     
    by report
    5330
    Cranial, extra–cranial
     
    75.0
    (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 gap
     
    by 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 both
     
    15.0
    5337
    hand or foot
     
    20.0
    5339
    arm or leg (except sciatic)
     
    40.0
    5340
    sciatic
     
    by report
    5341
    brachial or lumbar plexus
     
    by report
    5343
    cranial, extra–cranial
     
    75.0
    (For facial nerve, see 6002, 6003.)
    5345
    Transplantation ulnar nerve, elbow (independent procedure) (includes neurolysis)
     
    25.0
    5347
    Median nerve decompression at carpal tunnel, simple
     
    30.0
    (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, unilateral
     
    60.0
    5372
    bilateral
     
    80.0
    5375
    Cervico–thoracic (Smithwicke type, supra– and infra–diaphragmatic), unilateral
     
    70.0
    5376
    bilateral, concomitant or delayed
     
    100.0
    5381
    Lumbar, unilateral
     
    55.0
    5382
    bilateral
     
    75.0
    5385
    Splanchnicectomy (Peet type) unilateral
     
    65.0
    5386
    bilateral
     
    80.0
    5390
    Presacral neurectomy, hypogastric plexus
     
    50.0
    Eyeball
    Incision
    5420
    Goniotomy
     
    50.0
    Excision
    5421
    Enucleation of eyeball with or without sphere implant
     
    40.0
    5422
    with integrated implant
     
    50.0
    5424
    Secondary implantation of integrated implant
     
    60.0
    5427
    Evisceration of eyeball
     
    40.0
    5428
    with implantation in scleral shell
     
    50.0
    5431
    Suture of eyeball for wound or injury
     
    by report
    Cornea
    Incision
    5441
    Keratotomy, any type
     
    10.0
    5443
    Paracentesis of cornea
     
    10.0
    5445
    Removal of foreign body from surface of cornea
     
    2.0
    5448
    under slit lamp
     
    3.0
    Excision
    5451
    Keratectomy, partial
     
    30.0
    5452
    complete
     
    40.0
    5457
    Pterygium
     
    25.0
    Introduction
    5461
    Tattoo of cornea, mechanical or chemical
     
    30.0
    5465
    Curettage and cauterization of corneal ulcer
     
    5.0
    5466
    Iontophoresis of corneal ulcer
     
    5.0
    Repair
    5471
    Keratoplasty, (corneal transplant) lamellar
     
    100.0
    5472
    partial or complete, penetrating
     
    110.0
    Suture
    5481
    Suture of perforated cornea
     
    by 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, posterior
     
    30.0
    5496
    Aspiration of anterior chamber, diagnostic
     
    4.0
    Excision
    5501
    Sclerectomy for glaucoma, with scissors, punch or trephination
     
    60.0
    5503
    Scleral resection
     
    100.0
    Introduction
    5511
    Irrigation and/or air injection into anterior chamber
     
    15.0
    Suture
    5521
    Suture of sclera for wound or injury
     
    by report
    Iris and Ciliary Body
    Incision
    5531
    Iridotomy
     
    20.0
    5532
    with transfixion of iris; iris bombe
     
    20.0
    5534
    Iridotomy—performed with photocoagulator
     
    10.0
    Excision
    5541
    Excision of lesion of iris
     
    60.0
    5542
    and/or ciliary body (iridocylectomy)
     
    80.0
    5544
    Iridectomy; basal, optical or preliminary
     
    50.0
    5546
    peripheral
     
    50.0
    Repair
    5552
    Iridodialysis
     
    40.0
    5561
    Repair of prolapsed iris with suture of perforated sclera or cornea
     
    by report
    Manipulation
    5571
    Iridenclesis or comparable procedure
     
    50.0
    Destruction
    5580
    Diathermy of the ciliary body; cyclodiathermy
     
    30.0
    5582
    Cyclodialysis
     
    50.0
    Crystalline Lens
    Incision
    5601
    Discission (needling of lens), initial
     
    20.0
    5602
    subsequent
     
    10.0
    5603
    Aspiration of lens material for congenital cataract, one or more stages
     
    60.0
    Excision
    5611
    Extraction of lens, intracapsular, extracapsular or linear, unilateral
     
    80.0
    5616
    Removal of dislocated lens
     
    80.0
    Vitreous
    Introduction
    5622
    Transplantation of vitreous
     
    50.0
    Retina
    Repair
    5630
    Reattachment of retina, electrocoagulation, scleral resection, buckling or partial tubing
     
    100.0
    5631
    encircling tube, initial
     
    100.0
    5632
    subsequent
     
    by report
    5633
    Removal of encirclng tube
     
    40.0
    5634
    Reattachment of retina, light coagulation of retinal break(s), one or more stages during same period of hospitalization
     
    40.0
    5635
    with drainage of subretinal fluid
     
    50.0
    5636
    Light coagulation of retina for tumor, Eales disease, etc., initial
     
    40.0
    5637
    subsequent
     
    20.0
    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 stage
     
    60.0
    5647
    Muscle transplant (Hummelscheim type, etc.
     
    70.0
    Orbit
    Incision
    5651
    Orbitomy with exploration
     
    60.0
    5652
    with drainage of intraorbital abscess
     
    60.0
    5653
    with removal of intraorbital foreign body
     
    60.0
    5662
    Excision of benign lesion of orbit, requiring bone flap
     
    90.0
    5664
    Exenteration or evisceration of orbital contents with or without graft
     
    60.0
    5665
    including orbital bone
     
    by report
    Introduction
    5671
    Orbital injection of alcohol for hemorrhagic glaucoma or intractable pain
     
    10.0
    Repair
    (For plastic repair of orbit, see 0260–0324, 0619–0621.)
    Eyelids
    Incision
    5691
    Blepharotomy with drainage of abscess of eyelid
     
    2.0
    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), single
     
    5.0
    5703
    multiple, same lid
     
    6.0
    5704
    multiple, different lids
     
    7.0
    (For excision of lesion of eyelid, malignant, see 0194–0197, 0260-0324.)
    5712
    Epilation, electrolysis
     
    4.0
    (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, unilateral
     
    60.0
    5728
    fascia sling method
     
    40.0
    5729
    lid suture method
     
    25.0
    5730
    Cautery puncture for entropion or ectropion
     
    5.0
    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 conjunctiva
     
    1.0
    5742
    embedded in conjunctiva
     
    2.0
    5743
    Suture of conjunctiva
     
    5.0
    Excision
    5751
    Biopsy of conjunctiva
     
    5.0
    5753
    Excision of lesion of conjunctiva,
    e.g.,
    cyst
     
    5.0
    (For epithelioma, see 0175–0196, 0261–0269.)
    For nevus see 0175–0196, 0261–0269.)
    Repair
    5760
    Conjunctivoplasty, free graft using conjunctiva
     
    50.0
    5762
    using buccal mucous membrane
     
    60.0
    5774
    Flap operation of corneal ulcer
     
    20.0
    5775
    Flap operation: "flapping" of conjunctiva for perforating injuries or operative wound
     
    20.0
    (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 tumor
     
    60.0
    Introduction
    5821
    Catheterization of nasolacrimal duct with implantation of tube or stent
     
    10.0
    5823
    Injection procedure for dacryocystography
     
    3.0
    Repair
    5831
    Plastic operation on canaliculi
     
    by report
    5833
    Dacryocystorrhinostomy: fistulization of lacrimal sac into nasal cavity, with or without anterior ethmoidectomy
     
    70.0
    5835
    Closure of punctum by cautery
     
    4.0
    Manipulation
    5841
    Dilation of punctum
     
    2.0
    5843
    Probing of nasolocrimal duct
     
    3.0
    5846
    Probing and/or irrigation of canaliculus
     
    *2.0
    EAR
    External Ear
    Incision
    5901
    Drainage of abscess or hematoma of auricle, simple
     
    2.0
    5902
    complicated, including suppurative chondritis
     
    by report
    5905
    Drainage of abscess of external auditory canal
     
    2.0
    Excision
    5911
    Biopsy of ear
     
    3.0
    (For local destruction or excision of lesion of ear, see 0175–0197.)
    (For plastic closure see 0260–0324.)
    5916
    Excision; ear, partial, simple repair
     
    10.0
    5917
    Complete amputation, auricle
     
    20.0
    5920
    Excision; osteoma, external canal, simple
     
    5.0
    5923
    Excision of exostosis of external auditory canal, endaural or post–aural approach, complicated
     
    50.0
    5924
    Radical excision of malignant lesion of external auditory canal
     
    by report
    5926
    with neck dissection
     
    by report
    Endoscopy
    5931
    Otoscopy with removal of foreign body in external auditory canal
     
    2.0
    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, unilateral
     
    50.0
    5948
    bilateral
     
    70.0
    5949
    Reconstruct external auditory canal for congenital astresia, single stage
     
    100.0
    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 bilateral
     
    1.5
    Incision
    5961
    Myringotomy; tympanotomy; plicotomy, with or without Eustachian inflation and/or aspiration
     
    3.0
    5962
    Tympanotomy, diagnostic, exploratory for middle ear exposure
     
    50.0
    5963
    with insertion of tube for serous otitis media, unilateral
     
    5.0
    5964
    with insertion of collar button tube for muco–serous otitis media, unilateral or bilateral
     
    25.0
    5968
    Tympanolysis, transtympanic
     
    80.0
    Excision
    5971
    Mastoidectomy, simple
     
    50.0
    5972
    Mastoidectomy, modified radical or radical, without skin graft
     
    80.0
    5975
    with skin graft
     
    90.0
    5980
    Petrous apicectomy including radical mastoidectomy
     
    by report
    5982
    Removal of middle ear polyp
     
    10.0
    Repair
    5990
    Revision of radical mastoidectomy, with or without skin graft
     
    90.0
    5991
    Patching tympanic membrane, with or without cauterization
     
    2.0
    5992
    Myringoplasty, uncomplicated
     
    80.0
    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 approach
     
    100.0
    5994
    Typanoplasty with mastoidectomy
     
    120.0
    5996
    Incudo–stapedial arthrodesis, with or without graft
     
    70.0
    5997
    Stapes mobilization, primary or secondary
     
    70.0
    5998
    Stapedectomy with insertion of prosthetic stapes with fenestration of the oval window
     
    100.0
    5999
    Mastoid obliteration
     
    80.0
    Suture
    6001
    Closure of fistula, mastoid (independent procedure)
     
    25.0
    6002
    Decompression, intratemporal, facial nerve, with or without neurolysis
     
    100.0
    (See also 5330.)
    6003
    Suture and/or graft, facial nerve, intratemporal
     
    120.0
    Internal Ear
    Incision
    6011
    Labyrinthotomy, any type
     
    100.0
    6012
    Fenestration of semicircular canal
     
    100.0
    6014
    Revision of fenestration operation
     
    60.0
    Excision
    6021
    Labyrinthectomy
     
    100.0

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.).