Cnss Medical Acts

2014 - 03 - 21 -
Code Description NSSF Coverage K App

Regional IV administration of local anesthetic agent to upper or lower
1995 15 0
extremity
1996 Daily hospital management of epidural or subarachnoid drug administration 10 0
1997 Daily hospital management of IV controlled analgesia 7 0

1998 Monitored care, with or without sedation, in a non-surgical procedure 12 0
10040 Acne surgery 10 0
Incision and drainage of abscess, hematoma, seroma, fluid collection, or
10060 10 0
pilonidal cyst
10080 Incision and drainage of pilonidal cyst 10 0
10120 Incision and removal of foreign body, subcutaneous tissues 10 0
11044 Debridement: skin, subcutaneous tissue, muscle, and/or bone 15 0
Biopsy of skin, subcutaneous tissue and/or mucous membrane, with or
11100 15 0
without closure (separate procedure)
11200 Removal of skin tags, multiple fibrocutaneous tags, any area: up to 10 tags 10 0
11300 Shaving of epidermal or superficial dermal lesions: 1 to 2 lesions 5 0

Excision, benign lesion (unless listed elsewhere) except face, ears, eyelids,
11400 nose, lips, mucous membranes, with or without closure (separate 15 0
procedure)
Excision, benign lesion (unless listed elsewhere) face, ears, eyelids, nose,
11440 20 0
lips, mucous membranes, with or without closure (separate procedure)
11450 Excision of skin and subcutaneous tissue for hidradenitis 20 0

Excision, malignant lesion, except face, ears, eyelids, nose, lips, mucous
11600 25 0
membrane, with simple repair
Excision, malignant lesion, face, ears, eyelids, nose, lips, mucous membrane,
11646 30 0
with simple repair
11752 Excision of nail and nail matrix, partial or complete 15 0
11770 Excision of pilonidal cyst or sinus 40 0
11900 Injection, intralesional, up to and including seven 10 0
11920 Tattooing, intradermal 20 0
11950 Subcutaneous injection of filling material eg collagen 25 0
Insertion of tissue expander(s) for other than breast, including subsequent
11960 40 0
expansion
11971 Removal of tissue expander(s) without insertion of prosthesis 10 0
12001 Simple repair of wounds of skin 20 0
12046 Intermediate repair (layer closure) of wounds of skin 30 0
13101 Complex repair of wounds of skin 35 0
Secondary closure of surgical wound or dehiscence extensive or
13160 60 0
complicated
14000 Adjacent tissue transfer or rearrangement: defect up to 10 sq cm 50 0
14001 Adjacent tissue transfer or rearrangement: defect 11 to 30 sq cm 55 0
14300 Adjacent tissue transfer or rearrangement: defect more than 30 sq cm 65 0
14350 Filleted finger or toe flap, including preparation of recipient site 55 0
Excisional preparation/creation of recipient site by excision of intact skin,
15000 including subcutaneous tissues, scar, etc prior to repair with free skin graft 15 0
(list separately in addition to skin graft)
Split graft, trunk, scalp, arms, legs, hands, and/or feet: 100 sq cm or less, or
15100 50 0
each 1% of body area of infants and children
Split graft, face, eyelids, mouth, neck, ears, orbits, genitalia, and/or multiple
15120 55 0
digits: 100 sq cm or less, or each 1% of body area of infants and children
Split graft, each additional 100 sq cm or 1% of body area of infants and

15121 20 0
children, add
Full thickness graft, free, including direct closure of donor site, other than
15200 50 0
nose, ears, eyelids, and/or lips: up to 20 sq cm
Full thickness graft, free, including direct closure of donor site, other than
15201 20 0
nose, ears, eyelids, and/or lips:each additional 20 sq cm
Full thickness graft, free, including direct closure of donor site, nose, ears,
15260 55 0
eyelids, and/or lips: up to 20 sq cm
Full thickness graft, free, including direct closure of donor site, nose ears,
15261 20 0
eyelids, and/or lips: each additional 20 sq cm
15350 Application of allograft, or xenograft, skin 30 0
15570 Formation of direct or tubed pedicle, first stage 35 0
15580 Cross finger flap, including free graft to donor site 45 0
15650 Transfer of any tubed pedicle flap, any location (second stage) 25 0
15732 Muscle, myocutaneous, or fasciocutaneous flap 80 0
15740 Flap: island pedicle 70 0
15750 Flap: neurovascular pedicle 75 0
15755 Free flap (microvascular transfer) (two surgical teams procedure) 200 0
Graft: composite graft (full thickness of external ear or nasal ala), including
15760 60 0
primary closure
15770 Graft: derma-fat fascia 60 0
15780 Dermabrasion: total face 50 0
15781 Dermabrasion: regional face or elsewhere 30 0
15786 Abrasion: single lesion (eg, keratosis, scar) 10 0
15790 Chemical peel: total face 40 0
15791 Chemical peel: regional, face, hand, or elsewhere 40 0
15819 Cervicoplasty 55 0
15820 Blepharoplasty 40 0
15824 Rhytidectomy: 70 0
15831 Excision, excessive skin and subcutaneous tissue (including lipectomy) 70 0
Graft for facial nerve paralysis: free muscle graft by microsurgical technique,
15842 225 0
includes obtaining graft (two surgical teams procedure)
15845 Graft for facial nerve paralysis: regional muscle transfer or fascia graft 80 0
15850 Removal of sutures under anesthesia 15 0
15876 Suction assisted lipectomy: head and neck 90 0
15877 Suction assisted lipectomy: trunk 70 0
15878 Suction assisted lipectomy: upper extremity 60 0
15879 Suction assisted lipectomy: lower extremity 90 0
15920 Excision decubitus ulcer, coccygeal, with coccygectomy: with primary suture 50 0
15922 Excision decubitus ulcer, coccygeal, with coccygectomy: with flap closure 60 0
Excision decubitus ulcer, sacral, ischial, or trochanteric, with or without

15933 60 0
ostectomy
16000 Initial treatment, first degree burn, requiring only local treatment 5 0
Dressings and/or debridement, initial or subsequent: under general
16010 15 0
anesthesia, up to 9% of total body surface area
Dressings and/or debridement, initial or subsequent: under general
16015 40 0
anesthesia, face or hand, or over 9% of total body surface area
Dressings and/or debridement, initial or subsequent: without anesthesia, up
16025 15 0
to 9% of total body surface area
Dressings and/or debridement, initial or subsequent: without anesthesia,
16030 30 0
face or hand, or over 9% of total body surface area
Excision of burn wound, without skin grafting, employing alloplastic
16041 20 0
dressing, any anatomic site: up to 9% of total body surface area
Excision of burn wound, without skin grafting, employing alloplastic
16042 45 0
dressing, any anatomic site: over 9% of total body surface area
Destruction by any method, with or without surgical curettement, of benign
17000 facial, or benign premalignant lesions (not cutaneous vascular proliferative 10 0
lesions) in any location: up to 3 lesions
Destruction of cutaneous vascular proliferative lesions (eg, laser technique):
17106 15 0
up to 5 sq cm
17107 25 0
5 to 15 sq cm
17108 35 0
15 to 50 sq cm
17304 Chemosurgery (Mohs type technique) malignancies of skin 50 0
17340 Cryotherapy (CO2 slush, liquid nitrogen), per session 10 0
17360 Chemical exfoliation for acne (acne paste, acid, etc..) 10 0
17380 Electrolysis epilation, each half hour 10 0
19000 Puncture aspiration of cyst of breast, office procedure 5 0
19020 Mastotomy with exploration and drainage of abscess, deep 20 0
19030 Injection procedure only for mammary ductogram or galactogram 10 0
19100 Biopsy of breast: needle aspiration (separate procedure) 10 0
19101 Biopsy of breast: incisional (separate procedure) 30 0
19140 Mastectomy for gynecomastia 40 0
19160 Mastectomy, partial, for excision of cyst or tumor 40 0
19162 Mastectomy, partial: with axillary lymphadenectomy 100 0
19180 Mastectomy, simple, complete 60 0
19200 Mastectomy, radical, including pectoral muscles, axillary lymph nodes 100 0
Mastectomy, modified radical, including axillary lymph nodes with or

19240 100 0
without pectoralis minor muscle, but excluding pectoralis major muscle
19260 Excision of chest wall tumor involving ribs 100 0

Excision of chest wall tumor involving ribs, with plastic reconstruction: with
19272 135 0
or without mediastinal lymphadenectomy
19290 Preoperative placement of needle localization wire: breast, each lesion 10 0
19316 Mastopexy 70 0
19318 Reduction mammaplasty 70 0
19324 Mammaplasty, augmentation: without prosthetic implant 50 0
19328 Removal of mammary implant (intact implant or implant material) 50 0
Immediate insertion of breast prosthesis following mastopexy, mastectomy
19340 45 0
or in reconstruction
Delayed insertion of breast prosthesis following mastopexy, mastectomy or
19342 70 0
in reconstruction
19350 Nipple/areola reconstruction or correction of inverted nipples 50 0
Breast reconstruction, immediate or delayed, with tissue expander,
19357 105 0
including subsequent expansion
Breast reconstruction with latissimus dorsi flap, with or without prosthetic
19361 110 0
[mplant
19364 Breast reconstruction with free flap 170 0
Breast reconstruction with transverse rectus abdominis flap (TRAM),
19367 including closure of donor site, single or double pedicle, with or without 165 0
microvascular anastomosis
19370 Open periprosthetic capsulotomy or capsulectomy, breast 50 0
19380 Revision of reconstructed breast 55 0
20000 Incision of soft tissue abscess (eg, secondary to osteomyelitis) 15 0
20200 Biopsy, muscle, superficial 15 0
20205 Biopsy, muscle, deep 25 0
20206 Biopsy, muscle: percutaneous needle 10 0
Biopsy, bone, trocar or needle: superficial (eg, ilium, sternum, spinous
20220 10 0
process, ribs)
20225 Biopsy, bone, trocar or needle: deep (vertebral body, femur) 15 0
20240 Biopsy, bone, excisional (e.g.ilium, sternum, spinous process, rib, etc.) 15 0
20250 Biopsy, vertebral body, open: posterior approach 40 0

20251 Biopsy, vertebral body, open: anterior approach 80 0
20500 Injection of sinus tract: diagnostic or therapeutic (separate procedure) 10 0
20520 Removal of foreign body in muscle or tendon sheath: simple 15 0
20525 Removal of foreign body in muscle or tendon sheath: deep or complicated 30 0
20550 Injection, tendon sheath, ligament, trigger points or ganglion cyst 10 0

20600 Arthrocentesis, aspiration and/or injection 10 0
20615 Aspiration and injection for treatment of bone cyst 15 0
Insertion of wire or pin with application of skeletal traction, including
20650 15 0
removal (separate procedure)
Application of cranial tongs, caliper, or stereotactic frame, including
20660 15 0
20661 Application of halo, including removal 30 0
20665 Removal of tongs or halo applied by another physician 10 0
Application of a uniplane (pins or wires in one plane), unilateral, external
20690 fixation system(list in addition to code for treatment of closed or open 30 0
fracture)
Application of a multiplane (pins or wires in more than one plane),
20692 unilateral, external fixation system (eg, Ilizarov,Monticelli type) (list in 45 0
addition to code for fracture)
Adjustment or revision of external fixation system requiring anesthesia (eg,
20693 30 0
new pin(s) or wire(s), and/or new ring(s) or bar(s))
20694 Removal of external fixation system 20 0
20802 Replantation, arm 300 0
20805 Replantation, forearm 310 0
20808 Replantation, hand 320 0
20816 Replantation, digit , excluding thumb, complete amputation 165 0
20822 Replantation , digit, excluding thumb, incomplete amputation 135 0
20824 Replantation, thumb 190 0
20838 Replantation, leg or foot 300 0
20900 Bone graft, any donor area 35 0
20910 Cartilage graft 40 0
20920 Fascia lata graft 35 0
20924 Tendon graft, from a distance (eg, palmaris, toe extensor, plantaris) 40 0
Monitoring of interstitial fluid pressure (includes insertion of device) in
20950 10 0
detection of muscle compartment syndrome
20955 Bone graft with microvascular anastomosis 180 0
20969 Free osteocutaneous flap with microvascular anastomosis 180 0
Electrical stimulation to aid bone healing: non-invasive (non-operative) (list

20974 5 0
in additon to code for bony procedure, when applicable)
Electrical stimulation to aid bone healing: invasive (operative) (list in

20975 15 0
addition to code for appropriate bony procedure, when applicable)
Radical resection of tumor (eg, malignant neoplasm) of soft tissues of face
21015 35 0
or scalp
Excision of bone (eg, for osteomyelitis or bone abscess): mandible or facial
21025 55 0
bone(s)
21029 Removal by contouring of benign tumor of facial bone (eg, fibrous dysplasia) 50 0
21030 Excision of benign tumor or cyst of facial bone other than mandible 50 0
21031 Excision of torus mandibularis 15 0
21032 Excision of maxillary torus palatinus 30 0
21034 Excision of malignant tumor of facial bone other than mandible 105 0
21040 Excision of benign cyst or tumor of mandible: simple 15 0
21041 Excision of benign cyst or tumor of mandible: complex 40 0
21044 Excision of malignant tumor of mandible 75 0
21045 Excision of malignant tumor of mandible: radical resection 105 0
21050 Condylectomy, temporomandibular joint (separate procedure) 70 0
Meniscectomy, partial or complete, temporomandibular joint (separate
21060 75 0
procedure)
21070 Coronoidectomy (separate procedure) 60 0
Application of halo type appliance for maxillo-facial fixation, etc..includes
21100 25 0
Application of interdental fixation device for conditions other than fracture
21110 35 0
or dislocation, includes removal
21116 Injection procedure for temporomandibular joint arthrography 5 0
21120 Genioplasty: augmentation (autograft, allograft, prosthetic material) 45 0
21121 Genioplasty: sliding osteotomy, single piece 50 0
Genioplasty: sliding osteotomies, two or more osteotomies (eg, wedge
21122 55 0
excision or bone wedge reversal for asymmetrical chin)
Genioplasty: sliding, augmentation with interpositional bone grafts (includes
21123 75 0
obtaining autografts)
21125 Augmentation, mandibular body or angle: prosthetic material 50 0
Augmentation, mandibular body or angle: with bone graft, onlay or
21127 70 0
interpositional (includes obtaining autograft), unilateral
Reduction forehead: contouring and/or application of prosthetic material or
21138 100 0
bone graft (includes obtaining autograft)
21139 Reduction forehead: contouring and setback of anterior frontal sinus wall 140 0
Reconstruction midface, LeFort I: intrusion, single piece (eg, for Long Face
21141 140 0
Syndrome)
Reconstruction midface, LeFort I: single piece, segment movement in any
21145 180 0
direction, requiring bone grafts (includes obtaining autografts)
Reconstruction midface, LeFort I: three or more pieces, segment movement

21147 in any direction, requiring bone grafts (includes obtaining autografts) (eg, 220 0
ungrafted bilateral alveolar cleft or multiple osteotomies)
Reconstruction midface, LeFort II: anterior intrusion (eg, Treacher-Collins

21150 210 0
Syndrome)
Reconstruction midface, LeFort II: any direction, requiring bone grafts
21151 280 0
(includes obtaining autografts)
Reconstruction midface, LeFort III (extracranial), any type, requiring bone
21154 190 0
grafts (includes obtaining autografts): without LeFort I
Reconstruction midface, LeFort III (extracranial), any type, requiring bone
21155 240 0
grafts (includes obtaining autografts): with LeFort I
Reconstruction midface, LeFort III (extra and intracranial) with forehead
21159 advancement (eg, mono bloc), requiring bone grafts (includes obtaining 270 0
autografts): without LeFort I
Reconstruction superior-lateral orbital rim and lower forehead,
21172 advancement or alteration, with or without grafts (includes obtaining 210 0
autografts)
Reconstruction, bifrontal, superior-lateral orbital rims and lower forehead,
21175 advancement or alteration, with or without grafts (includes obtaining 240 0
autografts)
Reconstruction, entire or majority of forehead and/or supraorbital rims:
21179 240 0
with grafts (allograft or prosthetic material)
Reconstruction, entire or majority of forehead and/or supraorbital rims:
21180 280 0
with autograft (includes obtaining grafts)
Removal by contouring of benign tumor of cranial bones (eg, fibrous
21181 180 0
dysplasia), extracranial
Reconstruction of orbital walls, rims, forehead, nasoethmoid complex
21182 following intra-/extra-cranial excision of benign tumor of cranial bone, with 240 0
multiple autografts: graft area less than 40 cm2
Reconstruction of orbital walls, rims, forehead, nasoethmoid complex
21183 following intra-/extra-cranial excision of benign tumor of cranial bone, with 280 0
multiple autografts
Reconstruction midface, osteotomies (other than LeFort type) and bone
21188 180 0
grafts (includes obtaining autografts)
21193 Reconstruction of mandibular ramus, horizontal, vertical, 0 0
21194 Reconstruction of mandibular ramus, horizontal, vertical, 0 0
Reconstruction of mandibular ramus, sagittal split: without internal rigid
21195 90 0
fixation
Reconstruction of mandibular ramus, sagittal split: with internal rigid
21196 105 0
fixation
21198 Osteotomy, mandible or maxilla, segmental 140 0
Osteoplasty, facial bones: augmentation (autograft, allograft or prosthetic
21208 75 0
implant)
21209 Osteoplasty, facial bones: reduction 50 0
21210 Graft, bone: nasal, maxillary or malar areas (includes obtaining graft) 75 0
21215 Graft, bone: mandible (includes obtaining graft) 75 0
Graft: rib cartilage, autogenous, to face, nose or ear (includes obtaining
21230 105 0
graft)
21235 Graft: ear cartilage, autograft, to nose or ear (includes obtainig graft) 75 0
Arthroplasty, temporomandibular joint, with or without autograft (includes
21240 105 0
obtaining graft)
21242 Arthroplasty, temporomandibular joint, with allograft 85 0
21243 Arthroplasty, temporomandibular joint, with prosthetic joint replacement 115 0
Reconstruction of mandible, extraoral, with transosteal bone plate (eg,

21244 75 0
mandibular staple bone plate)
21245 Reconstruction of mandible or maxilla, subperiosteal implant 75 0
Reconstruction of mandibular condyle with bone and cartilage autografts
21247 140 0
(includes obtaining grafts) (eg, for hemifacial microsomia)
Reconstruction of mandible or maxilla, endosteal implant (eg, blade,
21248 75 0
cylinder): partial
Reconstruction of mandible or maxilla, endosteal implant (eg, blade,
21249 120 0
cylinder): complete
Reconstruction of zygomatic arch and glenoid fossa with bone and cartilage
21255 105 0
(includes obtaining autografts)
Reconstruction of orbit with osteotomies (extracranial) and with bone grafts
21256 105 0
(includes obtaining autografts) (eg, microphthalmia)
Periorbital osteotomies for orbital hypertelorism, with bone grafts:
21260 105 0
extracranial approach
Periorbital osteotomies for orbital hypertelorism, with bone grafts: any
21261 180 0
method
Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts:
21267 115 0
extracranial approach
Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts:
21268 150 0
combined intra- and extra-cranial approach
21270 Malar augmentation, prosthetic material 75 0
21275 Secondary revision of orbitocranial reconstruction 75 0
21280 Medial canthopexy (separate procdure) 40 0
21282 Lateral canthopexy 30 0
Reduction of masseter muscle and bone (eg, for treatment of benign
21295 10 0
masseteric hypertrophy): extraoral approach
Reduction of masseter muscle and bone (eg, for treatment of benign
21296 30 0
masseteric hypertrophy): intraoral approach
Closed treatment, nasal bone or septum fracture: with or without
21315 20 0
stabilization
Open treatment of nasal fracture: with internal and/or external skeletal

21335 50 0
fixation, with or without concomitant open treatment of fractured septum
21338 Open treatment of nasoethmoid fracture: with or without external fixation 50 0
Treatment of nasoethmoid complex fracture, with splint, wire, or headcap

21340 75 0
fixation, including repair of canthal ligaments and/or nasolacrimal apparatus
21343 Open treatment of depressed frontal sinus fracture 80 0
Open treatment of complicated (eg, comminuted or involving posterior

21344 110 0
wall) frontal sinus fracture, via coronal or multiple approaches
Closed treatment of nasomaxillary complex fracture (LeFort II type), with

21345 55 0
interdental wire fixation or fixation of denture or splint
Open treatment of nasomaxillary complex fracture (LeFort II type): with
21346 75 0
wiring and/or local fixation
Open treatment of nasomaxillary complex fracture (LeFort II type): requiring

21347 80 0
multiple open approaches or bone grafting (includes obtaining graft)
Percutaneous treatment of fracture of malar area, including zygomatic arch

21355 30 0
and malar tripod, with manipulation
21356 Open treatment of depressed zygomatic arch fracture (eg, Gilles approach) 30 0
Open treatment of depressed malar fracture, including zygomatic arch and

21360 50 0
malar tripod
Open treatment of complicated fractures of malar area, including zygomatic
21365 arch and malar tripod: with internal skeletal fixation and with multiple 80 0
surgical approaches
Open treatment of complicated (eg, comminuted or involving cranial nerve
21366 foramina) fracture(s) of malar area, including zygomatic arch and malar 90 0
tripod: with bone grafting (includes obtaining graft)
Open treatment of orbital floor blowout fracture:periorbital approach with
21390 60 0
or without alloplastic or other implant
Open treatment of orbital floor blowout fracture:periorbital approach with
21395 75 0
bone graft (includes obtaining graft)
21401 Closed treatment of fracture of orbit, except blowout with manipulation 20 0
21406 Open treatment of fracture of orbit, exceptbloout without implant 45 0
21407 Open treatment of fracture of orbit, except blowout with implant or graft 55 0
Closed treatment of palatal or maxillary fracture (LeFort I type): with

21421 35 0
interdental wire fixation or fixation of denture or splint
21422 Open treatment of palatal or alveolar ridge fractures (LeFort I type) 55 0
Open treatment of palatal or maxillary fracture (LeFort I type): complicated

21423 60 0
(comminuted or involving cranial nerve foramina), multiple approaches
Closed treatment of craniofacial separation (LeFort III type) using

21431 45 0
interdental wire fixation of denture or splint
Open treatment of craniofacial separation (LeFort III type): with wiring
21432 55 0
and/or internal fixation
Open treatment of craniofacial separation (LeFort III type): complicated (eg,
21433 comminuted or involving cranial nerve foramina, multiple surgical 180 0
approaches)
Open treatment of craniofacial separation (LeFort III type): complicated,
21436 multiple surgical approaches, with internal fixation, and bone graft 135 0
(includes obtaining graft)
Open treatment of mandibular or maxillary alveolar ridge fracture (separate
21445 35 0
procedure)
Closed treatment of mandibular fracture: with manipulation and internal
21451 30 0
fixation
Percutaneous treatment of mandibular fracture: with external or
21452 15 0
interdental fixation
21454 Open treatment of mandibular fracture with external fixation 40 0
Open treatment of closed or open mandibular fracture: with or without
21462 60 0
interdental fixation
21465 Open treatment of mandibular condylar fracture 65 0
Open treatment of complicated mandibular fracture by multiple surgical
21470 approaches, including internal fixation, interdental fixation, and/or wiring of 100 0
dentures or splints
21480 Closed treatment of temporomandibular dislocation, initial or subsequent 5 0
Closed treatment of temporomandibular dislocation, complicated (eg,

21485 20 0
recurrent requiring intermaxillary fixation or splinting)
21490 Open treatment of temporomandibular dislocation 40 0
21493 Closed treatment of hyoid fracture: without manipulation 10 0
21494 Closed treatment of hyoid fracture: with manipulation 30 0
21495 Open treatment of hyoid fracture 30 0
21497 Interdental wiring for condition other than fracture 25 0
Incision and drainage of deep abscess or hematoma of soft tissues of neck
21501 30 0
or thorax
Incision and drainage, deep abscess or hematoma, soft tissues of neck or
21502 35 0
thorax: with partial rib ostectomy
Incision, deep, with opening of bone cortex (eg, for osteomyelitis or bone
21510 35 0
abscess), thorax
21550 Biopsy, soft tissue of neck or thorax 15 0
21555 Excision of tumor, soft tissue of neck or thorax: subcutaneous 15 0
Excision of tumor of soft tissue of neck or thorax: deep, subfascial, or
21556 30 0
intramuscular
Radical resection of tumor (eg, malignant neoplasm) of soft tissue of neck or
21557 75 0
thorax
21600 Excision of rib, partial 35 0
21610 Costotransversectomy (separate procedure) 45 0
Excision first and/or cervical rib for outlet compression syndrome or other
21616 75 0
cause: with or without sympathectomy
21620 Ostectomy of sternum, partial 35 0
21627 Sternal debridement 30 0
21630 Radical resection of sternum: for tumor or osteomyelitis 80 0
21632 Radical resection of sternum: with mediastinal lymphadenectomy 115 0
21700 Division of scalenus anticus: without resection of cervical rib 35 0
21705 Division of scalenus anticus: with resection of cervical rib 65 0
Division of sternocleidomastoid for torticollis, open operation: with or
21720 35 0
without cast application
21740 Reconstructive repair of pectus excavatum or carinatum 85 0
Closure of sternotomy separation with or without debridement (separate
21750 75 0
procedure)
21805 Open treatment of rib fracture: without fixation, each 15 0
21810 Treatment of rib fracture: requiring external fixation (flail chest) 35 0
21825 Open treatment of sternum fracture with or without skeletal fixation 35 0
21920 Biopsy, soft tissue of back or flank 25 0
21930 Excision, tumor, soft tissue of back or flank 40 0
Radical resection of tumor (eg, malignant neoplasm) of soft tissues of back
21935 110 0
or flank
Partial resection of posterior vertebral component (spinous processes,
22100 lamina or facet) for intrinsic bony lesion, single vertebral segment: cervical, 50 0
thoracic or lumbar
Partial resection of posterior vertebral component (spinous process, lamina
or facet) for intrinsic bony lesion: cervical, thoracic or lumbar, each
22103 20 0
additional segment (list separately in addition to code for primary
procedure)
Partial excision of vertebral body, for intrinsic bony lesion, without
22110 decompression of spinal cord or nerve root(s), single vertebral segment: 80 0
cervical, thoracic, or lumbar
Partial excision of vertebral body, for intrinsic bony lesion, without
decompression of spinal cord or nerve root)s): cervical, thoracic or lumbar,
22116 20 0
each additional segment (list separately in addition to code for primary
procedure)
Osteotomy of spine, posterior or anterior approach, for correction of
22210 165 0
deformity, single segment: cervical, thoracic or lumbar
Osteotomy of spine, posterior or anterior approach, for correction of
22226 deformity, each additional segment (list separately in addition to code for 50 0
primary procedure)
22305 Closed treatment of vertebral process fracture, one or more 15 0
Closed treatment of vertebral body fracture, one or more, without
22310 15 0
manipulation
Closed treatment of vertebral body fracture and/or dislocation, with or
22315 50 0
without anesthesia, by manipulation or traction, each
Open treatment of vertebral fracture and/or dislocation: cervical, thoracic
22326 140 0
or lumbar, each
22505 Spine manipulation requiring anesthesia, any region 15 0
Arthrodesis, anterior transoral or extraoral technique, clivus-C1-C2 (atlas-
22548 axis), with bone graft, with or without excision of odontoid process 140 0
(separate procedure)
Arthrodesis, anterior interbody technique: cervical below C2, with bone
22554 120 0
graft (separate procedure)
Arthrodesis, anterior interbody technique: thoracic, with local bone (eg, rib)
22556 150 0
and/or bone allograft (separate procedure)
Arthrodesis, anterior interbody technique: lumbar, with bone graft
22558 150 0
Arthrodesis, anterior or anterolateral, each additional interspace (list
22585 40 0
separately in addition to single level arthrodesis)
Arthrodesis, posterior technique, craniocervical,atlas-axis or cervical below

22590 130 0
C2, with bone graft and/or internal fixation (separate procedure)
Arthrodesis, posterior or posterolateral technique, with local bone or bone

22610 135 0
allograft and/or internal fixation: thoracic or lumbar (separate procedure)
Arthrodesis, lateral transverse process technique, with local bone or bone

22625 150 0
allograft and/or internal wire fixation, lumbar (separate procedure)
Arthrodesis, posterior interbody technique, with local bone or bone

22630 150 0
allograft and/or internal wire fixation, lumbar (separate procedure)
Arthrodesis, posterior, posterolateral or lateral transverse process
22632 technique, each additional interspace (list separately in addition to code for 45 0
single level arthrodesis)
Arthrodesis, posterior, for spinal deformity, with or without cast, with bone
22800 130 0
graft: 6 or less vertebrae
Arthrodesis, posterior, for spinal deformity, with or without cast, with bone
22802 210 0
graft: 7 or more vertebrae
Arthrodesis, anterior, for spinal deformity, with or without cast, with bone
22810 165 0
graft: 4 to 7 vertebrae
Arthrodesis, anterior, for spinal deformity, with or without cast, with bone
22812 190 0
graft: 8 or more vertebrae
22830 Exploration of spinal fusion 50 0
Spinal instrumentation, posterior: without segmental fixation (eg, single
22840 100 0
Harrington rod technique)
Spinal instrumentation, posterior: segmental fixation (eg, pedicle fixation,
22842 200 0
dual rods with multiple hooks and sublaminal wires)
22845 Spinal instrumentation, anterior 160 0
22849 Reinsertion of spinal fixation device 80 0
22855 Removal of anterior or posterior segmental spinal instrumentation 75 0
22900 Excision, abdominal wall tumor, subfascial (eg, desmoid) 35 0
Removal of subdeltoid (or intratendinous) calcareous deposits, open
23000 40 0
method
23020 Capsular contracture release (Sever type procedure) for Erb's palsy 50 0
Incision and drainage, shoulder area: deep abscess or hematoma or infected
23030 20 0
bursa
Incision, deep, with opening of cortex (eg, for osteomyelitis or bone
23035 50 0
abscess), shoulder area
Arthrotomy, glenohumeral joint, for infection, with exploration, drainage or
23040 50 0
removal of foreign body
Arthrotomy, acromioclavicular, sternoclavicular joint, for infection, with
23044 40 0
exploration, drainage or removal of foreign body
23065 Biopsy, soft tissue of shoulder area: superficial 20 0
23066 Biopsy, soft tissue of shoulder area: deep 40 0
23075 Excision, tumor, shoulder area: subcutaneous 20 0
23076 Excision, tumor, shoulder area: deep, subfascial or intramuscular 50 0
Radical resection of tumor (eg, malignant neoplasm) of soft tissues of
23077 95 0
shoulder area
23100 Arthrotomy for biopsy, glenohumeral joint 40 0
Arthrotomy for biopsy or for excision of torn cartilage, acromioclavicular,
23101 40 0
sternoclavicular joint
23105 Arthrotomy for synovectomy: glenohumeral or sternoclavicular joint 50 0
Arthrotomy, glenohumeral joint, with joint exploration, with or without
23107 50 0
removal of loose or foreign body
23120 Claviculectomy: partial or total 55 0
23130 Acromioplasty or acromionectomy, partial 55 0
23140 Excision or curettage of bone cyst or benign tumor of clavicle or scapula 40 0
Excision or curettage of bone cyst or benign tumor of clavicle, scapula or

23145 65 0
proximal humerus: with autograft (includes obtaining graft) or with allograft
Sequestrectomy (eg, for osteomyelitis or bone abscess), humeral head to

23174 40 0
surgical neck, clavicle or scapula
Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg,
23180 40 0
for osteomyelitis), clavicle or scapula
Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg,
23184 60 0
for osteomyelitis), proximal humerus
23190 Ostectomy of scapula, partial 50 0
23200 Radical resection for tumor: clavicle, scapula or proximal humerus 75 0
Radical resection for tumor, proximal humerus: with autograft (includes
23221 130 0
obtaining graft) or with prosthetic replacement
23330 Removal of foreign body, shoulder: subcutaneous 20 0
23331 Removal of foreign body, shoulder: deep (eg, Neer prosthesis removal) 45 0
23332 Removal of foreign body, shoulder: complicated, including total shoulder 65 0
23350 Injection procedure for shoulder arthrography 10 0
23395 Muscle transfer, any type for paralysis of shoulder or upper arm: single 75 0
23397 Muscle transfer, any type for paralysis of shoulder or upper arm: multiple 115 0
23400 Scapulopexy (eg, Sprengel's deformity or for paralysis) 75 0
23406 Tenomyotomy, shoulder area: single or multiple through same incision 55 0
Repair of ruptured supraspinatus tendon (rotator cuff) or musculotendinous

23410 75 0
cuff: acute or chronic
23415 Coracoacromial ligament release, with or without acromioplasty 55 0
Repair of complete shoulder (rotator) cuff avulsion, chronic (includes
23420 85 0
acromioplasty)
23430 Tenodesis for rupture of long tendon of biceps 55 0
Resection or transplantation of long tendon of biceps, for chronic
23440 75 0
tenosynovitis
Capsulorrhaphy for recurrent dislocation of shoulder, anterior or posterior,
23450 85 0
any method, any type
Arthroplasty with glenoid and proximal humeral implant or replacement
23472 130 0
(eg, total shoulder)
23480 Osteotomy, clavicle, without internal fixation 40 0
Osteotomy, clavicle, with internal fixation or bone graft for nonunion or
23485 85 0
malunion (includes obtaining graft and/or necessary fixation)
23505 Closed treatment of clavicular fracture: with manipulation 20 0
Open treatment of clavicular fracture, with or without internal or external
23515 50 0
skeletal fixation
23525 Closed treatment of sternoclavicular dislocation: with manipulation 20 0
Open treatment of sternoclavicular dislocation, acute or chronic: with or
23532 50 0
without fascial graft (includes obtaining graft)
23545 Treatment of closed acromioclavicular dislocation: with manipulation 20 0
Open treatment of closed or open acromioclavicular dislocation, acute or
23550 45 0
chronic, without graft
Open treatment of closed or open acromioclavicular dislocation, acute or
23552 55 0
chronic: with fascial graft (includes obtaining graft)
Closed treatment of scapular fracture: with manipulation, with or without

23575 20 0
skeletal traction (with or without shoulder joint involvement)
Open treatment of scapular fracture (body, glenoid or acromion) with or

23585 60 0
without internal fixation
Closed treatment of proximal humeral (surgical or anatomical neck)
23605 20 0
fracture: with manipulation, with or without skeletal traction
Open treatment of proximal humeral (surgical or anatomical neck) fracture,
23615 with or without internal or external fixation, with/without repair of 75 0
tuberosity(ies)
Open treatment of proximal humeral fracture, with or without internal or
23616 external fixation, with/without repair of tuberosity(ies): with proximal 115 0
humeral prosthetic replacement
23625 Closed treatment of greater tuberosity fracture: with manipulation 20 0
Open treatment of greater tuberosity fracture, with or without internal or
23630 55 0
external fixation
23650 Closed treatment of shoulder dislocation, with manipulation 20 0
23660 Open treatment of acute shoulder dislocation 40 0
Closed treatment of shoulder dislocation, with fracture of greater
23665 20 0
tuberosity, with manipulation
Open treatment of shoulder dislocation, with fracture of greater tuberosity,
23670 75 0
with or without internal or external fixation
Closed treatment of shoulder dislocation, with surgical or anatomical neck
23675 40 0
fracture, with manipulation
Open treatment of shoulder dislocation, with surgical or anatomical neck
23680 65 0
fracture, with or without internal or external fixation
Manipulation under anesthesia, shoulder joint, including application of
23700 20 0
fixation apparatus (dislocation excluded)
Arthrodesis, shoulder joint: with primary autogenous graft (includes
23802 100 0
obtaining graft) or without local bone graft (separate procedure)
23900 Interthoracoscapular (forequarter) amputation of shoulder 115 0
23920 Disarticulation of shoulder 85 0
23921 Disarticulation of shoulder: secondary closure or scar revision 40 0
Incision and drainage, upper arm or elbow area: deep abscess or hematoma
23930 20 0
or infected bursa
23935 40 0
abscess), humerus or elbow
Arthrotomy (capsulotomy), elbow, for infection, with exploration, drainage

24000 35 0
or removal of foreign body or capsular excision for capsular release
24065 Biopsy, soft tissue of upper arm or elbow area: superficial 15 0

24066 Biopsy, soft tissue of upper arm or elbow area: deep 35 0
24075 Excision, tumor, upper arm or elbow area: subcutaneous 35 0
Radical resection of tumor (eg, malignant neoplasm), soft tissue of upper
24077 70 0
arm or elbow area
Arthrotomy, elbow: with joint exploration, with or without synovial biopsy,
24101 35 0
with or without removal of loose or foreign body
24102 Arthrotomy, elbow: for synovectomy 50 0
24105 Excision,olecranon bursa 35 0
24110 Excision or curettage of bone cyst or benign tumor, humerus 60 0
Excision or curettage of bone cyst or benign tumor, humerus: with autograft
24115 75 0
(includes obtaining graft) or with allograft
Excision or curettage of bone cyst or benign tumor of head or neck of radius
24120 70 0
or olecranon process
Excision or curettage of bone cyst or benign tumor of head or neck of radius
24125 or olecranon process: with autograft (includes obtaining graft) or with 50 0
allograft
24130 Excision, radial head 35 0
Sequestrectomy (eg, for osteomyelitis or bone abscess), shaft or distal
24134 50 0
humerus, radial head or neck, or olecranon process
Partial excision (craterization, saucerization or diaphysectomy) of bone (eg,

24140 35 0
for osteomyelitis), humerus, radial head or neck, or olecranon process
24150 Radical resection for tumor, shaft or distal humerus 70 0

Radical resection for tumor, shaft or distal humerus: with autograft
24151 100 0
24152 Radical resection for tumor, radial head or neck 50 0
Radical resection for tumor, radial head or neck: with autograft (includes
24153 70 0
obtaining graft)
24155 Resection of elbow joint (arthrectomy) 70 0
24160 Implant removal: elbow joint or radial head 35 0
24200 Removal of foreign body, upper arm or elbow area: subcutaneous 15 0
24201 Removal of foreign body, upper arm or elbow area: deep 35 0
24220 Injection procedure for elbow arthrography 10 0
24301 Muscle or tendon transfer, any type, upper arm or elbow, single 50 0
24305 Tendon lengthening, upper arm or elbow, single, each 50 0
24310 Tenotomy, open, elbow to shoulder, single, each 35 0
Tenoplasty, with muscle transfer, with or without free graft, elbow to
24320 70 0
shoulder, single
24330 Flexor-plasty, elbow 70 0
24340 Tenodesis for rupture of biceps tendon at elbow 50 0
Reinsertion of ruptured biceps tendon, distal, with or without tendon graft
24342 70 0
Fasciotomy, lateral or medial (eg,tennis elbow epycondilitis) with or without
24351 35 0
extensor origin detachment
Fasciotomy, lateral or medial (eg,tennis elbow epycondilitis) with annular
24352 35 0
ligament resection, stripping or partial ostectomy
24360 Arthroplasty, elbow: with membrane, or with distal humeral replacement 70 0
Arthroplasty, elbow: with implant and fascia lata ligament reconstruction or

24362 with distal humerus and proximal ulnar prosthetic replacement (total 125 0
elbow)
24366 Arthroplasty, radial head: with or without implant 50 0
24400 Osteotomy, humerus, with or without internal fixation 65 0
Multiple osteotomies with realignment on intramedullary rod, humeral
24410 100 0
shaft (Sofield type procedure)
24420 Osteoplsty, humerus, shortening or lengthening 100 0
Repair of nonunion or malunion, humerus: without graft (eg, compression
24430 85 0
technique)
Repair of nonunion or malunion, humerus: with iliac or other autograft
24435 100 0
24470 Hemiepiphyseal arrest (eg, for cubitus varus or valgus, distal humerus) 50 0
24495 Decompression fasciotomy, forearm, with brachial artery exploration 50 0

Prophylactic treatment (nailing, pinning, plating or wiring) with or without
24498 70 0
methyl methacrylate, humerus (open procedure)
Closed treatment of humeral shaft fracture: with manipulation, with or
24505 35 0
without skeletal traction
Open treatment of humeral shaft fracture, with insertion of intramedullary

24516 75 0
implant, with or without cerclage and/or locking screws
Closed treatment of supracondylar or transcondylar humeral fracture, with

24535 35 0
manipulation, with or without skin or skeletal traction or manipulation
Percutaneous skeletal fixation of supracondylar or transcondylar humeral

24538 50 0
fracture, with or without intercondylar extension
Open treatment of humeral supracondylar or transcondylar fracture, with

24545 75 0
or without internal or external fixation: without intercondylar extension
Open treatment of humeral supracondylar or transcondylar fracture, with

24546 100 0
or without internal fixation: with intercondylar extension
Closed treatment of humeral epicondylar fracture, medial or lateral: with
24565 35 0
manipulation
Open treatment of humeral epicondylar fracture, medial or lateral, with or
24575 70 0
without internal or external skeletal fixation
Closed treatment of humeral condylar fracture, medial or lateral: with or
24577 35 0
without manipulation
Open treatment of humeral condylar fracture, medial or lateral, with or
24579 75 0
without internal or external fixation
Open treatment of periarticular fracture and/or dislocation of the elbow

24586 90 0
(fracture distal humerus and proximal ulna and/or proximal radius)
Open treatment of periarticular fracture and/or dislocation of the elbow

24587 (fracture distal humerus and proximal ulna and/or proximal radius): with 100 0
implant arthroplasty
24600 Treatment of closed elbow dislocation 35 0
24615 Open treatment of acute or chronic elbow dislocation 50 0
Closed treatment of Monteggia type of fracture dislocation at elbow
24620 (fracture proximal end of ulna with dislocation of radial head), with 35 0
manipulation
Open treatment of Monteggia type of fracture dislocation at elbow (fracture
24635 proximal end of ulna with dislocation of radial head), with or without 75 0
internal or external fixation
Closed treatment of radial head subluxation in child (nursemaid elbow),
24640 15 0
with manipulation
24655 Closed treatment of radial head or neck fracture: with manipulation 35 0
Open treatment of radial head or neck fracture, with or without internal

24665 60 0
fixation or radial head excision or with radial head prosthetic implant
Closed treatment of ulnar fracture, proximal end (olecranon process): with

24675 35 0
manipulation
Open treatment of ulnar fracture proximal end (olecranon process), with or
24685 50 0
Arthrodesis, elbow joint: with or without autograft or allograft (includes
24802 80 0
obtaining graft other than locally obtained) separate procedure)
24900 Amputation, arm through humerus 50 0

24925 Amputation, arm through humerus: secondary closure or scar revision 35 0
24931 Amputation, arm through humerus: with implant 70 0
24935 Stump elongation, upper extremity 100 0
24940 Cineplasty, upper extremity, complete procedure 50 0
25000 Tendon sheath incision: at radial styloid , eg for de Quervain's disease 25 0
Tendon sheath incision: at wrist for stenosing tenosynovitis, with
25005 40 0
synovectomy
Decompression fasciotomy, forearm and/or wrist: flexor and/or extensor
25020 compartment, with or without debridement of non viable muscle and/or 35 0
nerve
Incision and drainage, forearm and/or wrist: deep abscess or hematoma or
25028 25 0
infected bursa
25035 40 0
abscess), forearm and/or wrist
Arthrotomy, radiocarpal or mediocarpal joint, for infection, with
25040 40 0
exploration, drainage, or removal of foreign body
25065 Biopsy, soft tissue of forearm and/or wrist: superficial (separate procedure) 15 0
25066 Biopsy, soft tissue of forearm and/or wrist: deep (separate procedure) 25 0
25075 Excision, tumor, forearm and/or wrist area (superficial) 25 0

Excision, tumor , forearm and/or wrist area: deep, subfascial or
25076 40 0
intramuscular
Radical resection of tumor (eg, malignant neoplasm), soft tissue of forearm
25077 60 0
and/or wrist area
25085 Capsulotomy, wrist (eg, for contracture) 25 0
Arthrotomy, wrist joint: with exploration, with or without biopsy, with or
25101 40 0
without removal of loose or foreign body
25105 Arthrotomy, wrist joint: for synovectomy 45 0
25107 Arthrotomy, distal radioulnar joint for repair of triangular cartilage complex 45 0
25110 Excision, lesion of tendon sheath, forearm and/or wrist 25 0

25111 Excision of ganglion, wrist (dorsal or volar) 25 0
Radical excision of bursa, synovia of wrist, or forearm tendon sheaths;

25115 45 0
flexors or extensors, with or without transposition of dorsal retinaculum
25118 Synovectomy, extensor tendon sheath, wrist, single compartment 30 0

Synovectomy, extensor tendon sheath, wrist, single compartment: with
25119 40 0
resection of distal ulna
Excision or curettage of bone cyst or benign tumor of radius or ulna
25120 45 0
(excluding head or neck of radius and olecranon process)
Excision or curettage of bone cyst or benign tumor of radius or ulna
25125 (excluding head or neck of radius and olecranon process): with autograft 50 0
(includes obtaining graft) or with allograft
25130 Excision or curettage of bone cyst or benign tumor of carpal bones 35 0
Excision or curettage of bone cyst or benign tumor of carpal bones: with
25135 40 0
autograft (includes obtaining graft) or with allograft
Partial excision (craterization, saucerization or diaphysectomy) of bone, or
25150 sequestrectomy (eg, for osteomyelitis or bone abscess), forearm and/or 45 0
wrist
25170 Radical resection for tumor, radius or ulna 70 0
25215 Carpectomy: all bones of proximal row 45 0
25230 Radial styloidectomy (separate procedure) 35 0
25240 Excision distal ulna (Darrach type procedure) 35 0
25246 Injection procedure for wrist arthrography 15 0
25248 Exploration for removal of deep foreign body, forearm or wrist 25 0
25250 Removal of wrist prosthesis: (separate procedure) 35 0
25251 Removal of wrist prosthesis: complicated, including total wrist 60 0
Repair, tendon or muscle, flexor, forearm and/or wrist: primary or
25260 40 0
secondary, single, each tendon or muscle
Repair, tendon or muscle, flexor, forearm and/or wrist: secondary, with free
25265 55 0
graft (includes obtaining graft), each tendon or muscle
Repair, tendon or muscle, extensor, forearm and/or wrist: primary or
25270 35 0
secondary, single, each tendon or muscle
Repair, tendon or muscle, extensor, secondary, with tendon graft (includes

25274 55 0
obtaining grat), forearm and/or wrist, each tendon or muscle
Lengthening or shortening of flexor or extensor tendon, forearm and/or

25280 35 0
wrist, single, each tendon
Tenotomy, open, flexor or extensor tendon, forearm and/or wrist, single,
25290 25 0
each tendon
Tenolysis, flexor or extensor tendon, forearm and/or wrist, single, each
25295 40 0
tendon
25300 Tenodesis at wrist: flexors or extensors of fingers 55 0
Tendon transplantation or transfer, flexor or extensor, forearm and/or
25310 55 0
wrist, single: each tendon
Tendon transplantation or transfer, flexor or extensor, foream and/or wrist,

25312 60 0
single: with tendon graft(s) (includes obtaining graft), each tendon
Flexor origin slide (eg, for cerebral palsy, Volkmann contracture) forearm
25315 65 0
and/or wrist
Flexor origin slide for cerebral palsy, forearm and/or wrist: with tendon
25316 70 0
(tendons) transfer
Capsulorrhaphy or reconstruction, capsulectomy, wrist, (includes
25320 60 0
synovectomy, resection of capsule, tendon insertions)
Arthroplasty, wrist, with or without interposition, with or without external
25332 85 0
or internal fixation
25335 Centralization of wrist on ulna (eg, radial club hand) 75 0
25350 Osteotomy, radius or ulna 60 0
25365 Osteotomy: radius and ulna 70 0
Multiple osteotomies, with realignment on intramedullary rod (Sofield type
25370 85 0
procedure): radius AND/OR ulna
25390 Osteoplasty, radius OR ulna: shortening 70 0
25391 Osteoplasty, radius OR ulna: lengthening with autograft 75 0
25392 Osteoplasty, radius AND ulna: shortening (excluding 64876) 90 0
25393 Osteoplasty, radius AND ulna: lengthening with autograft 100 0
Repair of nonunion or malunion, radius OR ulna: without graft (eg,
25400 75 0
compression technique)
Repair of nonunion or malunion, radius OR ulna: with iliac or other
25405 90 0
autograft (includes obtaining graft)
Repair of nonunion or malunion, radius AND ulna: with iliac or other
25420 100 0
autograft (includes obtaining graft)
25425 Repair of defect with autograft: radius OR ulna 75 0
25426 Repair of defect with autograft: radius AND ulna 100 0
Repair of nonunion, scaphoid (navicular) bone, with or without radial
25440 60 0
styloidectomy (includes obtaining graft and necessary fixation)
25441 Arthroplasty with prosthetic replacement: distal radius 85 0
Arthroplasty with prosthetic replacement: distal ulna, scaphoid, lunate or
25442 70 0
trapezium
Arthroplasty with prosthetic replacement: distal radius and partial or entire
25446 110 0
carpus (total wrist)
25447 Interposition arthroplasty, intercarpal or carpometacarpal joints 70 0
25449 Revision of arthroplasty, including removal of implant, wrist joint 60 0
25450 Epiphyseal arrest by epiphysiodesis or stapling: distal radius AND/OR ulna 60 0

25490 60 0
methyl methacrylate: radius or ulna
Prophylactic treatment (nailing, pinning, plating or wiring ) with or without
25491 65 0
methyl methacrylate: ulna (open procedure)
25492 70 0
methyl methacrylate: radius AND ulna (open procedure)
25505 Closed treatment of radial shaft fracture: with manipulation 30 0
Open treatment of radial shaft fracture: with/without internal or external
25515 60 0
fixation
Closed treatment of radial shaft fracture, with dislocation of distal
25520 35 0
radioulnar joint (Galeazzi fracture/dislocation)
Open treatment of radial shaft fracture, with internal and/or external
fixation, and closed treatment of dislocation of distal radioulnar joint
25525 70 0
(Galeazzi fracture/dislocation), with or without percutaneous skeletal
fixation
Open treatment of radial shaft fracture, with internal and/or external
fixation, with or without internal or external fixation of distal radioulnar
25526 70 0
joint, includes repair of triangular cartilage, with or without percutaneous
skeletal fixation
25535 Closed treatment of ulnar shaft fracture: with manipulation 25 0
Open treatment of ulnar shaft fracture: with/without internal or external
25545 60 0
fixation
25565 Closed treatment of radial and ulnar shaft fractures: with manipulation 35 0
Open treatment of radial and ulnar shaft fractures, with internal or external
25574 35 0
fixation of radius or ulna
Open treatment of radial and ulnar shaft fractures, with internal or external
25575 70 0
fixation: of radius and ulna
Closed treatment of distal radial fracture (Colles or Smith type) or
25605 epiphyseal separation, with or without fracture of ulnar styloid: with 35 0
manipulation
Percutaneous skeletal fixation of distal radial fracture or epiphyseal
25611 separation, with or without fracture of ulnar styloid, requiring manipulation, 40 0
with or without external fixation
Open treatment of distal radial fracture, or epiphyseal separation, with or
25620 without fracture of ulnar styloid, with or without internal or external 60 0
fixation
25624 Closed treatment of carpal scaphoid (navicular) fracture: with manipulation 25 0
Open treatment of carpal scaphoid (navicular) fracture, with or without

25628 65 0
Closed treatment of carpal bone fracture excluding carpal scaphoid
25635 25 0
(navicular): with manipulation, each bone
Open treatment of carpal bone fracture (excluding carpal scaphoid
25645 45 0
(navicular)), each bone
Closed treatment of radiocarpal or intercarpal dislocation, one or more
25660 25 0
bones, with manipulation
Open treatment of radiocarpal or intercarpal dislocation, one or more
25670 45 0
bones
25675 Closed treatment of distal radioulnar dislocation with manipulation 25 0
25676 Open treatment of distal radioulnar dislocation, acute or chronic 35 0
Closed treatment of trans-scaphoperilunar type of fracture dislocation, with
25680 35 0
manipulation
25685 Open treatment of trans-scaphoperilunar type of fracture dislocation 60 0
25690 Closed treatment of lunate dislocation, with manipulation 25 0
25695 Open treatment of lunate dislocation 45 0
Arthrodesis, wrist joint (including radiocarpal and/or ulnocarpal fusion):
25800 70 0
without bone graft (separate procedure)
Arthrodesis, wrist joint (including radiocarpal and/or ulnocarpal fusion):
25805 with sliding graft or iliac or other autograft (includes obtainig graft) separate 75 0
procedure)
Intercarpal fusion: with autograft (includes obtaining graft) or bone graft
25825 60 0
Amputation or reamputation, forearm through radius and ulna: closed or
25900 60 0
open circular
25907 Amputation, forearm: secondary closure or scar revision 35 0
25915 Krukenberg procedure 75 0
25922 Disarticulation through wrist or secondary closure or scar revision 35 0
25929 Transmetacarpal amputation or secondary closure or scar revision 35 0
26010 Drainage of finger abscess 10 0
26020 Drainage of tendon sheath, one digit and/or palm 25 0
26025 Drainage of palmar bursa 30 0
26034 35 0
abscess), hand or finger
26035 Decompression fingers and/or hand, injection injury (eg, grease gun) 45 0
26037 Decompressive fasciotomy, hand 35 0
26040 Fasciotomy, palmar, for Dupuytren's contracture: closed (subcutaneous) 35 0
26045 Fasciotomy, palmar, for Dupuytren's contracture: open, partial 35 0

26055 Tendon sheath incision for trigger finger 25 0
26060 Tenotomy, subcutaneous, single, each digit 15 0
Arthrotomy, with exploration, drainage or removal of foreign body:

26070 25 0
carpometacarpal, metacarpophalangeal or interphalangeal joint, each joint
Arthrotomy for synovial biopsy: carpometacarpal or metacarpophalangeal

26100 25 0
or interphalangeal joint
26115 Excision, tumor or vascular malformation, hand or finger, subcutaneous 25 0
Excision, tumor or vascular malformation, hand or finger: deep, subfascial

26116 45 0
intramuscular
Radical resection of tumor (eg, malignant neoplasm) of soft tissues of hand
26117 50 0
or finger
Fasciectomy, palmar only, with or without z-plasty, other local tissue
26121 55 0
rearrangement, or skin grafting (includes obtaining graft)
Fasciectomy, partial palmar with release of single digit including proximal
26123 interphalangeal joint, with or without Z-plasty, other local tissue 60 0
rearrangement, or skin grafting (includes obtaining the graft)
Fasiectomy, partial palmar with release of single digit including proximal
interphalageal joint, with/without Z-plasty, other local tissue
26125 30 0
rearrangement, or skin grafting (includes obtaining graft): each additional
digit (list separately in addition
26130 Synovectomy, carpometacarpal joint 40 0
Synovectomy, metacarpophalangeal joint including intrinsic release and
26135 40 0
extensor hood reconstruction, each digit
Synovectomy, proximal interphalangeal joint, including extensor
26140 40 0
reconstruction, each interphalangeal joint
Synovectomy tendon sheath, radical (tenosynovectomy), flexor, palm or
26145 40 0
finger, single, each digit
Excision of lesion of tendon sheath or capsule (eg, cyst or ganglion), hand or
26160 25 0
finger
26170 Excision of tendon, palm or finger, flexor, single (separate procedure), each 30 0
Excision or curettage of bone cyst or benign tumor of metacarpal or

26200 40 0
phalanges
Excision or curettage of bone cyst or benign tumor of metacarpal or
26205 55 0
phalanges: with autograft (includes obtaining graft)
Excision or curettage of bone cyst or benign tumor of proximal, middle or
26210 25 0
distal phalanx of finger
Excision or curettage of bone cyst or benign tumor of proximal, middle or
26215 40 0
distal phalanx of finger: with autograft (includes obtaining graft)

26235 for osteomyelitis): metacarpal or proximal, middle or distal phalanx of 40 0
finger
Radical resection (ostectomy) for tumor, metacarpal or proximal or middle
26255 65 0
phalanx of finger: with autograft (includes obtaining graft)
Radical resection (ostectomy) for tumor, proximal or middle or distal
26260 40 0
phalanx of finger or metacarpal
26263 Radical resection of interphalangeal joint, with internal skeletal fixation 70 0
26320 Removal of implant from finger or hand 25 0

Flexor tendon repair or advancement, single, not in no man's land primary
26350 40 0
or secondary without free graft,each tendon
Flexor tendon repair or advancement, single, not in no man's land
26352 45 0
secondary,with the graft(includes obtaining graft),each tendon
Flexor tendon repair or advancement, single, in no man's land primary each
26356 45 0
tendon
Flexor tendon repair or advancement,single, in no man's land secondary
26357 55 0
each tendon
Flexor tendon repair or advancement, single, in no man's land secondary
26358 60 0
with free graft (includes obtaining graft) each tendon
26370 Profundus tendon repair or advancement, with intact sublimis: primary 40 0
Profundus tendon repair or advancement, with intact sublimis: secondary

26372 60 0
with free graft (includes obtaining graft)
Profundus tendon repair or advancement, with intact sublimis: secondary
26373 40 0
without free graft
Flexor tendon excision, implantation of plastic tube or rod for delayed
26390 60 0
tendon graft, hand or finger
Removal of tube or rod and insertion of flexor tendon graft (includes
26392 65 0
obtaining graft), hand or finger
Extensor tendon repair, dorsum of hand, single, primary or secondary:
26410 30 0
without free graft, each tendon
Extensor tendon repair, dorsum of hand, single, primary or secondary: with
26412 40 0
free graft (includes obtaining graft), each tendon
Extensor tendon excision, implantation of plastic tube or rod for delayed
26415 55 0
extensor tendon graft, hand or finger
Removal of tube or rod and insertion of extensor tendon graft (includes
26416 60 0
obtaining graft), hand or finger
Extensor tendon repair, dorsum of finger, single, primary or secondary:
26418 25 0
Extensor tendon repair, dorsum of finger, single, primary or secondary: with
26420 40 0
free graft (includes obtaining graft), each tendon
26426 Extensor tendon repair, central slip repair, secondary (boutonnire 40 0

deformity): using local tissue
26428 Extensor tendon repair, central slip repair, secondary (boutonnire 45 0

deformity): with free graft (includes obtaining graft)
Extensor tendon repair, distal insertion (mallet finger) closed, splinting with
26432 25 0
or withour percutaneous pinning
Extensor tendon repair, distal insertion (mallet finger),open,primary or
26433 30 0
secondary,repair,without graft
Extensor tendon repair, distal insertion (mallet finger),open,primary or
26434 40 0
secondary repair with free graft (includes obtaining graft)
26437 Extensor tendon realignment, hand 40 0
26440 Tenolysis, simple, flexor tendon: palm OR finger, single, each tendon 30 0
26442 Tenolysis, simple, flexor tendon: palm AND finger, each tendon 50 0
26445 Tenolysis, extensor tendon, dorsum of hand or finger: each tendon 30 0
Tenolysis, complex, extensor tendon, dorsum of hand or finger, including
26449 40 0
hand and forearm
26450 Tenotomy, flexor, single, palm or finger, open, each 25 0
26460 Tenotomy, extensor, hand or finger, single, open, each 25 0
26471 Tenodesis: for proximal or distal interphalangeal joint stabilization 40 0
Tendon lengthening or shortening, extensor or flexor, hand or finger, single,
26476 40 0
each tendon
Tendon transfer or transplant, carpometacarpal area or dorsum of hand,
26483 single: with or without free tendon graft (includes obtaining graft), each 55 0
tendon
Tendon transfer or transplant, palmar, single, each tendon: without free
26485 50 0
tendon graft
Tendon transfer or transplant, palmar, single, each tendon: with free
26489 60 0
tendon graft (includes obtaining graft)
26490 Opponens plasty: tendon transfer, any type 50 0
Opponens plasty: tendon transfer with graft (includes obtaining graft) or
26492 60 0
hypothenar muscle transfer
26497 Tendon transfer to restore intrinsic function: ring and small finger 60 0
26498 Tendon transfer to restore intrinsic function: all four fingers 95 0
26499 Correction claw finger, other methods 60 0
26500 Tendon pulley reconstruction: with local tissues (separate procedure) 40 0
Tendon pulley reconstruction: with tendon or fascial graft (includes
26502 50 0
obtaining graft) or tendon prosthesis (separate procedure)
26508 Thenar muscle release for thumb contracture 40 0
26510 Cross intrinsic transfer 40 0
26516 Capsulodesis for M-P joint stabilization: single or two digit 40 0
26518 Capsulodesis for M-P joint stabilization: three or four digits 60 0
Capsulectomy or capsulotomy for contracture: metacarpophalangeal joint
26520 40 0
or interphalangeal joint, single, each joint
Arthroplasty, metacarpophalangeal joint or interphalangeal joint: single
26530 45 0
joint
Arthroplasty, metacarpophalangeal joint or interphalangeal joint: with
26531 55 0
prosthetic implant, single joint
Reconstruction, collateral ligament, metacarpophalangeal joint, single, with
26541 55 0
tendon or fascial graft (includes obtaining graft)
Reconstruction collateral ligament, metacarpophalangeal joint, with local
26542 40 0
tissue (eg, adductor advancement)
Reconstruction, collateral ligament, interphalangeal joint, single, including
26545 40 0
graft, each joint
26548 Repair and reconstruction, finger, volar plate, interphalangeal joint 55 0
26550 Pollicization of a digit 100 0
Toe-to-hand transfer with microvascular anastomosis: great toe "wrap
26551 300 0
around" with bone graft(includes obtaining graft)
26555 Positional change of other finger 110 0
26556 Free toe joint transfer with microvascular anastomosis 270 0
26560 Repair of syndactyly (web finger) each web space: with skin flaps 45 0
Repair of syndactyly (web finger) each web space: with skin flaps and grafts
26561 60 0
and/or involving bone, nails
26565 Osteotomy for correction of deformity: metacarpal or phalanx of finger 50 0
26568 Osteoplasty for lengthening of metacarpal or phalanx 55 0

26580 Repair cleft hand 60 0
26585 Repair bifid digit 60 0
26587 Reconstruction of supernumerary digit, soft tissue and bone 90 0
26590 Repair macrodactylia 150 0
26591 Repair or release, intrinsic muscles of hand (specify) 40 0
26596 Excision of constricting ring of finger, with multiple z-plasties 50 0
Release of scar contracture, flexor or extensor, with skin grafts,
26597 60 0
rearrangement flaps, or z-plasties, hand and/or finger
Closed tretament of metacarpal fracture, single: with manipulation, each
26605 25 0
bone
Closed treatment of metacarpal fracture, with manipulation, with internal
26607 40 0
or external fixation, each bone
Open treatment of metacarpal fracture, single, with or without internal or
26615 40 0
external fixation, each bone
26641 Closed treatment of carpometacarpal dislocation, thumb, with manipulation 25 0
Closed treatment of carpometacarpal or metacarpophalangeal fracture

26645 25 0
dislocation (Bennett fracture) single, with manipulation
Percutaneous skeletal fixation of carpometacarpal or metacarpophalangeal
26650 fracture dislocation, thumb (Bennett fracture), with manipulation: with or 40 0
without external fixation
Open treatment of carpometacarpal fracture dislocation thumb (Bennett
26665 40 0
fracture), with or without internal or external fixation
Percutaneous skeletal fixation of carpometacarpal dislocation, other than
26676 35 0
thumb (Bennett fracture), single, with manipulation
Open treatment of carpometacarpal dislocation, other than thumb (Bennett

26685 40 0
fracture): single, with or without internal or external fixation
Open treatment of carpometacarpal dislocation, other than thumb (Bennett

26686 70 0
fracture): complex, multiple or delayed reduction
Closed treatment of metacarpophalngeal dislocation, single, with
26700 25 0
manipulation
Percutaneous skeletal fixation of metacarpophalangeal dislocation, single,
26706 35 0
with manipulation
Open treatment of metacarpophalangeal dislocation, single, with or without
26715 40 0
Closed treatment of phalangeal shaft fracture, proximal or middle phalanx,
26725 finger or thumb, with manipulation, with or without skin or skeletal 20 0
traction, each
Percutaneous skeletal fixation of unstable phalangeal shaft fracture,
26727 30 0
proximal or middle phalanx, finger or thumb, with manipulation, each
Open treatment of phalangeal shaft fracture, proximal or middle phalanx,

26735 40 0
finger or thumb, with or without internal or external fixation, each
Closed treatment of articular fracture, involving metacarpophalangeal or

26742 25 0
interphalangeal joint: with manipulation, each
Open treatment of articular fracture, involving metacarpophalangeal or

26746 40 0
interphalangeal joint, with or without internal or external fixation, each
Closed treatment of distal phalangeal fracture, finger or thumb, with

26750 25 0
manipulation, each
Percutaneous skeletal fixation of distal phalangeal fracture, finger or thumb,
26756 30 0
each
Open treatment of distal phalangeal fracture, finger or thumb, with or
26765 30 0
without internal or external fixation, each
Closed treatment of interphalangeal joint dislocation, single, with
26770 25 0
manipulation
Percutaneous skeletal fixation of interphalangeal joint dislocation, single,
26776 30 0
with manipulation
Open treatment of interphalangeal joint dislocation, with or without
26785 30 0
internal or external fixation, single
Fusion in opposition, thumb, with autogenous graft (includes obtaining
26820 50 0
graft) (separate procedure)
Arthrodesis, carpometacarpal joint, any digit , with or without internal
26841 45 0
fixation (separate procedure)
Arthrodesis, carpometacarpal joint, any digit, with or without internal

26842 55 0
fixation: with autograft (includes obtaining graft) (separate procedure)
Arthrodesis, metacarpophalangeal joint, with or without internal fixation

26850 45 0
Arthrodesis, metacarpophalangeal joint, with or without internal fixation:

26852 50 0
with autograft (includes obtaining graft) (separate procedure)
Arthrodesis, interphalangeal joint, with or without internal fixation

26860 35 0
Arthrodesis, interphalangeal joint, with or without internal fixation: each
26861 15 0
additional joint
Arthrodesis, interphalangeal joint, with or without internal fixation, with
26862 45 0
autograft (includes obtaining graft) (separate procedure)
Arthrodesis, interphalangeal joint, with or without internal fixation: with
26863 25 0
autograft (includes obtaining graft), each additional digit
Amputation, metacarpal, with finger or thumb (ray amputation), single, with
26910 40 0
or without interosseous transfer
Amputation, finger or thumb, primary or secondary, any joint or phalanx,
26951 30 0
single, including neurectomies: with direct closure
Amputation, finger or thumb, primary or secondary, any joint or phalanx,

26952 50 0
single, including neurectomies: with local advancement flaps (V-Y, hood)
Incision and drainage, pelvis or hip joint area: deep abscess or hematoma or
26990 45 0
infected bursa
26992 70 0
abscess), pelvis and/or hip joint
27000 Tenotomy, adductor of hip, subcutaneous, closed (separate procedure) 30 0
Tenotomy, adductor of hip, subcutaneous, open, with or without obturator

27003 55 0
neurectomy
27006 Tenotomy, iliopsoas or abductors of hip, open (separate procedure) 55 0
27025 Fasciotomy, hip or thigh, any type 55 0
Arthrotomy, hip, for infection with drainage for exploration or removal of
27033 70 0
loose or foreign body
Hip joint denervation, intrapelvic or extrapelvic intra-articular branches of
27035 105 0
sciatic, femoral or obturator nerves
Capsulectomy or capsulotomy of hip, with or without excision of

27036 heterotopic bone, with release of hip flexor muscles (ie, gluteus medius, 70 0
gluteus minimus, tensor fascia latae, rectus femoris, sartorius, iliopsoas)
27040 Biopsy, soft tissue of pelvis and hip area: superficial 30 0

27047 Excision, tumor, pelvis and hip area: subcutaneous 30 0
Radical resection of tumor (eg, malignant neoplasm), soft tissue of pelvis
27049 85 0
and hip area
27050 Arthrotomy, for biopsy: sacro-iliac joint 40 0
27054 Arthrotomy for biopsy or synovectomy, hip joint 55 0
27062 Excision, ischial or trochanteric bursa or calcification 40 0
Excision of bone cyst or benign tumor: superficial (wing of ilium, symphysis

27065 35 0
pubis, or greater trochanter of femur) with or without autograft
Excision of bone cyst or benign tumor, deep pelvis, with or without

27066 65 0
autograft
Excision of bone cyst or benign tumor, pelvis: with autograft requiring
27067 75 0
separate incision
27070 Partial excision (craterization, saucerization) (eg, for osteomyelitis): pelvis 55 0
Radical resection for tumor or infection: ilium, including acetabulum, pubic

27076 125 0
rami, or ischium and acetabulum
27077 Radical resection for tumor or infection: innominate bone, total 120 0
Radical resection for tumor or infection: ischial tuberosity and greater
27079 70 0
trochanter of femur, with or without skin flaps
27080 Coccygectomy, primary 40 0
27086 Removal of foreign body, pelvis or hip, superficial 20 0
27087 Removal of foreign body, pelvis or hip, deep 45 0
27090 Removal of hip prosthesis (separate procedure) 50 0
Removal of hip prosthesis: complicated, including total hip and methyl
27091 110 0
methacrylate when applicable
27093 Injection procedure for hip arthrography 15 0
27097 Hamstring recession, proximal 50 0
27098 Adductor transfer to ischium 50 0
Transfer external oblique muscle to greater trochanter including fascial or
27100 70 0
tendon extension (graft)
Transfer paraspinal muscle to hip (includes fascial or tendon extension
27105 70 0
graft)
27110 Transfer iliopsoas: to greater trochanter or femoral neck 70 0
27120 Acetabuloplasty: (eg, Colonna, Whitman, Haygroves, or cup type) 105 0
27122 Acetabuloplasty: resection femoral head (Girdlestone procedure) 75 0
Partial hip replacement, prosthesis (eg, femoral stem prosthesis, bipolar
27125 105 0
arthroplasty)
Arthroplasty, acetabular and proximal femoral prosthetic replacement (total

27130 150 0
hip replacement), with or without autograft or allograft
Conversion of previous hip surgery to total hip replacement, with or without

27132 160 0
autograft or allograft
Revision of total hip arthroplasty: both components, with or without
27134 190 0
autograft or allograft
Revision of total hip arthroplasty: acetabular or femoral component only,
27137 140 0
with or without autograft or allograft
27140 Osteotomy and transfer of greater trochanter (separate procedure) 70 0
27146 Osteotomy, iliac, acetabular or innominate bone 100 0
Osteotomy, iliac, acetabular or innominate bone: with open reduction of hip
27147 135 0
and/or femoral osteotomy
27151 Osteotomy, iliac, acetabular or innominate bone: with femoral osteotomy 135 0
27158 Osteotomy, pelvis, bilateral for congenital malformation 105 0

27161 Osteotomy, femoral neck (separate procedure) 100 0
Osteotomy, intertrochanteric or subtrochanteric including internal or
27165 105 0
external fixation and/or cast
Bone graft, femoral head, neck, intertrochanteric or subtrochanteric area
27170 105 0
27175 Treatment of slipped femoral epiphysis: by traction, without reduction 30 0
27176 Treatment of slipped femoral epiphysis: by single or multiple pinning, in situ 70 0
Open treatment of slipped femoral epiphysis: single or multiple pinning or

27177 75 0
Open treatment of slipped femoral epiphysis: osteoplasty of femoral neck
27179 90 0
(Heyman type procedure)
Open treatment of slipped femoral epiphysis: osteotomy and internal
27181 105 0
fixation
27185 Epiphyseal arrest by epiphysiodesis or stapling, greater trochanter 50 0
27187 75 0
methyl methacrylate, femoral neck and proximal femur
27202 Open treatment of coccygeal fracture 50 0
Percutaneous skeletal fixation of posterior pelvic ring fracture and/or
27216 95 0
dislocation (includes ilium, sacroiliac joint and/or sacrum)
Open treatment of anterior ring fracture and/or dislocation, with internal
27217 90 0
fixation (includes pubis symphysis and/or rami)
Open treatment of posterior ring fracture and/or dislocation, with internal
27218 125 0
fixation (includes ilium, sacroiliac joint and/or sacrum)
Closed treatment of acetabulum (hip socket) fracture(s): with manipulation
27222 50 0
with or without skeletal traction
Open treatment of acetabular fracture(s) involving anterior and posterior
(two) columns, includes T-fracture and both column fracture with complete
27228 NULL 0
articular detachment, or single column or transverse fracture with
associated acetabular
Closed treatment of femoral fracture, proximal end, neck: without
27230 20 0
manipulation
Closed treatment of femoral fracture, proximal end, neck: with
27232 60 0
manipulation, with or without skeletal traction
Percutaneous skeletal fixation of femoral fracture, proximal end, neck,
27235 70 0
undisplaced, mildly displaced or impacted fracture
Open treatment of femoral fracture, proximal end, neck, internal fixation or
27236 95 0
prosthetic replacement (direct fracture exposure)
Closed treatment of intertrochanteric, pertrochanteric, or subtrochanteric
27240 femoral fracture, with manipulation: with or without skin or skeletal 50 0
traction
Open treatment of intertrochanteric, pertrochanteric, or subtrochanteric

27244 100 0
femoral fracture: with plate/screw type implant, with or without cerclage
Open treatment of intertrochanteric, pertrochanteric or subtrochanteric

27245 femoral fracture: with intramedullary implant, with or without interlocking 100 0
screws and/or cerclage
Open treatment of greater trochanteric fracture, with or without internal or
27248 50 0
external fixation
27250 Closed treatment of hip dislocation, traumatic 30 0
27253 Open treatment of hip dislocation, traumatic, without internal fixation 70 0
Open treatment of hip dislocation, traumatic, with acetabular wall and

27254 115 0
femoral head fracture, with or without internal or external fixation
Treatment of spontaneous hip dislocation (developmental, including

27257 congenital or pathological),by abduction, splint or traction: with 30 0
manipulation requiring anesthesia
Open treatment of spontaneous hip dislocation (developmental, including
27258 congenital or pathological): replacement of femoral head in acetabulum 100 0
(including tenotomy, etc) and/or femoral shaft shortening
27265 Closed treatment of post hip arthroplasty dislocation 30 0

27275 Manipulation hip joint, requiring general anesthesia 10 0
Arthrodesis, sacroiliac joint or symphysis pubis (including obtaining graft)
27280 85 0
Arthrodesis, hip joint (includes obtaining graft): with or without
27286 110 0
subtrochanteric osteotomy (separate procedure)
27290 Hind quarter amputation 145 0
27295 Disarticulation of hip 95 0
Incision and drainage of deep abscess or bone cortex, infected bursa, or
27301 35 0
hematoma, thigh, femur or knee region
27305 Fasciotomy, ilio-tibial, open 35 0
Tenotomy, subcutaneous, closed, adductor or hamstring, (separate
27306 25 0
procedure): single
Tenotomy, subcutaneous, closed, adductor or hamstring, (separate
27307 35 0
procedure): multiple
Arthrotomy, knee, for infection, with exploration, drainage or removal of
27310 35 0
foreign body
27320 Neurectomy, popliteal (gastrocnemius) or hamstring muscle 35 0
27323 Biopsy, soft tissue of thigh or knee area 15 0
27328 Excision, tumor, thigh or knee area: deep, subfascial, or intramuscular 35 0
Radical resection of tumor (eg, malignant neoplasm), soft tissue of thigh or
27329 85 0
knee area
Arthrotomy, knee: with joint exploration, with or without synovial biopsy,
27331 35 0
with or without removal of loose or foreign bodies
27332 Arthrotomy, knee, for meniscectomy: medial OR lateral 55 0
27333 Arthrotomy, knee, for meniscectomy: medial AND lateral 60 0
Arthrotomy, knee, for synovectomy: anterior AND/OR posterior including
27335 55 0
popliteal area
27340 Excision, prepatellar bursa 35 0
27345 Excision of synovial cyst of popliteal space (Baker's cyst) 45 0
27350 Patellectomy or hemipatellectomy 55 0
Excision or curettage of bone cyst or benign tumor of femur: with or
27357 without autograft (includes obtaining graft) or allograft with or without 65 0
internal fixation
27360 50 0
for osteomyelitis), femur, proximal tibia and/or fibula
27365 Radical resection for tumor, femur or knee, bone or knee 100 0
27370 Injection procedure for knee arthrography 15 0
27372 Removal of foreign body, deep, thigh region or knee area 35 0
Suture of infrapatellar tendon: primary or secondary reconstruction,
27381 65 0
including fascial or tendon graft
Suture of quadriceps or hamstring muscle rupture: primay or secondary
27386 55 0
reconstruction, including fascial or tendon graft
27390 Tenotomy, open, hamstring, knee to hip: single 35 0
27391 Tenotomy, open, hamstring, knee to hip: multiple, one leg 45 0
27392 Tenotomy, open, hamstring, knee to hip: multiple, bilateral 55 0
27393 Lengthening of hamstring tendon: single 35 0
27394 Lengthening of hamstring tendon: multiple, one leg 55 0
27395 Lengthening of hamstring tendon: multiple, bilateral 60 0
27396 Transplant, hamstring tendon to patella: single 50 0
27397 Transplant, hamstring tendon to patella: multiple 60 0
27400 Tendon or muscle transfer, hamstrings to femur (Eggers type procedure) 55 0
27403 Arthrotomy with open meniscus repair 60 0
27405 Repair, primary, torn ligament and/or capsule, knee: collateral or cruciate 55 0
27409 Repair, primary, torn ligament and/or capsule, knee: collateral and cruciate 95 0
Anterior tibial tubercle plasty for chondromalacia patellae (Maquet

27418 60 0
procedure)
27422 Reconstruction for recurrent dislocating patella: any method 55 0
27424 Reconstruction for recurrent dislocating patella: with patellectomy 55 0
27425 Lateral retinacular release (any method) 35 0
27427 Ligamentous reconstruction (augmentation), knee: extra-articular 55 0
27428 Ligamentous reconstruction (augmentation), knee: intra-articular (open) 75 0
Ligamentous reconstruction (augmentation), knee: intra-articular (open)

27429 95 0
and extra-articular
27430 Quadriceps plasty (Bennett or Thompson type) 55 0
27435 Capsulotomy, knee, posterior capsular release 55 0
27437 Arthroplasty, patella: without prosthesis 55 0
27438 Arthroplasty, patella: with prosthesis 60 0
27440 Arthroplasty, knee, tibial plateau 55 0
Arthroplasty, knee, tibial plateau: with debridement and partial
27441 60 0
synovectomy
Arthroplasty, knee, femoral condyles or tibial plateaus: with or without
27443 60 0
debridement and partial synovectomy
27445 Arthroplasty, knee, constrained prosthesis (eg, Walldius type) 95 0
27446 Arthroplasty, knee condyle and plateau: medial OR lateral compartment 95 0
Arthroplasty, knee condyle and plateau: medial AND lateral compartments

27447 140 0
with or without patella resurfacing (total fee replacement)
27448 Osteotomy, femur, shaft or supracondylar: without fixation 60 0

27450 Osteotomy, femur, shaft or supracondylar: with fixation 105 0
Osteotomy, proximal tibia, including fibular excision or osteotomy (includes

27455 95 0
correction of genu varus or genu valgus): before or after epiphyseal closure
27466 Osteoplasty, femur: lengthening or shortening 95 0

Osteoplasty, femur: combined lengthening and shortening with femoral
27468 135 0
segment transfer
Repair, nonunion or malunion, femur, distal to head and neck: with or
27472 110 0
without iliac or other autogenous bone graft (includes obtaining graft)
27475 Epiphyseal arrest by epiphysiodesis or stapling: distal femur 55 0
27477 Epiphyseal arrest by epiphysiodesis or stapling: tibia and fibula, proximal 60 0
Epiphyseal arrest by epiphysiodesis or stapling: combined, distal femur and

27479 95 0
proximal tibia and fibula
Hemiepiphyseal arrest, distal femur or proximal leg (eg, genu varus or
27485 55 0
valgus)
Revision of total knee arthroplasty, with or without allograft: one
27486 120 0
component
Revision of total knee arthroplasty, with or without allograft: all
27487 160 0
components
27488 Removal of knee prosthesis, including 95 0
Decompression fasciotomy, thigh and/or knee, one compartment (flexor or
27496 extensor or adductor) with or without debridement of nonviable muscle 35 0
and/or nerve
Decompression fasciotomy, thigh and/or knee, multiple compartments,

27498 55 0
with or without debridement of nonviable muscle and/or nerve
Closed treatment of femoral shaft fracture: with manipulation, with or

27502 55 0
without skin or skeletal traction
Closed treatment of supracondylar or transcondylar femoral fracture with
27503 or without intercondylar extension: with manipulation, with or without skin 55 0
or skeletal traction
Open treatment of femoral shaft fracture, with or without external fixation,

27506 with insertion of intramedullary implant, with or without cerclage and/or 100 0
locking screws, with or without plate/screws, with or without cerclage
Percutaneous skeletal fixation of supracondylar or transcondylar femoral

27509 35 0
fracture, with or without intercondylar extension
Closed treatment of femoral fracture, distal end, medial or lateral condyle:
27510 55 0
with manipulation
Open treatment of femoral supracondylar or transcondylar fracture without
27511 85 0
intercondylar extension, with internal fixation
Open treatment of femoral supracondylar or transcondylar fracture with
27513 110 0
intercondylar extension, with internal fixation
Open treatment of femoral fracture, distal end, medial or lateral condyle,
27514 95 0
with or without internal or external fixation
Closed treatment of distal femoral epiphyseal separation: with
27517 55 0
manipulation, with or without skin or skeletal traction
Open treatment of distal femoral epiphyseal separation, with or without
27519 90 0
Open treatment of patellar fracture, with internal fixation and/or partial or
27524 65 0
complete patellectomy and soft tissue repair
Closed treatment of tibial fracture, proximal (plateau): with or without
27532 55 0
manipulation, with skeletal traction
Open treatment of tibial fracture, proximal (plateau): unicondylar, with
27535 70 0
internal fixation
Open treatment of tibial fracture, proximal (plateau), bicondylar, with or
27536 100 0
Closed treatment of intercondylar spine(s) and/or tuberosity fracture(s) of
27538 35 0
knee, with manipulation
Open treatment of intercondylar spine(s) and or tuberosity(ies) fracture(s)
27540 75 0
of knee, with or without internal or external fixation
27550 Closed treatnent of knee dislocation 35 0
Open treatment of knee dislocation, with or without internal or external
27556 fixation: without primary ligamentous repair or 60 0
augmentation/reconstruction
Open treatment of knee dislocation with or without internal or external
27558 fixation: with primary ligamentous repair, with or without 100 0
augmentation/reconstruction
27560 Closed treatment of patellar dislocation 35 0
Open treatment of patellar dislocation, with or without partial or total
27566 60 0
patellectomy
Manipulation of knee joint under general anesthesia (includes application of
27570 15 0
traction or other fixation devices)
27580 Fusion of knee, any technique 100 0
Amputation, thigh, through femur, any level: with or without immediate
27591 60 0
fitting technique including first cast
27594 Amputation, thigh, secondary closure or scar revision 55 0
27598 Disarticulation at knee 60 0
Decompression fasciotomy, leg: anterior and/or lateral compartment(s)
27600 35 0
only
27601 Decompression fasciotomy, leg: posterior compartment(s) only 35 0
Decompression fasciotomy, leg: anterior and/or lateral and posterior
27602 45 0
compartment(s)
27603 Incision and drainage, leg or ankle: deep abscess, hematoma, infected bursa 25 0
27605 Tenotomy, Achilles tendon, subcutaneous (separate procedure) 25 0

27607 40 0
abscess), leg or ankle
Arthrotomy, ankle, for infection, with exploration, drainage or removal of
27610 40 0
foreign body
Arthrotomy, ankle, posterior capsular release, with or without Achilles
27612 40 0
tendon lengthening
27613 Biopsy, soft tissue of leg or ankle area 25 0
Radical resection of tumor (eg, malignant neoplasm), soft tissue of leg or
27615 80 0
ankle area
27618 Excision, tumor, leg or ankle area: subcutaneous 25 0
27619 Excision, tumor, leg or ankle area: deep, subfascial or intramuscular 55 0
Arthrotomy, ankle, with joint exploration, with or without biopsy, with or
27620 40 0
without removal of loose or foreign body
27625 Arthrotomy, ankle, for synovectomy 40 0
27626 Arthrotomy, ankle, for synovectomy: including tenosynovectomy 60 0
Excision of lesion of tendon, sheath or capsule (eg, cyst or ganglion), leg
27630 40 0
and/or ankle
27635 Excision or curettage of bone cyst or benign tumor, tibia or fibula 50 0
Excision or curettage of bone cyst or benign tumor, tibia or fibula: with
27637 65 0
autograft (includes obtaining graft) or allograft
27640 40 0
for osteomyelitis or exostosis): tibia or fibula
27645 Resection for tumor, radical: tibia, fibula, talus or calcaneus 75 0
27648 Injection procedure for ankle arthrography 10 0
Repair, primary, open or percutaneous, ruptured Achilles tendon: with or
27652 60 0
without graft
27654 Repair, secondary, ruptured Achilles tendon, with or without graft 65 0
27656 Repair, fascial defect of leg 25 0
Repair or suture of flexor or extensor tendon of leg: primary, without graft,
27658 25 0
single, each
Repair or suture of flexor or extensor tendon of leg: secondary with graft,
27659 40 0
single, each
27675 Repair for dislocating peroneal tendons: with or without fibular osteotomy 60 0
Tenolysis, including tibia, fibula and ankle flexor: single multiple (through
27681 40 0
same incision)
Lengthening or shortening of tendon, leg or ankle: single or multiple
27686 40 0
(through same incision)
27687 Gastrocnemius recession (eg, Strayer procedure) 40 0
Transfer or transplant of single tendon (with muscle redirection or
27691 rerouting): superficial anterior tibial or posterior tibial through interosseous 60 0
space
Transfer or transplant of single tendon (with muscle redirection or
27692 rerouting): anterior tibial or posterior tibial through interosseous space, 25 0
each additional tendon
Suture, primary, torn, ruptured or severed ligament, ankle: both collateral
27696 60 0
ligaments
Suture, secondary repair, torn, ruptured or severed ligament, ankle,
27698 40 0
collateral (e.g. Watson-Jones procedure)
27700 Arthroplasty, ankle 75 0
27703 Arthroplasty, ankle: with implant or secondary reconstruction, total ankle 100 0
27704 Removal of ankle implant (prosthesis) 40 0

27705 Osteotomy: tibia or tibia and fibula 80 0
27707 Osteotomy: fibula 40 0
Osteotomy: multiple, with realignment on intramedullary rod (Sofield type
27712 90 0
procedure), tibia and fibula
27715 Osteoplasty, tibia and fibula, lengthening 95 0
Repair of nonunion or malunion, tibia: without graft (eg, compression
27722 90 0
technique) or with sliding graft, local bone
Repair of nonunion or malunion, tibia: with iliac or other autograft (includes
27724 100 0
obtaining graft) or by synostosis, with fibula, any method
27727 Repair of congenital pseudarthrosis, tibia 85 0
Epiphyseal arrest by epiphysiodesis or stapling: distal tibia or distal tibia and
27730 60 0
fibula
27732 Epiphyseal arrest by epiphysiodesis or stapling: distal fibula 40 0
Epiphyseal arerst by epiphysiodesis or stapling, combined, proximal and
27740 60 0
distal tibia and fibula
Epiphyseal arrest by epiphysiodesis or stapling, combined, proximal and
27742 75 0
distal tibia, fibula: and distal femur
Closed treatment of tibial shaft fracture (with or without fibular fracture):
27752 40 0
with manipulation
Percutaneous skeletal fixation of tibial shaft fracture (with or without fibular
27756 60 0
fracture) (eg, pins or screws)
Open treatment of tibial shaft fracture (with or without fibular fracture),
27758 75 0
with plate/screws, with or without cerclage
Open treatment of tibial shaft fracture, (with or without fibular fracture) by

27759 90 0
intramedullary implant, with or without interlocking screws and/or cerclage
Closed treatment of distal tibial fracture (medial malleolus): with

27762 40 0
manipulation, with or without skeletal traction
Open treatment of medial malleolus fracture, with internal or external
27766 40 0
fixation
Closed treatment of proximal or distal fibula or shaft fracture: with
27781 25 0
manipulation
Open treatment of proximal or distal fibula or shaft fracture, with or
27784 40 0
Treatment of closed bimalleolar or trimalleolar ankle fracture, (including
27810 40 0
Pott's): with manipulation
Open treatment of bimalleolar or trimalleolar ankle fracture, with internal
27822 or external fixation, medial and/or lateral malleolus: without fixation of 65 0
posterior lip
Open treatment of trimalleolar ankle fracture, with internal or external

27823 70 0
fixation, medial and/or lateral malleolus: with fixation of posterior lip
Closed treatment of fracture of weight bearing articular portion of distal

27825 tibia (eg, pilon or tibial plafond), with or without anesthesia: with skeletal 40 0
traction and/or requiring manipulation
Open treatment of fracture of weight bearing articular surface/portion of
27826 distal tibia (eg, pilon or tibial plafond), with internal or external fixation: of 65 0
fibula or tibia only
Open treatment of fracture of weight bearing articular surface/portion of
27828 distal tibia (eg, pilon or tibial plafond), with or without internal or external 105 0
fixation: of both tibia and fibula
27830 Closed treatment of proximal tibiofibular joint dislocation 25 0
Open treatment of proximal tibiofibular joint dislocation with internal or
27832 40 0
external fixation or excision of distal or proximal fibula
27840 Closed treatment of ankle dislocation 25 0
27842 Closed treatment of ankle dislocation, with percutaneous skeletal fixation 40 0

Open treatment of ankle dislocation, with or without percutaneous skeletal
27846 60 0
fixation: without repair or internal fixation
Open treatment of ankle dislocation, with or without percutaneous skeletal
27848 75 0
fixation: with repair or internal or external fixation
Manipulation of ankle under general anesthesia (includes application of
27860 15 0
traction or other fixation apparatus)
27870 Arthrodesis, ankle, any method (separate procedure) 90 0
27871 Arthrodesis, tibiofibular joint, proximal or distal (separate procedure) 60 0
Amputation leg, through tibia and fibula: with or without immediate fitting
27881 60 0
technique including application of first cast
27884 Amputation leg: secondary closure or scar revision 40 0
Amputation ankle, through malleoli of tbia and fibula (Syme, Pirogoff type
27888 60 0
procedures), with plastic closure and resection of nerves
27889 Ankle disarticulation 60 0
Decompression fasciotomy, leg: posterior or anterior and/or lateral

27892 40 0
compartments only, with debridement of nonviable muscle and/or nerve
28001 Incision and drainage, infected bursa, foot 25 0

Deep dissection below fascia, for deep infection of foot, with or without
28002 25 0
tendon sheath involvement: single bursal space, specify
Deep dissection below fascia, for deep infection of foot, with or without
28003 35 0
tendon sheath involvement: multiple areas
28005 35 0
abscess), foot
28008 Fasciotomy, foot and/or toe 25 0
28010 Tenotomy, subcutaneous, toe: single or multiple 25 0
Arthrotomy, with exploration, drainage or removal of loose or foreign body:
28020 intertarsal or tarsometatarsal joint or metatarsophalangeal joint or 35 0
interphalangeal joint
28030 Neurectomy of intrinsic musculature of foot 35 0
28035 Tarsal tunnel release (posterior tibial nerve decompression) 35 0
28046 Radical resection of tumor (eg, malignant neoplasm), soft tissue of foot 50 0
Arthrotomy for synovial biopsy: interphalangeal joint or

28054 25 0
metatarsophalangeal or intertarsal or tarsometatarsal
28060 Fasciectomy, excision of plantar fascia:(separate procedure) 35 0
Synovectomy, intertarsal, tarsometatarsal or metatarsophalangeal joint,
28070 35 0
each
28072 Synovectomy, metatarsophalangeal joint, each 35 0
28080 Excision of interdigital (Morton) neuroma, single, each 30 0
28086 Synovectomy, tendon sheath, foot: flexor or extensor 25 0
Excision of lesion of tendon or fibrous sheath or capsule (including
28090 25 0
synovectomy) (cyst or ganglion): foot or toe
Excision or curettage of bone cyst or benign tumor, talus or calcaneus or
28102 metatarsal or phalanges of foot: with or without iliac or other autograft 45 0
(includes obtaining graft) or allograft
Ostectomy, partial or complete excision: one or more metatarsal head or
28110 35 0
tarsal coalition or calcaneus (bunionette) (separate procedure)

28120 for osteomyelitis or talar bossing), talus, calcaneus, tarsal, metatarsal bone, 35 0
or phalanges of toe
28126 Condylectomy, phalangeal base, single toe, each 25 0
28130 Talectomy (astragalectomy) 50 0
28140 Metatarsectomy 50 0
28150 Phalangectomy of toe, single, each head of phalanx, toe 25 0
28160 Hemiphalangectomy or interphalangeal joint excision, toe, single, each 25 0
28171 Radical resection for tumor: tarsal or metatarsal or phalanx of toe 50 0

28192 Removal of foreign body, foot: deep 35 0
Repair or suture of tendon, foot, flexor, single: primary or secondary,
28200 35 0
Repair or suture of tendon, foot, flexor or extensor, single: primary or
28202 40 0
secondary with free graft, single tendon (includes obtaining graft)
28222 Tenolysis, flexor or extensor, foot: single or multiple (through same incision) 25 0
Tenotomy, open, flexor or extensor: toe or foot, single or multiple (separate

28230 25 0
procedure)
Advancement of posterior tibial tendon with excision of accessory navicular
28238 50 0
bone (Kidner type procedure)
28240 Tenotomy, lengthening, or release, abductor hallucis muscle 35 0
Division of plantar fascia and muscle (Steindler stripping) (separate
28250 25 0
procedure)
Capsulotomy, midfoot: medial release only with or without tendon
28260 50 0
lengthening (separate procedure)
Capsulotomy, midfoot: extensive, including posterior talotibial capsulotomy

28262 105 0
and tendon(s) lengthening as for resistant clubfoot deformity
28264 Capsulotomy, midtarsal (Heyman type procedure) 70 0
Capsulotomy for contracture: interphalangeal joint or metatarsophalangeal

28270 25 0
joint, with or without tenorrhaphy, single, each joint (separate procedure)
Webbing operation (create syndactylism of toes) for soft corn (Kelikian type
28280 25 0
procedure)
28285 Hammertoe operation: one toe or for cock-up fifthh toe, any method 25 0
Ostectomy, partial, exostectomy or condylectomy, single, metatarsal head,
28288 25 0
first through fifth, each metatarsal head
Hallux valgus (bunion) correction: with or without metatarsal osteotomy or
28296 55 0
tendon transfer
Osteotomy, phalanx, calcaneus or talus, midtarsal bones, metatarsal(s)
28300 40 0
single or multiple
Reconstruction, angular deformity of toe (overlapping second toe, fifth toe,
28313 25 0
curly toes),soft tissue procedures
28315 Sesamoidectomy, first toe (separate procedure) 25 0
Repair of nonunion or malunion: tarsal bones or metatarsal, with or without
28322 50 0
Reconstruction, toe, macrodactyly: soft tissue resection or requiring bone
28340 50 0
resection
Reconstruction, toe(s): polydactyly or syndactyly, with or without skin graft
28345 35 0
(s), each web
Closed treatment or percutaneous skeletal fixation of calcaneal fracture:
28406 35 0
with manipulation
Open treatment of closed or open calcaneal fracture, with or without
28420 internal or external skeletal fixation: with primary autogenous bone graft 85 0
Closed treatment or percutaneous skeletal fixation of talus fracture: with
28436 25 0
manipulation
Open treatment of talus fracture, with or without internal or external
28445 70 0
fixation
Closed treatment or percutaneous skeletal fixation of tarsal bone fracture
28456 25 0
(except talus and calcaneus): with manipulation, each
Open treatment of closed or open tarsal bone fracture (except talus and
28465 40 0
calcaneus), with or without internal or external fixation, each
Closed treatment or percutaneous skeletal fixation of metatarsal fracture:
28476 25 0
with manipulation
Open treatment of metatarsal fracture, with/without internal or external
28485 35 0
fixation
Closed or open treatment or percutaneous skeletal fixation of fracture of
28496 any toe, phalanx or phalanges: with manipulation with or without fixation 25 0
(internal or external), each
Closed or open treatment of sesamoid fracture, with or without internal
28531 25 0
fixation
28540 Closed treatment of tarsal bone dislocation 25 0
Percutaneous skeletal fixation of tarsal bone dislocation other than
28546 25 0
talotarsal, with manipulation
Open treatment of tarsal bone dislocation, with or without internal or
28555 40 0
external fixation
Closed treatment or percutaneous skeletal fixation of talotarsal joint
28576 25 0
dislocation, with manipulation
Open treatment of talotarsal joint dislocation, with or without internal or
28585 40 0
external fixation
28600 Closed treatment of tarsometatarsal joint dislocation 25 0
Percutaneous skeletal fixation of tarsometatarsal joint dislocation, with
28606 45 0
manipulation
Open treatment of tarsometatarsal joint dislocation with or without internal
28615 50 0
or external fixation
Closed treatment or percutaneous skeletal fixation of metatarsophalangeal
28636 25 0
joint dislocation, with manipulation
Open treatment of metatarsophalangeal joint dislocation, with or without
28645 35 0
Closed treatment or percutaneous skeletal fixation of interphalangeal joint
28666 dislocation, with manipulation or open treatment with or without internal 25 0
or external fixation
28705 Pantalar, triple or subtalar arthrodesis (separate procedure) 95 0
Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse: with or

28735 70 0
without osteotomy as for flat foot correction (separate procedure)
Arthrodesis, midtarsal navicular-cuneiform, with tendon lengthening and

28737 55 0
advancement (Miller type procedure) (separate procedure)
Arthrodesis, great toe: tarsometatarsal, metatarsophalangeal or
28755 50 0
interphalangeal joint (separate procedure)
Arthrodesis, great toe, interphalangeal joint, with extensor hallucis longus
28760 transfer to first metatarsal neck (Jones type procedure) (separate 50 0
procedure)
28800 Amputation, foot: midtarsal or transmetatarsal 50 0
28810 Amputation, metatarsal, with toe, single 40 0
28820 Amputation, toe: metatarsophalangeal joint 25 0
29000 Application of halo type body cast 20 0
29015 Application of Risser jacket, localizer, body and/or head 20 0
29025 Application of turnbuckle jacket, body and/or head 20 0
29035 Application of body cast, shoulder to hips 15 0
Application of body cast, shoulder to hips: including head and/or one or
29040 20 0
both thighs
29049 Application: plaster figure of eight 10 0
29055 Application: shoulder spica 15 0
29058 Application: plaster Velpeau 10 0
29065 Application: shoulder to hand (long arm) cast 10 0
29075 Application: elbow to finger (short arm) cast 10 0
29085 Application: hand and lower forearm (gauntlet) cast 10 0
29105 Application of short or long arm splint (static or dynamic) 5 0
29130 Application of finger splint: static or dynamic 5 0
29200 Strapping: thorax low back, shoulder, elbow or wrist, hand or finger 5 0
29305 Application of hip spica cast: one leg 15 0
29325 Application of hip spica cast: one and one half spica or both legs 20 0
29355 Application of long leg cast (thigh to toes): walking or ambulatory type 10 0
29365 Application of cylinder cast (thigh to ankle) 10 0

Application of short leg cast (below knee to toes): walking or ambulatory
29425 10 0
type
29435 Application of patellar bearing (PTB) cast 10 0
29440 Adding walker to previously applied cast 5 0
Application of clubfoot cast with moulding or manipulation, long or short
29450 10 0
leg
29505 Application of short or long leg splint 5 0
29520 Strapping: hip, knee, ankle or toes 5 0
29580 Unna boot 5 0
29590 Denis-Browne splint strapping 5 0
29700 Removal or bivalving: gauntlet, boot, or body cast 5 0
29705 Removal or bivalving: full arm or full leg cast, shoulder or hip spica 10 0
29715 Removal or bivalving: turnbuckle jacket 5 0
29720 Repair of spica, body cast or jacket 5 0
29730 Windowing of cast 5 0
29740 Wedging of cast 10 0
Arthroscopy, diagnostic: any joint, with or without biopsy, limited

29800 debridement, partial synovectoomy, removal of loose or foreign body, lysis 40 0
and resection of adhesios or lavage and drainage (separate procedure)
29804 Arthroscopy, temporomandibular joint, surgical 45 0

Arthroscopy, shoulder, surgical: with complete synovectomy, extensive
29819 debridement, decompression of subacromial space with partial 65 0
acromioplasty with or without coracoacromial release
Arthroscopy, elbow, surgical: with complete synovectomy, or extensive
29836 55 0
debridement
Arthroscopy, wrist, surgical: with complete synovectomy, extensive
29845 debridement, excision and/or repair of triangular fibrocartilage with or 50 0
without debridement, or internal fixation for fracture instability
29848 Arthroscopy: wrist, surgical, with release of transverse carpal ligament 40 0
Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity

29850 fracture(s) of the knee, with or without manipulation: with or without 90 0
internal or external fixation (includes arthroscopy)
Arthroscopically aided treatment of tibial fracture, proximal (plateau):
29855 unicondylar, with or without internal or external fixation (includes 90 0
arthroscopy)
Arthroscopically aided treatment of tibial fracture, proximal (plateau):
29856 bicondylar, with or without internal or external fixation (includes 95 0
arthroscopy)
Arthroscopy, knee, surgical: for major synovectomy (2 or more
compartments), abrasion arthroplasty (includes chondroplasty where
29876 65 0
necessary), medial OR lateral meniscectomy, lysis of adhesions, or drilling
for intact osteochondritis dissecans
Arthroscopy, knee, surgical: with meniscectomy (medial AND lateral,

29880 75 0
including any meniscal shaving), or meniscus repair (medial OR lateral)
29883 Arthroscopy, knee, surgical: with meniscus repair (medial AND lateral) 90 0
Arthroscopy, knee, surgical: with drilling for osteochondritis dissecans with

29885 bone graft, with or without internal fixation (with debridement of base of 70 0
lesion)
Arthroscopically aided anterior OR posterior cruciate ligament
29888 95 0
repair/augmentation or reconstruction
Arthroscopy, ankle (tibiotalar and fibulotalar joints) surgical: with removal
29894 45 0
of loose body or foreign body, or synovectomy
30000 Drainage abscess or hematoma, nasal (separate procedure) 10 0
30100 Biopsy, intranasal (separate procedure) 10 0
30110 Excision, nasal polyp(s) 15 0
30120 Excision or surgical planing, skin of nose, for rhinophyma 45 0
30124 Excision dermoid cyst, nose: simple, skin, subcutaneous 15 0
30125 Excision dermoid cyst, nose: complex, under bone or cartilage 50 0
30140 Submucous resection turbinate, complete or partial 30 0
30160 Rhinectomy 60 0
30200 Injection into turbinate(s), therapeutic (separate procedure) 5 0
30220 Insertion, nasal septal prosthesis (button) 10 0
30300 Removal foreign body, intranasal: requiring general anesthesia 15 0
30320 Removal foreign body, intranasal: by lateral rhinotomy 50 0
30400 Rhinoplasty, primary or secondary, with or without turbinectomy 80 0
30430 Rhinoplasty, secondary: minor revision (tip rhinoplasty) 45 0
30520 Submucous resection of nasal septum 40 0
30540 Repair choanal atresia: intranasal 60 0
30545 Repair choanal atresia: transpalatine 80 0
30560 Lysis intranasal synechia 10 0
30620 Septal or other intranasal dermatoplasty (no graft included) 50 0
30630 Repair nasal septal perforations or fistula 50 0
30801 Cauterization and/or ablation, mucosa of turbinates (separate procedure) 15 0
30901 Control nasal hemorrhage, any method (separate procedure) 15 0

30920 Ligation arteries: ethmoidal or internal maxillary artery, transantral 55 0
Lavage by cannulation: sphenoid or maxillary sinus (antrum puncture, or
31000 15 0
natural ostium)
31020 Sinusotomy, maxillary (antrotomy): intranasal 20 0
Sinusotomy maxillary (antrotomy): radical (Caldwell-Luc), with or without
31030 40 0
removal of antrochoanal polyps
31040 Pterygomaxillary fossa surgery, any approach 60 0
31070 Sinusotomy, sphenoid, frontal or intanasal 40 0
Sinusotomy frontal: transorbital, unilateral (for mucocele or osteoma, Lynch
31075 60 0
type)
31080 Sinusotomy frontal: obliterative or nonbiliterarive 85 0
31090 Sinusotomy combined, three or more sinuses 75 0
31200 Ethmoidectomy 50 0
31215 Maxillectomy: with or without orbital exenteration 120 0
31231 Nasal endoscopy, diagnostic: unilateral or bilateral (separate procedure) 5 0
31233 Nasal/sinus endoscopy, diagnostic: with maxillary or sphenoid sinusoscopy 15 0
Nasal/sinus endoscopy, surgical: with biopsy, polypectomy, debridement,

31237 30 0
control of epistaxis or concha bullosa resection (separate procedure)
31239 Nasal/sinus endoscopy, surgical: with dacryocystorhinostomy 50 0

31254 Nasal/sinus endoscopy, surgical: with total or partial ethmoidectomy 35 0
Nasal/sinus endoscopy, surgical: with maxillary antrostomy, with or without
31256 25 0
removal of tissue from maxillary sinus
Nasal/sinus endoscopy, surgical: with frontal sinus exploration, with or
31276 55 0
without removal of tissue from frontal sinus
Nasal/sinus endoscopy, surgical: with sphenoidotomy, with or without
31287 25 0
removal of tissue from sphenoid sinus
Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak:
31290 110 0
ethmoid or sphenoid region
31292 Nasal/sinus endoscopy, surgical: with orbital wall decompression 95 0
31294 Nasal/sinus endoscopy, surgical: with optic nerve decompression 115 0
Laryngotomy (thyrotomy, laryngofissure): with removal of tumor or
31300 70 0
laryngocele, cordectomy
31360 Laryngectomy: total or subtotal supraglottic, without radical neck dissection 105 0
31365 Laryngectomy: total, with radical neck dissection 160 0

31368 Laryngectomy: subtotal supraglottic, with radical neck dissection 150 0
31370 Partial laryngectomy (hemilaryngectomy) 100 0
31390 Pharyngolaryngectomy with radical neck dissection: without reconstruction 130 0
31395 Pharyngolaryngectomy with radical neck dissection: with reconstruction 190 0
31400 Arytenoidectomy or arytenoidopexy, external approach 60 0

31420 Epiglottidectomy 60 0
31500 Endotracheal intubation and ventilation (emergency procedure) 15 0
Laryngoscopy, direct or indirect, diagnostic with or without biopsy (separate
31510 15 0
procedure)
Laryngoscopy, direct, diagnostic with or without biopsy (separate
31520 20 0
procedure) newborn
Laryngoscopy, direct, with or without tracheoscopy: diagnostic, with
31526 operating microscope with or without biopsy or removal of foreign body 30 0
Laryngoscopy, direct, operative, with excision of vocal cord nodule(s) or
31540 polyp(s) and or stripping of vocal cords, with or without operating 45 0
microscope
31578 Laryngoscopy, flexible fiberoptic: therapeutic (separate procedure) 20 0
31580 Laryngoplasty other than cricoid split 100 0
31586 Treatment of closed laryngeal fracture: with closed manipulative reduction 50 0
31587 Laryngoplasty, cricoid split 55 0

31590 Laryngeal reinnervation by neuromuscular pedicle 100 0
Section recurrent laryngeal nerve, therapeutic, unilateral (separate
31595 60 0
procedure)
31600 Tracheostomy, (separate procedure) 30 0
Construction of tracheoesophageal fistula and subsequent insertion of an

31611 30 0
alaryngeal speech prosthesis (eg, voice button, Blom-Singer prosthesis)
Tracheal puncture, percutaneous for aspiration of mucus (transtracheal

31612 5 0
aspiration) (separate procedure)
31613 Tracheostoma revision (separate procedure) 35 0
31615 Tracheobronchoscopy through established tracheostomy incision 15 0
Bronchoscopy, flexible or rigid: diagnostic (with or without cell washing or
31625 brushing, biopsy, transbronchial lung biopsy, or therapeutic aspiration of 35 0
tracheobronchial tree) (separate procedure)
Bronchoscopy, flexible or rigid: therapeutic (removal of foreign body,

bronchial dilation and placement of stent, closed reduction of fracture,
31630 40 0
excision of tumor, or destruction of tumor or relief of stenosis by any
method other than excision (eg, l
Brochoscopy: with injection of contrast material for segmental
31656 15 0
bronchography (fiberscope only)
31708 Instillation of contrast material for laryngography, without catheterization 10 0
Catheterization for bronchography, with or without the injection of contrast

31710 10 0
material
31715 Transtracheal injection for bronchography 10 0
31750 Tracheoplasty: cervical 60 0
31760 Tracheoplasty: intrathoracic 140 0
31766 Carinal reconstruction 140 0
31770 Bronchoplasty 140 0
31780 Excision tracheal stenosis, tumor or carcinoma and anastomosis: cervical 100 0
31786 Excision of tracheal tumor or carcinoma: thoracic 140 0

31800 Tracheorrhaphy, suture of external tracheal wound or injury 50 0
Closure of tracheostomy or tracheal fistula: with or without plastic repair
31820 30 0
31830 Revision of tracheostomy scar (separate procedure) 30 0
Thoracentesis, puncture of pleural cavity for aspiration, initial or
32000 10 0
subsequent
32005 Chemical pleurodesis (eg, for recurrent or persistent pneumothorax) 15 0
32020 Tube thoracostomy with or without water seal (separate procedure) 25 0
32035 Thoracostomy: with rib resection for empyema 50 0
Thoracotomy: with exploration and biopsy, control of hemorrhage or
32100 60 0
postoperative complications
Thoracotomy, major: with cyst(s) removal, with or without pneumonolysis,
32140 70 0
or removal of intrapleural foreign body or clots
Thoracotomy, major: with excision-plication of bullae, with or without any
32141 70 0
pleural procedure
32220 Decortication, pulmonary, (separate procedure): total 100 0
32310 Pleurectomy, parietal (separate procedure) 85 0
32400 Biopsy, pleura: percutaneous needle, one or more specimens 15 0
32402 Biopsy, pleura: open 50 0
32405 Biopsy, lung or mediastinum, percutaneous needle 15 0
32440 Pneumonectomy 150 0
Lobectomy, total or segmental, with or without bronchoplasty or
32480 120 0
decortication
32500 Wedge resection of lung, single or multiple 100 0
32601 Thoracoscopy, diagnostic, with or without biopsy (separate procedure) 50 0

32650 Thoracoscopy,surgical: with pleurodesis, any method 100 0
Thoracoscopy, surgical: with pulmonary decortication, with or without
32651 95 0
intrapleural pneumonolysis
Thoracoscopy, surgical: with removal of intrapleural foreign body, fibrin or
32653 80 0
control of traumatic hemorrhage,
Thoracoscopy, surgical: with excision-plication of bullae, including any
32655 80 0
pleural procedure, with or without parietal pleurectomy
Thoracoscopy, surgical: with removal of clot or foreign body from
pericardial sac, creation of pericardial window, partial resection of
32658 80 0
pericardial sac for drainage, total pericardiectomy, or excision of pericardial
cyst, tumor or mass
32662 Thoracoscopy, surgical: with excision of mediastinal cyst, tumor, or mass 95 0
Thoracoscopy, surgical: with segmental or total lobectomy, or wedge

32663 100 0
resection(s) of lung
32664 Thoracoscopy, surgical: with thoracic sympathectomy 85 0
32665 Thoracoscopy, surgical: with esophagomyotomy 100 0
32800 Repair lung hernia through chest wall 60 0
Closure of chest wall following open flap drainage for empyema (Clagett
32810 60 0
type procedure)
32815 Open closure of major bronchial fistula 150 0
32820 Major reconstruction, chest wall (post traumatic) 100 0
32900 Resection of ribs, extrapleural, all stages 60 0
32905 Thoracoplasty 150 0
32940 Pneumonolysis, extrapleural, including filling or packing procedures 70 0
32960 Pneumothorax, therapeutic 15 0
Cardiopulmonary bypass (extracorporeal circulation): add to primary
33000 60 0
procedure if performed
Total circulatory arrest under cardiopulmonary bypass: add to primary
33002 25 0
procedure
33010 Pericardiocentesis 15 0
33015 Tube pericardiostomy 30 0
33020 Pericardiotomy, with removal of foreign body (primary procedure) 75 0
33025 Creation of pericardial window or partial resection for drainage 75 0
33030 Pericardiectomy, complete (separate procedure) 115 0
33050 Excision of pericardial cyst or tumor 90 0
33120 Excision of intracardiac tumor 130 0
Insertion of permanent pacemaker with epicardial electrode(s): open
33200 75 0
procedure
Insertion of or replacement of permanent pacemaker with transvenous
33206 45 0
electrode(s): atrial or ventricular
Insertion or replacement of permanent pacemaker with transvenous
33208 55 0
electrode(s): atrial and ventricular
Insertion or replacement of temporary transvenous single chamber cardiac
33210 25 0
electrode, or pacemaker catheter (separate procedure)
Insertion or replacement of temporary transvenous dual chamber pacing
33211 30 0
electrodes (separate procedure)
Insertion or replacement of pacemaker pulse generator only: single
33212 35 0
chamber
33213 Insertion or replacement of pacemaker pulse generator only: dual chamber 40 0
Insertion or eplacement of implantable cardioverter-defibrillator pulse

33240 45 0
generator only
Implantation of automatic implantable cardioverter-defibrillator pads with
33245 85 0
or without sensing electrodes
Insertion or replacement of implantable cardioverter-defibrillator lead(s) by
33247 65 0
other than thoracotomy
Insertion or replacement of implantable cardioverter-defibrillator lead(s) by
33249 other than thoracotomy: with insertion of cardio-defibrillator pulse 85 0
generator
Operative ablation of supraventricular arrhythmogenic focus or pathway

33250 150 0
(eg, Wolff-Parkinson-White, A-V node re-entry), tract(s), and or focus (foci)
33300 Repair of cardiac wound or removal of foreign body 100 0

33320 Suture repair of aorta or great vessels 100 0
33330 Insertion of graft, aorta or great vessels 135 0
33400 Valvuloplasty, aortic valve, open 130 0
33404 Construction of apical-aortic conduit 180 0
Replacement, aortic valve: with or without aortic annulus enlargement,
33411 130 0
noncoronary cusp
33416 Resection or incision of subvalvular aortic stenosis 175 0
33417 Aortoplasty (gusset) for supravalvular stenosis 175 0
33420 Valvotomy, mitral valve (commisurotomy): closed 145 0
33425 Valvuloplasty, mitral valve, any method 150 0
33430 Replacement, mitral valve 125 0
33452 Valvotomy, tricuspid valve 95 0
Valvuloplasty or valvectomy, tricuspid valve, with or without insertion of
33460 125 0
tricuspid ring
Tricuspid valve replacement or repositioning and plication for Ebstein
33468 130 0
anomaly
33472 Valvotomy, pulmonary valve (commisurotomy) closed or open 95 0
Right ventricular resection for infundibular stenosis, with or without
33476 165 0
commisurotomy or gusset
33478 Pulmonary artery patch for supraventricular stenosis 140 0
33480 Double valve procedure 250 0
33483 Triple valve pocedure 270 0
33500 Repair of coronary arteriovenous or arteriocardiac chamber fistula 110 0
33503 Anomalous coronary artery: graft 130 0
33505 Anomalous coronary artery: reimplantation 200 0
Coronary artery bypass, single coronary graft, vein or artery, (includes
33510 170 0
obtaining graft)
Coronary artery bypass, double coronary graft, vein or artery, (includes
33511 190 0
obtaining grafts), with or without endarterectomy
Coronary artery bypass, triple coronary graft, vein or artery, (includes
33512 200 0
obtaining grafts), with or without endarterectomy
Coronary artery bypass, four or more coronary grafts, vein or artery,
33513 215 0
(includes obtaining grafts), with or without endarterectomy
33542 Myocardial resection (eg, repair of myocardial aneurysm) 130 0
Repair of postinfarction ventricular septal defect, with or without
33545 150 0
myocardial resection
33641 Repair atrial septal defect, secundum, with or without patch 100 0
Direct or patch closure, sinus venosus, with or without anomalous
33645 170 0
pulmonary venous drainage
Repair of atrial septal defect and ventricular septal defect, with direct or
33647 200 0
patch closure
33648 Correction of cor triatriatum 190 0
33649 Repair of tricuspid atresia 270 0
33650 Bicaval - bipulmonary bypass procedure 270 0
Repair of incomplete or partial atrioventricular canal (ostium primum atrial
33660 175 0
septal defect), with or without atrioventricular valve repair
33670 Repair of complete atrioventricular canal, with prosthetic valve 250 0
33681 Closure of ventricular septal defect, with or without patch 180 0
Closure of ventricular septal defect, with pulmonary valvotomy or
33684 200 0
infundibular resection, with or without patch
33690 Banding of pulmonary artery 100 0
Complete repair of tetralogy of Fallot: with or without closure of previous
33697 250 0
shunt
Repair sinus of Valsalva fistula, with/ without repair of ventricular septal
33710 150 0
defect
33720 Repair sinus of Valsalva aneurysm 90 0
33730 Complete repair of total anomalous venous return 200 0
33735 Atrial septectomy or septostomy any method 120 0
33750 Shunt: systemic or vena cava to pulmonary artery, with or without graft 120 0
33774 Repair of transposition of the great arteries, any method 300 0

33784 Total repair of double outlet ventricle 350 0
33785 Total repair of single ventricle (double inlet ventricle) 350 0
33786 Total repair, truncus arteriosus (Rastelli type operation) 200 0
33788 Reimplantation of anomalous pulmonary artery 125 0
Aortic suspension (aortopexy) for tracheal decompression (eg, for
33800 100 0
tracheomalacia) (separate procedure)
33803 Division of aberrant vessel (vascular ring): with or without reanastomosis 120 0
33813 Obliteration of aortopulmonary septal defect 100 0

33820 Patent ductus arteriosus: ligation and/or division, any age 120 0
Excision or repair of coarctation of aorta, with or without associated patent
33840 180 0
ductus arteriosus, any type
Ascending aorta graft, with or without valve suspension, with or without

33860 225 0
coronary reconstruction, with or without aortic root replacement
33870 Transverse arch graft, with or without cardiopulmonary by-pass 210 0
33875 Descending thoracic aorta graft, with or without cardiopulmonary by-pass 175 0
33877 Repair of thoracoabdominal aortic aneurysm with graft 230 0
33916 Pulmonary embolectomy or endarterectomy with or without embolectomy 125 0
Donor cardiectomy with or without pneumonectomy, with preparation and

33930 200 0
maintenance of allograft
33935 Heart-lung transplant with recipient cardiectomy-pneumonectomy 385 0
33945 Heart transplant, with or without recipient cardiectomy 275 0
33970 Intra-aortic balloon counterpulsation: add to primary procedure 30 0
33975 Implantation and removal of ventricle assist device: single ventricle 130 0
33976 Implantation and removal of ventricle assist device: double ventricle 175 0
Arterial embolectomy or thrombectomy, with or without catheter: carotid,
34001 subclavian, innominate, axillary, brachial, radial, or ulnar artery (separate 85 0
procedure)
Arterial embolectomy or thrombectomy, with or without catheter: renal,
34151 100 0
celiac, mesenteric, aortoiliac artery (separate procedure)
Arterial embolectomy or thrombectomy, with or without catheter:
34203 popliteal-tibio-peroneal, femoropopliteal, or aortoiliac artery (separate 80 0
procedure)
Venous thrombectomy, direct or with catheter: vena cava, iliac, or

34401 70 0
femoropopliteal vein by abdominal or by leg incision (separate procedure)
Venous thrombectomy, direct or with catheter: vena cava, iliac, or

34451 90 0
femoropopliteal vein, by abdominal and leg incision (separate procedure)
Venous thrombectomy, direct or with catheter: axillary and subclavian vein,

34471 65 0
by neck or arm incision (separate procedure)
34501 Valvuloplasty, femoral vein (separate procedure) 120 0
34510 Venous valve transposition, any vein donor (separate procedure) 120 0
34520 Cross-over vein graft to venous system (separate procedure) 120 0
34530 Saphenopopliteal vein anastomosis (separate procedure) 120 0
Direct repair of aneurysm, false aneurysm, or excision and graft insertion,
with or without patch graft for aneurysm, ruptured aneurysm, or occlusive
35001 130 0
disease: carotid, subclavian, innominate, vertebral, or axillary- brachial
artery
35045 with or without patch graft: for aneurysm, false aneurysm, ruptured 75 0
aneurysm or occlusive disease, radial or ulnar artery
Direct repair of aneurysm,false aneurysm, or excision and graft insertion,
35082 with or without patch graft: for aneurysm, false aneurysm, or occlusive 200 0
disease, abdominal aorta, visceral artery, iliac artery
35092 with or without patch graft: for ruptured aneurysm, abdominal aorta 225 0
involving visceral vessels
Direct repair of aneurysm, false aneurysm,or excision and graft insertion,
with or without patch graft: for aneurysm, false aneurysm or occlusive
35131 105 0
disease, iliac (common, hypogastric, external), common femoral, or
popliteal artery
35132 with or without patch graft: for ruptured aneurysm iliac (common, 125 0
hypogastric, external), common femoral, or popliteal artery
35180 Repair, congenital arteriovenous fistula: head and neck or extremities 85 0

35182 Repair, congenital arteriovenous fistula: thorax and abdomen 110 0
Repair, acquired or traumatic arteriovenous fistula: head and neck thorax
35188 110 0
and abdomen, or lower limbs
35201 Repair blood vessel, direct: neck, extremity, hand, finger, without graft 70 0
35211 Repair blood vessel, direct: intrathoracic, with bypass, without graft 140 0
35216 Repair blood vessel, direct: intrathoracic, without bypass 120 0
35221 Repair blood vessel, direct or with graft: intra-abdominal 110 0
35231 Repair blood vessel, with graft: neck, extremity, hand, finger 80 0
35241 Repair blood vessel, with graft: intrathoracic, with bypass 150 0
35246 Repair blood vessel, with graft: intrathoracic without bypass 125 0
Thromboendarterectomy, with or without patch graft: carotid, vertebral,
35301 125 0
subclavian, innominate
Thromboendarterectomy, with or without patch graft: abdominal aorta,
35331 175 0
and/or major branches, iliac - femoral
Thromboendarterectomy, with or without patch graft: axillary, brachial,
35381 common femoral, deep (profunda), femoral and/or popliteal, and/or 100 0
tibioperoneal
35470 Transluminal balloon angioplasty, percutaneous: any vessel 55 0
35480 Transluminal peripheral atherectomy, open or percutaneous: any vessel 55 0
35526 Bypass graft, with vein or prosthesis: carotid, subclavian , vertebral, axillary, 125 0
Bypass graft, with vein or prosthesis: aorto-splenic, renal, iliac, celiac, or

35531 165 0
mesenteric
35583 In-situ or reversed vein bypass: femoral-popliteal, or femoral-tibial 150 0
35681 Bypass graft, composite 60 0
Exploration (not followed by surgical repair), with or without lysis of artery:
35701 35 0
carotid, femoral, popliteal, or other artery
Exploration for postoperative hemorrhage, thrombosis, or infection: neck,
35800 45 0
extremity (separate procedure)
Exploration for postoperative hemorrhage, thrombosis, or infection:
35840 70 0
abdomen, chest (separate procedure)
35870 Repair of graft-enteric fistula 140 0
35875 Thrombectomy and/or repair of arterial or venous graft 70 0
35901 Excision of infected graft 70 0
Introduction of catheter, superior or inferior vena cava (separate
36010 15 0
procedure)
36011 Selective catheter placement, venous system: any site (separate procedure) 15 0
36100 Introduction of needle or intracatheter: any site (separate procedure) 15 0
36215 Selective catheter placement, arterial system: any site (separate procedure) 35 0
Selective catheter placement, coronary artery, single or multiple (separate
36230 35 0
procedure)
Insertion of implantable intra-arterial infusion pump (eg, for chemotherapy
36260 60 0
of liver) (separate procedure)
36261 Revision of implanted intra-arterial infusion pump (separate procedure) 35 0
36262 Removal of implanted intra-arterial infusion pump (separate procedure) 25 0
Placement of peripheral venous catheter by cutdown (outside O.R.)

36420 10 0
36450 Exchange transfusion, blood 20 0
36460 Transfusion, intrauterine, fetal 35 0
36470 Injection of sclerosing solution 10 0
36481 Percutaneous portal vein catheterization by any method 45 0
Placement of central venous catheter (subclavian, jugular, or other vein):
36488 15 0
percutaneous or cutdown separate procedure)
Repositioning of previously placed central venous catheter under
36493 10 0
fluoroscopic guidance (separate procedure)
36510 Catheterization of umbilical vein (separate procedure) 10 0
Percutaneous insertion or revision of implantable intravenous infusion
36530 35 0
pump chamber or Broviac catheter (separate procedure)
Insertion or revision of implantable intravenous pump, chamber, or Broviac
36531 40 0
catheter, open procedure
36532 Removal of implantable intravenous infusion pump (separate procedure) 20 0
Removal of implantable pediatric intravenous infusion pump or Broviac

36533 30 0
catheter (separate procedure)
Arterial catheterization or cannulation for sampling, monitoring or
36620 transfusion (separate procedure): percutaneous or cutdown, or prolonged 10 0
infusion therapy
36660 Catheterization, umbilical artery, newborn, for diagnosis or therapy 10 0
36821 Arterio-venous anastomosis, direct, any site 60 0
36825 Creation of arteriovenous fistula: any graft 70 0
Revision of an arteriovenous fistula, with or without thrombectomy,
36832 60 0
autogenous or non-autogenous graft
36834 Plastic repair of arteriovenous aneurysm 65 0
36835 Transposition of basilic vein A-V fistula 80 0
36861 Cannula declotting: with or without balloon catheter 15 0
Anastomosis: portocaval, renoportal, caval-mesenteric or splenorenal,
37140 150 0
proximal
Anastomosis: splenorenal, distal (selective decompression of
37181 175 0
esophagogastric varices, any technique)
37190 Plastic repair of arteriovenous aneurysm 60 0
Transcatheter retrieval, percutaneous, of intravascular foreign body (eg,
37203 35 0
fractured venous or arterial catheter)
Transcatheter occlusion or embolization (eg, for tumor destruction, to
37204 achieve hemostasis, to occlude a vascular malformation), percutaneous, any 120 0
method, non-central nervous system, non-head or neck
Transcatheter placement of an intravascular stent, (non coronary vessel),

37205 55 0
percutaneous or open: initial vessel
Transcatheter placement of an intravascular stent, (non coronary vessel),
37206 30 0
percutaneous or open: each additional vessel
37565 Ligation of internal jugular vein or carotid artery 35 0
37609 Ligation or biopsy, temporal artery 15 0
37615 Ligation, major artery (eg, post-traumatic, rupture): neck 30 0
37616 Ligation, major artery (eg, post-traumatic, rupture): chest or abdomen 100 0
37618 Ligation, major artery (eg, post-traumatic, rupture): extremity 30 0
Interruption, partial or complete, of inferior vena cava by suture, ligation,
37620 65 0
plication, clip, extravascular, intravascular (umbrella device)
Interruption, partial or complete, of femoral vein, by ligature,
37650 35 0
intravascular device
Interruption, partial or complete, of common iliac vein by ligature,
37660 70 0
intravascular device
Ligation and division of long saphenous vein at saphenofemoral junction, or
37700 25 0
distal interruptions
Ligation and division and complete stripping of long and/or short saphenous
37720 45 0
veins, open or endoscopic
Ligation,division and complete stripping, long or short saphenous veins, and

37735 radical with excision of ulcer,and skin graft, interruption of communicating 70 0
veins, and excision of deep fascia, open or endoscopic
Ligation of perforators, subfascial, radical (Linton type), with or without skin

37760 70 0
graft, open or endoscopic
Ligation and division of short saphenous vein at saphenopoplit-eal junction
37780 15 0
Ligation, division, and/or excision of recurrent or secondary varicose veins
37785 30 0
(clusters), one leg
38100 Splenectomy 90 0
38115 Repair of ruptured spleen with or without partial splenectomy 90 0
38200 Injection procedure for splenoportography 20 0
38230 Bone marrow harvesting for transplantation, per site 30 0
Blood-derived peripheral stem cell harvesting for transplantation, (per
38231 20 0
collection)
38240 Bone marrow or blood-derived peripheral stem cell transplantation 15 0
38300 Drainage of lymph node abscess or lymphadenitis 20 0
38380 Suture and/or ligation of thoracic duct: cervical approach 45 0
38381 Suture and/or ligation of thoracic duct: transthoracic approach 85 0
38382 Suture and/or ligation of thoracic duct: abdominal approach 60 0
38500 Biopsy or excision of lymph node(s): superficial (separate procedure) 20 0
Biopsy of lymph node(s): by needle, superficial (eg, cervical, inguinal, or
38505 10 0
axillary)
Biopsy or excision of lymph node(s): deep (cervical with or without excision
38510 30 0
of scalene fat pad, or axillary nodes) (separate procedure)
Biopsy or excision of lymph node(s): internal mammary node(s) (separate
38530 35 0
procedure)
Excision of cystic hygroma, axillary or cervical, without deep neurovascular
38550 45 0
dissection
Excision of cystic hygroma, axillary or cervical, with deep neurovascular
38555 90 0
dissection
Limited lymphadenectomy for staging (separate procedure): pelvic and
38562 65 0
para-aortic, retroperitoneal (aortic and/or splenic)
38700 Radical lymphadenectomy: suprahyoid 60 0
38720 Radical lymphadenectomy: cervical (complete) 90 0
38724 Cervical lymphadenectomy (modified radical neck dissection) 90 0
38745 Radical lymphadenectomy: axillary 80 0
38760 Radical lymphadenectomy: inguinofemoral, superficial 50 0
Radical lymphadenectomy: inguinofemoral, superficial, in continuity with
38765 pelvic lymphadenectomy, including external iliac, hypogastric, and 100 0
obturator nodes (separate procedure)
Radical lymphadenectomy: pelvic, including external iliac, hypogastric, and
38770 90 0
obturator nodes (separate procedure)
Radical lymphadenectomy: retroperitoneal, including pelvic, aortic, and
38780 100 0
renal nodes
38790 Injection procedure for lymphangiography 10 0
Mediastinotomy, with exploration, drainage, or removal of foreign body:
39000 40 0
cervical approach
Mediastinotomy, with exploration, drainage, or removal of foreign body:
39010 80 0
transthoracic approach or sternal split
39200 Excision of mediastinal cyst 80 0
39220 Excision of mediastinal tumor 100 0
39400 Mediastinoscopy, with or without biopsy 30 0
39501 Repair of diaphragmatic laceration, any approach 90 0
Repair, paraesophageal hiatus hernia, transabdominal, with or without

39502 100 0
funduloplasty, vagotomy, and/or pyloroplasty, except neonatal
Repair, neonatal diaphragmatic hernia, with or without chest tube insertion,

39503 170 0
with or without creation of ventral hernia
39520 Repair of diaphragmatic hernia, (except neonatal): any approach 100 0
Imbrication of diaphragm for eventration, transthoracic or transabdominal,
39545 100 0
paralytic or nonparalytic
40490 Biopsy of lip (separate procedure) 10 0
40500 Vermilionectomy with mucosal advancement 30 0
40510 Excision of lip: transverse wedge excision with primary closure 30 0
40520 Excision of lip: V-excision with primary direct linear closure 30 0
40525 Excision of lip: full thickness, reconstruction with any flap 60 0
40530 Resection of lip, more than one-fourth, without reconstruction 30 0
40650 Repair of lip, full thickness: any part 30 0
Plastic repair of cleft lip/nasal deformity: primary, partial or complete,
40700 85 0
unilateral
Plastic repair of cleft lip/nasal deformity: primary bilateral, one stage
40701 100 0
procedure
Plastic repair of cleft lip/nasal deformity: primary bilateral, two stages, per
40702 60 0
stage
Plastic repair of cleft lip/nasal deformity: secondary, by recreation of defect
40720 95 0
and reclosure
Plastic repair of cleft lip/nasal deformity: with cross lip pedicle flap (Abbe-
40761 95 0
Estlander type), including sectioning and insertion of pedicle
40806 Incision of labial frenum (frenotomy) 15 0
40808 Biopsy, vestibule of mouth 15 0
Excision of lesion of mucosa and submucosa, vestibule of mouth: without
40810 15 0
repair
Excision of lesion of mucosa and submucosa of vestibule of mouth: with
40814 20 0
repair
Excision of lesion of mucosa and submucosa, vestibule of mouth: complex
40816 40 0
with excision of underlying muscle
40818 Excision of mucosa of vestibule of mouth as donor graft 15 0
Excision of frenum, labial or buccal (frenumectomy, frenulectomy,
40819 15 0
frenectomy)
Destruction of lesion or scar of vestibule of mouth by physical methods (eg,
40820 15 0
laser, thermo, cryo, chemical)
40830 Closure of laceration, vestibule of mouth 15 0
40840 Vestibuloplasty: anterior and/or posterior; unilateral or bilateral 40 0
Vestibuloplasty: entire arch or complex (including ridge extension, muscle
40845 90 0
repositioning)
Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or
41000 floor of mouth: lingual, sublingual, supramylohyoid or submental or 15 0
submandibular space
41010 Incision of lingual frenum (frenotomy) 15 0
Extraoral incision and drainage of abscess, cyst, or hematoma of floor of
41015 20 0
mouth: sublingual, submental, submandibular or masticator space
41100 Biopsy of tongue: any part (separate procedure) 20 0
41108 Biopsy of floor of mouth (separate procedure) 20 0
Excision of lesion of tongue with or without closure: any part (separate
41110 20 0
procedure)
Excision of lesion of tongue with closure: with local tongue flap (separate
41114 50 0
procedure)
41115 Excision of lingual frenum (frenectomy) 20 0
41116 Excision, lesion floor of mouth 20 0
41120 Glossectomy: partial 50 0
41135 Glossectomy: partial or total, with unilateral radical neck dissection 150 0
41250 Repair of laceration : floor of mouth and/or tongue 20 0
41500 Mechanical fixation of tongue other than suture (eg, K-wire) 20 0
41510 Suture of tongue to lip for micrognathia (Douglas type procedure) 20 0
41520 Frenoplasty (surgical revision of frenum, eg, with Z-plasty) 25 0
41825 Excision of lesion or tumor, dentoalveolar structures: with or without repair 20 0
42000 Drainage of abscess of palate, uvula (separate procedure) 15 0

Biopsy or excision, lesion of palate, uvula: with or without closure (separate
42104 15 0
procedure)
42107 Excision, lesion of palate, uvula: with local flap closure 30 0
42120 Resection of palate or extensive resection of lesion (separate procedure) 40 0
42140 Uvulectomy 10 0
42145 Palatopharyngoplasty (uvulopalatopharyngoplasty, uvulopharyngoplasty) 60 0
42180 Repair, laceration of palate 15 0

Repair of hard and/or soft palate (palatoplasty) for cleft palate, lengthening,
42200 80 0
or repair of anterior palate: any method
42260 Repair of nasolabial fistula 30 0
Drainage of abscess: parotid, submaxillary or sublingual gland (separate
42310 20 0
procedure)
42325 Fistulization of sublingual salivary cyst 20 0
42330 Sialolithotomy: submaxillary, sublingual or parotid, office procedure 20 0
42340 Sialolithotomy: parotid, extraoral 30 0
42400 Biopsy of salivary gland: needle (separate procedure) 5 0
42405 Biopsy of salivary gland: incisional (separate procedure) 20 0
42408 Excision of sublingual cyst (ranula) (separate procedure) 30 0
42409 Marsupialization of sublingual salivary cyst (ranula) (separate procedure) 20 0
Excision of parotid tumor or parotid gland: lateral lobe, with or without

42415 100 0
dissection and preservation of facial nerve
Excision of parotid gland: total, with dissection and preservation of facial
42420 110 0
nerve
42425 Excision of parotid gland: total en bloc removal with sacrifice of facial nerve 65 0
42426 Excision of parotid gland: total, with unilateral radical neck dissection 100 0
42440 Excision of submandibular (submaxillary) tumor and/or gland 45 0
42450 Excision of sublingual gland 30 0
42500 Plastic repair of salivary duct, sialodochoplasty: primary or simple 30 0
42505 Plastic repair of salivary duct, sialodochoplasty: secondary or complicated 40 0
42507 Parotid duct diversion, bilateral (Wilke type procedure) 40 0

Parotid duct diversion, bilateral: with excision of one or both submandibular
42509 75 0
glands
Parotid duct diversion, bilateral: with ligation of both submandibular
42510 50 0
(Wharton's) ducts
42550 Injection procedure for sialography (separate procedure) 10 0
42600 Closure of salivary fistula 30 0
Incision and drainage abscess: retropharyngeal or parapharyngeal, intraoral
42720 15 0
approach (separate procedure)
Incision and drainage abscess: peritonsillar retropharyngeal or
42725 35 0
parapharyngeal, external approach (separate procedure)
42800 Biopsy: oropharynx, hypopharynx or nasopharynx (separate procedure) 15 0

Excision branchial cleft cyst or vestige, confined to skin and subcutaneous
42810 20 0
tissues
Excision branchial cleft cyst, vestige, or fistula, extending beneath
42815 50 0
subcutaneous tissues and/or into pharynx
Tosillectomy and adenoidectomy, including treatment of postoperative
42821 35 0
complications: any age
42830 Adenoidectomy (separate procedure): primary or secondary 20 0
Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone:
42842 55 0
without closure
Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone:
42844 100 0
closure with local flap (eg, tongue, buccal) or other flap
42860 Excision of tonsil tag(s) 15 0
42870 Excision or destruction of lingual tonsil, any method (separate procedure) 35 0
42880 Excision of nasopharyngeal lesion (eg, fibroma) 40 0

42900 Suture of wound or injury of pharynx 35 0
42950 Pharyngoplasty 55 0
42953 Pharyngoesophageal repair 55 0
42955 Pharyngostomy (fistulization of pharynx, external for feeding) 45 0
Control oropharyngeal or nasopharyngeal hemorrhage, primary or
42960 15 0
secondary (eg, post-tonsillectomy): simple
Control oropharyngeal or nasopharyngeal hemorrhage, primary or
42961 35 0
secondary: complicated, requiring hospitalization
Control oropharyngeal or nasoppharyngeal hemorrhage, primary or
42962 45 0
secondary: with secondary surgical intervention (separate procedure)
43020 Esophagotomy, cervical approach: with or without removal of foreign body 70 0
43030 Cricopharyngeal myotomy 50 0

Esophagotomy, thoracic approach, for biopsy, removal of foreign body, or
43045 100 0
diverticulum
Esophagectomy, partial or total, with or without anastomosis and or
43115 190 0
reconstruction, any approach, any method
43120 Esophagogastrectomy, thoracoabdominal approach 180 0
Diverticulectomy of hypopharynx or esophagus, with or without myotomy:
43130 70 0
cervical approach
Diverticulectomy of hypopharynx or esophagus, with or without myotomy:
43135 100 0
thoracic approach
43200 Esophagoscopy, rigid or flexible fiberoptic: diagnostic (separate procedure) 15 3
43205 Esophagoscopy, rigid or flexible fiberoptic: therapeutic 30 0
Upper gastrointestinal endoscopy (esophagus, stomach, and either the

43235 25 3
duodenum and/or jejunum as appropriate): diagnostic (separate procedure)
Upper gastrointestinal endoscopy (esophagus, stomach, and either the

43241 30 0
duodenum and/or jejunum as appropriate): therapeutic
Endoscopic retrograde cholangiopancreatography (ERCP) diagnostic
43260 40 6
Endoscopic retrograde cholangiopancreatography (ERCP) therapeutic
43264 70 6
Esophagoplasty (plastic repair or reconstruction), cervical approach: without
43300 60 0
repair of tracheoesophageal fistula
Esophagoplasty (plastic repair or reconstruction), cervical approach: with
43305 100 0
Esophagoplasty (plastic repair or reconstruction), thoracic approach:
43310 100 0
without repair of tracheoesophageal fistula
Esophagoplasty (plastic repair or reconstruction), thoracic approach: with
43312 180 0
Esophagogastrostomy (cardioplasty) with or without vagotomy and
43320 100 0
pyloroplasty: abdominal or thoracic approach
Fundoplication for gastroesophageal reflux or hiatus hernia eg. Nissen,
43324 110 0
Belsey IV, or Hill procedure, (any approach)
Esophagomyotomy (Heller type),with or without hiatal hernia repair:
43330 100 0
abdominal or thoracic approach
43340 Esophagojejunostomy (without total gastrectomy) 100 0
43350 Esophagostomy 70 0
43400 Direct ligation of esophageal varices 100 0
43410 Suture of esophageal wound or injury: cervical approach 70 0
43415 Suture of esophageal wound or injury: thoracic approach 100 0
43420 Closure of esophagostomy or fistula 70 0
Dilation of esophagus, by unguided sound or bougie, single or multiple
43450 15 0
passes (separate procedure)
43456 Dilation of esophagus, by balloon or dilator: retrograde 15 0
Dilation of esophagus for achalasia (balloon 30 mm or larger) (separate
43458 20 0
procedure)
Esophagogastric tamponade, with balloon (Sengstaaken type) (separate
43460 15 0
procedure)
43500 Gastrotomy: with exploration or removal of foreign body 70 0
43520 Pyloromyotomy (Fredet-Ramstedt type operation) 70 0
Biopsy of stomach: by capsule, tube, peroral (one or more specimens)
43600 15 0
43605 Biopsy of stomach: by laparatomy (separate procedure) 60 0
43610 Local excision of stomach ulcer or tumor 70 0
Gastrectomy, total: with repair by intestinal transplant, without
43620 160 0
lymphadenectomy
Gastrectomy, total: with repair by intestinal transplant, with
43621 170 0
lymphadenectomy
Hemigastrectomy: distal subtotal gastrectomy including pyloroplasty,

43631 120 0
gastroduodenostomy or gastrojejunostomy: with or without vagotomy
Hemigastrectomy: proximal subtotal gastrectomy including pyloroplasty,

43638 140 0
gastroduodenostomy or gastrojejunostomy: with or without vagotomy
Vagotomy including pyloroplasty, with or without gastrostomy: truncal or

43640 115 0
selective or highly selective
Percutaneous and/or endoscopic placement of gastrostomy tube (separate
43750 30 0
procedure)
43760 Change of gastrostomy tube (separate procedure) 15 0
Repositioning of the gastric feeding tube through the duodenum for enteric
43761 15 0
nutrition (separate procedure)
43800 Pyloroplasty 70 0
43810 Gastroduodenostomy or gastrojejunostomy, 70 0
43825 Gastrojejunostomy with vagotomy, any type 115 0
43830 Gastrostomy 70 0
43832 Gastrostomy, permanent, with construction of gastric tube 70 0
43840 Gastrorrhaphy 70 0
Gastric restrictive procedure with or without bypass for morbid obesity, any
43842 130 0
method
Revision of gastrojejunostomy with reconstruction, with or without
43860 120 0
vagotomy
43870 Closure of gastrostomy, surgical 60 0
43880 Closure of gastrocolic fistula 115 0
44005 Enterolysis with acute bowel obstruction (separate procedure) 80 0
Enterotomy, small bowel other than duodenum: for exploration, biopsy, or
44020 75 0
foreign body removal (separate procedure)
44050 Reduction of volvulus, intussusception, internal hernia, by laparatomy 70 0
44100 Biopsy of intestine by capsule, tube, peroral (one or more specimens) 20 0

Excision of one or more lesions of small or large bowel not requiring
44110 anastomosis, exteriorization, or fistulization: single or multiple 80 0
enterotomies
44120 Enterectomy: with anastomosis 95 0
44140 Colectomy, partial: with anastomosis or skin level cecostomy or colostomy 105 0
Colectomy, partial: with colpoproctostomy (low pelvic anastomosis), with or

44146 130 0
without colostomy
Colectomy, total, abdominal, without proctectomy: with continent
44150 135 0
ileostomy or ileoproctostomy
Colectomy, total or subtotal, with proctectomy: with rectal mucosectomy,
44153 ileoanal or coloanal anastomosis, creation of reservoir (S or J), with or 180 0
without loop ileostomy or colostomy
44156 Colectomy, total, abdominal, with proctectomy: with continent ileostomy 140 0
44157 Laparatomy for newborn intestinal occlusion 130 0

Enterostomy or cecostomy, tube (eg, for decompression or feeding)
44300 70 0
44310 Ileostomy or jejunostomy, non-tube (separate procedure) 75 0
44320 Colostomy or skin level cecostomy (separate procedure) 75 0
44321 Colostomy in newborn 85 0
Revision of colostomy: simple (release of superficial scar) (separate
44340 20 0
procedure)
44345 Reconstruction of colostomy (separate procedure) 70 0
Small intestine endoscopy, enteroscopy beyond second portion of
44360 35 0
duodenum: diagnostic or therapeutic (separate procedure)
Fiberoptic ileoscopy through stoma: diagnostic, with/without biopsy and/or

44380 15 0
collection of specimen by brushing or washing (separate procedure)
Fiberoptic ileoscopy through stoma: with biopsy and/or collection of

44382 15 0
specimen by brushing or washing (separate procedure)
Fiberoptic evaluation of small intestinal or pelvic pouch: diagnostic, with or
44385 without biopsy and/or collection of specimen by brushing or washing 15 0
Fiberoptic colonoscopy through colostomy: diagnostic or therapeutic
44388 15 0
Suture of intestine , large or small, for perforated ulcer, diverticulum,
44602 80 0
wound, injury or rupture, single or multiple
Closure of enterostomy, large or small intestine: with or without resection
44625 80 0
and anastomosis
44626 Closure of colostomy (under age 2 years) 85 0
44640 Closure of intestinal cutaneous fistula 80 0
44650 Closure of enteroenteric or enterocolic fistula 90 0
44660 Closure of enterovesical fistula 95 0
44800 Excision of Meckel's diverticulum or omphalomesenteric duct 70 0
44820 Excision of benign lesion of mesentery (separate procedure) 60 0
44821 Excision of malignant lesion of mesentery (separate procedure) 90 0
44850 Suture of mesentery (separate procedure) 60 0
44950 Appendectomy, any method (non-incidental procedure) 60 0
45000 Transrectal drainage of pelvic abscess (separate procedure) 25 0
Incision and drainage of deep supralevator, pelvirectal, or retrorectal
45020 25 0
abscess
Biopsy of anorectal wall, anal approach (eg, congenital megacolon)
45100 25 0
45108 Anorectal myomectomy for short segment megacolon 50 0
Proctectomy: complete, combined abdominoperineal, with colostomy, one
45110 150 0
or two stages
Proctectomy, complete: (eg, for congenital megacolon, Swenson, Duhamel,
45120 160 0
or Soave type operation)
Excision of rectal procidentia with anastomosis: abdominal and/or perineal
45135 100 0
approach
45150 Division of stricture of rectum (separate procedure) 35 0
Excision of rectal tumor by proctotomy, transacral or transcoccygeal
45160 100 0
approach
45170 Excision of rectal tumor, transanal approach 50 0
Proctosigmoidoscopy: diagnostic with or without biopsy (separate
45300 20 0
procedure)
45330 Sigmoidoscopy, therapeutic (separate procedure) 30 0
Colonoscopy, with standard sigmoidoscope, transabdominal via colotomy,
45355 25 0
single or multiple (separate procedure)
45378 Colonoscopy, fiberoptic, beyond splenic flexure: diagnostic 40 3
45383 Colonoscopy, fiberoptic, beyond splenic flexure: therapeutic 45 0
45505 Proctoplasty: for prolapse of mucous membrane or stenosis 50 0
45520 Perirectal injection of sclerosing solution for prolapse 15 0
45540 Proctopexy for prolapse: abdominal or perineal approach 100 0
Closure of rectovesical fistula or rectourethral fistula: with or wihtout
45805 100 0
colostomy
45905 Dilation of anal or rectal sphincter (separate procedure) under anesthesia 15 0
45915 Removal of impacted feces or foreign body (separate procedure) 15 0

Incision and drainage of ischiorectal, perirectal or perianal abscess
46040 35 0
Incision and drainage of ischiorectal or intramural abscess, with
46060 40 0
fistulectomy, submuscular
46070 Incision, anal septum (infant) 30 0
46080 Sphincterotomy, anal (separate procedure) 30 0
46200 Fissurectomy, with or without sphincterotomy 35 0
46260 Hemorrhoidectomy, external and/or internal 45 0
Hemorrhoidectomy, internal and external: with fistulectomy and/or
46262 50 0
fissurectomy
Surgical treatment of anal fistula: fistulotomy / fistulectomy (separate
46270 45 0
procedure)
46500 Injection of sclerosing solution, hemorrhoids (separate procedure) 15 0
46600 Anoscopy: diagnostic (separate procedure) 5 0
46610 Anoscopy: therapeutic (separate procedure) 15 0
46700 Anoplasty, for stricture (separate procedure) 55 0
46715 Repair of congenital anovaginal fistula (cutback like procedure) 55 0
Construction of anus for high congenital absence: perineal or
46730 150 0
sacrococcygeal approach or abdomino-perineal approach
46750 Sphincteroplasty, anal, for incontinence or prolapse 65 0
46760 Sphincteroplasty, anal, for incontinence: muscle transplant 150 0
Destruction of internal or external hemorrhoids or of lesion(s) of anus, any

46900 20 0
method (eg. Banding, sclerotherapy, cryotherapy, laser or other)
46937 Cryosurgery of rectal tumor: benign (separate procedure) 20 0

46938 Cryosurgery of rectal tumor: malignant (separate procedure) 30 0
Curettage or cauterization of anal fissure, including dilation of anal
46940 20 0
sphincter (separate procedure)
46945 Ligation of internal hemorrhoids (separate procedure) 20 0
47000 Biopsy of liver, percutaneous needle (separate procedure) 15 0
47010 Hepatotomy for drainage of abscess or cyst, one or two stages 65 0
47100 Biopsy of liver, wedge (separate procedure) 65 0
47101 Transjugular liver biopsy 65 0
47102 Transjugular intrahepatic porto-systemic shunt 75 0
47120 Hepatectomy: partial lobectomy 130 0
47122 Hepatectomy: trisegmentectomy 200 0
47125 Hepatectomy: total left lobectomy 200 0
47130 Hepatectomy: total right lobectomy 200 0
Donor hepatectomy, with preparation and maintenance of allograft: from
47133 400 0
cadaver donor
Donor hepatectomy, with preparation and maintenance of allograft: partial,
47134 300 0
from living donor
Liver allotransplantation: orthotopic, partial or whole, from cadaver or living
47135 500 0
donor, any age
Liver allotransplantation: heterotopic, partial or whole, from cadaver or
47136 400 0
living donor, any age
47300 Marsupialization of cyst or abscess of liver 70 0
47320 Evacuation of hydatid cyst, single, any method 75 0
47325 Evacuation of hydatid cyst, multiple, any method 90 0
Management of liver hemorrhage: hepatorrhaphy, with or without ligation
47350 80 0
of hepatic artery
Hepaticotomy or hepaticostomy with exploration, drainage, or removal of
47400 110 0
calculus
Choledochotomy or choledochostomy with exploration, drainage, or
47425 removal of calculus, with or without cholecystotomy: with or without 110 0
transduodenal sphincterotomy or sphincteroplasty
47460 Transduodenal sphincterotomy or sphincteroplasty (separate procedure) 110 0
Cholecystotomy or cholecystostomy with exploration, drainage, or removal

47480 55 0
of calculus (separate procedure)
47500 Injection procedure for percutaneous transhepatic cholangiography 20 0
47510 Introduction of percutaneous transhepatic catheter for biliary drainage 50 0
47511 Introduction of transhepatic stent for internal and external biliary drainage 55 0
47525 Change of percutaneous biliary drainage catheter (separate procedure) 20 0
47530 Revision and/or reinsertion of transhepatic T-tube (separate procedure) 30 0
47600 Cholecystectomy: with or without cholangiography, any method 80 0

47610 Cholecystectomy: with exploration of common duct 110 0
Cholecystectomy: with transduodenal sphincterotomy or sphincteroplasty,
47620 110 0
with or without cholangiography
47630 Percutaneous stone extraction by basketing 50 0
Exploration for congenital atresia of bile ducts, without repair, with or
47700 80 0
without liver biopsy, with or without cholangiography
47701 Portoenterostomy (eg, Kasai procedure) 180 0
47720 Cholecystoenterostomy: direct (any method) 80 0
47760 Anastomosis, direct, of extrahepatic biliary ducts and gastrointestinal tract 130 0
47765 Anastomosis, direct, of intrahepatic ducts and gastrointestinal tract 140 0

Reconstruction, plastic, of extrahepatic biliary ducts with end-to-end
47800 120 0
anastomosis
47801 Placement of choledochal stent (separate procedure) 80 0
48000 Drainage of abdomen for pancreatitis (separate procedure) 80 0
48100 Biopsy of pancreas (separate procedure) 70 0
48102 Biopsy of pancreas, percutaneous needle 15 0
48120 Excision of lesion of pancreas (eg, cyst, adenoma) 90 0
Pancreatectomy, distal subtotal, with or without splenectomy: with or
48145 130 0
without pancreaticojejunostomy
Pancreatectomy,proximal subtotal, with pancreaticoduodenectomy
48150 205 0
(Whipple type procedure), and pancreatic jejunostomy
48155 Pancreatectomy,total 190 0
48180 Pancreaticojejunostomy, side-to-side anastomosis (Puestow type operation) 120 0
48500 Marsupialization of cyst of pancreas 80 0
48520 Internal anastomosis of pancreatic cyst to gastro-intestinal tract: direct 90 0
48540 Internal anastomosis of pancreatic cyst to gastrointestinal tract: Roux-en-Y 110 0
Exploratory laparatomy, exploratory celiotomy, with or without biopsy

49000 80 0
49002 Reopening of recent laparatomy (separate procedure) 70 0
Exploration of retroperitoneal area with or without biopsy (separate
49010 70 0
procedure)
Drainage of peritoneal abscess or localizd peritonitis, transabdominal
49020 70 0
49040 Drainage of subdiaphragmatic or subphrenic abscess (separate procedure) 70 0
49060 Drainage of retroperitoneal abscess (separate procedure) 70 0

Peritoneocentesis, abdominal paracentesis or peritoneal lavage (diagnostic
49080 15 0
or therapeutic)
49180 Biopsy, abdominal or retroperitoneal mass, percutaneous needle 15 0
Excision or destruction by any method of intra-abdominal or retroperitoneal
49200 90 0
tumors or cysts or endometriomas
Excision or destruction by any method of intra-abdominal or retroperitoneal
49201 110 0
tumors or cysts or endometriomas: extensive
49215 Excision of presacral or sacrococcygeal tumor 110 0
Staging celiotomy for Hodgkin's or lymphoma (includes splenectomy,
49220 biopsies of liver lobes, and possible removal of abdominal nodes, abdominal 110 0
node and/or bone marrow biopsies, ovarian repositioning)
49255 Omentectomy, epiploectomy, resection of omentum (separate procedure) 70 0
49400 Pneumoperitoneum 15 0
49420 Insertion of intraperitoneal cannula or catheter 15 0
49425 Insertion of peritoneal-venous shunt (eg, LeVeen shunt) 70 0
49426 Revision of peritoneal-venous shunt 60 0
Injection procedure (eg, contrast media) for evaluation of previously placed
49427 10 0
peritoneal-venous shunt
Repair initial inguinal hernia, under age 5 years, with or without
49496 55 0
hydrocelectomy
Repair inguinal hernia, age 5 years or over, initial, recurrent, or sliding, with
49507 70 0
or without prosthesis, with or without hydrocelectomy
49550 Repair femoral, umbilical, or lumbar hernia, any age, initial 55 0
Repair femoral, umbilical, or lumbar hernia, any age, recurrent, with or
49553 70 0
without prosthesis
Repair incisional (abdominal) hernia, reducible, with or without prosthesis:
49560 70 0
initial separate procedure)
Repair incisional (abdominal) hernia, reducible, with or without prosthesis:
49565 90 0
recurrent, with total abdominal repair
49590 Repair spigelian hernia 55 0
49600 Repair of omphalocele: small, with primary closure 55 0
49605 Repair of omphalocele: large or gastroschisis, with or without prosthesis 110 0
Repair of omphalocele: with staged closure of prosthesis, reduction in

49606 110 0
operating room, under anesthesia
49610 Repair of omphalocele (Gross type operation): first stage 70 0
49611 Repair of omphalocele (Gross type operation): second stage 55 0
49900 Secondary suture of abdominal wall for evisceration or dehiscence 55 0
Omental flap (eg, for reconstruction of sternal and chest wall defects (list
49905 55 0
separately in addition to code for primary procedure)
50020 Drainage of perirenal or renal abscess (separate procedure) 70 0
50040 Nephrostomy, nephrotomy with drainage 70 0
50045 Nephrotomy, with exploration 80 0
50060 Nephrolithotomy 110 0
50065 Nephrolithotomy: secondary surgical operation for calculus 120 0
50070 Nephrolithotomy: complicated by congenital kidney abnormality 115 0
Nephrolithotomy: removal of large staghorn calculus filling renal pelvis and
50075 150 0
calyces (including anatrophic pyelolithotomy)
Percutaneous nephrostolithotomy or pyelostolithotomy, with or without
50080 110 0
dilation, endoscopy, lithotripsy, stenting or basket extraction
50100 Transection or repositioning of aberrant renal vessels (separate procedure) 90 0
50125 Pyelotomy: with exploration, drainage, pyelostomy 90 0

Pyelotomy: with removal of calculus (pyelolithotomy, pelviolithotomy,
50130 90 0
including coagulum pyelolithotomy)
Pyelotomy: complicated (eg, secondary operation, congenital kidney
50135 100 0
abnormality)
50200 Renal biopsy: percutaneous, by trocar or needle 20 0
50205 Renal biopsy: by surgical exposure of kidney 75 0
Nephrectomy, including partial ureterectomy, any approach including rib
50220 100 0
resection
Nephrectomy, including partial ureterectomy, any approach including rib
50230 resection: radical, with regional lymphadenectomy and/or vena caval 140 0
thrombectomy
50234 Nephrectomy, with total ureterectomy and bladder cuff 140 0
50240 Nephrectomy, partial 100 0
50280 Excision or unroofing of cyst(s) of kidney 75 0
50290 Excision of perinephric cyst 75 0
Donor nephrectomy, with preparation and maintenance of homograft: from
50320 120 0
live donor, unilateral
50340 Recipient nephrectomy (separate procedure), bilateral 100 0
Renal homotransplantation, implantation of graft: excluding donor and
50360 150 0
recipient nephrectomy
Renal homotransplantation, implantation of graft: with recipient
50365 200 0
nephrectomy
50370 Removal of transplanted homograft (eg, infarcted or rejected kidney) 90 0
50380 Renal autotransplantation, reimplantation of kidney 130 0
50390 Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous 20 0
Introduction of intracatheter or catheter into renal pelvis for drainage

50392 20 0
and/or injection, percutaneous
Introduction of ureteral catheter or stent into ureter through renal pelvis
50393 25 0
for drainage and/or injection, percutaneous
Injection procedure for pyelography through nephrostomy or pyelostomy
50394 15 0
tube, or indwelling catheter
Introduction of guide into renal pelvis and/or ureter with dilation to
50395 25 0
establish nephrostomy tract, percutaneous
Manometric studies through nephrostomy or pyelostomy tube, or
50396 10 0
indwelling catheter
50398 Change of nephrostomy or pyelostomy tube 10 0
Pyeloplasty (Foley Y-pyeloplasty), with or without plastic operation on

50400 110 0
ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting
50500 Nephrorrhaphy, suture of kidney wound or injury 100 0

50520 Closure of nephrocutaneous or pyelocutaneous fistula 90 0
50525 Closure of nephrovisceral fistula (eg, renocolic), including visceral repair 100 0
Symphysiotomy for horseshoe kidney with or without pyeloplasty and/or

50540 110 0
other plastic procedure, unilateral or bilateral (one operation)
Renal endoscopy through established nephrostomy or pyelostomy,
50551 25 0
diagnostic or therapeutic
50590 Lithotripsy, extracorporeal shock wave 65 0
50600 Ureterotomy with exploration or drainage (separate procedure) 70 0
50605 Ureterotomy for insertion of indwelling stent, all types 70 0
50610 Ureterolithotomy 70 0
50650 Ureterectomy, with bladder cuff (separate procedure) 95 0
Ureterectomy, total, ectopic ureter, combination abdominal, vaginal and/or
50660 110 0
perineal approach
Injection procedure for ureterography or ureteropyelography through
50684 5 0
ureterostomy or indwelling ureteral catheter
50686 Manometric studies through ureterostomy or indwelling ureteral catheter 10 0
50688 Change of ureterostomy tube 10 0

Injection procedure for visualization of ilial conduit and/or
50690 10 0
ureteropyelography exclusive of radiologic service
50700 Ureteroplasty, plastic operation on ureter (eg, stricture) 100 0
Ureterolysis, with or without repositioning of ureter for retroperitoneal
50715 90 0
fibrosis or for ovarian vein sydrome
Ureterolysis, for retrocaval ureter, with reanastomosis of upper urinary
50725 110 0
tract or vena cava
Revision of urinary-cutaneous anastomosis (any type urostomy): with or
50728 70 0
without repair of fascial defect and hernia
50740 Ureteropyelostomy, anastomosis of ureter and renal pelvis or calyx 110 0
50760 Uretero-ureterostomy 100 0
50770 Transureteroureterostomy, anastomosis of ureter to contralateral ureter 115 0
50780 Ureteroneocystostomy, anastomosis of single ureter to bladder 100 0

50782 Ureteroneocystostomy, anastomosis of duplicated ureter to bladder 115 0
Ureteroneocystostomy, anastomosis of ureter to bladder, with vesico-psoas
50785 110 0
hitch or bladder flap
50800 Ureteroenterostomy, direct anastomosis of ureter to intestine 90 0
Ureterosigmoidostomy, with creation of sigmoid bladder and establishment

50810 120 0
of abdominal or perineal colostomy, including bowel anastomosis
50815 Ureterocolon conduit, including bowel anastomosis 120 0

Ureteroileal conduit (ileal bladder), including bowel anastomosis (Bricker
50820 120 0
operation)
Continent diversion, including bowel anastomosis using any segment of
50825 150 0
small and/or large bowel (Kock pouch or Camey enterocystoplasty)
Urinary undiversion (eg, taking down of ureteroileal conduit,
50830 ureterosigmoidostomy or ureteroenterostomy with ureteroenterostomy or 160 0
ureteroneocystostomy)
Replacement of all or part of ureter by bowel segment, including bowel
50840 125 0
anastomosis
50860 Ureterostomy, transplantation of ureter to skin 80 0
50900 Ureterorrhaphy (separate procedure) 80 0
50920 Closure of ureterocutaneous fistila 80 0
50930 Closure of ureterovesical fistula, (including visceral repair) 95 0
50940 Deligation of ureter 70 0
Ureteral endoscopy through established ureterostomy diagnostic or
50951 30 0
therapeutic
51005 Aspiration of bladder: by trocar, intracatheter or needle 10 0
51010 Aspiration of bladder with insertion of suprapubic catheter 20 0
Cystotomy or cystostomy: with fulguration and/or insertion of radioactive
51020 25 0
material
Cystotomy or cystostomy: with cryosurgical destruction of intravesical
51030 40 0
lesion
51040 Cystostomy, cystotomy with drainage 40 0
51045 Cystotomy, with insertion of ureteral catheter or stent (separate procedure) 40 0
Cystolithotomy, cystotomy with removal of calculus: without vesical neck

51050 40 0
dissection
51060 Transvesical ureterolithotomy 45 0
Cystotomy, with stone basket extraction and/or ultrasonic or
51065 45 0
electrohydraulic fragmentation of ureteral calculus
51080 Drainage of perivesical or prevesical space abscess 25 0
51500 Excision of urachal cyst or sinus, with or without umbilical hernia repair 50 0
51520 Cystotomy: for simple excision of vesical neck (separate procedure) 60 0
Cystotomy: for excision of bladder diverticulum, single or multiple (separate
51525 85 0
procedure)
51530 Cystotomy: for excision of bladder tumor 75 0
51535 Cystotomy for excision, incision, or repair of ureterocele 75 0
51550 Cystectomy, partial 105 0
Cystectomy, partial, with reimplantation of ureter(s) into bladder
51565 150 0
(ureteroneocystostomy)
Cystectomy, complete: with bilateral pelvic lymphadenectomy, including
51575 200 0
external iliac, hypogastric and obturator nodes
Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous
51580 200 0
transplantations
Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous
51585 transplants: with bilateral pelvic lymphadenectomy, including iliac, 220 0
hypogastric and obturator nodes
Cystectomy, complete, with ureteroileal conduit or sigmoid bladder,
51590 200 0
including bowel anastomosis
Cystectomy, complete, with ureteroileal conduit or sigmoid bladder,

51595 including bowel anastomosis: with bilateral pelvic lymphadenectomy, 240 0
including external iliac, hypogastric and obturator nodes
Cystectomy, complete, with continent diversion, any technique, using any

51596 250 0
segment of small and/or large bowel to construct neobladder
51600 Injection procedure for cystography or voiding urethrocystography 10 0

Injection procedure and replacement of chain for contrast and/or chain
51605 10 0
urethrocystography
51610 Injection procedure for retrograde urethrocystography 10 0
51700 Bladder irrigation, simple, lavage and/or irrigation (separate procedure) 5 0
51705 Change of cystostomy tube (separate procedure) 10 0
51720 Bladder instillation of anticarcinogenic agent (including detention time) 15 0
51725 Simple cystometrogram (CMG) (eg, spinal manometer) 10 0

51726 Complex cystometrogram (eg, calibrated electronic equipment) 15 0
Simple uroflowmetry (UFR) (eg. stop-watch flow rate, mechanical
51736 5 0
uroflowmeter)
51739 Sound recording of external stream (eg, Lyons or Keitzer type) 5 0
51741 Complex uroflowmetry (eg, calibrated electronic equipment) 10 0
Urethral pressure profile studies (UPP) (urethral closure pressure profile),
51772 10 0
any technique
Electromyography studies (EMG) of anal or urethral sphincter, any
51785 10 0
technique
Stimulus evoked response (eg, measurement of bulbocavernous reflex
51792 10 0
latency time)
51795 Voiding pressure studies (VP): bladder voiding pressure, any technique 10 0
Voiding pressure studies (VP): intra-abdominal voiding pressure (AP) (rectal,
51797 10 0
gastric, intra-peritoneal)
Cystoplasty or cystourethroplasty, plastic operation on bladder and/or
51800 vesical neck (anterior Y-plasty, vesical fundus resection), any procedure, 110 0
with or without resection of posterior vesical neck
51820 Cystourethroplasty with unilateral or bilateral ureteroneocystostomy 120 0
Anterior vesicourethropexy, or urethropexy (Marshall-Marchetti-Krantz
51840 80 0
type)
Abdomino-vaginal vesical neck suspension, with or without endoscopic
51845 70 0
control (eg, Stamey, Raz, modified Pereyra)
51860 Cystorrhaphy, suture of bladder wound, injury or rupture 70 0
51880 Closure of cystostomy (separate procedure) 40 0
51900 Closure of vesicovaginal fistula 80 0
51920 Closure of vesicouterine fistula 80 0
51925 Closure of vesicoenteric fistula: with hysterectomy 100 0
51940 Closure of bladder exstrophy 140 0
51960 Enterocystoplasty, including bowel anastomosis 150 0
51980 Cutaneous vesicostomy 70 0
52000 Cystourethroscopy diagnostic or therapeutic 25 0
52204 Cystourethroscopy, with biopsy (separate procedure) 25 0
Cystourethroscopy, with fulguration (including cryosurgery or laser surgery)

52214 25 0
of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands

52224 25 0
for treatment of MINOR (less than 0.5 cm) lesion(s) with or without biopsy

52234 30 0
for resection of SMALL bladder tumor(s) (0.5 to 2.0 cm)
52235 50 0
for resection of MEDIUM bladder tumor(s) (2.0 to 5.0 cm)
52240 80 0
for resection of LARGE bladder tumor(s) (greater than 5.0 cm)
Cystourethroscopy, with insertion of radioactive substance, with or without
52250 35 0
biopsy or fulguration
52260 Cystourethroscopy, with dilation of bladder for interstitial cystitis 25 0
52270 Cystourethroscopy, with internal urethrotomy 30 0
52276 Cystourethroscopy with direct vision internal urethrotomy 35 0
52277 Cystourethroscopy, with resection of external sphincter (sphincterotomy) 40 0
Cystourethroscopy, with calibration and/or dilation of urethral stricture or

52281 stenosis, with or without meatotomy and injection procedure for 25 0
cystography, male or female
Cystourethroscopy, with steroid injection into stricture (separate
52283 25 0
procedure)
Cystourethroscopy for treatment of the female urethral syndrome and
52285 fulguration of polyp(s) of urethra, bladder neck, and/or trigone (separate 25 0
procedure)
Cystourethroscopy: with ureteral meatotomy, unilateral or bilateral
52290 30 0
Cystourethroscopy: with resection or fulguration of ureterocele(s),
52300 35 0
unilateral or bilateral (separate procedure)
Cystourethroscopy: with incision or resection of orifice of bladder
52305 40 0
diverticulum, single or multiple (separate procedure)
Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent
52310 30 0
from urethra or bladder (separate procedure)
Litholapaxy: crushing or fragmentation of calculus by any means in bladder
52317 50 0
and removal of fragments
Cystourethroscopy (including ureteral catheterization): removal or
52320 fragmentation of ureteral calculus, with or without manipulation (separate 40 0
procedure)
Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons
52332 25 0
or double-J type) (separate procedure)
Cystourethroscopy, with insertion of ureteral guide wire through kidney to

52334 35 0
establish a percutaneous nephrostomy, retrograde (separate procedure)
Cystourethroscopy, with ureteroscopy and/or pyeloscopy (includes dilation

52335 of the ureter and or pyeloureteral junction by any method) with or without 40 0
lithotripsy or removal of calculus (separate procedure)
Cystourethroscopy, with ureteroscopy and/or pyeloscopy (includes dilation

52339 of the ureter and/or pyeloureteral junction by any method: with resection 60 0
of tumor (separate procedure)
Cystourethroscopy, with incision, fulguration or resection of bladder neck,
52340 and/or posterior urethra (congenital valves, obstructive hypertrophic 60 0
mucosal folds)
52450 Transurethral incision of prostate 45 0
52500 Transurethral resection of bladder neck (separate procedure) 50 0
52510 Transurethral balloon dilation of the prostatic urethra, any method 40 0
Transurethral resection of prostate including complete vasectomy,
52601 meatotomy, cystourethroscopy, urethral calibration and/or dilation, and 100 0
internal urethrotomy
Transurethral fulguration for postoperative bleeding occuring after the
52606 40 0
usual follow-up time
52612 Transurethral resection of prostate 60 0
52640 Transurethral resection: of post operative bladder neck contracture 40 0
Transurethral cryosurgical removal of prostate (postoperative irrigations
52650 70 0
and aspiration of sloughing tissue included)
52700 Transurethral drainage of prostatic abscess 40 0
Urethrotomy or urethrostomy, external: pendulous urethra, (separate
53000 15 0
procedure)
Urethrotomy or urethrostomy, external: perineal urethra, external
53010 25 0
53020 Meatotomy, cutting of meatus (separate procedure), any age 10 0
53040 Drainage of deep periurethral abscess 30 0
53060 Drainage of Skene's gland abscess or cyst 15 0
Drainage of perineal urinary extravasation: uncomplicated (separate
53080 30 0
procedure)
53085 Drainage of perineal urinary extravasation: complicated 50 0
53200 Biopsy of urethra 15 0
53210 Urethrectomy, total, including cystostomy 90 0
53220 Excision or fulguration of carcinoma of urethra 40 0
53230 Excision of urethral diverticulum (separate procedure) 60 0
53240 Marsupialization of urethral diverticulum 35 0
53250 Excision of bulbourethral gland (Cowper's gland) 35 0
53260 Excision or fulguration: urethral polyp(s), distal urethra 20 0
53265 Excision or fulguration: urethral caruncle 20 0
53270 Excision or fulguration: Skene's gland 20 0
53275 Excision or fulguration: urethral prolapse 20 0
Urethroplasty: first stage, for fistula, diverticulum, or stricture (eg,
53400 80 0
Johannsen type)
Urethroplasty: second stage (formation of urethra), including urinary
53405 80 0
diversion
53410 Urethroplasty: one-stage reconstruction of anterior urethra 100 0
Urethroplasty: transpubic or perineal, one stage, for reconstruction or
53415 120 0
repair of prostatic or membranous urethra
Urethroplasty, two-stage reconstruction or repair of prostatic or
53420 80 0
membranous urethra: each stage
Operation for correction of male urinary incontinence, with or without
53440 80 0
introduction of prosthesis
53442 Removal of perineal prosthesis introduced for continence 50 0
Urethroplasty with tubularization of posterior urethra and/or lower bladder
53443 90 0
for incontinence (eg, Tenago, Leadbetter procedure)
Operation for correction of urinary incontinence with placement of
53445 inflatable urethral or bladder neck sphincter, including placement of pump 90 0
and/or reservoir
Removal, repair or replacement of inflatable sphincter including pump
53447 50 0
and/or reservoir and/or cuff
53449 Surgical correction of hydraulic abnormality of inflatable sphincter device 35 0
53450 Urethromeatoplasty, with mucosal advancement 35 0

Urethromeatoplasty, with partial excision of distal urethral segment
53460 35 0
(Richardson type procedure)
53500 Suture of urethral wound or injury 35 0
53510 Suture of urethral wound or injury: perineal 50 0
53515 Suture of urethral wound or injury: prostatomembranous 80 0
53520 Closure of urethrostomy or urethrocutaneous fistula 50 0
53600 Dilation of urethral stricture by passage of sound or urethral dilator 10 0
Dilation of urethral stricture or vesical neck by passage of sound or urethral
53605 15 0
dilator
53620 Dilation of urethral stricture by passage of filiform and follower 10 0
53640 Passage of filiform and follower for acute vesical retention 10 0
53670 Catheterization, urethra 5 0
54000 Slitting of prepuce, dorsal or lateral (separate procedure) 15 0
54015 Incision and drainage of penis, deep 15 0
Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum
54050 10 0
contagiosum): any method
54100 Biopsy penis: (separate procedure) 15 0
54110 Excision of penile plaque (Peyronie disease) 50 0
54111 Excision of penile plaque: with graft 60 0
54115 Removal foreign body from deep penile tissue (eg, plastic implant) 50 0
54120 Amputation of penis: partial 50 0
54130 Amputation of penis, radical: with bilateral lymphadenectomy 120 0
54150 Circumcision, using clamp or other device: newborn 10 0
54152 Circumcision, using clamp or other device: except newborn 15 0
Circumcision, surgical excision other than clamp, device, or dorsal slit:
54160 15 0
newborn
Circumcision, surgical excision other than clamp, device, or dorsal slit:
54161 25 0
except newborn
54162 Revision of circumcision in operating room 30 0
54200 Injection procedure for Peyronie disease 15 0
54205 Injection procedure for Peyronie disease: with surgical exposure of plaque 50 0
54220 Irrigation of corpora cavernosa for priapism 15 0

54230 Injection procedure for corpora cavernosography 15 0
Injection of corpora cavernosa with pharmacologic agent(s) (eg, papaverine,
54235 15 0
phentolamine)
54240 Penile plethysmography 15 0
54250 Nocturnal penile tumescence and/or rigidity test 15 0
Plastic operation on penis for correction of chordee or for hypospadias

54304 60 0
repair with or without transplantation of prepuce and/or skin
Urethroplasty for second stage hypospadias repair (including urinary

54316 90 0
diversion) with free skin graft obtained from site other than genitalia
Urethroplasty for third stage hypospadias repair to release penis from
54318 60 0
scrotum (eg, third stage Cecil repair)
One stage distal hypospadias repair (with or without chordee or
54322 circumcision): with simple meatal advancement (eg, Magpi, V-flap) or with 80 0
urethroplasty by local skin flaps
One stage distal hypospadias repair (with or without chordee or circucision):

54326 with urethroplasty by local skin flaps and mobilization of urethra, or with 100 0
correction of chordee with urethroplasty with skin graft
One stage proximal penile or penoscrotal hypospadias repair requiring

54332 extensive dissection to correct chordee and urethroplasty by use of skin 125 0
graft tube and/or island flap
Repair of hypospadias complications (ie, fistula, stricture, diverticula): by
54340 50 0
closure, incision, or excision, simple
Repair of hypospadias complications (ie. Fistula, stricture, diverticula):
54344 requiring mobilization of skin flaps and urethroplasty with flap or patch 85 0
graft
Repair of hypospadias complications (ie, fistula, stricture, diverticula):
54348 requiring extensive dissection and urethroplasty with flap, patch or tubed 85 0
graft (includes urinary diversion)
Repair of hypospadias cripple requiring extensive dissection and excision of
54352 previously constructed structures including re-release of chordee and 85 0
reconstruction of urethra and penis
54360 Plastic operation on penis to correct angulation 50 0
Plastic operation on penis for epispadias distal to external sphincter: with or
54385 100 0
without incontinence
Plastic operation on penis for epispadias distal to external sphincter: with
54390 140 0
exstrophy of bladder
54400 Insertion of penile prosthesis 50 0
54402 Removal or replacement of penile prosthesis 50 0
Insertion of inflatable (multi-component) penile prosthesis, including
54405 85 0
placement of pump, cylinders, and/or reservoir
Removal, repair, or replacement of inflatable (multi-component) penile
54407 50 0
prosthesis, including pump and/or reservoir and/or cylinders
Surgical correction of hydraulic abnormality of inflatable (multi-component)

54409 50 0
prosthesis including pump and/or reservoir and/or cylinders
Corpora cavernosa-saphenous vein shunt (priapism operation), unilateral or

54420 70 0
bilateral
Corpora cavernosa-corpus spongiosum shunt (priapism operation),
54430 50 0
unilateral or bilateral
Corpora cavernosa-glans penis fistulization (eg, biopsy needle, Winter
54435 30 0
procedure, rongeur, or punch) for priapism
54440 Plastic operation of penis for injury 50 0
54500 Biopsy of testis: needle (separate procedure) 10 0
54505 Biopsy of testis: incisional (separate procedure) 25 0
54510 Excision of local lesion of testis 35 0
Orchiectomy: simple (including subcapsular), with or without testicular
54520 40 0
prosthesis, scrotal or inguinal approach
54530 Orchiectomy, radical, for tumor: any approach 60 0
54560 Exploration for undescended testis with abdominal exploration 70 0
Reduction of torsion of testis, surgical, with or without fixation of
54600 45 0
contralateral testis
54620 Fixation of contralateral testis (separate procedure) 20 0
54640 Orchiopexy, any type, with or without hernia repair 60 0
54660 Insertion of testicular prosthesis (separate procedure) 20 0
54670 Suture or repair of testicular injury 45 0
54680 Transplantation of testis(es) to thigh (because of scrotal destruction) 60 0
Incision and drainage of epididymis, testis, and/or scrotal space (eg, abscess
54700 25 0
or hematoma)
54800 Biopsy of epididymis, needle 15 0
54820 Exploration of epididymis, with or without biopsy 25 0
54830 Excision of local lesion of epididymis 35 0
54840 Excision of spermatocele, with or without epididymectomy 35 0
54860 Epididymectomy: unilateral or bilateral 35 0
Epididymovasostomy, anastomosis of epididymis to vas deferens: unilateral
54900 70 0
or bilateral
Puncture aspiration of hydrocele, tunica vaginalis, with or without injection
55000 10 0
of medication
55040 Excision of hydrocele: unilateral 35 0
55060 Repair of tunica vaginalis hydrocele (Bottle type) 30 0
55100 Drainage of scrotal wall abscess 10 0
55110 Scrotal exploration 20 0
55120 Removal of foreign body in scrotum 20 0
55150 Resection of scrotum 30 0
55175 Scrotoplasty 30 0
Vasotomy, cannulization with or without incision of vas, unilateral or
55200 20 0
bilateral (separate procedure)
55250 Vasectomy, unilateral or bilateral (separate procedure) 20 0
Vasotomy for vasograms, seminal vesiculograms, or epididymograms,
55300 20 0
55400 Vasovasostomy, vasovasorrhaphy 60 0
Ligation (percutaneous) of vas deferens, unilateral or bilateral (separate
55450 20 0
procedure)
55500 Excision of hydrocele of spermatic cord, unilateral (separate procedure) 35 0
55520 Excision of lesion of spermatic cord (separate procedure) 40 0

Excision of varicocele or ligation of spermatic veins for varicocele: (separate
55530 30 0
procedure)
Excision of varicocele or ligation of spermatic veins for varicocele:
55535 50 0
abdominal approach
55600 Vesiculotomy 45 0
55650 Vesiculectomy, any approach 70 0
55680 Excision of Mullerian duct cyst 40 0
55700 Biopsy, prostate: needle or punch, single or multiple, any approach 15 0
55705 Biopsy, prostate: incisional, any approach 30 0
55720 Prostatotomy, external drainage of prostatic abscess, any approach 40 0
55740 Prostatolithotomy, removal of prostatic calculus (separate procedure) 60 0
Prostatectomy, perineal, subtotal (including control of postoperative
55801 bleeding, vasectomy, meatotomy, urethralcalibration and/or dilation, and 90 0
internal urethrotomy)
55810 Prostatectomy, radical, with or without lymphadenectomy 150 0
Prostatectomy (vasectomy, meatotomy, urethral calibration and/or dilation,
55821 and internal urethrotomy): suprapubic or retropubic, subtotal, one or two 95 0
stages
55860 Exposure of prostate, any approah, for insertion of radiocative substance 70 0
Exposure of prostate, any approach, for insertion of radioactive substance:

55862 90 0
with limited pelvic lymphadenectomy
Exposure of prostate, any approach, for insertion of radioactive substance:
55865 with bilateral lymphadenectomy, including external iliac, hypogastric and 130 0
obturator nodes
56300 Laparoscopy (peritoneoscopy), diagnostic (separate procedure) 30 0
Laparoscopy (peritoneoscopy), surgical: with fulguration of oviducts (with or
56301 45 0
without transection)
Laparoscopy (peritoneoscopy), surgical: with occlusion of oviducts by device
56302 45 0
(eg, band, clip, or Falope ring)
Laparoscopy (peritoneoscopy), surgical: with fulguration or excision of

56303 45 0
lesion of the ovary, pelvic viscera, or peritoneal surface by any method
56304 Laparoscopy (peritoneoscopy), surgical: with lysis of adhesions 45 0
56305 Laparoscopy (peritoneoscopy), surgical: with biopsy (single or multiple) 35 0
56306 Laparoscopy (peritoneoscopy), surgical: with aspiration (single or multiple) 35 0
Laparoscopy (peritoneoscopy), surgical: with removal of adnexal structures

56307 65 0
(partial or total oophorectomy and/or salpingectomy)
Laparoscopy (peritoneoscopy), surgical: with vaginal hysterectomy with or
56308 without removal of tube(s), with or without removal of ovary(s) 80 0
(laparoscopic assisted vaginal hysterectomy)
Laparoscopy (peritoneoscopy), surgical: with removal of leiomyomata,
56309 55 0
subserosal (single or multiple)
Laparoscopy (peritoneoscopy), surgical: with retroperitoneal lymph node
56311 60 0
biopsy(ies)
Laparoscopy (peritoneoscopy), surgical: with bilateral total pelvic
56312 75 0
lymphadenectomy
Laparoscopy (peritoneoscopy), surgical: with bilateral total pelvic

56313 85 0
lymphadenectomy and peri-aortic lymph node biopsy, single or multiple
56315 Laparoscopy (peritoneoscopy), surgical: appendectomy 60 0

Laparoscopy (peritoneoscopy), surgical: repair of inguinal hernia, with or
56317 50 0
without prosthesis
Laparoscopy (peritoneoscopy), surgical: with ligation of spermatic veins for
56320 35 0
varicocele
56322 Laparoscopy (peritoneoscopy), surgical: transection of vagus nerves 100 0
56324 Laparoscopy (peritoneoscopy), surgical: cholecystoenterostomy 75 0
56340 Laparoscopy (peritoneoscopy), surgical: choelcystectomy (any method) 80 0
Laparoscopy(peritoneoscopy), surgical: cholecystectomy with

56341 110 0
cholangiography
Laparoscopy (peritoneoscopy), surgical: cholecystectomy with exploration
56342 110 0
of common duct
56343 Laparoscopy (peritoneoscopy), surgical: with salpingostomy (unilateral) 80 0
56344 Laparoscopy (peritoneoscopy), surgical: with fimbrioplasty (unilateral) 75 0
56350 Hysteroscopy, diagnostic (separate procedure) 20 0

Hysteroscopy, surgical: with biopsy of endometrium and/or polypectomy,
56351 25 0
with or without D & C
56352 Hysteroscopy, surgical: with lysis of intrauterine adhesions (any method) 25 0

Hysteroscopy, surgical: with division or resection of intrauterine septum
56353 30 0
(any method)
56354 Hysteroscopy, surgical: with removal of leiomyomata 35 0
56355 Hysteroscopy, surgical: with removal of impacted foreign body 25 0
56356 Hysteroscopy, surgical: with endometrial ablation (any method) 35 0
56405 Incision and drainage of vulva or perineal abscess 10 0
56420 Incision and drainage of Bartholin's gland abscess 10 0
56440 Marsupialization of Bartholin's gland cyst 25 0
56441 Lysis of labial adhesions 15 0
56501 Destruction of lesion(s) vulva (condylomata, multiple), any method 15 0
56605 Biopsy of vulva or perineum (separate procedure) 10 0
56620 Vulvectomy 55 0
56631 Vulvectomy, radical, partial or complete: with lymphadenectomy 110 0
56700 Partial hymenectomy or revision of hymenal ring 15 0
56720 Hymenotomy, simple incision 5 0
56740 Excision of Bartholin's gland or cyst 25 0
56800 Plastic repair of introitus 30 0
56805 Clitoroplasty for adrenogenital syndrome 100 0
56810 Perineoplasty, repair of perineum, non-obstetrical (separate procedure) 35 0
57000 Colpotomy: with exploration or drainage of pelvic abscess 20 0

57065 Destruction of vaginal lesions, any method 20 0
57100 Biopsy of vaginal mucosa: (separate procedure) 10 0
57110 Vaginectomy, complete removal of vagina 45 0
57120 Colpocleisis (Lefort type) 45 0
57130 Excision of vaginal septum 20 0
57135 Excision of vaginal cyst or tumor 20 0
57200 Colporrhaphy: suture of injury of vagina (non obstetrical) 30 0
Colpoperineorrhaphy: suture of injury of vagina and/or perineum (non
57210 35 0
obstetrical)
Plastic operation on urethral sphincter, vaginal approach (eg, Kelly urethral
57220 25 0
plication) (separate procedure)
57230 Plastic repair of urethrocele (separate procedure) 35 0
Anterior colporrhaphy, repair of cystocele with or without repair of
57240 40 0
urethrocele (separate procedure)
Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy
57250 35 0
Combined anteroposterior colporrhaphy: with or without enterocele repair
57265 55 0
57270 Repair of enterocele, abdominal or vaginal approach (separate procedure) 50 0
57280 Colpopexy, abdominal approach 55 0

Sacrospinous ligament fixation for prolapse of vagina following
57282 55 0
hysterectomy (separate procedure)
Sling operation for stress incontinence (eg, fascia or synthetic) (separate
57288 80 0
procedure)
57289 Pereyra procedure, including anterior colporrhaphy (separate procedure) 70 0

57292 Construction of artificial vagina: with or without graft 85 0
57300 Closure of rectovaginal fistula: vaginal or transanal approach 50 0
Closure of rectovaginal fistula: abdominal approach with or without
57307 65 0
cocomitant colostomy
57310 Closure of urethrovaginal fistula: any method 50 0
57330 Closure of vesicovaginal fistula: transvesical and vaginal approach 65 0
57400 Dilation of vagina under anesthesia (separate procedure) 15 0
57410 Pelvic examination under anesthesia (separate procedure) 15 0
57452 Colposcopy (vaginoscopy): (separate procedure) 10 0
57454 Colposcopy: with biopsies, or biopsy of the cervix (separate procedure) 10 0
Colposcopy: with loop electrosurgical excision(s) of the cervix (LEEP)

57460 20 0
Cervix, biopsy, single or multiple, or local excision of lesion, with or without
57500 10 0
fulguration (separate procedure)
Endocervical curettage (not done as part of a dilation and curettage)
57505 10 0
Cauterization of cervix: electro, thermal, cryo, or laser ablation (separate
57510 15 0
procedure)
Conization of cervix, with or without fulguration, with or without dilation
57520 25 0
and curettage, with or without repair (any method)
57530 Trachelectomy (cervicectomy), amputation of cervix (separate procedure) 35 0
Excision of cervical stump, abdominal approach: with or without pelvic floor

57545 50 0
repair
57550 Excision of cervical stump, vaginal approach 35 0
Excision of cervical stump, vaginal approach: with anterior and/or posterior
57555 50 0
repair, with or without repair of enterocele
57700 Cerclage of uterine cervix, non obstetrical 25 0
57720 Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach 25 0
57820 Dilation and curettage of cervical stump (separate procedure) 15 0
Endometrial and/or endocervical sampling (biopsy) without cevical dilation,
58100 5 0
any method (separate procedure)
Dilation and curettage, diagnostic and/or therapaeutic (non obstetrical)
58120 25 0
58140 Myomectomy, single or multiple (separate procedure): any approach 65 0
Total abdominal hysterectomy (corpus and cervix), with or without removal
58150 90 0
of tube(s), with or without removal of ovary(ies)
Total abdominal hysterectomy (corpus and cervix), with or without removal
58152 of tube(s), with or without removal of ovary(ies): with colpo- 95 0
urethrocystopexy
Supracervical abdominal hysterectomy (subtotal hysterectomy), with or
58180 70 0
without removal of tube(s), with or without removal of ovary(ies)
Total abdominal hysterectomy, including partial vaginectomy, with para-
58200 aortic and pelvic lymph node sampling, with or without removal of tube(s), 130 0
with or without removal of ovary(ies)
Pelvic exenteration for gynecologic malignancy (total abdominal
58240 hysterectomy, removal of bladder, ureteral transplantations and/or 210 0
abdominoperineal resection of rectum and colon and colostomy
58262 Vaginal hysterectomy: with or without removal of tube(s) and/or ovary(ies) 90 0
Vaginal hysterectomy: with colpo-urethrocystopexy (Marshall-Marchetti-

58267 100 0
Krantz or Pereyra type, with/without endoscopic control)
Vaginal hysterectomy, with or without removal of tube(s), with or without
58270 100 0
removal of ovary(ies): with repair of enterocele
58275 Vaginal hysterectomy, with total or partial colpectomy 110 0
58300 Insertion of intrauterine device (IUD) 5 0
58301 Removal of intrauterine device (IUD) 5 0
58321 Artificial insemination: Intra-cervical or intra-uterine 10 0
58340 Injection procedure for hysterosalpingography 5 0
Transcervical introduction of fallopian tube catheter for diagnosis and/or re-

58345 30 0
establishing patency (any method), with or without hysterosalpingography
58350 Hydrotubation of oviduct 5 0

Uterine suspension, with or without shortening of round and/or
58400 50 0
sacrouterine ligaments (separate procedure)
58520 Hysterorrhaphy, repair or ruptured uterus (non obstetrical) 55 0
58540 Hysteroplasty, repair of uterine anomaly (Strassman type) 70 0
Ligation or transection of fallopian tube(s), abdominal or vaginal approach,
58600 35 0
Ligation or transection of fallopian tube(s), abdominal or vaginal approach,
58605 postpartum, unilateral or bilateral, during same hospitalization (separate 30 0
procedure)
Occlusion of fallopian tube(s) by device (eg, band, clip, Falope ring) vaginal
58615 35 0
or suprapubic approach
Salpingectomy, complete or partial, unilateral or bilateral (separate
58700 40 0
procedure)
Salpingo-oophorectomy, complete or partial, unilateral or bilateral
58720 50 0
58740 Lysis of adhesions (salpingolysis, ovariolysis) (separate procedure) 40 0
58750 Tubotubal anastomosis, microsurgical, unilateral 70 0
58752 Tubouterine implantation, microsurgical, unilateral 60 0
58760 Fimbrioplasty, microsurgical, unilateral 55 0
58770 Salpingostomy (salpingoneostomy), microsurgical, unilateral 50 0
58800 Drainage of ovarian cyst(s), unilateral or bilateral: vaginal approach 25 0
58805 Drainage of ovarian cyst(s), unilateral or bilateral: abdominal approach 40 0
58820 Drainage of ovarian abscess: vaginal approach 30 0

58822 Drainage of ovarian abscess: abdominal approach 45 0
58825 Transposition, ovary(s) 40 0
58900 Biopsy of ovary, unilateral or bilateral 45 0
58920 Wedge resection or bisection of ovary, unilateral or bilateral 50 0
58940 Oophorectomy, partial or total, unilateral or bilateral 60 0
Oophorectomy, unilateral or bilateral: for ovarian malignancy, with or
without para-aortic and pelvic lymph node biopsies, peritoneal
58943 105 0
washings/biopsies, diaphragmatic assessments, salpingectomy(s),
omentectomy
Resection of ovarian malignancy with bilateral salpingo-oophorectomy and
58951 omentectomy: with total abdominal hysterectomy, pelvic and limited para- 120 0
aortic lymphadenctomy
Resection of ovarian malignancy with bilateral salpingo-oophorectomy and

58952 130 0
omentectomy: with radical dissection for debulking
58960 Laparatomy, for staging or restaging of ovarian malignancy 65 0

58970 Follicle puncture for oocyte retrieval, any method 30 0
58974 Embryo transfer, any method (separate procedure) 20 0
58976 Gamete or zygote intrafallopian transfer, any method 40 0
59000 Amniocentesis, any method 10 0
59012 Cordocentesis (intrauterine), any method 25 0
59015 Chorionic villus sampling, any method 20 0
59020 Fetal contraction stress test (separate procedure) 5 0
59025 Fetal non-stress test (separate procedure) 5 0
59030 Fetal scalp blood sampling (separate procedure) 10 0
Initiation and/or supervision of internal fetal monitoring during labor by
59050 10 0
consultant with report
59100 Hysteretomy, abdominal (eg, for removal of hydatiform mole, abortion) 60 0
Surgical treatment of ectopic pregnancy: tubal or ovarian, requiring

59120 60 0
salpingectomy and/or oophorectomy, abdominal or vaginal approach
Surgical treatment of ectopic pregnancy: tubal or ovarian, without
59121 60 0
salpingectomy and/or oophorectomy
59130 Surgical treatment of ectopic pregnancy: abdominal pregnancy 60 0
59140 Surgical treatment of ectopic pregnancy: cervical, with evacuation 35 0
Laparoscopic treatment of ectopic pregnancy: with or without
59151 60 0
salpingectomy and/or oophorectomy
59160 Curettage, postpartum (separate procedure) 25 0
59200 Insertion of cervical dilator (eg.laminaria) (separate procedure) 5 0
59300 Episiotomy or vaginal repair only, by other than attending physician 15 0
59320 Cerclage of cervix, during pregnancy: vaginal 20 0
59325 Cerclage of cervix , during pregnancy: abdominal 40 0
59350 Hysterorrhaphy of ruptured uterus 45 0
Vaginal delivery only (with or without episiotomy and/or forceps) including
59410 60 0
postpartum care
59414 Manual removal of retained placenta by consultant 30 0
59515 Cesarean delivery including postpartum care, with or without hysterectomy 80 0
Treatment of incomplete or missed abortion, any trimester, completed

59812 25 0
surgically
59830 Treatment of septic abortion, completed surgically 35 0
59840 Induced abortion, by dilation and curettage 20 0
59841 Induced abortion, by dilation and evacuation 30 0
Induced abortion, by one or more intra-amniotic injections (amniocentesis-
59850 40 0
injections), including delivery of fetus and secundines

59851 injections), including delivery of fetus and secundines: with dilation and 40 0
curettage and/or evacuation
59852 injections), including delivery of fetus and secundines: with hysterotomy 55 0
(failed intra-amniotic injection)
59870 Uterine evacuation and curettage for hydatiform mole 35 0
60000 Incision and drainage of thyroglossal cyst, infected 15 0
60100 Biopsy, thyroid, percutaneous needle 15 0
60200 Excision of cyst or adenoma of thyroid, or transection of isthmus 55 0
60210 Partial thyroid lobectomy, unilateral: with or without isthmusectomy 60 0
60220 Total thyroid lobectomy, unilateral (hemithyroidectomy) 90 0
Total thyroid lobectomy, unilateral: with contralateral subtotal lobectomy,
60225 110 0
including isthmus
60240 Thyroidectomy, total or complete 120 0
Thyroidectomy, total or subtotal for malignancy: with limited neck
60252 130 0
dissection
Thyroidectomy, total or subtotal for malignancy: with radical neck
60254 140 0
dissection
Thyroidectomy, including substernal thyroid gland, sternal split or
60270 120 0
transthoracic approach
60271 Thyroidectomy, including substernal thyroid gland: cervical approach 100 0
60280 Excision of thyroglossal duct cyst or sinus 50 0
60500 Parathyroidectomy 105 0
Parathyroidectomy, with mediastinal exploration, sternal split or
60505 130 0
transthoracic approach
60520 Thymectomy, partial or total (separate procedure) 100 0
Adrenalectomy, partial or complete, or exploration of adrenal gland with or

60540 110 0
without biopsy, transabdominal, lumbar or dorsal (separate procedure)
Adrenalectomy, partial or complete, with excision of adjacent

60545 130 0
retroperitoneal tumor, unilateral
60600 Excision of carotid body tumor: without excision of carotid artery 110 0
60605 Excision of carotid body tumor: with excision of carotid artery 130 0
Subdural tap through fontanelle or suture, infant, unilateral or bilateral:
61000 15 0
each session
Ventricular puncture through previous burr hole, fontanelle, suture or
61026 implanted ventricular catheter/reservoir: with or without injection of drug 15 0
or other substance for diagnosis or treatment
Cisternal or lateral cervical (C1-C2) puncture: without injection (separate
61050 15 0
procedure)
61105 Twist drill hole for subdural or ventricular puncture (separate procedure) 45 0
Twist drill hole for subdural or ventricular puncture: for implanting
61107 60 0
ventricular catheter or pressure recording device (separate procedure)
Twist drill hole for subdural or ventricular puncture: for evacuation and/or
61108 70 0
drainage of subdural hematoma (separate procedure)
Burr hole(s) or trephine: with biopsy of brain or intracranial lesion (separate
61140 105 0
procedure)
Burr hole(s) or trephine: with drainage of brain abscess or cyst (separate
61150 115 0
procedure)
Burr hole(s) with evacuation and/or drainage of hematoma, extradural or
61154 100 0
subdural (separate procedure)
Burr hole(s): with aspiration of hematoma or cyst, intracerebral (separate
61156 105 0
procedure)
Burr hole(s): for implanting ventricular catheter, reservoir, EEG electrode(s),
61210 60 0
or pressure recording device (separate procedure)
Insertion of subcutaneous reservoir, pump or continuous infusion system
61215 70 0
for connection to ventricular catheter (separate procedure)
61304 Craniectomy or craniotomy, exploratory, supratentorial 130 0
61305 Craniectomy or craniotomy, exploratory, infratentorial (posterior fossa) 160 0
Craniectomy or craniotomy for evacuation of hematoma or drainage of

61312 160 0
intracranial abscess (separate procedure)
61330 Decompression of orbit only, transcranial approach 155 0
Exploration of orbit (transcranial approach): with biopsy, removal of lesion
61332 175 0
or foreign body
Craniectomy, suboccipital with cervical laminectomy for decompression of
61343 medulla and spinal cord, with or without dural graft (eg, Arnold-Chiari 190 0
malformation)
61345 Other cranial decompression, posterior fossa 175 0
Craniectomy, subtemporal, for section, compression or decompression of
61450 165 0
sensory root of gasserian ganglion
Craniectomy, suboccipital: for exploration or decompression of cranial
61458 175 0
nerves
Craniectomy, suboccipital: for mesencephalic tractotomy or
61480 pedunculotomy, section of one or more cranial nerves or for medullary 160 0
tractotomy
61490 Craniectomy for lobotomy, including cingulotomy 165 0
61500 Craniectomy: with excision of tumor or other bone lesion of skull 130 0
61501 Craniectomy: for osteomyelitis 110 0
Craniectomy, trephination, bone flap craniotomy: for excision of brain
61510 175 0
tumor or abscess or fenestration of syst, supratentorial
Craniectomy for excision of brain tumor, infratentorial or posterior fossa:

61518 220 0
cerebellopontine angle tumor, or midline tumor at base of skull

61520 265 0
cerbellopontine angle tumor
61521 265 0
midline tumor at base of skull
Craniectomy, infratentorial or posterior fossa: for excision or fenestration of
61524 175 0
cyst or brain abscess
Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of
61530 cerebellopontine angle tumor: combined with or without middle/posterior 265 0
fossa craniotomy/craniectomy
Craniotomy, with elevation of bone flap for subdural implantation of an
61533 140 0
electrode array: for long term seizure monitoring
Craniotomy, trephination, bone flap craniotomy: for excision of
61534 130 0
epileptogenic focus without electrocorticography during surgery
Craniotomy, trephination, bone flap craniotomy: for removal of epidural or
61535 subdural electrode array, without excision of cerebral tissue (separate 70 0
procedure)
Craniotomy, trephination, bone flap craniotomy: for excision of cerebral
61536 epileptogenic focus, with electrocorticography during surgery (includes 195 0
removal of electrode array)
Craniotomy, trephination, bone flap craniotomy: for lobectomy with
61539 195 0
electrocorticography during surgery, partial or total
Craniotomy, trephination, bone flap craniotomy: for transection of corpus
61541 185 0
callosum
61542 Craniotomy, trephination, bone flap craniotomy: for total hemispherectomy 200 0
Craniotomy, trephination, bone flap craniotomy: for partial or subtotal

61543 145 0
hemispherectomy
Craniotomy, trephination, bone flap craniotomy: for excision of
61545 235 0
craniopharyngioma
Craniotomy for hypophysectomy or excision of pituitary tumor, intracranial
61546 200 0
approach
Hypophysectomy or excision of pitutary tumor, transnasal or transseptal
61548 160 0
approach, non-stereotactic
Craniectomy for craniostenosis: single or multiple sutures, or frontal or
61550 135 0
partial bone flap, or bifrontal bone flap
Extensive craniectomy for multiple cranial suture craniosynostosis (eg,
61558 155 0
cloverleaf skull): with or without grafts
Excision, intra- and extracranial, benign tumor of cranial bone (eg, fibrous
61563 150 0
dysplasia): with or without optic nerve decompression
Craniectomy or craniotomy: with treatment of penetrating wound of brain
61571 165 0
with or without removal of foreign from brain
Transoral approach to skull base, brain stem or upper spinal cord for biopsy,
61576 decompression or excision of lesion: with or without splitting of tongue 245 0
and/or mandible (including tracheostomy)
Transcatheter occlusion or embolization (eg, for tumor destruction, to

61624 achieve hemostoasis, to occlude a vascular malformation), percutaneous, 135 0
any method: central nervous system (intracranial, cord)
Surgery of intracranial arteriovenous malformation: infratentorial or dural ,

61680 225 0
supratentorial
Surgery of intracranial aneurysm, intracranial approach: vertebral-basilar
61702 255 0
circulation or carotid circulation
Surgery of intracranial aneurysm, cervical approach by application of
61703 115 0
occluding clamp to cervical carotid artery (Selverstone- Crutchfield type)
61705 Surgery of aneurysm, vascular malformation or carotid-cavernous fistula 215 0
Surgery of aneurysm, vascular malformation or carotid-cavernous fistula: by

61710 195 0
intra-arterial embolization, injection procedure, or balloon catheter
Anastomosis, arterial, extracranial-intracranial (eg, middle cerebral/cortical)

61711 195 0
arteries
Microdissection, intracranial or spinal procedure (list separately in addition
61712 25 0
to code for primary procedure)
Creation of lesion by stereotactic method, including burr hole(s) and
61720 localizing and recording techniques, single or multiple stages: globus 105 0
pallidus or thalamus
Creation of lesion by stereotactic method, including burr hole(s) and
61735 localizing and recording techniques, single or multiple stages: subcortical 130 0
structures other than globus pallidus or thalamus
Stereotactic biopsy, aspiration, or excision, including burr hole(s), for
61750 90 0
intracranial lesion
Stereotactic biopsy, aspiration, or excision, including burr hole(s), for
61751 100 0
intracranial lesion: with computerized tomography
Stereotactic localization, any method, including burr hole(s): with insertion
61770 100 0
of catheter(s) for brachytherapy
Creation of lesion by stereotactic method, percutaneous, by neurolytic

61790 80 0
agent (eg, alcohol, thermal, electrical, radiofrequency): gasserian ganglion
Twist drill or burr hole(s) for implantation of neurostimulator electrodes:

61850 110 0
cortical or subcortical
Craniectomy or craniotomy for implantation of neurostimulator electrodes,
61860 135 0
cerebral
Twist drill, burr hole, craniotomy or craniectomy for steriotactic
implantation of one neurostimulator array in in subcortical site (eg.
61862 90 0
thalamus, globus pallidus,subthalamic nucleus, periventricular
periacqueductal gray)
Incision and subcutaneous placement of cranial neurostimulator pulse
61885 20 0
generator or receiver, direct or inductive coupling
Revision or removal of cranial neurostimulator electrodes or pulse
61888 25 0
generator or receiver
62000 Elevation of depressed skull fracture: simple, extradural 80 0
Elevation of depressed skull fracture: compound or comminuted, extradural
62005 110 0
with or without repair of dura and/or debridment of brain
Craniotomy for repair of dural/CSF leak, including surgery for
62100 150 0
rhinorrhea/otorrhea
Reduction of craniomegalic skull (eg, treated hydrocephalus): not requiring
62115 100 0
bone grafts or cranioplasty
Reduction of craniomegalic skull (eg, treated hydrocephalus): with
62116 150 0
cranioplasty (prosthetic material)
Reduction of craniomegalic skull (eg, treated hydrocephalus): requiring
62117 craniotomy and reconstruction with or without bone autograft (includes 160 0
obtaining grafts)
62120 Repair of encephalocele, skull vault, including cranioplasty 155 0
62121 Craniotomy with repair of encephalocele, skull base 140 0
62142 Removal of bone flap or prosthetic plate of skull 70 0
62143 Replacement of bone flap or prosthetic plate of skull 100 0
62145 Cranioplasty for skull defect with or without reparative brain surgery 125 0
62146 Cranioplasty with autograft (includes obtaining bone grafts) 135 0
62180 Ventriculocisternostomy (Torkildsen type operation) 85 0
62190 Creation of shunt: subarachnoid/subdural-atrial, -jugular, -auricular 80 0
Creation of shunt: subarachnoid / subdural-peritoneal, subdural-pleural,
62192 90 0
other terminus
62194 Replacement or irrigation, subarachnoid/subdural catheter 35 0
Ventriculocisternostomy, third ventricle: stereotactic method or any
62201 90 0
method
62220 Creation of shunt: ventriculo-atrial, -jugular, -auricular 100 0
62223 Creation of shunt: ventriculo-peritoneal, -pleural, other terminus 110 0
62225 Replacement or irrigation, ventricular catheter 35 0
Replacement or revision of CSF shunt, obstructed valve, or distal catheter in
62230 70 0
shunt system
62256 Removal of complete CSF shunt system: without replacement 40 0
Removal of complete CSF shunt system: with replacement by similar or
62258 110 0
other shunt at same operation
62268 Percutaneous aspiration, spinal cord cyst or syrinx 30 0
62269 Biopsy of spinal cord, percutaneous needle 30 0
62270 Spinal puncture, diagnostic 10 0
62273 Injection, lumbar epidural, of blood or clot patch 15 0
Injection of anesthetic or other substance, diagnostic or therapeutic:
62274 15 0
epidural, subarachnoid, or subdural, single
Injection of anesthetic or other substance, diagnostic or therapeutic:
62277 20 0
epidural, subarachnoid, or subdural, continuous
Injection of neurolytic substance (eg, alcohol, phenol, iced saline solution):
62280 25 0
subarachnoid, caudal, or epidural
Injection procedure for myelography and/or computerized axial
62284 15 0
tomography, spinal (other than C1-C2 and posterior fossa)
Aspiration procedure, percutaneous, of nucleus pulposus of intervertebral
62287 50 0
disk, any method, single or multiple levels
Injection of substance other than anesthetic, contrast or neurolytic
62288 15 0
solutions: any site (separate procedure)
62290 Injection procedure for diskography, each level: any site 15 0
Injection procedure for chemonucleolysis, including diskography,
62292 50 0
intervertebral disk, single or multiple levels, lumbar
Injection procedure, arterial, for occlusion of arteriovenous malformation,
62294 60 0
spinal
Implantation, revision or repositioning of tunneled intrathecal or epidural
62350 catheter, for long term medication administration via an external pump or 45 0
implantable reservoir/infusion pump
Implantation or replacement of device for intrathecal or epidural drug
62360 20 0
infusion, subcutaneous reservoir
Laminectomy with exploration and/or decompression of spinal cord and/or

63001 cauda equina, without facetectomy, foraminotomy or diskectomy, one or 110 0
two vertebral segments: cervical, thoracic, lumbar or sacral
Laminectomy with removal of abnormal facets and/or pars inter-articularis

63012 with decompression of cauda equina and nerve roots for spondylolisthesis, 110 0
lumbar (Gill type procedure)
Laminectomy with exploration and/or decompression of spinal cord and/or

63015 cauda equina, without facetectomy, foraminotomy or diskectomy, more 130 0
than 2 vertebral segments: cervical, thoracic or lumbar
Laminotomy with decompression of nerve root(s), including partial

63020 facetectomy, foraminotomy and/or excision of herniated intervertebral 100 0
disk: one interspace, cervical or lumbar
Laminotomy with decompression of nerve root(s), including partial
disk: each additional interspace, cervical or lumbar
Laminotomy, with decompression of nerve root(s), including partial
disk, re-exploration: cervical or lumbar
Laminectomy, facetectomy and foraminotomy (unilateral or bilateral) with
63045 decompression of spinal cord, cauda equina and/or nerve root(s), single 120 0
vertebral segment: cervical
63046 decompression of spinal cord, cauda equina and/or nerve root(s), single 110 0
vertebral segment: thoracic or lumbar
63048 decompression of spinal cord, cauda equina and/or nerve root(s): each 30 0
additional segment, cervical, thoracic or lumbar
Transpedicular approach with decompression of spinal cord, cauda equina
63055 140 0
and/or nerve roots, single segment: thoracic or lumbar
Transpedicular approach with decompression of spinal cord, cauda equina

63057 30 0
and/or nerve root(s): each additional segment, thoracic or lumbar
Costovertebral approach with decompression of spinal cord or nerve root

63064 150 0
(s), thoracic: single segment
Costovertebral approach with decompression of spinal cord or nerve root
63066 30 0
(s), thoracic: each additional segment
Diskectomy, anterior, with decompression of spinal cord and/or nerve root
63075 135 0
(s), including osteophytectomy: cervical or thoracic , single
Diskectomy, anterior, with decompression of spinal cord and/or nerve root
63076 (s), including osteophytectomy: cervical or thoracic, each additional 30 0
interspace
Vertebral corpectomy, partial or complete, anterior approach or trans-
63081 thoracic approach, with decompression of spinal cord and/or nerve root(s): 145 0
cervical or thoracic, single segment
Vertebral corpectomy, partial or complete, anterior approach with
63082 decompression of spinal cord and/or nerve root(s): cevical or thoracic, each 30 0
additional segment
Vertebral corpectomy, partial or complete, combined thoracolumbar
63087 approach with decompression of spinal cord and/or nerve root(s), lower 175 0
thoracic or lumbar: single segment
Vertebral corpectomy, partial or complete, combined thoracolumbar
63088 approach with decompression of spinal cord and/or nerve root(s), lower 30 0
thoracic or lumbar: each additional segment
Vertebral corpectomy, transperitoneal or retroperitoneal approach with
63090 decompression of spinal cord, cauda equina and/or nerve root(s), lower 170 0
thoracic, lumbar, or sacral: single segment
Vertebral corpectomy, transperitoneal or retroperitoneal approach with
63091 decompression of spinal cord, cauda equina and/or nerve root(s), lower 30 0
thoracic, lumbar, or sacral: each additional segment
Laminectomy with myelotomy (eg, Bischof or Drez type), cervical, thoracic
63170 130 0
or thoracolumbar
Laminectomy with drainage of intramedullary cyst/syrinx: to subarachnoid
63172 120 0
space or to peritonial space
Laminectomy and section of dentate ligaments, with or without dural graft,
63180 130 0
cervical: one or more segments
63185 Laminectomy with rhizotomy: one or more segments 105 0
63191 Laminectomy with section of spinal accessory nerve 120 0
Laminectomy with cordotomy, with section of one spinothalamic tract, one
63194 130 0
stage: cervical
Laminectomy with cordotomy, with section of both spinothalamic tracts,
63196 135 0
one stage: cervical or thoracic
Laminectomy with cordotomy, with section of both spinothalamic tracts,
63198 155 0
two stages within fourteen days: cervical
63200 Laminectomy, with release of tethered spinal cord, lumbar 130 0
Laminectomy for excision or occlusion of arteriovenous malformation of
63250 245 0
spinal cord: cervical or thoracic
Laminectomy for excision or occlusion of arteriovenous malformation of
63252 245 0
spinal cord: thoracolumbar
Laminectomy for excision of intraspinal lesion other than neoplasm,
63270 160 0
external or intradural: any site
Laminectomy for biopsy and/or excision of intraspinal neoplasm: extradural,
63275 155 0
any site
Laminectomy for biopsy/excision of intraspinal neoplasm: intradural,
63280 180 0
extramedullary, any site
Laminectomy for biopsy/excision of intraspinal neoplasm: intradural,
63285 220 0
intramedullary, any level
Laminectomy for biopsy/excision of intraspinal neoplasm: combined
63290 220 0
extradural-intradural lesion, any level
Vertebral corpectomy, partial or complete, for excision of intraspinal lesion,
63300 160 0
single segment: extradural or intradural, any level
Vertebral corpectomy, partial or complete, for excision of intraspinal lesion:
63308 40 0
each additional segment
Creation of lesion of spinal cord by stereotactic method, percutaneous, any
63600 90 0
modality (including stimulation and/or recording)
Stereotactic stimulation of spinal cord, percutaneous, separate procedure
63610 70 0
not followed by other surgery
63615 Stereotactic biopsy, aspiration, or excision of lesion, spinal cord 115 0
63650 Percutaneous implantation of neurostimulator electrodes: epidural 45 0
Laminectomy for implantation of neurostimulator electrodes: epidural or
63655 65 0
subdural
63660 Revision or removal of neurostimulator electrodes 40 0
Incision and subcutaneous placement of spinal neurostimulator pulse
63685 50 0
Revision or removal of implanted spinal neurostimulator pulse generator or
63688 35 0
receiver
Electronic analysis of implanted neuromuscular pulse generator system:
63690 5 0
with or without reprogramming of pulse generator
63700 Repair of meningocele or myelomeningocele 140 0
63709 Repair of dural/CSF leak or pseudomeningocele, with laminectomy 100 0
63710 Dura graft, spinal 100 0
Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other:

63740 80 0
including laminectomy or percutaneous, not requiring laminectomy
63744 Replacement, irrigation or revision of lumbosubarachnoid shunt 50 0
63746 Removal of entire lumbosubarachnoid shunt system without replacement 40 0
Injection, anesthetic agent: somatic nerve, any division or branch, single

64400 15 0
level
Injection, anesthetic agent: somatic nerve, any division or branch, each
64401 5 0
additional level
64413 Injection nerve plexus, somatic 15 0
Injection, anesthetic agent, sphenopalatine ganglion, carotid sinus, or
64505 15 0
stellate ganglion)
64520 Injection, lumbar or thoracic (paravertebral sympathetic) 20 0
64530 Injection, cliac plexus, with or without radiologic monitoring 25 0
64553 Percutaneous implantation of neurostimulator electrodes: any site 15 0
64573 Incision for implantation of neurostimulator electrodes: any site 30 0
64585 Revision or removal of peripheral neurostimulator electrodes 20 0
Incision and subcutaneous placement of pripheral neurostimulator pulse
64590 25 0
Revision or removal of peripheral neurostimulator pulse generator or
64595 20 0
receiver
Destruction by neurolytic agent (eg, chemical, thermal, electrical, or
64600 10 0
radiofrequency) of somatic nerve, per level
64612 Destruction by neurolytic agent under radiologic monitoring, per level 25 0
64702 Neuorplasty: digital, one or both, same digit 30 0

64704 Neuroplasty: nerve of hand or foot 30 0
64708 Neuroplasty, major peripheral nerve, arm or leg: other than specified 45 0
64712 Neuroplasty: sciatic nerve 55 0
64713 Neuroplasty: brachial plexus 90 0
64714 Neuroplasty: lumbar plexus 75 0
64716 Neuroplasty and/or transposition: any major nerve 40 0
64722 Decompression of nerve 35 0
Internal neurolysis requiring use of operating microscope (list separately in

64727 30 0
addition to code for neuroplasty) (neuroplasty includes external neurolysis)
64732 Transection or avulsion of nerve: any site other than vagus 40 0

Transection or avulsion of nerve: vagus (vagotomy), transthoracic or
64752 70 0
abdominal
Transection or avulsion of nerve: vagi limited to proximal stomach (selective
64755 proximal vagotomy, proximal gastric vagotomy, parietal cell vagotomy, 95 0
supra- or highly selective vagotomy)
64774 Excision of neuroma: cutaneous nerve, any site, hand or foot 40 0
64784 Excision of neuroma: major peripheral nerve, except sciatic 65 0
64786 Excision of neuroma: sciatic nerve 110 0
Implantation of nerve end into bone or muscle (list separately in addition to
64787 35 0
neuroma excision)
64788 Excision of neurofibroma or neurolemmoma: cutaneous nerve 35 0
64790 Excision of neurofibroma or neurolemmoma: major peripheral nerve 75 0
64795 Biopsy of nerve 15 0
64802 Sympathectomy: cervical, thoracolumbar or lumbar 65 0
64804 Sympathectomy: cervicothoracic 100 0
Microdissection and/or microrepair of nerve (list separately in addition to
64830 25 0
code for nerve repair)
64831 Suture of nerve: hand or foot, each nerve 60 0
64856 Suture of major peripheral nerve, arm or leg: including transposition 95 0
64857 Suture of major peripheral nerve, arm or leg: without transposition 95 0
64859 Suture of each additional major peripheral nerve 30 0
64861 Suture of brachial or lumbar plexus 135 0
64864 Suture of nerve: facial, extracranial 85 0
64865 Suture of nerve: facial, intratemporal, with or without grafting 110 0
64866 Anastomosis: facial-spinal accessory, facial-hypogossal or facial-phrenic 110 0
Suture of nerve: requiring secondary or delayed suture (list separately in

64872 70 0
addition to code for primary nerve suture)
Suture of nerve: requiring extensive mobilization, or transposition of nerve
64874 80 0
(list separately in addition to code for nerve suture)
Suture of nerve: requiring shortening of bone of extremity (list separately in
64876 90 0
addition to code for nerve suture)
64885 Nerve graft (includes obtaining graft), head or neck 120 0
Nerve graft (includes obtaining graft), single or multiple strand, hand, foot,
64890 120 0
arm or leg
64901 Nerve graft, each additional nerve: single or multiple strand 75 0
64905 Nerve pedicle transfer: first stage 80 0
64907 Nerve pedicle transfer: second stage 100 0
65091 Evisceration of ocular contents: with or without implant 45 0
Enucleation of eye: with or without implant, with or without attachment of
65105 55 0
muscles
Exenteration of orbit: with or without skin graft, therapeutic removal of
65110 90 0
bone, muscle or myocutaneous flap
Reinsertion of ocular implant, with or without conjunctival graft or use of

65150 50 0
foreign material for reinforcement and/or attachment of muscles to implant
65175 Removal of ocular implant 40 0

Removal of foreign body, external eye: including concretions, conjunctival,
65210 10 0
subconjunctival, or scleral nonperforating
65222 Removal of foreign body, external eye: corneal, with slit lamp 10 0
65235 Removal of foreign body, intraocular: from anterior chamber or lens 55 0
Removal of foreign body, intraocular: from posterior segment, magnetic
65260 70 0
extraction
Removal of foreign body, intraocular: from posterior segment, nonmagnetic
65265 90 0
extraction
Repair of laceration: conjunctiva, with or without nonperforating laceration
65270 20 0
sclera, direct closure
Repair of laceration: cornea, nonperforating, with or without removal of
65275 45 0
foreign body
Repair of laceration: cornea and/or sclera, perforating, not involving uveal
65280 50 0
tissue
Repair of laceration: cornea and/or sclera, perforating, with reposition or
65285 90 0
resection of uveal tissue
65286 Repair of laceration: application of tissue glue, wounds of sclera/cornea 40 0
65290 Repair of wound, extraocular muscle, tendon and/or Tenon's capsule 35 0

65291 Exploration of eye under general anesthesia 15 0
65292 Removal of sutures under general anesthesia (child) 15 0
65400 Keratectomy: lamellar, partial (except pterygium) 40 0
65410 Biopsy of cornea 10 0
65420 Excision or transposition of pterygium: without graft 30 0
65426 Excision or transposition of pterygium: with graft 35 0
65430 Scraping of cornea, diagnostic, for smear and/or culture 10 0
Removal of corneal epithelium: with or without chemocauterization
65435 10 0
(abrasion, curettage)
Removal of corneal epithelium: with application of chelating agent (such as
65436 30 0
EDTA)
Destruction of lesion of cornea by cryotherapy, photocoagulation or
65450 20 0
thermo-cauterization
65600 Tattoo of cornea, mechanical or chemical 30 0
65710 Keratoplasty: lamellar 80 0
65730 Keratoplasty: penetrating 95 0
65770 Keratoprosthesis 115 0
65771 Radial keratotomy 85 0
Corneal relaxing incision or wedge resection for correction of surgically
65772 40 0
induced astigmatism
Paracentesis of anterior chamber of eye (separate procedure): with
65800 15 0
diagnostic aspiration of aqueous
65820 Goniotomy 50 0
65850 Trabeculotomy ab externo 70 0
Trabeculoplasty by laser surgery, one or more sessions (defined treatment
65855 40 0
series)
Severing adhesions of anterior segment, laser technique (separate
65860 30 0
procedure)
Severing adhesions of anterior segment of eye, incisional technique (with or
65880 without injection of air or liquid) (separate procedure): corneo-vitreal 50 0
adhesions
65900 Removal of epithelial downgrowth, anterior chamber of eye 60 0
65920 Removal of implanted material, anterior segment of eye 55 0
65930 Removal of blood clot, anterior segment of eye 50 0
66130 Excision of lesion, sclera 50 0
Fistulization of sclera for glaucoma: with iridectomy, any technique
66155 55 0
Fistulization of sclera for glaucoma: trabeculectomy ab externo (separate
66170 75 0
procedure)
Aqueous shunt to extraocular reservoir, (eg, Molteno, Schocket, or Denver-
66180 85 0
Krupin)
66185 Revision of aqueous shunt to extraocular reservoir 55 0
66220 Repair of scleral staphyloma: without graft 50 0
66225 Repair of scleral staphyloma: with graft 75 0
Revision or repair of operative wound of anterior segment, any type, early
66250 45 0
or late, major or minor procedure
Iridectomy, with corneoscleral or corneal section: for removal of lesion,
66600 60 0
and/or with cyclectomy
Iridectomy, with corneoscleral or corneal section: peripheral or sector, for
66625 45 0
glaucoma (separate procedure)
Iridectomy, with corneoscleral or corneal section:optical (seperate
66635 45 0
procedure)
66680 Repair of iris, ciliary body (as for iridodialysis) 45 0
Suture of iris, ciliary body (separate procedure) with retrieval of suture
66682 45 0
through small incision (eg, McCannel suture)
Ciliary boby destruction: diathermy, cyclophotocoagulation, cryotherapy or
66700 35 0
cyclodialysis
66761 Iridotomy/iridectomy by laser surgery (eg, for glaucoma) 25 0
Iridoplasty by photocoagulation (eg, for improvement of vision, for
66762 30 0
widening of anterior chamber angle)
66770 Destruction of cyst or lesion iris or ciliary body (nonexcisional procedure) 35 0
Discission, secondary membranous cataract (opacified posterior lens

66820 30 0
capsule and/or anterior hyaloid): stab incision technique
Discission of secondary membranous cataract (opacified posterior lens

66821 20 0
capsule and/or anterior hyaloid): laser surgery (one or more stages)
Repositioning of intraocular lens prosthesis, requiring an incision (separate
66825 55 0
procedure)
Removal of secondary membranous cataract with corneo-scleral section,

66830 55 0
with or without iridectomy (iridocapsulotomy, iridocapsulectomy)
66840 Removal of lens material: aspiration technique, one or more stages 55 0

Removal of lens material: phacofragmentation technique (mechanical or
66850 65 0
ultrasonic), with aspiration
66852 Removal of lens material: pars plana approach, with or without vitrectomy 65 0
66920 Removal of lens material: extra- or intracapsular 65 0
Extra- or intracapsular cataract removal with insertion of intraocular lens

66984 90 0
prosthesis (one stage procedure), manual or mechanical technique
Insertion of intraocular lens prosthesis (secondary implant), not associated

66985 70 0
with concurrent cataract removal, with or without anterior vitrectomy
66986 Exchange of intraocular lens 80 0

Removal of vitreous, anterior approach (open sky technique or limbal
67005 45 0
incision): partial, or subtotal removal with mechanical vitrectomy
Aspiration or release of vitreous, subretinal or choroid fluid, pars plana
67015 45 0
approach (posterior sclerotomy)
Injection of vitreous substitute, pars plana or limbal approach, (fluid-gas
67025 45 0
exchange), with or without aspiration (separate procedure)
67028 Intravitreal injection of pharmacologic agent (separate procedure) 20 0
67030 Discission of vitreous strands (without removal), pars plana approach 30 0
Severing of vitreous strands, vitreous face adhesions, sheets, membranes or
67031 35 0
opacities, laser surgery (one or more stages)
Vitrectomy, mechanical, pars plana approach: with or without epiretinal

67038 135 0
membrane stripping, or focal or panretinal endolaser photocoagulation
Vitrectomy, mechanical, pars plana approach: with endolaser panretinal

67040 115 0
photocoagulation
Repair of retinal detachment, one or more sessions: cryotherapy,
67105 diathermy, or photocoagulation (laser or xenon arc), with or without 50 0
drainage of subretinal fluid
Repair of retinal detachment: scleral buckling (such as lamellar excision,

67107 100 0
imbrication or encircling procedure), with or without implant
Repair of retinal detachment: with vitrectomy, any method, with or without

air or gas tamponade, focal endolaser photocoagulation, cryotherapy,
67108 135 0
drainage of subretinal fluid, scleral buckling, and/or removal of lens by same
technique
Repair of retinal detachment, one or more sessions: by injection of air or
67110 55 0
other gas (eg, pneumoretinopexy)
67112 Repair of retinal detachment: previously operated upon, any technique 125 0
67115 Release of encircling material (posterior segment) 40 0

67120 Removal of implanted material, posterior segment: extraocular 40 0
67121 Removal of implanted material, posterior segment: intraocular 70 0
Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration)
67145 without drainage, one or more sessions, photocoagulation (laser or xenon 40 0
arc), cryotherapy, or diathermy
Destruction of localized lesion of retina (eg, maculopathy, choroidopathy,
67208 small tumors), one or more sessions: cryotherapy, diathermy or 65 0
photocoagulation (laser or xenon arc)
Destruction of localized lesion of retina: radiation by implantation of source
67218 90 0
(includes removal of source)
Destruction of extensive or progressive retinopathy (eg, diabetic
67227 retinopathy), one or more sessions: cryotheapy, diathermy, or 55 0
photocoagulation (laser or xenon arc)
67311 Strabismus surgery: any technique, any number of muscles 60 0
Placement of adjustable suture(s) during strabismus surgery, including
67335 postoperative adjustment(s) (report in addition to specific strabismus 20 0
surgery)
67345 Chemodenervation of extraocular muscle 20 0
67350 Biopsy of extraocular muscle 20 0
Orbitotomy without bone flap (frontal or transconjunctival approach): for
67400 exploration, with or without biopsy, drainage, removal of lesion or foreign 60 0
body, or removal of bone for decompression
67415 Fine needle aspiration of orbital contents 10 0
Orbitotomy with bone flap or window, lateral approach: with removal of
67420 lesion, foreign body, drainage, bone for decompression or exploration, with 90 0
or without biopsy
Retrobulbar injection: medication, alcohol (separate procedure, does not
67500 10 0
include supply of medication)
67515 Injection of therapeutic agent into Tenon's capsule 10 0
Optic nerve decompression (eg, incision or fenestration of optic nerve
67570 90 0
sheath)
67700 Blepharotomy, drainage of abscess, eyelid 10 0
67710 Severing of tarsorrhaphy 10 0
67715 Canthotomy (separate procedure) 10 0
67800 Excision of chalazion(s), single or multiple, same or different lids 30 0
67810 Biopsy of eyelid 10 0
Correction of trichiasis: incision of lid margin, with or without free mucous
67835 40 0
membrane graft
Excision of lesion of eyelid (except chalazion) without closure or with simple
67840 20 0
direct closure
67850 Destruction of lesion of lid margin (up to 1 cm) 15 0
67875 Temporary closure of eyelids by suture (eg, Frost suture) 10 0
Construction of intermarginal adhesions, median tarsorrhaphy, or
67880 25 0
canthorrhaphy: without transposition of tarsal plate
Construction of intermarginal adhesions, median tarsorrhaphy, or
67882 30 0
canthorrhaphy: with transposition of tarsal plate
67900 Repair of brow ptosis (supraciliary, mid-forehead or coronal approach) 40 0

Repair of blepharoptosis: frontalis muscle technique with suture, other
67902 60 0
material or fascial sling (includes obtaining fascia)
Blepharoptosis repair: (tarso)levator resection or advancement, internal or
67903 40 0
external approach
Blepharoptosis repair: conjunctivo-tarso-Muller's muscle-levator resection
67908 35 0
(eg, Fasanella-Servat type)
67909 Reduction of overcorrection of ptosis 35 0
67911 Correction of lid retraction 35 0
67914 Repair of ectropion: suture or thermocauterization 25 0
Repair of ectropion: blepharoplasty, excision tarsal wedge or extensive (eg,
67916 35 0
Kuhnt-Szymanowski or tarsal strip operations)
67921 Repair of entropion: suture or thermocauterization 20 0
Repair of entropion: blepharoplasty, excision tarsal wedge or extensive (eg,
67923 40 0
Wheeler operation)
Suture of recent wound, eyelid,involving lid margin, tarsus, and/or palpebral
67930 35 0
conjunctiva: partial or full thickness
67938 Removal of embedded foreign body, eyelid 10 0
67950 Canthoplasty (reconstruction of canthus) 50 0
Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva,

67961 canthus, or full thickness, may include preparation for skin graft or pedicle 45 0
flap with adjacent tissue transfer or rearrangement
Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap

67971 75 0
from opposing eyelid: first stage
Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap
67975 60 0
from opposing eyelid: second stage
68020 Incision of conjunctiva, drainage of cyst(s) 10 0
68100 Biopsy of conjunctiva 10 0
68110 Excision of lesion, conjunctiva 15 0
68130 Excision of lesion, conjunctiva: with adjacent sclera 35 0
68200 Subconjunctival injection 5 0
Conjunctivoplasty, with or without reconstruction cul-de-sac: with
68326 conjunctival graft, extensive rearrangement, or buccal mucous membrane 50 0
graft (includes obtaining graft)
68330 Repair of symblepharon: conjunctivoplasty, without graft 30 0
Repair of symblepharon: with free graft conjunctiva or buccal mucous
68335 50 0
membrane (includes obtaining graft)
Repair of symblepharon: division of symblepharon with or without insertion
68340 30 0
of conformer or contact lens
68360 Conjunctival flap: bridge or partial 30 0
68362 Conjunctival flap: total (eg, Gunderson thin flap or purse string flap) 50 0
68400 Snip incision of lacrimal punctum 10 0
68510 Biopsy of lacrimal gland 30 0
68525 Biopsy or excision of lacrimal sac 50 0
68540 Excision of lacrimal gland tumor: frontal approach without osteotomy 65 0
68550 Excision of lacrimal gland tumor: frontal approach with osteotomy 85 0
68700 Plastic repair of lacrimal canaliculi 45 0
68705 Correction of everted punctum, cautery 15 0
68720 Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity) 55 0
Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity): with or
68750 60 0
without insertion of tube or stent
Closure of lacrimal punctum by thermocauterization, ligation, or laser
68760 10 0
surgery
68801 Dilation of lacrimal punctum, with or without irragation, one or both eyes 10 0
68810 Probing of nasolacrimal duct, with or without irrigation, one or both eyes 10 0
68815 Probing of nasolacrimal duct with implantation of tube or stent, one eye 20 0
68840 Probing of lacrimal canaliculi, with or without irrigation 10 0

68850 Injection of contrast medium for dacryocystography 10 0
69000 Drainage external ear, abscess or hematoma (separate procedure) 10 0
69100 Biopsy external ear or auditory canal (separate procedure) 10 0
69110 Excision external ear: partial, simple repair or complete amputation 20 0
69140 Excision exostosis(es), external auditory canal 50 0
Radical excision external auditory canal lesion: with or without neck
69150 110 0
dissection
69200 Removal foreign body from external auditory canal (separate procedure) 5 0
69210 Removal impacted cerumen (separate procedure), one or both ears 5 0

69220 Debridement, mastoidectomy cavity 10 0
69300 Otoplasty, protruding ear, with or without size reduction 50 0
Reconstruction of external auditory canal (meatoplasty) (eg, for stenosis
69310 70 0
due to trauma, infection), (separate procedure)
69320 Reconstruction external auditory canal for congenital atresia, single stage 110 0
Myringotomy including aspiration and/or eustachian tube inflation

69420 15 0
69424 Ventilating tube removal when originally inserted by another physician 10 0
69433 Tympanostomy (requiring insertion of ventilating tube) 20 0

Middle ear exploration through postauricular or ear canal incision (separate
69440 75 0
procedure)
69501 Mastoidectomy: simple 75 0
69511 Mastoidectomy: radical, any procedure 90 0
69530 Petrous apicectomy including radical mastoidectomy 120 0
69535 Resection temporal bone, external approach 210 0
69540 Excision aural polyp (separate procedure) 20 0
69603 Revision mastoidectomy: resulting in radical mastoidectomy or apicectomy 110 0
69604 Revision mastoidectomy: resulting in tympanoplasty or mastoidectomy 90 0
69620 Myringoplasty, uncomplicated 60 0

Tympanoplasty without mastoidectomy (including canalplasty, atticotomy
69631 75 0
and/or middle ear surgery), initial or revision: any method
Tympanoplasty with antrotomy or mastoidectomy (including canalplasty,
69635 atticotomy, middle ear surgery, and/or tympanic membrane repair): with or 110 0
without ossicular chain reconstruction, any method
Stapedectomy or stapedotomy with reestablishment of ossicular continuity,

69660 80 0
with or without use of foreign material
Stapedectomy or stapedotomy with reestablishment of ossicular continuity,

69661 100 0
with or without use of foreign material: with footplate drill out
69666 Repair oval window fistula (separate procedure) 75 0

69667 Repair round window fistula (separate procedure) 75 0
69670 Mastoid obliteration (separate procedure) 75 0
69676 Tympanic neurectomy 75 0
69700 Closure postauricular fistula, mastoid (separate procedure) 50 0
69720 Decompression facial nerve, intratemporal 110 0
69740 Suture facial nerve, intratemporal, with or without graft or decompression 110 0
Labyrinthotomy, with or without cryosurgery or other nonexcisional

69801 50 0
destructive procedures or tack procedure: transcanal
Labyrinthotomy, with or without cryosurgery or other nonexcisional
69802 75 0
destructive procedures or tack procedure: with mastoidectomy
69805 Endolymphatic sac operation: with or without shunt 110 0
69905 Labyrinthectomy: transcanal 75 0
69910 Labyrinthectomy: with mastoidectomy 120 0
69950 Vestibular nerve section, transcranial approach 155 0
69955 Total facial nerve decompression and/or repair (may include graft) 160 0
69960 Decompression internal auditory canal 160 0
69970 Removal of tumor, temporal bone 180 3
74283 Barium enema, therapeutic, for reduction of intussuception 25 0
75989 Radiological guidance for percutanous drainage of fluid collection 20 0
Localization of breast nodule or calcification before operations with marker
76096 5 0
and confirmation of its position with appropriate imaging
Ophtalmic echography, diagnostic:A-scan only, with amplitude
76511 5 5
quantification
76512 Ophtalmic echography, diagnostic:B-scan only 5 4
Echography, breast(s) (unilateral or bilateral), B-scan and or real time image
76645 5 10
documentation
Echography, abdominal (unilateral or bilateral), B-scan and or real time
76700 5 15
image documentation: complete
Echography, abdominal (unilateral or bilateral), B-scan and or real time

76705 5 10
image documentation: limited (e.g, single organ, quadrant, follow-up)
Echography, pregnant uterus (unilateral or bilateral), B-scan and or real

76805 5 10
time image documentation: complete (fetal and maternal evaluation)
76818 Fetal biophysical profile 5 0

Echocardiography, fetal, cardiovascular system, reral time with image
76825 5 10
documentation (2D) with or without M-mode recording
Doppler echocardiography, fetal, cardiocascular system. pulsed wave
76827 10 12
and/or continuous wave spectral display
Echography, pelvic (nonobstetruc), B-scan and/or real time with image
76856 5 10
documentation complete
77761 Intracavitary radioelement application 30 0
85095 Bone marrow :aspiration only 5 0
85097 Bone marrow : smear interpretation only 5 0
85102 Bone marrow biopsy: needle or trochar 5 0
Fine needle aspiration with or without preparation of smears : supperficial
88170 5 0
tissue (eg, thyroid, breast, prostate)
Fine needle aspiration with or without preparation of smears : deep tissue
88171 5 0
under radiologic guidance
90802 Interactive medical psychiatric diagnostic interview examination 10 0
90808 Narcosynthesis for psychiatric diagnostic and therapeutic purposes 9 0
90810 Interactive individual medical psychotherapy 12 0
Individual medical psychotherapy by a physician, with continuing medical
diagnostic evaluation, and drug management when indicated, including
90816 9 0
insight oriented, behavior modifying or supportive psychotherapy: 20 to 30
minutes
90818 12 0
minutes
90842 15 0
minutes
90845 Medical psychoanalysis 8 0
90846 Family medical psychotherapy (without the paptient present) 10 0
Family medical psychotherapy (conjoint psychotherapy) by a physician, with
90847 continuing medical diagnostic evaluation, and drug management as 12 0
indicated
Multiple-family group medical psychotherapy by a physician, with continuig

90849 4 0
medical diagnostic evaluation, and drug management when indicated
Group medical psychotherapy (other than of a multiple-family group) by a

90853 physician, with continuing medical diagnostic evaluation and drug 4 0
management when indicated
90857 Interactive group medical psychotherapy 4 0
Pharmacologic management, including prescription, use and review of
90862 6 0
medication with no more than minimal medical psychotherapy
Electroconvulsive therapy with or without monitoring, single or multiple
90870 14 0
seizures, per day
Individual psychophysiological therapy incorporating biofeedback training
90875 9 0
by any modality: up to 50 minutes
90880 Medical hypnotherapy 14 0
90901 Biofeedback training by any modality 3 0
90911 Biofeedback training, anorectal, including EMG and/or manometry 6 0
90935 Dialysis procedure: acute, any mode, hospitalized patient, up to 3 sessions 30 0
Dialysis procedure: chronic, any mode, with or without substantial revision

90937 5 0
of dialysis prescription
Dialysis training, patient, including helper when applicable, any mode, per
90989 30 0
course (excluding dialysis)
90997 Hemoperfusion (eg, with activated charcoal or resin) 30 0
Esophageal intubation and collection of washings for cytology, including
91000 10 0
preparation of specimens (separate procedure)
Esophageal motility study with or without stimulant (eg. mecholyl or similar
91010 15 0
stimulant) or acid perfusion
91020 Esophagogastric manometric studies 15 0
91030 Esophagus, acid perfusion (Bernstein) test for esophagitis 15 0
Esophagus, acid reflux test, with intraluminal pH electrode for detection of
91032 15 0
gastroesophageal reflux
Esophagus, acid reflux test, with intraluminal pH electrode for detection of
91033 20 0
gastroesophageal reflux: prolonged recording (24 hours)
Gastric analysis test with injection of stimulant of gastric secretion (eg,
91052 10 0
histamine, insulin, pentagastrin, calcium and secretin)
Gastric intubation, washings, and preparation of slides for cytology
91055 10 0
91060 Gastric saline load test 5 0
91065 Breath hydrogen test (eg, for detection of lactase deficiency) 5 0
91100 Intestinal bleeding tube, passage, positioning and monitoring 8 0
Gastric intubation and aspiration or lavage for treatment (eg, for ingested
91105 5 0
poisons or drugs)
91122 Anorectal manometry 15 0
91299 Echoendoscopy 40 0
Eye examination: routine(external examination, visual acuity, PAM or BAT,

92002 direct ophthalmoscopy, tonometry, gross visual fields, muscle balance, slit 7 0
lamp microscopy, color vision test (plates), with or without refraction
Eye examination: comprehensive (external examination, visual acuity, PAM

or BAT, direct ophthalmoscopy, tonometry, gross visual fields, muscle
92004 11 0
balance, slit lamp microscopy, color vision test plates, optic disc assessment
with three-mirror lens (with
Ophthalmological examination and evaluation under general anesthesia,
92018 with or without manipulation of globe for passive range of motion or other 15 0
manipulation to facilitate diagnostic examination
92020 Gonioscopy with medical diagnostic evaluation (separate procedure) 2 0
Sensorimotor examination with multiple measurements of ocular deviation
92060 and medical diagnostic evaluation (eg, restrictive or paretic muscle with 6 0
diplopia) (separate procedure)
Orthoptic and/or pleoptic training, with continual medical direction and
92065 2 0
evaluation (separate procedure)
Fitting of contact lens for treatment of disease, with medical supervision
92070 6 0
and follow-up
Visual field examination, unilateral or bilateral, with medical diagnostic
92081 evaluation: limited (eg, tangent screen, Autoplot, arc perimeter, or single 6 0
stimulus level automated test) (separate procedure)
Visual field examination, unilateral or bilateral, with medical diagnostic

92082 evaluation: intermediate (at least 2 isopters on Goldmann perimeter, or 6 0
automated suprathreshold screening program) (separate procedure)
Visual field examination, unialteral or bilateral, with medical diagnostic

92083 evaluation: extended (eg, at least 3 isopters on Goldmann perimeter and 6 0
static determination within the central 30 degrees) (separate procedure)
Serial tonometry (separate procedure) same day (eg, diurnal curve or

92100 6 0
medical treatment of acute elevation of intraocular pressure)
Tonography with medical diagnostic evaluation, recording indentation
92120 tonometer method or perilimbal suction method, with or without water 6 0
provocation (separate procedure)
Provocative tests for glaucoma, with medical diagnostic evaluation, without
92140 3 0
tonography (separate procedure)
92150 Photocoagulation or laser first session 20 10
92151 Photocoagulation or laser each supplemetn session max 3 10 10
Ophthalmoscopy, extended as for retinal detachment (may include use of
92225 contact lens, drawing or sketch, and/or fundus biomicroscopy), with 6 0
medical diagnostic evaluation (separate procedure)
Ophthalmoscopy, with medical diagnostic evaluation: with fluorescein
92235 angiography (includes multiframe photography), or with fundus 8 6
photography
Oculoelectromyography, one or more extraocular muscles, one or both
92265 6 0
eyes, with medical diagnostic evaluation (separate procedure)
Electro-oculography, with medical diagnostic evaluation (separate
92270 6 0
procedure)
Electroretinography, with medical diagnostic evaluation (separate
92275 7 0
procedure)
92280 Visually evoked potential study (response), with diagnostic evaluation 5 0
Color vision examination, extended, eg, anomaloscope or equivalent

92283 2 0
Dark adaptation examination, with medical diagnostic evaluation (separate
92284 2 0
procedure)
External ocular photography with medical diagnostic evaluation for

92285 documentation of medical progress (eg, close-up photography, slit lamp 3 0
photography, goniophotography, stereo-photography) (separate procedure)
Special anterior segment photography with medical diagnostic evaluation,

92286 with specular endothelial microscopy and cell count, with or without 6 3
fluorescein angiography
92288 Pachymetry 6 0
92289 Confocal microscopy 6 0
92290 Corneal topography (mapping) 6 0
Prescription of optical and physical characteristics of and fitting of contact

92310 10 0
lens(es), with medical supervision of adaptation: corneal or corneoscleral
Prescription of prosthesis and direction of fitting and supply by independent

92335 3 0
technician, with medical supervision of adaptation
92502 Otolaryngologic examination under general anesthesia 15 0
Medical evaluation of speech, language, and/or hearing problems (separate
92506 5 0
procedure)
92511 Nasopharyngoscopy with endoscope (separate procedure) 5 0
92512 Nasal function studies, eg, rhinomanometry (separate procedure) 5 0
92516 Facial nerve function studies (separate procedure) 3 0
92520 Laryngeal function studies 5 0
Spontaneous nystagmus test (including gaze and fixation nystagmus) with
92541 3 0
recording
92542 Positional nystagmus test, minimum of 4 positions, with recording 2 0
Caloric vestibular test, each irrigation (binaural, bithermal stimulation
92543 3 0
constitutes four tests), with recording
Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation,
92544 2 0
with recording
92545 Oscillating tracking test, with recording 2 0
92546 Torsion swing test, with recording 2 0
Basic comprehensive audiometry (pure tone, air and bone, and speech
92557 2 3.5
threshold and discrimination)
Special audiometry (tone decay test, short increment sensitivity test (SISI),
92563 2 0
and pure tone (Stenger) test
Tympanometry (impedance testing) with or without acoustic reflex and/or
92567 2 3.5
acoustic decay reflex test
92584 Electrocochleography 3 0
92585 Brainstem evoked response recording (evoked response audiometry) 5 2
92590 Hearing aid examination and selection, monaural or binaural 1 0
92592 Hearing aid check, monaural or binaural 1 0
92594 Electroacoustic evaluation for hearing aid, monaural or binaural 2 0
92950 Cardiopulmonary resuscitation (eg, cardiac arrest) 25 0
92953 Temporary transcutaneous pacing 3 0
92960 Cardioversion, elective, electrical conversion of arrhythmia, external 15 0
Thrombolysis, coronary: by intracoronary infusion, including selective
92975 50 0
coronary angiography
92977 Thrombolysis, coronary: by intravenous infusion 30 0
Intravascular ultrasound (coronary vessel or graft) during therapeutic
92978 12 0
intervention including imaging supervision, interpretation and report
Transcatheter placement of an intracoronary stent(s), percutaneous, with or

92980 120 0
without other therapeutic intervention, any method: single vessel
Transcatheter placement of an intracoronary stent(s), percutaneous, with or

92981 30 0
without other therapeutic intervention, any method: each additional vessel
92982 Percutaneous transluminal angioplasty: single vessel 85 70

92984 Percutaneous transluminal angioplasty: each additional vessel 15 0
92987 Percutaneous balloon valvuloplasty: mitral valve 150 70
92990 Percutaneous balloon valvuloplasty: pulmonary valve 110 70
Atrial septectomy or septostomy: transvenous method, balloon, Rashkind
92992 110 70
type (includes cardiac catheterization)
Atrial septectomy or septostomy: blade method (Park septostomy) (includes
92993 110 70
cardiac catheterization)
Percutaneous transluminal coronary atherectomy, by mechanical or other
92995 100 70
method, with or without balloon angioplasty: single vessel
Percutaneous transluminal coronary atherectomy, by mechanical or other

92996 20 0
method, with or without balloon angioplasty: each additional vessel
93010 ECG, interpretation and report only 2 2

Cardiovascular stress test using maximal or submaximal treadmill or bicycle
93015 exercise, continuous ECG monitoring, and/or pharmacological stress: with 10 2
physician supervision, with interpretation and report
Cardiovascular stress test using maximal or submaximal treadmill or bicycle
exercise, continuous ECG monitoring, and/or pharmacological stress: with
93016 3 0
physician supervision only, without interpretation and report (separate
procedure)
93024 Ergonovine provocation test 8 0
Vectorcardiogram (VCG), with or without ECG: with interpretation and
93220 4 3
report
ECG monitoring for 24 hours by continuous computerized monitoring and
93235 non-continuous recording and real-time data analysis: includes monitoring 10 4
and real time analysis with report and interpretation
93278 Signal-averaged electrocardiography (SAECG), with or without ECG 8 2
Echocardiography, trans-thoracic, with or without M-mode recording, with
93307 15 10
or without Doppler, with or without spectral color
Echocardiography, real time with image documentation (2D) with or
93312 20 10
without M-mode recording: transesophageal
Combined right heart catheterization and retrograde left heart
93326 40 0
catheterization
Echocardiography, 2D, with or without M-mode recording, during rest and
93350 cardiovascular stress test (maximal or submaximal treadmill or bicycle 15 11
exercise), with ECG monitoring, interpretation, and report
93501 Right heart catheterization 25 40
Insertion and placement of flow directed catheter (eg, Swan-Ganz) for
93503 20 0
monitoring purposes
93505 Endomyocardial biopsy 30 0
Left heart catheterization, retrograde, from the radial artery, brachial
93510 artery, axillary artery, or femoral artery: percutaneous or by surgical 40 40
cutdown
93524 Combined transseptal and retrograde left heart catheterization 45 0
Combined right heart catheterization and transseptal left heart
93527 catheterization through intact septum (with or without retrograde left heart 50 0
catheterization)
93536 Percutaneous insertion of intra-aortic balloon catheter 50 0
93546 Combined left heart catheterization and left ventricular angiography 40 70
Combined left heart catheterization, selective coronary angiography, one or

93547 45 70
more coronary arteries, and selective left ventricular angiography

93548 more coronary arteries, selective left ventricular angiography, with aortic 50 70
root aortography
Combined right and left heart catheterization, selective coronary
93549 angiography, one or more coronary arteries, and selective ventricular 60 96
angiography
93552 more coronary arteries, selective left ventricular cineangiography and 60 96
visualization of bypass grafts
Esophageal recording of atrial electrogram ( with or without ventricular
93615 8 0
electrogram)
Comprehensive electrophysiologic evaluation: right atrial and right
ventricular pacing and recording, His bundle recording, including insertion
93619 50 0
and repositioning of multiple electrode catheters, without induction or
attempted induction of arrhyt
Comprehensive electrophysiologic evaluation with right atrial and right
93620 75 0
and repositioning of multiple electrode catheters: with induction of
arrhythmia
Comprehensive electrophysiologic evaluation with right atrial and right
93621 85 0
and repositioning of multiple electrode catheters: with left atrial recordings
from coronary sinus or
Electrophysiologic follow-up study with pacing and recording to test efficacy

93624 30 0
of therapy, including induction or attempted induction of arrhythmia
Electrophysiologic evaluation of cardioverter-defibrillator leads (includes

93640 de-fibrillation threshold testing and sensing function) at time of initial 25 0
implantation or replacement
Electrophysiologic evaluation of cardioverter-defibrillator leads (includes

93641 defibrillation threshold testing and sensing function) at time of initial 35 0
implantation or replacement, with testing of pulse generator
Electrophysiologic evaluation of cardioverter-defibrillator (evaluation of

defibrillation threshold, induction of arrhythmia, sensing and pacing for
93642 30 0
arrhythmia termination, and programming of sensing or therapeutic
parametrs)
Intracardiac catheter ablation of atrioventricular node function,
93650 atrioventricular conduction for creation of complete heart block, with or 70 0
without temporary pacemaker placement
Intracardiac catheter ablation of arrhythmogenic focus: for treatment of

93651 supraventricular tachycardia by ablation of fast or slow AV pathways, 110 0
accessory AV connections or other atrial foci, singly or in combination
Intracardiac catheter ablation of arrhythmogenic focus: for treatment of
93652 115 0
ventricular tachycardia
Evaluation of cardiovascular function with tilt table evaluation, with
93660 continuous ECG monitoring and intermittent blood pressure monitoring, 15 0
with or without pharmacological intervention
Electronic analysis of dual-chamber or single chamber pacemaker system:
(evaluation of programmable parameters at rest and during activity if
93731 6 0
applicable, using ECG recording and interpretation at rest and during
exercise, analysis of event markers an
Electronic analysis of cardioverter/defibrillator only (interrogation,
93738 5 0
evaluation of pulse generator status: with or without reprogramming
Ambulatory blood pressure monitoring for 24 hours, including recording,
93784 8 4
scanning analysis, interpretation and report
93792 Sphygmocardiography 8 0
Non-invasive physiologic studies of extracranial arteries, bilateral

93875 (periorbital flow direction with arterial compression, ocular 3 12
plethysmography,analog velocity waveform spectral analysis, Doppler)
93880 Duplex scan of extracranial arteries: complete bilateral study 15 14

93882 Duplex scan of extracranial arteries: follow-up or limited study 10 14
93886 Transcranial Doppler study of the intracranial arteries: complete study 20 12
Transcranial Doppler study of the intracranial arteries: follow-up or limited
93888 10 12
study
Non-invasive physiologic studies of extremity arteries, bilateral, without
93920 5 12
exercise: upper extremity arteries
Non-invasive physiologic studies of extremity arteries, bilateral, without
93921 5 12
exercise: lower extremity arteries
Non-invasive physiologic studies of extremity arteries, bilateral, with
93923 10 12
exercise: upper extremity arteries
Non-invasive physiologic studies of extremity arteries, bilateral, with
93924 10 12
exercise: lower extremity arteries
Duplex scan of lower extremity arteries or arterial bypass grafts: complete
93925 10 14
bilateral study
Duplex scan of lower extremity arteries or arterial bypass grafts: follow-up
93926 10 14
or limited study
Duplex scan of upper extremity arteries or arterial bypass grafts: complete
93930 10 14
bilateral study
Duplex scan of upper extremity arteries or arterial bypass grafts: follow-up
93931 10 14
or limited study
93965 Non-invasive physiologic studies of extremity veins, bilateral 5 12
Duplex scan of extremity veins including responses to compression and
93970 10 14
other maneuvers: complete study
Duplex scan of extremity veins including responses to compression and
93971 10 14
other maneuvers: follow-up or limited study
Duplex scan of arterial inflow and venous outflow of abdominal, pelvic,
93975 20 14
and/or retroperitoneal organs: complete study
Duplex scan of arterial inflow and venous outflow of abdominal, pelvic,
93976 10 14
and/or retroperitoneal organs: follow-up or limited study
Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts:
93978 10 14
complete study
Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts:
93979 10 14
follow-up or limited study
93980 Duplex scan of penile and/or testicular vessels 10 14
93981 Non-invasive physiologic studies of penile or testicular vessels 5 0
93982 Contrast enhanced color Doppler abdominal scan 30 0
93985 Trans cutaneous measurement of oxygen partial pressure (TcPO2) 5 0
Spirometry, including graphic record, total and timed vital capacity,

94010 2 3
expiratory flow rate measurement(s), and/or maximal voluntary ventilation
Bronchospasm evaluation: before and after bronchodilator (aerosol or

94060 4 3
parenteral) or exercise
Prolonged postexposure evaluation of bronchopasm with multiple
94070 spirometric determinations (aerosol only), antigen, exercise, cold air, 5 3
methocholine
Vital capacity screening tests: total capacity, with timed forced expiratory
94150 5 3
volume (state duration), maximal mid expiratory and peak flow rates
94200 Maximum breathing capacity, maximal voluntary ventilation 1 3

Functional residual capacity or residual volume: helium method, nitrogen
94240 2 3
open circuit method, or other method
94260 Thoracic gas volume (total lung capacity and residual volume) 3 3
Determination of resistance to airflow, oscillatory or plethysmographic
94360 4 3
method
94375 Respiratory flow volume loop 2 3
94400 Breathing response to CO2 (CO2 response curve) 3 3
94620 Pulmonary stress testing, simple or complex 8 3
Ventilation assist and management for assist or controlled breathing:
94656 10 0
initiation and first day (not in ICU, CCU or ICN)
Ventilation assist and management, subsequent days, per day (included in
94657 5 0
ICU attendance fee if by same physician)
Continuous positive airway pressure ventilation (CPAP), initiation and
94660 5 0
management, per day
94664 Aerosol or vapor inhalation or bronchodilation, per session 3 0
Manipulation of chest wall eg, cupping, percussing, and vibration to
94667 3 0
facilitate lung function, per session
Oxygen uptake, expired gas analysis: rest and exercise, direct, with or
94680 3 0
without CO2 output, percentage oxygen extracted
Analysis of arterial blood gas (oxygen saturation, pO2, pCO2, CO2, pH): rest
94700 1 0
only (per analysis)
Analysis of arterial blood gas (oxygen saturation, pO2, pCO2, CO2, pH): rest
94705 6 0
and exercise (including cannulization of artery)
94720 Carbon monoxide diffusing capacity, any method 3 3
94750 Pulmonary compliance study, any method 4 3
Noninvasive ear or pulse oximetry for oxygen saturation: by continuous
94762 5 0
overnight monitoring (separate procedure)
94772 Circadian respiratory pattern recording, 12 to 24 hour continuous recording 10 0
Percutaneous tests (scratch, puncture, prick) with allergenic extracts or

95004 antibiotics, immediate type reaction (allergen included), per test, up to 10 1 0
tests
95027 Skin end point titration 4 0
Intracutaneous (intradermal) tests with allergenic extracts, delayed type
95028 2 0
reaction including reading and allergen, per test
95044 Patch or application tests, up to 10 tests, per test 1 0
95052 Photo patch tests, up to 10 tests, per test 1 0
95060 Opthalmic mucous membrane tests, per test 3 0
95065 Direct nasal mucous membrane tests, per test 3 0
Inhalation bronchial challenge testing (not including necessary pulmonary

95070 15 0
function tests): with histamine, methacholine, or similar compounds
Inhalation bronchial challenge testing (not including necessary pulmonary

95071 20 0
function tests): with antigens or gases
Ingestion challenge test (sequential and incremental ingestion of test items,
95075 15 0
eg, food, drug or other substance)
95078 Provocative testing (eg, Rinkel test) 5 0
Professional services for allergen immunotherapy in prescribing physician's

95120 5 0
office or institution, including provision of allergenic extract, single antigen
Rapid desensitization procedure, each hour (eg, insulin, penicillin, horse

95180 15 0
serum)
Multiple sleep latency testing (MSLT), recording, analysis and interpretation

95805 12 0
of physiological measurements of sleep during multiple nap opportunities
95807 Sleep study, 3 or more parameters of sleep other than sleep staging 12 0
95808 Polysomnography: sleep staging with 1 - 3 additional parameters of sleep 15 0
Polysomnography: sleep staging with 4 or more additional parameters of

95810 20 0
sleep
95812 Electroencephalogram (EEG) extended monitoring: up to one hour 8 0
95813 Electroencephalogram (EEG) extended monitoring: greater than one hour 12 0
Electroencephalogram (EEG) including recording awake and drowsy, with

95816 7 7
hyperventilation and/or photic stimulation
Electroenceohalogram (EEG) including recording awake and asleep, with
95819 8 7
hyperventilation and/or photic stimulation
95822 Electroencephalogram (EEG): sleep only 9 7
95824 Electroencephalogram (EEG): cerebral death evaluation only 5 7
95827 Electroencephalogram (EEG): all night sleep only 11 0
95829 Electrocorticogram at surgery (separate procedure) 40 0
95830 Insertion by physician of sphenoidal electrodes for EEG recording 5 0
95864 EMG-NCV, electromyography-nerve conduction velocity: extensive 15 4
95869 EMG-NCV, electromyography-nerve conduction velocity: limited 10 2
95920 Intraoperative neurophysiology testing, per hour 30 0
95925 Somatosensory testing (eg, cerebral evoked potentials), one or more nerves 5 0
95933 Orbicularis oculi (blink) reflex, by electrodiagnostic testing 5 0

Neuromuscular junction testing (repetitive stimulation, paired stimuli), each
95937 5 0
nerve, any one method
Monitoring for identification and lateralization of cerebral seizure focus,
95950 electroencephalographic (eg, 8 channel EEG) recording and interpretation, 10 0
each 24 hours
Monitoring for localization of cerebral seizure focus by cable or radio, 16 or
more channel telemetry, combined electroencephalographic (EEG) and
95951 40 0
video recording and interpretation (eg, for presurgical localization), each 24
hours
Monitoring for localization of cerebral seizure focus by computerized
95953 portable 16 or more channel EEG, electroencephalographic (EEG) recording 20 0
and interpretation, each 24 hours
Pharmacological or physical activation requiring physician attendance

95954 16 0
during EEG recording of activation phase (eg, thiopental activation test)
95955 Electroencephalogram (EEG) during non-intracranial (eg, carotid) surgery 7 0
Monitoring for localization of cerebral seizure focus by cable or radio, 16 or

95956 more channel telemetry, electroencephalographic recording and 20 0
interpretation, each 24 hours
Digital analysis of electroencephalogram (EEG) (eg, for epileptic spike

95957 13 0
analysis) list separately in addition to code for primary procedure
Wada activation test for hemispheric function, including

95958 28 0
electroencephalographic (EEG) monitoring
Functional cortical mapping by stimulation of electrodes on brain surface, or
95961 of depth electrodes, to provoke seizures or identify vital cortex: initial hour 19 0
of physician attendance
Functional cortical mapping by stimulation of electrodes on brain surface, or
95962 of depth electrodes, to provoke seizures or identify vital cortex: each 21 0
additional hour of physician attendance
Electronic analysis of implanted neurostimulator pulse generator system
(eg. rate, pulse amplitude and duration, configuration of wave form, battery
95972 10 0
status, electrode selectability, output modulation, cycling impedance and
patient measurements): comp
Electronic analysis of implanted neurostimulator pulse generator system ):
complex brain, spinal cord or peripheral (except cranial nerve)
95973 6 0
neurostimulator pulse generator/transmitter, with intraoperative or
subsequent programming: each additional 30
Psychological testing (includes psychodiagnostic assessment of personality,
96100 psychopathology, emotionality, intellectual abilities, eg, WAIS-R, Rorschach, 12 0
MMPI) with interpretation and report
Assessment of aphasia (includes assessment of expressive and receptive
96105 speech and language function, language comprehension, speech production 12 0
ability, reading, spelling, writing) with interpretation and report
Developmental testing: extended (includes assessment of motor language,

social, adaptive and/or cognitive functioning by standardized
96111 12 0
developmental instruments, eg, Bayley Scales of Infant Development)
with interpretation and report, per h
Neurobehavioral status exam (clinical assessment of thinking, reasoning and
judgment, eg,acquired knowledge, attention, memory, visual spatial
96115 12 0
abilities, language functions, planning) with interpretation and report, per
hour
Neuropsychological testing battery (eg, Halstead-Reitan, Luria, WAIS-R) with
96117 12 0
interpretation and report, per hour
Chemotherapy administration: subcutaneous or intramuscular, with or
96400 2 0
without local anesthesia
Chemotherapy administration, intavenous, intra-arterial, or prolonged

96408 30 0
infusion: initiation of a cycle (maximum once every two weeks)
Chemotherapy administration: intravenous or intra-arterial, subsequent

96409 10 0
session, maximum of three sessions per month (per session)
96440 Chemotherapy administration into pleural cavity 15 0

96445 Chemotherapy administration into peritoneal cavity 15 0
96450 Chemotherapy administration into CNS (eg, intrathecal) 15 0
High dose chemotherapy for hematopoietic stem cell mobilization or
96455 30 0
transplantation
96530 Refilling and maintenance of implantable pump or reservoir 5 0
97003 Occupational therapy evaluation 8 0
97010 Application of a modality to one or more areas: hot or cold packs 2 1
97012 Application of a modality to one or more areas: traction, mechanical 3 1
97016 Application of a modality to one or more areas: vasopneumatic devices 2 1
97018 Application of a modality to one or more areas: paraffin bath 1 1

97020 Application of a modality to one or more areas: microwave 1 1
97022 Application of a modality to one or more areas: whirlpool 2 1
97024 Application of a modality to one or more areas: diathermy 1 1
97026 Application of a modality to one or more areas: infrared 1 1
97028 Application of a modality to one or more areas: ultraviolet 1 1
Application of a modality to one or more areas: electrical stimulation
97032 3 1
(manual), each 15 minutes
Application of a modality to one or more areas: iontophoresis, each 15
97033 3 1
minutes
Application of a modality to one or more areas: contast baths, each 15
97034 3 1
minutes
97035 Application of a modality to one or more areas: ultrasound, each 15 minutes 3 1

Application of a modality to one or more areas: Hubbard tank, each 15
97036 3 1
minutes
Therapeutic procedure, one or more areas, each 15 minutes: therapeutic

97110 6 0
exercises to develop strength and endurance, range of motion and flexibility
Therapeutic procedure, one or more areas, each 15 minutes:

97112 neuromuscular reeducation of movement, balance, coordination, 6 0
kinesthetic sense, posture, and proprioception
Therapeutic procedure, one or more areas, each 15 minutes: aquatic
97113 6 0
therapy with therapeutic exercises
Therapeutic procedure, one or more areas, each 15 minutes: gait training
97116 5 0
(includes stair climbing)
Therapeutic procedure, one or more areas, each 15 minutes: massage
97124 including effleurage, petrissage, and/or tapotement (stroking, compression, 5 0
percussion)
Manual therapy techniques (eg, mobilization/manipulation, manual

97140 6 0
lymphatic drainage, manual traction), one or more regions, each 15 minutes
Orthotics fitting and training, upper and/or lower extremities, each 15

97504 6 0
minutes
97520 Prosthetic training, upper and/or lower extremities, each 15 minutes 6 0
97703 Checkout for orthotic/prosthetic use, established patient, each 15 minutes 3 0
Physical performance test or measurement (eg, musculoskeletal, functional

97750 6 0
capacity), with written report, each 15 minutes
Anesthesia with induced hypothermia by surface cooling to below 34? C,
99116 20 0
add to regular fee
99135 Anesthesia with induced hypotension, add to regular fee 10 0
99180 Hyperbaric oxygen therapy: initial management 25 0
99183 Hyperbaric oxygen therapy: subsequent, per session 15 0
99199 TPN - total parenteral nutrition, per day 10 0
Newborn resuscitation: provision of positive pressure ventilation and/or

99440 chest compressions in the presence of acute inadequate ventilation and/or 20 0
cardiac output (Apgar score below 5), with or without intubation
99500 Intrauterine fetal skin biopsy 20 0

99501 Intrauterine fetal thoracocentesis 20 0
99502 Intrauterine fetal urodochocentesis 20 0
99503 Intrauterine cardiocentesis 20 0
99504 Intrauterine drainage of polyhydramnios 20 0
Glucose monitoring for 24 hours by continuous computerized monitoring
99505 recording and real-time data analysis: includes monitoring and real-time 10 0
analysis with report and interpretation
99999 Gait and Motion

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2014 - 03 - 21 -

Code Description NSSF Coverage K App

1996 Daily hospital management of epidural or subarachnoid drug administration 10 0

1997 Daily hospital management of IV controlled analgesia 7 0

11300 Shaving of epidermal or superficial dermal lesions: 1 to 2 lesions 5 0

11450 Excision of skin and subcutaneous tissue for hidradenitis 20 0

Split graft, each additional 100 sq cm or 1% of body area of infants and

15831 Excision, excessive skin and subcutaneous tissue (including lipectomy) 70 0

Excision decubitus ulcer, sacral, ischial, or trochanteric, with or without

Mastectomy, modified radical, including axillary lymph nodes with or

19260 Excision of chest wall tumor involving ribs 100 0

20250 Biopsy, vertebral body, open: posterior approach 40 0

20500 Injection of sinus tract: diagnostic or therapeutic (separate procedure) 10 0

20520 Removal of foreign body in muscle or tendon sheath: simple 15 0

20525 Removal of foreign body in muscle or tendon sheath: deep or complicated 30 0

20550 Injection, tendon sheath, ligament, trigger points or ganglion cyst 10 0

Electrical stimulation to aid bone healing: non-invasive (non-operative) (list

Electrical stimulation to aid bone healing: invasive (operative) (list in

Reconstruction midface, LeFort I: three or more pieces, segment movement

Reconstruction midface, LeFort II: anterior intrusion (eg, Treacher-Collins

21243 Arthroplasty, temporomandibular joint, with prosthetic joint replacement 115 0

Reconstruction of mandible, extraoral, with transosteal bone plate (eg,

Open treatment of nasal fracture: with internal and/or external skeletal

21338 Open treatment of nasoethmoid fracture: with or without external fixation 50 0

Treatment of nasoethmoid complex fracture, with splint, wire, or headcap

21343 Open treatment of depressed frontal sinus fracture 80 0

Open treatment of complicated (eg, comminuted or involving posterior

Closed treatment of nasomaxillary complex fracture (LeFort II type), with

Open treatment of nasomaxillary complex fracture (LeFort II type): requiring

Percutaneous treatment of fracture of malar area, including zygomatic arch

Open treatment of depressed malar fracture, including zygomatic arch and

21401 Closed treatment of fracture of orbit, except blowout with manipulation 20 0

21406 Open treatment of fracture of orbit, exceptbloout without implant 45 0

Closed treatment of palatal or maxillary fracture (LeFort I type): with

Open treatment of palatal or maxillary fracture (LeFort I type): complicated

Closed treatment of craniofacial separation (LeFort III type) using

21480 Closed treatment of temporomandibular dislocation, initial or subsequent 5 0

Closed treatment of temporomandibular dislocation, complicated (eg,

Arthrodesis, posterior technique, craniocervical,atlas-axis or cervical below

Arthrodesis, posterior or posterolateral technique, with local bone or bone

Arthrodesis, lateral transverse process technique, with local bone or bone

Arthrodesis, posterior interbody technique, with local bone or bone

23140 Excision or curettage of bone cyst or benign tumor of clavicle or scapula 40 0

Excision or curettage of bone cyst or benign tumor of clavicle, scapula or

Sequestrectomy (eg, for osteomyelitis or bone abscess), humeral head to

23332 Removal of foreign body, shoulder: complicated, including total shoulder 65 0

23350 Injection procedure for shoulder arthrography 10 0

23400 Scapulopexy (eg, Sprengel's deformity or for paralysis) 75 0

23406 Tenomyotomy, shoulder area: single or multiple through same incision 55 0

Repair of ruptured supraspinatus tendon (rotator cuff) or musculotendinous

Closed treatment of scapular fracture: with manipulation, with or without

Open treatment of scapular fracture (body, glenoid or acromion) with or

Arthrotomy (capsulotomy), elbow, for infection, with exploration, drainage

24065 Biopsy, soft tissue of upper arm or elbow area: superficial 15 0

Partial excision (craterization, saucerization or diaphysectomy) of bone (eg,

24150 Radical resection for tumor, shaft or distal humerus 70 0

24360 Arthroplasty, elbow: with membrane, or with distal humeral replacement 70 0

Arthroplasty, elbow: with implant and fascia lata ligament reconstruction or

24495 Decompression fasciotomy, forearm, with brachial artery exploration 50 0

Open treatment of humeral shaft fracture, with insertion of intramedullary

Closed treatment of supracondylar or transcondylar humeral fracture, with

Percutaneous skeletal fixation of supracondylar or transcondylar humeral

Open treatment of humeral supracondylar or transcondylar fracture, with

Open treatment of humeral supracondylar or transcondylar fracture, with