CPT 2017 American Medical Association. All Rights Reserved. Charts 2018 American College of Obstetricians and Gynecologists. All Rights Reserved.

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1 2018 National Physician Fee Schedule CPT codes and descriptions only are copyright 2017 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. COLUMN 1 COLUMN 2 COLUMN 3 COLUMN 4 COLUMN 5 Liability DAYS Op Op Op Procs Procs Surgeon Surgeon HCPCS Level II Codes G0101 Ca screen;pelvic/breast exam XXX 0% 0% 0% No No Maybe No Q0091 Obtaining screen pap smear XXX 0% 0% 0% No No Maybe No INTEGUMENTARY SYSTEM Skin, Subcutaneous, and Accessory Structures Acne surgery % 80% 10% Yes No No No Drainage of skin abscess % 80% 10% Yes No No No Drainage of skin abscess % 80% 10% Yes No No No Drainage of pilonidal cyst % 80% 10% Yes No No No Drainage of pilonidal cyst % 80% 10% Yes No No No Remove foreign body % 80% 10% Yes No No No Remove foreign body % 80% 10% Yes No No No Drainage of hematoma/fluid % 80% 10% Yes No No No Puncture drainage of lesion % 80% 10% Yes No No No Complex drainage wound % 80% 10% Yes No No No Debride genitalia & perineum NA NA % 0% 0% Yes No No No Debride genit/per/abdom wall NA NA % 0% 0% Yes No No No Deb subq tissue 20 sq cm/< % 0% 0% Yes No No No Deb musc/fascia 20 sq cm/< % 0% 0% Yes No No No Biopsy skin lesion % 0% 0% Yes No No No Biopsy skin add-on ZZZ 0% 0% 0% No No No No Removal of skin tags <w/ % 80% 10% Yes No No No Remove skin tags add-on ZZZ 0% 0% 0% No No No No Exc h-f-nk-sp b9+marg 0.5/< % 80% 10% Yes No No No Exc h-f-nk-sp b9+marg % 80% 10% Yes No No No Exc h-f-nk-sp b9+marg % 80% 10% Yes No No No Exc h-f-nk-sp b9+marg % 80% 10% Yes No No No Exc h-f-nk-sp b9+marg % 80% 10% Yes No No No Exc h-f-nk-sp b9+marg >4 cm % 80% 10% Yes No No No Exc h-f-nk-sp mal+marg 0.5/< % 80% 10% Yes No No No Exc s/n/h/f/g mal+mrg % 80% 10% Yes No No No Exc s/n/h/f/g mal+mrg % 80% 10% Yes No No No Exc s/n/h/f/g mal+mrg % 80% 10% Yes No No No Exc s/n/h/f/g mal+mrg % 80% 10% Yes No No No Exc s/n/h/f/g mal+mrg >4 cm % 80% 10% Yes No No No Remove contraceptive capsule % 0% 0% Yes No Maybe No Implant hormone pellet(s) % 0% 0% Yes No No No Insert drug implant device XXX 0% 0% 0% Yes No Maybe No Remove drug implant device XXX 0% 0% 0% Yes No Maybe No Remove/insert drug implant XXX 0% 0% 0% Yes No Maybe No Rpr s/n/ax/gen/trk cm % 0% 0% Yes No No No Rpr s/n/a/gen/trk cm % 0% 0% Yes No No No Rpr s/n/a/gen/trk cm % 0% 0% Yes No No No Rpr s/n/ax/gen/trnk >30.0 cm % 0% 0% Yes No No Maybe Charts 2018 American College of Obstetricians and Gynecologists. All Rights Reserved. 1

2 Liability DAYS Op Op Op Procs Procs Surgeon Surgeon Closure of split wound % 80% 10% Yes No No No Closure of split wound % 80% 10% Yes No No No Intmd rpr n-hf/genit 2.5cm/< % 80% 10% Yes No No No Intmd rpr n-hf/genit % 80% 10% Yes No No No Intmd rpr n-hf/genit % 80% 10% Yes No No No Intmd rpr n-hf/genit % 80% 10% Yes No No No Intmd rpr n-hf/genit % 80% 10% Yes No Maybe No Intmd rpr n-hf/genit >30.0cm % 80% 10% Yes No Yes Maybe Cmplx rpr f/c/c/m/n/ax/g/h/f % 80% 10% Yes No No No Cmplx rpr f/c/c/m/n/ax/g/h/f % 80% 10% Yes No No No Cmplx rpr f/c/c/m/n/ax/g/h/f ZZZ 0% 0% 0% No No No No Late closure of wound NA NA % 71% 19% Yes No No No Remove sutures same surgeon XXX 0% 0% 0% No No No No Remove sutures diff surgeon % 0% 0% Yes No No No Dressing change not for burn 0.86 NA NA % 0% 0% Yes No No No Destruction Destruct premalg lesion % 80% 10% Yes No No No Destruct premalg les ZZZ 0% 0% 0% No No No No Destroy premal lesions 15/> % 80% 10% No No No No Destruct b9 lesion % 80% 10% Yes No No No Destruct lesion 15 or more % 80% 10% Yes No No No Destruction of skin lesions % 80% 10% Yes No No No Destruction of skin lesions % 80% 10% Yes No No No Destruction of skin lesions % 80% 10% Yes No No No Destruction of skin lesions % 80% 10% Yes No No No Destruction of skin lesions % 80% 10% Yes No No No Destruction of skin lesions % 80% 10% Yes No No No Breast Drainage of breast lesion % 0% 0% Yes No No No Drain breast lesion add-on ZZZ 0% 0% 0% No No No No Bx breast percut w/o image % 0% 0% Yes Yes No No Biopsy of breast open % 80% 10% Yes Yes No No Removal of breast lesion % 71% 19% Yes Yes No No Excision breast lesion % 71% 19% Yes Yes No Maybe Excision addl breast lesion 2.93 NA NA 4.67 ZZZ 0% 0% 0% No No No Maybe HEMIC/LYMPHATIC SYSTEM Removal pelvic lymph nodes NA NA % 73% 16% Yes No Yes Maybe Removal abdomen lymph nodes NA NA % 73% 16% Yes No Yes Maybe Laparoscopy lymph node biop 8.49 NA NA % 80% 10% Laparoscopy lymphadenectomy NA NA % 80% 10% Laparoscopy lymphadenectomy NA NA % 80% 10% Laps pelvic lymphadec NA NA % 80% 10% Charts 2018 American College of Obstetricians and Gynecologists. All Rights Reserved. 2

3 Liability DAYS Op Op Op Procs Procs Surgeon Surgeon Remove groin lymph nodes NA NA % 73% 16% Yes Yes Yes Maybe Remove groin lymph nodes NA NA % 73% 16% Yes Yes Yes Maybe Remove pelvis lymph nodes NA NA % 73% 16% Yes Yes Yes Maybe Remove abdomen lymph nodes NA NA % 73% 16% Yes No Yes Maybe DIGESTIVE SYSTEM Intestine (Except Rectum) Freeing of bowel adhesion NA NA % 81% 10% Yes No Yes Maybe Lap enterolysis NA NA % 81% 10% Yes No Yes Maybe Appendix Appendectomy NA NA % 81% 10% Yes No Yes Maybe Appendectomy add-on 1.53 NA NA 2.44 ZZZ 0% 0% 0% No No Yes Maybe Appendectomy NA NA % 81% 10% Yes No Yes Maybe Laparoscopy appendectomy 9.45 NA NA % 81% 10% Yes Rectum Destruction rectal tumor NA NA % 81% 10% Yes No No Maybe Repair of rectocele NA NA % 81% 10% Yes No Yes Maybe Repair rect/bladder fistula NA NA % 81% 10% Yes No Yes Maybe Repair rectourethral fistula NA NA % 81% 10% Yes No Yes Maybe Anus Incision of anal abscess % 80% 10% Yes No No No Incision of rectal abscess 6.37 NA NA % 81% 10% Yes No No No Incise external hemorrhoid % 80% 10% Yes No No No Destruction anal lesion(s) % 80% 10% Yes No No No Destruction anal lesion(s) % 80% 10% Yes No No No Cryosurgery anal lesion(s) % 80% 10% Yes No No No Laser surgery anal lesions % 80% 10% Yes No No No Excision of anal lesion(s) % 80% 10% Yes No No No Destruction anal lesion(s) % 80% 10% Yes No No No Destroy internal hemorrhoids % 81% 10% Yes No Maybe No Treatment of anal fissure % 80% 10% Yes No No No Treatment of anal fissure % 80% 10% Yes No Maybe No Abdomen, Peritoneum, and Omentum Exploration of abdomen NA NA % 81% 10% Yes No Yes Maybe Reopening of abdomen NA NA % 81% 10% Yes No Yes Maybe Exploration behind abdomen NA NA % 81% 10% Yes No Yes Maybe Drainage abdom abscess open NA NA % 81% 10% Yes No Yes No Drain open retroperi abscess NA NA % 81% 10% Yes No No Maybe Abd paracentesis % 0% 0% Yes No No No Abd paracentesis w/imaging % 0% 0% Yes No No No Biopsy abdominal mass % 0% 0% Yes No No No Exc abd tum 5 cm or less NA NA % 81% 10% Yes No Yes Maybe Exc abd tum over 5 cm NA NA % 81% 10% Yes No Yes Maybe Exc abd tum over 10 cm NA NA % 81% 10% Yes No Yes Maybe Removal of omentum NA NA % 81% 10% Yes No Yes Maybe Diag laparo separate proc 5.14 NA NA % 80% 10% Yes No Yes No Charts 2018 American College of Obstetricians and Gynecologists. All Rights Reserved. 3

4 Liability DAYS Op Op Op Procs Procs Surgeon Surgeon Laparoscopy biopsy 5.44 NA NA % 80% 10% Laparoscopy aspiration 6.01 NA NA % 80% 10% Lap insert tunnel ip cath 6.32 NA NA % 80% 10% Lap w/omentopexy add-on 3.50 NA NA 5.48 ZZZ 0% 0% 0% No No Yes Maybe Remove foreign body adbomen NA NA % 81% 10% Yes No No Maybe Insert tun ip cath perc % 0% 0% Yes No Maybe No Insert tun ip cath w/port 7.08 NA NA % 81% 10% Yes No No No Repair of abdominal wall NA NA % 81% 10% Yes No Yes Maybe Omental flap intra-abdom 6.54 NA NA ZZZ 0% 0% 0% No URINARY SYSTEM Ureter Incision of kidney NA NA % 83% 9% Yes Yes Yes Maybe Release of ureter NA NA % 83% 9% Yes Yes Yes Maybe Release of ureter NA NA % 83% 9% Yes No Yes Maybe Release/revise ureter NA NA % 83% 9% Yes No Yes Maybe Bladder Incise & drain bladder 4.49 NA NA % 83% 9% Yes No Yes Maybe Incise bladder/drain ureter 7.81 NA NA % 83% 9% Yes No Yes No Drain bl w/cath insertion % 0% 0% Yes No No No Insert bladder catheter % 0% 0% Yes No No No Insert temp bladder cath % 0% 0% Yes No No No Insert bladder cath complex % 0% 0% Yes No No No Simple cystometrogram NA NA 000 0% 0% 0% Yes No Maybe No Simple cystometrogram NA NA 000 0% 0% 0% Yes No Maybe No Simple cystometrogram % 0% 0% Yes No Maybe No Complex cystometrogram NA NA 000 0% 0% 0% Yes No No No Complex cystometrogram NA NA 000 0% 0% 0% Yes No No No Complex cystometrogram % 0% 0% Yes No No No Cystometrogram w/up NA NA 000 0% 0% 0% Yes No Maybe No Cystometrogram w/up NA NA 000 0% 0% 0% Yes No Maybe No Cystometrogram w/up % 0% 0% Yes No Maybe No Cystometrogram w/vp NA NA 000 0% 0% 0% Yes No Maybe No Cystometrogram w/vp NA NA 000 0% 0% 0% Yes No Maybe No Cystometrogram w/vp % 0% 0% Yes No Maybe No Cystometrogram w/vp&up NA NA 000 0% 0% 0% Yes No Maybe No Cystometrogram w/vp&up NA NA 000 0% 0% 0% Yes No Maybe No Cystometrogram w/vp&up % 0% 0% Yes No Maybe No Urine flow measurement NA NA XXX 0% 0% 0% Yes No Maybe No Urine flow measurement NA NA XXX 0% 0% 0% Yes No Maybe No Urine flow measurement XXX 0% 0% 0% Yes No Maybe No Electro-uroflowmetry first NA NA XXX 0% 0% 0% Yes No No No Electro-uroflowmetry first NA NA XXX 0% 0% 0% Yes No No No Electro-uroflowmetry first XXX 0% 0% 0% Yes No No No Charts 2018 American College of Obstetricians and Gynecologists. All Rights Reserved. 4

5 Liability DAYS Op Op Op Procs Procs Surgeon Surgeon Anal/urinary muscle study NA NA XXX 0% 0% 0% Yes No No No Anal/urinary muscle study NA NA XXX 0% 0% 0% Yes No No No Anal/urinary muscle study XXX 0% 0% 0% Yes No No No Anal/urinary muscle study NA NA XXX 0% 0% 0% Yes No Maybe No Anal/urinary muscle study NA NA XXX 0% 0% 0% Yes No Maybe No Anal/urinary muscle study XXX 0% 0% 0% Yes No Maybe No Urinary reflex study NA NA 000 0% 0% 0% Yes No Maybe No Urinary reflex study NA NA 000 0% 0% 0% Yes No Maybe No Urinary reflex study % 0% 0% Yes No Maybe No Intraabdominal pressure test NA NA ZZZ 0% 0% 0% No No Maybe No Intraabdominal pressure test NA NA ZZZ 0% 0% 0% No No Maybe No Intraabdominal pressure test ZZZ 0% 0% 0% No No Maybe No Attach bladder/urethra NA NA % 83% 9% Yes No Yes Maybe Attach bladder/urethra NA NA % 83% 9% Yes No Yes Maybe Repair bladder neck NA NA % 83% 9% Yes No Yes Maybe Repair of bladder wound NA NA % 83% 9% Yes No Yes Maybe Repair of bladder wound NA NA % 83% 9% Yes No Yes Maybe Repair of bladder opening 7.87 NA NA % 83% 9% Yes No Yes Maybe Repair bladder/vagina lesion NA NA % 83% 9% Yes No Yes Maybe Close bladder-uterus fistula NA NA % 83% 9% Yes No Yes Maybe Hysterectomy/bladder repair NA NA % 83% 9% Yes No Yes Maybe Laparo urethral suspension NA NA % 83% 9% Yes No Yes Maybe Laparo sling operation NA NA % 83% 9% Yes No Yes Maybe Cystoscopy % 0% 0% Yes No No No Cystoscopy implant stent 6.39 NA NA % 0% 0% No No No Cystoscopy and treatment % 0% 0% No No No Cystoscopy chemodenervation % 0% 0% No No No Urethra Dilation of urethra % 0% 0% Yes No No No Dilation of urethra % 0% 0% Yes No No No MALE GENITAL SYSTEM Circumcision w/regionl block Yes No Maybe No Circumcision neonate Yes No No No FEMALE GENITAL SYSTEM Vulva, Perineum, and Introitus I & d of vulva/perineum Yes No No Yes Drainage of gland abscess Yes No No No Surgery for vulva lesion 2.89 NA NA Yes No No No Lysis of labial lesion(s) Yes No Maybe No Hymenotomy 0.68 NA NA Yes No Maybe No Destroy vulva lesions sim Yes No No No Destroy vulva lesion/s compl Yes No No No Biopsy of vulva/perineum Yes No No Yes Charts 2018 American College of Obstetricians and Gynecologists. All Rights Reserved. 5

6 Liability DAYS Op Op Op Procs Procs Surgeon Surgeon Biopsy of vulva/perineum ZZZ No No No Yes Partial removal of vulva 7.53 NA NA Yes No Yes Maybe Complete removal of vulva 9.68 NA NA Yes No Yes Maybe Extensive vulva surgery NA NA Yes No Yes Maybe Extensive vulva surgery NA NA Yes Extensive vulva surgery NA NA Yes Extensive vulva surgery NA NA Yes Extensive vulva surgery NA NA Yes Extensive vulva surgery NA NA Yes Extensive vulva surgery NA NA Yes Yes Yes Maybe Partial removal of hymen 2.84 NA NA Yes No Yes Maybe Remove vagina gland lesion 4.88 NA NA Yes Yes No No Repair of vagina 3.93 NA NA Yes No Yes Maybe Repair clitoris NA NA Yes No Yes Maybe Repair of perineum 4.29 NA NA Yes Exam of vulva w/scope Yes No No No Exam/biopsy of vulva w/scope Yes No No No Vagina Exploration of vagina 3.02 NA NA % 80% 10% Yes No Maybe No Drainage of pelvic abscess 6.84 NA NA % 74% 14% Yes No Maybe No Drainage of pelvic fluid % 0% 0% Yes No Maybe No I & d vaginal hematoma pp 2.73 NA NA % 80% 10% Yes No Maybe No I & d vag hematoma non-ob 5.18 NA NA % 80% 10% Yes No Maybe No Destroy vag lesions simple % 80% 10% Yes No No No Destroy vag lesions complex % 80% 10% Yes No No No Biopsy of vagina % 0% 0% Yes No No No Biopsy of vagina % 80% 10% Yes No No No Remove vagina wall partial 7.50 NA NA % 74% 14% Yes No Yes Maybe Remove vagina tissue part NA NA % 74% 14% Yes No Yes Maybe Vaginectomy partial w/nodes NA NA % 74% 14% Yes No Yes Maybe Remove vagina wall complete NA NA % 74% 14% Yes No Yes Maybe Remove vagina tissue compl NA NA % 74% 14% Yes No Yes Maybe Vaginectomy w/nodes compl NA NA % 74% 14% Yes No Yes Maybe Closure of vagina 8.28 NA NA % 74% 14% Yes No Yes Maybe Remove vagina lesion % 80% 10% Yes No Yes Maybe Remove vagina lesion % 80% 10% Yes No No No Treat vagina infection % 0% 0% Yes No No No Insert uteri tandem/ovoids % 0% 0% Yes No No Yes Ins vag brachytx device % 0% 0% Yes No Maybe No Insert pessary/other device % 0% 0% Yes No No No Fitting of diaphragm/cap % 0% 0% Yes No Maybe No Treat vaginal bleeding % 80% 10% Yes No No No Repair of vagina 4.42 NA NA % 74% 14% Yes No Yes Maybe Repair vagina/perineum 5.71 NA NA % 74% 14% Yes No Yes Maybe Revision of urethra 4.85 NA NA % 74% 14% Yes No Yes Maybe Repair of urethral lesion 6.30 NA NA % 74% 14% Yes No Yes Maybe Charts 2018 American College of Obstetricians and Gynecologists. All Rights Reserved. 6

7 Liability DAYS Op Op Op Procs Procs Surgeon Surgeon Anterior colporrhaphy NA NA % 74% 14% Yes No Yes Maybe Repair rectum & vagina NA NA % 74% 14% Yes No Yes Maybe Cmbn ant pst colprhy NA NA % 74% 14% Yes No Yes Maybe Cmbn ap colprhy w/ntrcl rpr NA NA % 74% 14% Yes No Yes Maybe Insert mesh/pelvic flr addon 4.88 NA NA 7.29 ZZZ 0% 0% 0% No No Yes Maybe Repair of bowel bulge 7.57 NA NA % 74% 14% Yes No Yes Maybe Repair of bowel pouch NA NA % 74% 14% Yes No Yes Maybe Suspension of vagina NA NA % 74% 14% Yes No Yes Maybe Colpopexy extraperitoneal 7.97 NA NA % 74% 14% Yes No Yes Maybe Colpopexy intraperitoneal NA NA % 74% 14% Yes No Yes Maybe Repair paravag defect open NA NA % 83% 9% Yes Repair paravag defect vag NA NA % 83% 9% Yes Revise/remove sling repair NA NA % 74% 14% Yes No Yes Maybe Repair bladder defect NA NA % 74% 14% Yes No Yes Maybe Repair bladder & vagina NA NA % 74% 14% Yes No Yes Maybe Construction of vagina 8.64 NA NA % 74% 14% Yes No Yes No Construct vagina with graft NA NA % 74% 14% Yes No Yes Maybe Revise vag graft via vagina 7.82 NA NA % 74% 14% Yes No Yes Maybe Revise vag graft open abd NA NA % 74% 14% Yes No Yes Maybe Repair rectum-vagina fistula 8.71 NA NA % 74% 14% Yes No Yes Maybe Repair rectum-vagina fistula NA NA % 74% 14% Yes No Yes Maybe Fistula repair & colostomy NA NA % 74% 14% Yes No Yes Maybe Fistula repair transperine NA NA % 74% 14% Yes No Yes Maybe Repair urethrovaginal lesion 7.65 NA NA % 74% 14% Yes No Yes Maybe Repair urethrovaginal lesion 8.91 NA NA % 74% 14% Yes No Yes Maybe Repair bladder-vagina lesion 8.88 NA NA % 74% 14% Yes No Yes Maybe Repair bladder-vagina lesion NA NA % 74% 14% Yes No Yes Maybe Repair vagina NA NA % 74% 14% Yes No Yes Maybe Dilation of vagina 2.27 NA NA % 0% 0% Yes No Maybe No Pelvic examination 1.75 NA NA % 0% 0% Yes No No No Remove vaginal foreign body 2.49 NA NA % 80% 10% Yes No Maybe No Exam of vagina w/scope % 0% 0% Yes No No No Exam/biopsy of vag w/scope % 0% 0% Yes No No No Repair paravag defect lap NA NA % 83% 9% Yes Laparoscopy surg colpopexy NA NA % 74% 14% Yes No Yes Maybe Revise prosth vag graft lap NA NA % 74% 14% Yes No Yes Maybe Cervix Uteri Exam of cervix w/scope % 0% 0% Yes No No No Bx/curett of cervix w/scope % 0% 0% No No No Biopsy of cervix w/scope % 0% 0% cerv curettage w/scope % 0% 0% Bx of cervix w/scope leep % 0% 0% No No No No No No No No No Charts 2018 American College of Obstetricians and Gynecologists. All Rights Reserved. 7

8 Liability DAYS Op Op Op Procs Procs Surgeon Surgeon Conz of cervix w/scope leep % 0% 0% No No No Biopsy of cervix % 0% 0% Yes No No No cervical curettage % 80% 10% Yes No No No Cauterization of cervix % 80% 10% Yes No No No Cryocautery of cervix % 80% 10% Yes No No No Laser surgery of cervix % 80% 10% Yes No No No Conization of cervix % 74% 14% Yes No No No Conization of cervix % 74% 14% Yes No No No Removal of cervix 5.27 NA NA % 74% 14% Yes No Yes Maybe Removal of cervix radical NA NA % 74% 14% Yes No Yes Maybe Removal of residual cervix NA NA % 74% 14% Yes No Yes Maybe Remove cervix/repair pelvis NA NA % 74% 14% Yes No Yes Maybe Removal of residual cervix 6.34 NA NA % 74% 14% Yes No Yes Maybe Remove cervix/repair vagina 9.94 NA NA % 74% 14% Yes No Yes Maybe Remove cervix repair bowel 9.36 NA NA % 74% 14% Yes No Yes Maybe D&c of cervical stump % 80% 10% Yes No No No Revision of cervix 4.35 NA NA % 74% 14% Yes No Maybe No Revision of cervix 4.61 NA NA % 74% 14% Yes No Yes No Dilation of cervical canal % 0% 0% Yes No No No Corpus Uteri Biopsy of uterus lining % 0% 0% Yes No No No Bx done w/colposcopy add-on ZZZ 0% 0% 0% No No Maybe No Dilation and curettage % 80% 10% Yes No No No Myomectomy abdom method NA NA % 74% 14% Yes No Yes Maybe Myomectomy vag method 8.91 NA NA % 74% 14% Yes No Yes Maybe Myomectomy abdom complex NA NA % 74% 14% Yes No Yes Maybe Total hysterectomy NA NA % 74% 14% Yes No Yes Maybe Total hysterectomy NA NA % 74% 14% Yes No Yes Maybe Partial hysterectomy NA NA % 74% 14% Yes No Yes Maybe Extensive hysterectomy NA NA % 74% 14% Yes No Yes Maybe Extensive hysterectomy NA NA % 74% 14% Yes No Yes Maybe Removal of pelvis contents NA NA % 74% 14% Yes No Yes Maybe Vaginal hysterectomy NA NA % 74% 14% Yes No Yes Maybe Vag hyst including t/o NA NA % 74% 14% Yes Vag hyst w/t/o & vag repair NA NA % 74% 14% Yes Vag hyst w/urinary repair NA NA % 74% 14% Yes No Yes Maybe Vag hyst w/enterocele repair NA NA % 74% 14% Yes No Yes Maybe Hysterectomy/revise vagina NA NA % 74% 14% Yes No Yes Maybe Hysterectomy/revise vagina NA NA % 74% 14% Yes No Yes Maybe Extensive hysterectomy NA NA % 74% 14% Yes No Yes Maybe Vag hyst complex NA NA % 74% 14% Yes No Yes Maybe Vag hyst incl t/o complex NA NA % 74% 14% Yes Vag hyst t/o & repair compl NA NA % 74% 14% Yes Vag hyst w/uro repair compl NA NA % 74% 14% Yes No Yes Maybe Vag hyst w/enterocele compl NA NA % 74% 14% Yes No Yes Maybe Charts 2018 American College of Obstetricians and Gynecologists. All Rights Reserved. 8

9 Liability DAYS Op Op Op Procs Procs Surgeon Surgeon ^58300 Insert intrauterine device XXX 0% 0% 0% No No No No Remove intrauterine device % 0% 0% Yes No Maybe No Artificial insemination % 0% 0% Yes No Maybe No Artificial insemination % 0% 0% Yes No Maybe No Sperm washing % 0% 0% Yes No Maybe No Catheter for hysterography % 0% 0% Yes No No No Reopen fallopian tube 4.70 NA NA % 80% 10% Yes Yes Yes Yes Insert heyman uteri capsule 7.56 NA NA % 74% 14% Yes No No No Reopen fallopian tube % 80% 10% Yes Yes No No metr ablate thermal % 80% 10% Yes No No Yes metrial cryoablation % 80% 10% Yes Suspension of uterus 7.14 NA NA % 74% 14% Yes No Yes Maybe Suspension of uterus NA NA % 74% 14% Yes No Yes Maybe Repair of ruptured uterus NA NA % 74% 14% Yes No Yes Maybe Revision of uterus NA NA % 74% 14% Yes No Yes No Lsh uterus 250 g or less NA NA % 74% 14% Lsh w/t/o ut 250 g or less NA NA % 74% 14% Yes Lsh uterus above 250 g NA NA % 74% 14% Yes Lsh w/t/o uterus above 250 g NA NA % 74% 14% Yes Laparoscopic myomectomy NA NA % 74% 14% Yes Laparo-myomectomy complex NA NA % 74% 14% Yes Lap radical hyst NA NA % 74% 14% Yes Laparo-asst vag hysterectomy NA NA % 74% 14% Laparo-vag hyst incl t/o NA NA % 74% 14% Yes Laparo-vag hyst complex NA NA % 74% 14% Yes Laparo-vag hyst w/t/o compl NA NA % 74% 14% Yes Hysteroscopy dx sep proc % 0% 0% Yes No Maybe Yes Hysteroscopy biopsy % 0% 0% No No Yes Hysteroscopy lysis 5.20 NA NA % 0% 0% Hysteroscopy resect septum 5.75 NA NA % 0% 0% Hysteroscopy remove myoma 6.60 NA NA % 0% 0% Hysteroscopy remove fb % 0% 0% Hysteroscopy ablation % 0% 0% No No Yes No Maybe Yes No No Yes No Maybe Yes Hysteroscopy sterilization % 74% 14% No No Yes Tlh uterus 250 g or less NA NA % 74% 14% Yes Tlh w/t/o 250 g or less NA NA % 74% 14% Yes Tlh uterus over 250 g NA NA % 74% 14% Yes Charts 2018 American College of Obstetricians and Gynecologists. All Rights Reserved. 9

10 Liability DAYS Op Op Op Procs Procs Surgeon Surgeon Tlh w/t/o uterus over 250 g NA NA % 74% 14% Yes Laps tot hyst resj mal NA NA % 74% 14% Yes Oviduct/Ovary Division of fallopian tube 5.91 NA NA % 74% 14% Yes No Yes Maybe Division of fallopian tube 5.28 NA NA % 74% 14% Yes No Yes No Ligate oviduct(s) add-on 1.45 NA NA 2.18 ZZZ 0% 0% 0% No No Yes No Occlude fallopian tube(s) 3.94 NA NA % 80% 10% Yes No Yes No Laparoscopy lysis NA NA % 84% 7% Laparoscopy remove adnexa NA NA % 80% 10% Laparoscopy excise lesions NA NA % 84% 7% Laparoscopy tubal cautery 5.91 NA NA % 80% 10% Laparoscopy tubal block 5.91 NA NA % 80% 10% Laparoscopy fimbrioplasty NA NA % 80% 10% Laparoscopy salpingostomy NA NA % 80% 10% Yes Yes Yes No No Yes No No Yes Yes Yes No Yes Yes No Laps abltj uterine fibroids NA NA % 74% 14% Yes Removal of fallopian tube NA NA % 74% 14% Yes No Yes Maybe Removal of ovary/tube(s) NA NA % 74% 14% Yes No Yes Maybe Adhesiolysis tube ovary NA NA % 74% 14% Yes No Yes Maybe Repair oviduct NA NA % 74% 14% Yes Yes Yes Maybe Revise ovarian tube(s) NA NA % 74% 14% Yes Yes Yes No Fimbrioplasty NA NA % 74% 14% Yes Yes Yes Maybe Create new tubal opening NA NA % 74% 14% Yes Yes Yes No Ovary Drainage of ovarian cyst(s) % 74% 14% Yes No No No Drainage of ovarian cyst(s) 6.42 NA NA % 74% 14% Yes No Yes Maybe Drain ovary abscess open 4.70 NA NA % 74% 14% Yes Yes Yes No Drain ovary abscess percut NA NA % 74% 14% Yes Yes Yes Maybe Transposition ovary(s) NA NA % 74% 14% Yes No Yes Maybe Biopsy of ovary(s) 6.59 NA NA % 74% 14% Yes No Yes Maybe Partial removal of ovary(s) NA NA % 74% 14% Yes No Yes Maybe Removal of ovarian cyst(s) NA NA % 74% 14% Yes No Yes Maybe Removal of ovary(s) 8.22 NA NA % 74% 14% Yes No Yes Maybe Removal of ovary(s) NA NA % 74% 14% Yes No Yes Maybe Resect ovarian malignancy NA NA % 74% 14% Yes No Yes Maybe Resect ovarian malignancy NA NA % 74% 14% Yes No Yes Maybe Resect ovarian malignancy NA NA % 74% 14% Yes No Yes Maybe Tah rad dissect for debulk NA NA % 74% 14% Yes No Yes Maybe Tah rad debulk/lymph remove NA NA % 74% 14% Yes No Yes Maybe Charts 2018 American College of Obstetricians and Gynecologists. All Rights Reserved. 10

11 Liability DAYS Op Op Op Procs Procs Surgeon Surgeon Bso omentectomy w/tah NA NA % 74% 14% Yes No Yes Maybe Resect recurrent gyn mal NA NA % 74% 14% Yes No Yes Maybe Resect recur gyn mal w/lym NA NA % 74% 14% Yes No Yes Maybe Exploration of abdomen NA NA % 74% 14% Yes No Yes Maybe In Vitro Fertilization Retrieval of oocyte % 0% 0% Yes No Maybe No Transfer of embryo % 0% 0% Yes No Yes Maybe Transfer of embryo % 0% 0% Yes No Yes Maybe MATERNITY CARE AND DELIVERY Antepartum Services Amniocentesis diagnostic % 0% 0% Yes No No No Amniocentesis therapeutic 3.00 NA NA % 0% 0% Yes No No No Fetal cord puncture prenatal 3.44 NA NA % 0% 0% Yes No Maybe No Chorion biopsy % 0% 0% Yes No Maybe No Fetal contract stress test NA NA 000 0% 0% 0% No No Maybe No Fetal contract stress test NA NA 000 0% 0% 0% No No Maybe No Fetal contract stress test % 0% 0% No No Maybe No Fetal non-stress test NA NA 000 0% 0% 0% No No Maybe No Fetal non-stress test NA NA 000 0% 0% 0% No No Maybe No Fetal non-stress test % 0% 0% No No Maybe No Fetal scalp blood sample 1.99 NA NA % 0% 0% Yes No Maybe No Fetal monitor w/report 0.89 NA NA 1.47 XXX 0% 0% 0% No No Maybe No Fetal monitor/interpret only 0.74 NA NA 1.22 XXX 0% 0% 0% No No Maybe No Transabdom amnioinfus w/us % 0% 0% Yes No Yes No Umbilical cord occlud w/us 8.99 NA NA % 0% 0% Yes No No No Fetal fluid drainage w/us % 0% 0% Yes No Yes No Fetal shunt placement w/us 8.99 NA NA % 0% 0% Yes No Yes No Excision Remove uterus lesion NA NA % 60% 23% Yes No Yes Maybe Treat ectopic pregnancy NA NA % 60% 23% Yes No Yes Maybe Treat ectopic pregnancy NA NA % 60% 23% Yes No Yes Maybe Treat ectopic pregnancy NA NA % 60% 23% Yes No Maybe No Treat ectopic pregnancy NA NA % 60% 23% Yes No Maybe No Treat ectopic pregnancy NA NA % 60% 23% Yes No Yes No Treat ectopic pregnancy 5.94 NA NA % 60% 23% Yes No Yes No Treat ectopic pregnancy NA NA % 60% 23% Yes No Yes No Treat ectopic pregnancy NA NA % 60% 23% Yes No Yes No D & c after delivery % 80% 10% Yes No Maybe No Introduction Insert cervical dilator % 0% 0% Yes No No No Repair Episiotomy or vaginal repair % 0% 0% Yes No Maybe No Revision of cervix 2.48 NA NA % 0% 0% Yes No Maybe No Revision of cervix 4.06 NA NA % 0% 0% Yes No Maybe No Repair of uterus 4.94 NA NA % 0% 0% Yes No Yes No Charts 2018 American College of Obstetricians and Gynecologists. All Rights Reserved. 11

12 Liability DAYS Op Op Op Procs Procs Surgeon Surgeon Vaginal Delivery, Antepartum, and Postpartum Care Obstetrical care NA NA MMM 0% 0% 0% Yes No No No Obstetrical care NA NA MMM 0% 0% 0% Yes No Maybe No Obstetrical care NA NA MMM 0% 0% 0% Yes No No No Antepartum manipulation 1.71 NA NA 2.98 MMM 0% 0% 0% No No Maybe No Deliver placenta 1.61 NA NA 2.65 MMM 0% 0% 0% Yes No Maybe No Antepartum care only MMM 0% 0% 0% No No Maybe No Antepartum care only MMM 0% 0% 0% No No Maybe No Care after delivery MMM 0% 0% 0% Yes No No No Cesarean Delivery Cesarean delivery NA NA MMM 0% 0% 0% Yes No No No Cesarean delivery only NA NA MMM 0% 0% 0% Yes No Yes Maybe Cesarean delivery NA NA MMM 0% 0% 0% Yes No No No Remove uterus after cesarean 8.53 NA NA ZZZ 0% 0% 0% No No Yes Maybe Delivery After Previous Cesarean Delivery Vbac delivery NA NA MMM 0% 0% 0% Yes No Maybe No Vbac delivery only NA NA MMM 0% 0% 0% Yes No Maybe No Vbac care after delivery NA NA MMM 0% 0% 0% Yes No Maybe No Attempted vbac delivery NA NA MMM 0% 0% 0% Yes No Maybe No Attempted vbac delivery only NA NA MMM 0% 0% 0% Yes No Yes No Attempted vbac after care NA NA MMM 0% 0% 0% Yes No Maybe No Abortion Treatment of miscarriage % 60% 23% Yes No No No Care of miscarriage % 60% 23% Yes No No No Treatment of miscarriage % 60% 23% Yes No Maybe No Treat uterus infection 6.59 NA NA % 60% 23% Yes No Maybe No Abortion % 80% 10% Yes No Maybe No Abortion % 80% 10% Yes No Maybe No Abortion 5.90 NA NA % 60% 23% Yes No Maybe No Abortion 5.92 NA NA % 60% 23% Yes No Maybe No Abortion 8.23 NA NA % 60% 23% Yes No Maybe No Abortion 6.43 NA NA % 60% 23% Yes No Maybe No Abortion 7.79 NA NA % 60% 23% Yes No Maybe No Abortion 9.33 NA NA % 60% 23% Yes No Maybe No Other Procedures Abortion (mpr) 3.99 NA NA % 0% 0% Yes No Yes Maybe Evacuate mole of uterus 6.57 NA NA % 60% 23% Yes No Yes No Remove cerclage suture 2.13 NA NA % 0% 0% Yes No Maybe No NERVOUS SYSTEM Injection, Drainage, or Aspiration Njx interlaminar crv/thrc % 0% 0% Yes No No No Njx interlaminar lmbr/sac % 0% 0% Yes No No No Njx interlaminar crv/thrc % 0% 0% Yes Yes No No Njx interlaminar lmbr/sac % 0% 0% Yes Yes No No Charts 2018 American College of Obstetricians and Gynecologists. All Rights Reserved. 12

13 Liability DAYS Op Op Op Procs Procs Surgeon Surgeon Neurostimulators Implant neuroelectrodes % 80% 10% Yes Yes No No Neuroeltrd stim post tibial % 0% 0% Yes No Maybe No Implant neuroelectrodes NA NA % 76% 13% Yes No No No Insrt/redo pn/gastr stimul % 80% 10% Yes No No Maybe RADIOLOGY Gynecological and Obstetrical X-ray female genital tract NA NA XXX 0% 0% 0% No No Maybe No X-ray female genital tract NA NA XXX 0% 0% 0% No No Maybe No X-ray female genital tract XXX 0% 0% 0% No No Maybe No X-ray fallopian tube NA NA XXX 0% 0% 0% No No Maybe No X-ray fallopian tube NA NA XXX 0% 0% 0% No No Maybe No X-ray fallopian tube XXX 0% 0% 0% No No Maybe No X-ray exam of perineum NA NA XXX 0% 0% 0% No No Maybe No X-ray exam of perineum NA NA XXX 0% 0% 0% No No Maybe No X-ray exam of perineum XXX 0% 0% 0% No No Maybe No Other Procedures d render w/intrp postproces NA NA XXX 0% 0% 0% No No Maybe No d render w/intrp postproces NA NA XXX 0% 0% 0% No No Maybe No d render w/intrp postproces XXX 0% 0% 0% No No Maybe No d render w/intrp postproces NA NA XXX 0% 0% 0% No No Maybe No d render w/intrp postproces NA NA XXX 0% 0% 0% No No Maybe No d render w/intrp postproces XXX 0% 0% 0% No No Maybe No Abdomen and Retroperitoneum Us exam abdom complete NA NA XXX 0% 0% 0% Image No Maybe No Us exam abdom complete NA NA XXX 0% 0% 0% Image No Maybe No Us exam abdom complete XXX 0% 0% 0% Image No Maybe No Echo exam of abdomen NA NA XXX 0% 0% 0% Image No Maybe No Echo exam of abdomen NA NA XXX 0% 0% 0% Image No Maybe No Echo exam of abdomen XXX 0% 0% 0% Image No Maybe No Us exam abdo back wall comp NA NA XXX 0% 0% 0% Image No Maybe No Us exam abdo back wall comp NA NA XXX 0% 0% 0% Image No Maybe No Us exam abdo back wall comp XXX 0% 0% 0% Image No Maybe No Us exam abdo back wall lim NA NA XXX 0% 0% 0% Image No Maybe No Us exam abdo back wall lim NA NA XXX 0% 0% 0% Image No Maybe No Us exam abdo back wall lim XXX 0% 0% 0% Image No Maybe No Pelvis - Obstetrical Ob us < 14 wks single fetus NA NA XXX 0% 0% 0% No No Maybe No Ob us < 14 wks single fetus NA NA XXX 0% 0% 0% No No Maybe No Ob us < 14 wks single fetus XXX 0% 0% 0% No No Maybe No Ob us < 14 wks addl fetus NA NA ZZZ 0% 0% 0% No No Maybe No Ob us < 14 wks addl fetus NA NA ZZZ 0% 0% 0% No No Maybe No Ob us < 14 wks addl fetus ZZZ 0% 0% 0% No No Maybe No Ob us >/= 14 wks sngl fetus NA NA XXX 0% 0% 0% No No Maybe No Ob us >/= 14 wks sngl fetus NA NA XXX 0% 0% 0% No No Maybe No Ob us >/= 14 wks sngl fetus XXX 0% 0% 0% No No Maybe No Charts 2018 American College of Obstetricians and Gynecologists. All Rights Reserved. 13

14 Liability DAYS Op Op Op Procs Procs Surgeon Surgeon Ob us >/= 14 wks addl fetus NA NA ZZZ 0% 0% 0% No No Maybe No Ob us >/= 14 wks addl fetus NA NA ZZZ 0% 0% 0% No No Maybe No Ob us >/= 14 wks addl fetus ZZZ 0% 0% 0% No No Maybe No Ob us detailed sngl fetus NA NA XXX 0% 0% 0% No No Maybe No Ob us detailed sngl fetus NA NA XXX 0% 0% 0% No No Maybe No Ob us detailed sngl fetus XXX 0% 0% 0% No No Maybe No Ob us detailed addl fetus NA NA ZZZ 0% 0% 0% No No Maybe No Ob us detailed addl fetus NA NA ZZZ 0% 0% 0% No No Maybe No Ob us detailed addl fetus ZZZ 0% 0% 0% No No Maybe No Ob us nuchal meas 1 gest NA NA XXX 0% 0% 0% No No Maybe No Ob us nuchal meas 1 gest NA NA XXX 0% 0% 0% No No Maybe No Ob us nuchal meas 1 gest XXX 0% 0% 0% No No Maybe No Ob us nuchal meas add-on NA NA XXX 0% 0% 0% No No Maybe No Ob us nuchal meas add-on NA NA XXX 0% 0% 0% No No Maybe No Ob us nuchal meas add-on XXX 0% 0% 0% No No Maybe No Ob us limited fetus(s) NA NA XXX 0% 0% 0% No No Maybe No Ob us limited fetus(s) NA NA XXX 0% 0% 0% No No Maybe No Ob us limited fetus(s) XXX 0% 0% 0% No No Maybe No Ob us follow-up per fetus NA NA XXX 0% 0% 0% No No Maybe No Ob us follow-up per fetus NA NA XXX 0% 0% 0% No No Maybe No Ob us follow-up per fetus XXX 0% 0% 0% No No Maybe No Transvaginal us obstetric NA NA XXX 0% 0% 0% No No Maybe No Transvaginal us obstetric NA NA XXX 0% 0% 0% No No Maybe No Transvaginal us obstetric XXX 0% 0% 0% No No Maybe No Fetal biophys profile w/nst NA NA XXX 0% 0% 0% No No Maybe No Fetal biophys profile w/nst NA NA XXX 0% 0% 0% No No Maybe No Fetal biophys profile w/nst XXX 0% 0% 0% No No Maybe No Fetal biophys profil w/o nst NA NA XXX 0% 0% 0% No No Maybe No Fetal biophys profil w/o nst NA NA XXX 0% 0% 0% No No Maybe No Fetal biophys profil w/o nst XXX 0% 0% 0% No No Maybe No Umbilical artery echo NA NA XXX 0% 0% 0% No No Maybe No Umbilical artery echo NA NA XXX 0% 0% 0% No No Maybe No Umbilical artery echo XXX 0% 0% 0% No No Maybe No Middle cerebral artery echo NA NA XXX 0% 0% 0% No No Maybe No Middle cerebral artery echo NA NA XXX 0% 0% 0% No No Maybe No Middle cerebral artery echo XXX 0% 0% 0% No No Maybe No Echo exam of fetal heart NA NA XXX 0% 0% 0% No No Maybe No Echo exam of fetal heart NA NA XXX 0% 0% 0% No No Maybe No Echo exam of fetal heart XXX 0% 0% 0% No No Maybe No Echo exam of fetal heart NA NA XXX 0% 0% 0% No No Maybe No Echo exam of fetal heart NA NA XXX 0% 0% 0% No No Maybe No Echo exam of fetal heart XXX 0% 0% 0% No No Maybe No Echo exam of fetal heart NA NA XXX 0% 0% 0% No No Maybe No Echo exam of fetal heart NA NA XXX 0% 0% 0% No No Maybe No Echo exam of fetal heart XXX 0% 0% 0% No No Maybe No Echo exam of fetal heart NA NA XXX 0% 0% 0% No No Maybe No Charts 2018 American College of Obstetricians and Gynecologists. All Rights Reserved. 14