Medicaid vs. Medicare Facility. Nevada Medicaid Rates (1) Medicare Non-Facility. Medicare Facility Rates (2) Procedur

Transcription

1 230-12

2

3

4 Division of Health Care Financing & Policy SB 278 Section 16 - Physician Rates Reporting Medicaid 2012 Physician Rates vs. Medicare 2012 Physician Rate Comparison Facility & Non-Facility Rate Comparison Procedur e Code Description Nevada Medicaid Rates (1) Medicare Facility Rates (2) Medicare Non-Facility Rates (2) Medicaid vs. Medicare Facility Medicaid vs. Medicare Non-Facility FNA W/O IMAGE (64.60) FNA W/IMAGE (51.51) ACNE SURGERY (27.15) (41.19) DRAINAGE OF SKIN ABSCESS (25.65) (45.46) DRAINAGE OF SKIN ABSCESS (29.65) (55.58) DRAINAGE OF PILONIDAL CYST (31.16) (108.59) DRAINAGE OF PILONIDAL CYST (20.68) (123.31) REMOVE FOREIGN BODY (34.17) (83.87) REMOVE FOREIGN BODY (15.18) (105.57) DRAINAGE OF HEMATOMA/FLUID (26.38) (70.67) PUNCTURE DRAINAGE OF LESION (34.52) (69.09) COMPLEX DRAINAGE WOUND (44.37) (112.80) DEBRIDE INFECTED SKIN (22.35) DEBRIDE INFECTED SKIN ADD-ON (5.99) DEBRIDE GENITALIA & PERINEUM (57.74) (57.74) DEBRIDE ABDOM WALL (72.11) (72.11) DEBRIDE GENIT/PER/ABDOM WALL (47.21) (47.21) REMOVE MESH FROM ABD WALL (5.89) (5.89) DEBRIDE SKIN AT FX SITE (43.18) (265.01) DEBRIDE SKIN MUSC AT FX SITE (10.68) (259.88) DEB SKIN BONE AT FX SITE (293.62) DEB SUBQ TISSUE 20 SQ CM/< (49.94) DEB MUSC/FASCIA 20 SQ CM/< (14.20) (91.62) DEB BONE 20 SQ CM/< (50.25) (138.84) DEB SUBQ TISSUE ADD-ON DEBRI (8.44) (23.21) DEB MUSC/FASCIA ADD-ON DEBRI (15.92) (33.57) DEB BONE ADD-ON DEBRI (29.52) (54.37) TRIM SKIN LESION (28.38) TRIM SKIN LESIONS 2 TO (24.95) TRIM SKIN LESIONS OVER (29.12) BIOPSY SKIN LESION (5.66) (63.28) BIOPSY SKIN ADD-ON (2.62) (10.90) REMOVAL OF SKIN TAGS (33.75) (48.51) REMOVE SKIN TAGS ADD-ON (1.39) (3.55) SHAVE SKIN LESION (2.87) (45.00) SHAVE SKIN LESION (5.21) (50.23) SHAVE SKIN LESION (6.74) (57.87) SHAVE SKIN LESION (9.07) (69.21) SHAVE SKIN LESION (35.52)

5 11306 SHAVE SKIN LESION (0.58) (44.87) SHAVE SKIN LESION (3.30) (54.08) SHAVE SKIN LESION (51.30) SHAVE SKIN LESION (3.63) (48.28) SHAVE SKIN LESION (6.01) (52.10) SHAVE SKIN LESION (8.07) (61.73) SHAVE SKIN LESION (10.72) (70.14) EXC TR-EXT B9+MARG 0.5 < CM (33.25) (78.27) EXC TR-EXT B9+MARG CM (36.10) (82.56) EXC TR-EXT B9+MARG CM (18.21) (71.51) EXC TR-EXT B9+MARG CM (33.60) (78.98) EXC TR-EXT B9+MARG CM (35.15) (92.41) EXC TR-EXT B9+MARG > 4.0 CM (89.44) (157.15) EXC H-F-NK-SP B9+MARG 0.5 < (26.11) (67.88) EXC H-F-NK-SP B9+MARG (30.74) (78.63) EXC H-F-NK-SP B9+MARG (30.06) (71.11) EXC H-F-NK-SP B9+MARG (29.96) (76.06) EXC H-F-NK-SP B9+MARG (28.40) (83.50) EXC H-F-NK-SP B9+MARG > 4 CM (60.87) (120.65) EXC FACE-MM B9+MARG 0.5 < CM (42.11) (74.52) EXC FACE-MM B9+MARG CM (46.19) (83.64) EXC FACE-MM B9+MARG CM (29.63) (73.57) EXC FACE-MM B9+MARG CM (26.69) (73.87) EXC FACE-MM B9+MARG CM (23.76) (79.22) EXC FACE-MM B9+MARG > 4 CM (63.70) (128.89) REMOVAL SWEAT GLAND LESION (109.80) (241.60) REMOVAL SWEAT GLAND LESION (124.42) (289.71) REMOVAL SWEAT GLAND LESION (112.51) (249.00) REMOVAL SWEAT GLAND LESION (113.79) (283.40) REMOVAL SWEAT GLAND LESION (111.86) (246.54) REMOVAL SWEAT GLAND LESION (118.00) (285.81) EXC TR-EXT MAL+MARG 0.5 < CM (27.71) (102.26) EXC TR-EXT MAL+MARG CM (28.78) (111.25) EXC TR-EXT MAL+MARG CM (36.81) (125.04) EXC TR-EXT MAL+MARG CM (54.85) (145.96) EXC TR-EXT MAL+MARG CM (63.70) (167.05) EXC TR-EXT MAL+MARG > 4 CM (124.59) (258.56) EXC H-F-NK-SP MAL+MARG 0.5 < (31.67) (107.66) EXC S/N/H/F/G MAL+MRG (26.95) (109.78) EXC S/N/H/F/G MAL+MRG (27.97) (116.20) EXC S/N/H/F/G MAL+MRG (36.50) (128.33) EXC S/N/H/F/G MAL+MRG (37.43) (139.34) EXC S/N/H/F/G MAL+MRG > 4 CM (40.70) (158.46) EXC F/E/E/N/L MAL+MRG 0.5CM< (22.17) (99.95) EXC F/E/E/N/L MAL+MRG (2.60) (87.22) EXC F/E/E/N/L MAL+MRG (2.63) (93.74) EXC F/E/E/N/L MAL+MRG (17.25) (110.16)

6 11644 EXC F/E/E/N/L MAL+MRG (9.62) (122.69) EXC F/E/E/N/L MAL+MRG > 4 CM (38.71) (161.15) TRIM NAIL(S) (13.72) DEBRIDE NAIL (15.31) DEBRIDE NAIL 6 OR MORE (15.59) REMOVAL OF NAIL PLATE (37.60) REMOVE NAIL PLATE ADD-ON (5.27) DRAIN BLOOD FROM UNDER NAIL (13.39) (29.95) REMOVAL OF NAIL BED (74.70) (122.95) REMOVE NAIL BED/FINGER TIP (92.17) (150.15) BIOPSY NAIL UNIT (9.21) (65.75) REPAIR OF NAIL BED (27.27) (125.58) RECONSTRUCTION OF NAIL BED (0.80) (94.43) EXCISION OF NAIL FOLD TOE (47.17) (120.63) REMOVAL OF PILONIDAL LESION (37.37) (132.08) REMOVAL OF PILONIDAL LESION (64.27) (205.44) REMOVAL OF PILONIDAL LESION (143.82) (264.10) INJECTION INTO SKIN LESIONS (4.29) (29.86) ADDED SKIN LESIONS INJECTION (6.05) (28.38) THERAPY FOR CONTOUR DEFECTS (23.16) THERAPY FOR CONTOUR DEFECTS (13.14) (45.55) THERAPY FOR CONTOUR DEFECTS (15.25) (55.94) THERAPY FOR CONTOUR DEFECTS (10.44) (56.90) INSERT TISSUE EXPANDER(S) (143.94) (143.94) REPLACE TISSUE EXPANDER (164.55) (164.55) REMOVE TISSUE EXPANDER(S) (96.65) (259.78) REMOVAL OF CONTRACEPTIVE CAP (2.44) (54.29) IMPLANT HORMONE PELLET(S) (4.15) (28.28) INSERT DRUG IMPLANT DEVICE (3.12) (59.66) REMOVE DRUG IMPLANT DEVICE (2.44) (60.06) REMOVE/INSERT DRUG IMPLANT (41.06) REPAIR SUPERFICIAL WOUND(S) (14.22) REPAIR SUPERFICIAL WOUND(S) (6.95) REPAIR SUPERFICIAL WOUND(S) (8.71) REPAIR SUPERFICIAL WOUND(S) (17.03) REPAIR SUPERFICIAL WOUND(S) (7.80) REPAIR SUPERFICIAL WOUND(S) (13.66) REPAIR SUPERFICIAL WOUND(S) (30.61) REPAIR SUPERFICIAL WOUND(S) (12.22) REPAIR SUPERFICIAL WOUND(S) (12.13) REPAIR SUPERFICIAL WOUND(S) (10.10) REPAIR SUPERFICIAL WOUND(S) (13.96) REPAIR SUPERFICIAL WOUND(S) REPAIR SUPERFICIAL WOUND(S) CLOSURE OF SPLIT WOUND (34.92) (127.11) CLOSURE OF SPLIT WOUND (33.17) (59.46) INTMD WND REPAIR S/A/T/EXT (44.89) (131.68)

7 12032 INTMD WND REPAIR S/A/T/EXT (57.37) (171.89) INTMD WND REPAIR S/TR/EXT (43.02) (151.77) INTMD WND REPAIR S/A/T/EXT (47.74) (193.95) INTMD WND REPAIR S/A/T/EXT (34.71) (181.64) INTMD WND REPAIR S/TR/EXT (43.96) (195.57) INTMD WND REPAIR N-HF/GENIT (37.43) (125.30) INTMD WND REPAIR N-HF/GENIT (46.13) (139.40) INTMD WND REPAIR N-HF/GENIT (36.15) (182.35) INTMD WND REPAIR N-HF/GENIT (56.47) (191.15) INTMD WND REPAIR N-HF/GENIT (45.50) (199.63) INTMD WND REPAIR N-HF/GENIT (60.65) (246.47) INTMD WND REPAIR FACE/MM (28.07) (119.18) INTMD WND REPAIR FACE/MM (52.87) (147.22) INTMD WND REPAIR FACE/MM (44.01) (176.17) INTMD WND REPAIR FACE/MM (37.67) (181.00) INTMD WND REPAIR FACE/MM (47.74) (223.84) INTMD WND REPAIR FACE/MM (53.72) (232.34) INTMD WND REPAIR FACE/MM (41.84) (270.15) REPAIR OF WOUND OR LESION (50.43) (132.90) REPAIR OF WOUND OR LESION (55.76) (173.88) REPAIR WOUND/LESION ADD-ON (6.83) (42.12) REPAIR OF WOUND OR LESION (53.75) (137.30) REPAIR OF WOUND OR LESION (80.31) (201.67) REPAIR WOUND/LESION ADD-ON (7.28) (42.21) REPAIR OF WOUND OR LESION (53.41) (140.20) REPAIR OF WOUND OR LESION (134.65) (249.16) REPAIR WOUND/LESION ADD-ON (10.72) (47.45) REPAIR OF WOUND OR LESION (33.59) (120.02) REPAIR OF WOUND OR LESION (37.87) (130.06) REPAIR OF WOUND OR LESION (41.02) (183.99) REPAIR WOUND/LESION ADD-ON (10.15) (54.45) LATE CLOSURE OF WOUND (170.67) (170.67) SKIN TISSUE REARRANGEMENT (118.00) (241.88) SKIN TISSUE REARRANGEMENT (126.76) (275.13) SKIN TISSUE REARRANGEMENT (135.23) (266.68) SKIN TISSUE REARRANGEMENT (93.09) (246.14) SKIN TISSUE REARRANGEMENT (130.61) (261.34) SKIN TISSUE REARRANGEMENT (73.60) (240.33) SKIN TISSUE REARRANGEMENT (112.74) (215.01) SKIN TISSUE REARRANGEMENT (63.51) (247.17) SKIN TISSUE REARRANGEMENT (58.74) (260.41) SKIN TISSUE REARRANGE ADD-ON (5.66) (5.66) SKIN TISSUE REARRANGEMENT (111.16) (111.16) WOUND PREP TRK/ARM/LEG (37.79) (159.87) WOUND PREP ADDL 100 CM (7.07) (38.04) WOUND PREP F/N/HF/G (34.98) (167.14) WND PREP F/N/HF/G ADDL CM (14.08) (48.29)

8 15040 HARVEST CULTURED SKIN GRAFT (8.73) (145.21) SKIN PINCH GRAFT (139.90) (266.66) SKIN SPLT GRFT TRNK/ARM/LEG (153.80) (304.32) SKIN SPLT GRFT T/A/L ADD-ON (17.56) (98.22) EPIDRM AUTOGRFT TRNK/ARM/LEG (128.84) (246.24) EPIDRM AUTOGRFT T/A/L ADD-ON (12.55) EPIDRM A-GRFT FACE/NCK/HF/G (118.61) (230.61) EPIDRM A-GRFT F/N/HF/G ADDL (16.73) (33.30) SKN SPLT A-GRFT FAC/NCK/HF/G (91.76) (252.02) SKN SPLT A-GRFT F/N/HF/G ADD (72.35) DERM AUTOGRAFT TRNK/ARM/LEG (66.39) (180.90) DERM AUTOGRAFT T/A/L ADD-ON (10.81) (20.17) DERM AUTOGRAFT FACE/NCK/HF/G (69.98) (179.81) DERM AUTOGRAFT F/N/HF/G ADD (1.61) CULT SKIN GRFT T/ARM/LEG (75.92) (139.30) CULT SKIN GRFT T/A/L ADDL (0.41) (10.85) CULT SKIN GRAFT T/A/L +% (19.30) (30.10) CULT SKIN GRAFT F/N/HF/G (19.44) (82.46) CULT SKIN GRFT F/N/HFG ADD (17.54) (27.27) CULT EPIDERM GRFT F/N/HFG +% (12.35) SKIN FULL GRAFT TRUNK (170.06) (332.84) SKIN FULL GRAFT TRUNK ADD-ON (5.00) (78.83) SKIN FULL GRAFT SCLP/ARM/LEG (94.87) (254.76) SKIN FULL GRAFT ADD-ON (5.49) (74.99) SKIN FULL GRFT FACE/GENIT/HF (212.73) (345.97) SKIN FULL GRAFT ADD-ON (7.79) (84.86) SKIN FULL GRAFT EEN & LIPS (225.95) (377.55) SKIN FULL GRAFT ADD-ON (17.99) (96.49) Skin sub graft trnk/arm/leg (53.98) Skin sub graft t/a/l add-on (9.30) Skin sub grft t/arm/lg child (78.33) Skn sub grft t/a/l child add (24.11) Skin sub graft face/nk/hf/g (49.46) Skin sub graft f/n/hf/g addl (7.74) Skn sub grft f/n/hf/g child (72.55) Skn sub grft f/n/hf/g ch add (25.20) FORM SKIN PEDICLE FLAP (158.52) (341.82) FORM SKIN PEDICLE FLAP (166.58) (310.63) FORM SKIN PEDICLE FLAP (141.03) (291.56) FORM SKIN PEDICLE FLAP (117.54) (256.18) SKIN GRAFT (49.25) (176.73) SKIN GRAFT (57.52) (173.47) SKIN GRAFT (91.77) (213.13) SKIN GRAFT (93.76) (213.68) TRANSFER SKIN PEDICLE FLAP (99.11) (229.47) FOREHEAD FLAP W/VASC PEDICLE (209.24) (330.96) MUSCLE-SKIN GRAFT HEAD/NECK (57.06) (228.11)

9 15734 MUSCLE-SKIN GRAFT TRUNK (252.43) (440.05) MUSCLE-SKIN GRAFT ARM (136.54) (323.80) MUSCLE-SKIN GRAFT LEG (157.17) (334.34) ISLAND PEDICLE FLAP GRAFT (236.15) (399.64) NEUROVASCULAR PEDICLE GRAFT (184.50) (184.50) FREE MYO/SKIN FLAP MICROVASC (230.99) (230.99) FREE SKIN FLAP MICROVASC (169.55) (169.55) FREE FASCIAL FLAP MICROVASC (165.32) (165.32) COMPOSITE SKIN GRAFT (142.29) (290.66) DERMA-FAT-FASCIA GRAFT (172.11) (172.11) Acellular derm matrix implt ABRASION LESION SINGLE (17.72) (130.43) ABRASION LESIONS ADD-ON (31.90) CHEMICAL PEEL NONFACIAL (146.51) (328.01) CHEMICAL PEEL NONFACIAL (97.37) (227.37) REVISION OF LOWER EYELID (73.19) (129.37) REVISION OF LOWER EYELID (78.21) (141.59) REVISION OF UPPER EYELID (46.86) REVISION OF UPPER EYELID (27.56) (90.58) EXC SKIN ABD (186.55) (186.55) GRAFT FOR FACE NERVE PALSY (163.90) (163.90) GRAFT FOR FACE NERVE PALSY (185.80) (185.80) FLAP FOR FACE NERVE PALSY (191.29) (191.29) SKIN AND MUSCLE REPAIR FACE (208.46) (208.46) EXC SKIN ABD ADD-ON REMOVAL OF SUTURES (47.88) REMOVAL OF SUTURES (1.30) (55.32) DRESSING CHANGE NOT FOR BURN (1.05) (1.05) TEST FOR BLOOD FLOW IN GRAFT (7.93) (7.93) REMOVAL OF TAIL BONE ULCER (94.63) (94.63) REMOVAL OF TAIL BONE ULCER (126.90) (126.90) REMOVE SACRUM PRESSURE SORE (112.06) (112.06) REMOVE SACRUM PRESSURE SORE (125.03) (125.03) REMOVE SACRUM PRESSURE SORE (129.86) (129.86) REMOVE SACRUM PRESSURE SORE (187.87) (187.87) REMOVE SACRUM PRESSURE SORE (103.95) (103.95) REMOVE SACRUM PRESSURE SORE (111.31) (111.31) REMOVE HIP PRESSURE SORE (114.25) (114.25) REMOVE HIP PRESSURE SORE (84.74) (84.74) REMOVE HIP PRESSURE SORE (148.15) (148.15) REMOVE HIP PRESSURE SORE (160.93) (160.93) REMOVE HIP PRESSURE SORE (299.00) (299.00) REMOVE THIGH PRESSURE SORE (97.50) (97.50) REMOVE THIGH PRESSURE SORE (179.39) (179.39) REMOVE THIGH PRESSURE SORE (200.50) (200.50) REMOVE THIGH PRESSURE SORE (184.74) (184.74) REMOVE THIGH PRESSURE SORE (181.57) (181.57)

10 15958 REMOVE THIGH PRESSURE SORE (189.30) (189.30) INITIAL TREATMENT OF BURN(S) (2.32) (26.45) DRESS/DEBRID P-THICK BURN S (14.10) (42.55) DRESS/DEBRID P-THICK BURN M (16.49) (52.86) DRESS/DEBRID P-THICK BURN L (18.35) (69.13) INCISION OF BURN SCAB INITI ESCHAROTOMY ADDL INCISION (4.70) (4.70) DESTRUCT PREMALG LESION (24.95) (51.24) DESTRUCT PREMALG LES DESTROY PREMAL LESIONS 15/> (24.15) DESTRUCTION OF SKIN LESIONS (0.85) (70.35) DESTRUCTION OF SKIN LESIONS DESTRUCTION OF SKIN LESIONS DESTRUCT B9 LESION (37.81) (81.38) DESTRUCT LESION 15 OR MORE (38.87) (87.12) CHEMICAL CAUTERY TISSUE (10.09) (54.02) DESTRUCTION OF SKIN LESIONS (22.69) (49.34) DESTRUCTION OF SKIN LESIONS (30.73) (85.47) DESTRUCTION OF SKIN LESIONS (33.33) (94.55) DESTRUCTION OF SKIN LESIONS (35.92) (100.74) DESTRUCTION OF SKIN LESIONS (38.29) (108.51) DESTRUCTION OF SKIN LESIONS (39.12) (113.67) DESTRUCTION OF SKIN LESIONS (31.95) (84.53) DESTRUCTION OF SKIN LESIONS (33.18) (87.92) DESTRUCTION OF SKIN LESIONS (34.88) (95.74) DESTRUCTION OF SKIN LESIONS (37.01) (102.91) DESTRUCTION OF SKIN LESIONS (41.61) (112.91) DESTRUCTION OF SKIN LESIONS (31.08) (106.35) DESTRUCTION OF SKIN LESIONS (30.37) (82.95) DESTRUCTION OF SKIN LESIONS (34.64) (89.74) DESTRUCTION OF SKIN LESIONS (36.31) (98.97) DESTRUCTION OF SKIN LESIONS (41.91) (109.62) DESTRUCTION OF SKIN LESIONS (40.37) (113.12) DESTRUCTION OF SKIN LESIONS (35.15) (112.58) MOHS 1 STAGE H/N/HF/G (66.43) (363.88) MOHS ADDL STAGE (34.81) (239.36) MOHS 1 STAGE T/A/L (59.68) (337.33) MOHS ADDL STAGE T/A/L (32.91) (222.33) MOHS SURG ADDL BLOCK (9.36) (36.73) CRYOTHERAPY OF SKIN (10.30) (12.82) DRAINAGE OF BREAST LESION (0.21) (70.43) DRAIN BREAST LESION ADD-ON (0.07) (5.12) INCISION OF BREAST LESION (38.47) (211.69) INJECTION FOR BREAST X-RAY (88.87) BX BREAST PERCUT W/O IMAGE (4.81) (88.35) BIOPSY OF BREAST OPEN (31.14) (156.46) BX BREAST PERCUT W/IMAGE (116.73)

11 19103 BX BREAST PERCUT W/DEVICE (5.37) (384.94) CRYOSURG ABLATE FA EACH (34.12) (2,797.31) NIPPLE EXPLORATION (5.75) (155.56) EXCISE BREAST DUCT FISTULA (52.35) (206.48) REMOVAL OF BREAST LESION (78.55) (160.29) EXCISION BREAST LESION (99.14) (189.17) EXCISION ADDL BREAST LESION (7.56) (7.56) REMOVAL OF CHEST WALL LESION (289.02) (289.02) REVISION OF CHEST WALL (522.53) (522.53) EXTENSIVE CHEST WALL SURGERY (545.73) (545.73) PLACE NEEDLE WIRE BREAST (101.22) PLACE NEEDLE WIRE BREAST (38.14) PLACE BREAST CLIP PERCUT PLACE PO BREAST CATH FOR RAD , (632.98) PLACE BREAST CATH FOR RAD (4.51) (4.51) PLACE BREAST RAD TUBE/CATHS (4.94) (892.99) REMOVAL OF BREAST TISSUE (95.12) (213.60) PARTICAL MASTECTOMY (312.04) (312.04) P-MASTECTOMY W/LN REMOVAL (167.22) (167.22) MAST SIMPLE COMPLETE (272.87) (272.87) MAST SUBQ (117.44) (117.44) MAST RADICAL (230.76) (230.76) MAST RAD URBAN TYPE (261.27) (261.27) MAST MOD RAD (251.56) (251.56) SUSPENSION OF BREAST (78.70) (78.70) REDUCTION OF LARGE BREAST (141.18) (141.18) ENLARGE BREAST (104.39) (104.39) ENLARGE BREAST WITH IMPLANT (78.37) (78.37) REMOVAL OF BREAST IMPLANT (115.81) (115.81) REMOVAL OF IMPLANT MATERIAL (157.39) (157.39) IMMEDIATE BREAST PROSTHESIS (616.52) (616.52) DELAYED BREAST PROSTHESIS (217.45) (217.45) BREAST RECONSTRUCTION (86.14) (251.80) CORRECT INVERTED NIPPLE(S) (61.42) (204.74) BREAST RECONSTRUCTION (309.89) (309.89) BREAST RECONSTR W/LAT FLAP (447.41) (447.41) BREAST RECONSTRUCTION (331.11) (331.11) BREAST RECONSTRUCTION (128.74) (128.74) BREAST RECONSTRUCTION (266.82) (266.82) BREAST RECONSTRUCTION (314.84) (314.84) BREAST RECONSTRUCTION (274.01) (274.01) SURGERY OF BREAST CAPSULE (160.29) (160.29) REMOVAL OF BREAST CAPSULE (171.50) (171.50) REVISE BREAST RECONSTRUCTION (172.46) (172.46) DESIGN CUSTOM BREAST IMPLANT (32.32) (174.21) I&D ABSCESS SUBFASCIAL (18.32) (91.78) EXPLORE WOUND NECK (61.28) (61.28)

12 20101 EXPLORE WOUND CHEST (27.34) (276.18) EXPLORE WOUND ABDOMEN (34.59) (271.55) EXPLORE WOUND EXTREMITY (37.54) (282.42) EXCISE EPIPHYSEAL BAR (137.66) (137.66) MUSCLE BIOPSY (15.57) (132.96) DEEP MUSCLE BIOPSY (27.88) (162.20) NEEDLE BIOPSY MUSCLE (9.18) (207.60) BONE BIOPSY TROCAR/NEEDLE (13.15) BONE BIOPSY TROCAR/NEEDLE (430.28) BONE BIOPSY EXCISIONAL BONE BIOPSY EXCISIONAL (95.06) (95.06) OPEN BONE BIOPSY (32.87) (32.87) OPEN BONE BIOPSY (16.32) (16.32) INJECTION OF SINUS TRACT INJECT SINUS TRACT FOR X-RAY (0.16) (88.75) REMOVAL OF FOREIGN BODY REMOVAL OF FOREIGN BODY (197.58) THER INJECTION CARP TUNNEL (10.25) (29.70) Inj dupuytren cord w/enzyme (13.36) INJ TENDON SHEATH/LIGAMENT (14.97) INJ TENDON ORIGIN/INSERTION (12.43) INJ TRIGGER POINT 1/2 MUSCL (7.51) INJECT TRIGGER POINTS =/> (15.62) Place ndl musc/tis for rt (52.32) (52.32) DRAIN/INJECT JOINT/BURSA (15.83) DRAIN/INJECT JOINT/BURSA (0.36) (18.00) DRAIN/INJECT JOINT/BURSA (2.86) (24.11) ASPIRATE/INJ GANGLION CYST (4.30) (22.66) TREATMENT OF BONE CYST (56.30) INSERT AND REMOVE BONE PIN APPLY REM FIXATION DEVICE (88.13) (88.13) APPLICATION OF HEAD BRACE (59.96) (59.96) APPLICATION OF PELVIS BRACE (2.37) (2.37) APPLICATION OF THIGH BRACE (9.82) (9.82) APPLICATION OF HALO (234.95) (234.95) REMOVAL OF FIXATION DEVICE (6.44) REMOVAL OF SUPPORT IMPLANT (207.15) REMOVAL OF SUPPORT IMPLANT (112.71) (316.18) APPLY BONE FIXATION DEVICE (386.17) (386.17) APPLY BONE FIXATION DEVICE (753.07) (753.07) ADJUST BONE FIXATION DEVICE REMOVE BONE FIXATION DEVICE (31.36) COMP MULTIPLANE EXT FIXATION (102.10) (102.10) COMP EXT FIXATE STRUT CHANGE (831.29) (831.29) REPLANTATION ARM COMPLETE REPLANT FOREARM COMPLETE REPLANTATION HAND COMPLETE

13 20816 REPLANTATION DIGIT COMPLETE REPLANTATION DIGIT COMPLETE REPLANTATION THUMB COMPLETE REPLANTATION THUMB COMPLETE REPLANTATION FOOT COMPLETE REMOVAL OF BONE FOR GRAFT REMOVAL OF BONE FOR GRAFT REMOVE CARTILAGE FOR GRAFT REMOVE CARTILAGE FOR GRAFT REMOVAL OF FASCIA FOR GRAFT REMOVAL OF FASCIA FOR GRAFT (4.19) (118.35) REMOVAL OF TENDON FOR GRAFT REMOVAL OF TISSUE FOR GRAFT SP BONE ALGRFT MORSEL ADD-ON SP BONE ALGRFT STRUCT ADD-ON (2.01) (2.01) SP BONE AGRFT LOCAL ADD-ON SP BONE AGRFT MORSEL ADD-ON SP BONE AGRFT STRUCT ADD-ON (1.55) (1.55) FLUID PRESSURE MUSCLE (131.43) FIBULA BONE GRAFT MICROVASC ILIAC BONE GRAFT MICROVASC (28.95) (28.95) MT BONE GRAFT MICROVASC (272.59) (272.59) OTHER BONE GRAFT MICROVASC BONE/SKIN GRAFT MICROVASC BONE/SKIN GRAFT ILIAC CREST (31.92) (31.92) BONE/SKIN GRAFT METATARSAL BONE/SKIN GRAFT GREAT TOE ELECTRICAL BONE STIMULATION (12.25) (38.18) ELECTRICAL BONE STIMULATION (19.46) (19.46) US BONE STIMULATION (0.88) (21.77) ABLATE BONE TUMOR(S) PERQ (3,577.15) CPTR-ASST DIR MS PX (19.16) (19.16) INCISION OF JAW JOINT (102.72) (102.72) EXC FACE LES SC < 2 CM (30.10) (126.97) EXC FACE LES SBQ 2 CM/> (21.15) (21.15) EXC FACE TUM DEEP < 2 CM (33.86) (162.42) EXC FACE TUM DEEP 2 CM/> (34.78) (34.78) RESECT FACE TUM < 2 CM (230.57) (230.57) RESECT FACE TUM 2 CM/> (62.28) (62.28) EXCISION OF BONE LOWER JAW (118.17) (265.10) EXCISION OF FACIAL BONE(S) (134.63) (258.15) CONTOUR OF FACE BONE LESION (117.39) (253.88) EXCISE MAX/ZYGOMA B9 TUMOR (92.96) REMOVE EXOSTOSIS MANDIBLE (90.60) (193.24) REMOVE EXOSTOSIS MAXILLA (77.20) (189.56) EXCISE MAX/ZYGOMA MAL TUMOR (182.13) (352.82) EXCISE MANDIBLE LESION (281.33) (389.37)

14 21044 REMOVAL OF JAW BONE LESION (145.42) (145.42) EXTENSIVE JAW SURGERY (253.78) (253.78) REMOVE MANDIBLE CYST COMPLEX (238.73) (238.73) EXCISE LWR JAW CYST W/REPAIR (237.46) (237.46) REMOVE MAXILLA CYST COMPLEX (239.82) (239.82) EXCIS UPPR JAW CYST W/REPAIR (235.26) (235.26) REMOVAL OF JAW JOINT (47.79) (47.79) REMOVE JAW JOINT CARTILAGE (52.56) (52.56) REMOVE CORONOID PROCESS (86.66) (86.66) Mnpj of tmj w/anesth (58.15) (198.24) PREPARE FACE/ORAL PROSTHESIS (29.02) (192.87) PREPARE FACE/ORAL PROSTHESIS (81.55) (463.64) PREPARE FACE/ORAL PROSTHESIS (69.20) (357.30) PREPARE FACE/ORAL PROSTHESIS (30.28) (370.95) PREPARE FACE/ORAL PROSTHESIS (53.62) (375.56) PREPARE FACE/ORAL PROSTHESIS (115.79) (428.73) PREPARE FACE/ORAL PROSTHESIS (21.06) (354.53) PREPARE FACE/ORAL PROSTHESIS (102.49) (464.41) PREPARE FACE/ORAL PROSTHESIS (131.80) (316.90) PREPARE FACE/ORAL PROSTHESIS (59.12) (352.98) PREPARE FACE/ORAL PROSTHESIS (53.76) (354.10) PREPARE FACE/ORAL PROSTHESIS , , MAXILLOFACIAL FIXATION (105.97) (458.16) INTERDENTAL FIXATION (323.51) (457.11) INJECTION JAW JOINT X-RAY (114.08) RECONSTRUCTION OF CHIN (196.33) (346.14) RECONSTRUCTION OF CHIN (105.55) (240.59) RECONSTRUCTION OF CHIN (36.78) (36.78) RECONSTRUCTION OF CHIN (130.08) (130.08) AUGMENTATION LOWER JAW BONE (119.46) (2,525.41) AUGMENTATION LOWER JAW BONE (178.85) (3,625.90) REDUCTION OF FOREHEAD (111.57) (111.57) REDUCTION OF FOREHEAD (93.73) (93.73) REDUCTION OF FOREHEAD (221.23) (221.23) RECONSTRUCT MIDFACE LEFORT (331.56) (331.56) RECONSTRUCT MIDFACE LEFORT (237.51) (237.51) RECONSTRUCT MIDFACE LEFORT (375.79) (375.79) RECONSTRUCT MIDFACE LEFORT (332.90) (332.90) RECONSTRUCT MIDFACE LEFORT (556.64) (556.64) RECONSTRUCT MIDFACE LEFORT (395.72) (395.72) RECONSTRUCT MIDFACE LEFORT (100.35) (100.35) RECONSTRUCT MIDFACE LEFORT (87.05) (87.05) RECONSTRUCT MIDFACE LEFORT (153.73) (153.73) RECONSTRUCT MIDFACE LEFORT RECONSTRUCT MIDFACE LEFORT RECONSTRUCT MIDFACE LEFORT RECONSTRUCT ORBIT/FOREHEAD (179.79) (179.79)

15 21175 RECONSTRUCT ORBIT/FOREHEAD (264.85) (264.85) RECONSTRUCT ENTIRE FOREHEAD RECONSTRUCT ENTIRE FOREHEAD CONTOUR CRANIAL BONE LESION (21.17) (21.17) RECONSTRUCT CRANIAL BONE RECONSTRUCT CRANIAL BONE (185.11) (185.11) RECONSTRUCT CRANIAL BONE (196.38) (196.38) RECONSTRUCTION OF MIDFACE (183.50) (183.50) RECONST LWR JAW W/O GRAFT (289.54) (289.54) RECONST LWR JAW W/GRAFT (200.01) (200.01) RECONST LWR JAW W/O FIXATION (269.28) (269.28) RECONST LWR JAW W/FIXATION (306.76) (306.76) RECONSTR LWR JAW SEGMENT (196.25) (196.25) RECONSTR LWR JAW W/ADVANCE (18.57) (18.57) RECONSTRUCT UPPER JAW BONE (352.27) (352.27) AUGMENTATION OF FACIAL BONES (159.45) (1,284.09) REDUCTION OF FACIAL BONES (178.62) (368.04) FACE BONE GRAFT (162.17) (1,633.61) LOWER JAW BONE GRAFT (234.09) (3,511.89) RIB CARTILAGE GRAFT EAR CARTILAGE GRAFT (22.18) (194.68) RECONSTRUCTION OF JAW JOINT (138.27) (138.27) RECONSTRUCTION OF JAW JOINT (109.25) (109.25) RECONSTRUCTION OF JAW JOINT (378.78) (378.78) RECONSTRUCTION OF LOWER JAW (288.11) (288.11) RECONSTRUCTION OF JAW (90.10) (335.34) RECONSTRUCTION OF JAW RECONSTRUCT LOWER JAW BONE (90.55) (90.55) RECONSTRUCTION OF JAW (168.55) (381.74) RECONSTRUCTION OF JAW (191.90) (471.36) RECONSTRUCT LOWER JAW BONE (311.44) (311.44) RECONSTRUCTION OF ORBIT (93.88) (93.88) REVISE EYE SOCKETS (115.22) (115.22) REVISE EYE SOCKETS (294.92) (294.92) REVISE EYE SOCKETS (244.77) (244.77) REVISE EYE SOCKETS (342.07) (342.07) REVISE EYE SOCKETS (403.63) (403.63) AUGMENTATION CHEEK BONE (235.63) REVISION ORBITOFACIAL BONES (24.79) (24.79) REVISION OF EYELID (139.08) (139.08) REVISION OF EYELID (61.41) (61.41) REVISION OF JAW MUSCLE/BONE REVISION OF JAW MUSCLE/BONE (129.72) (129.72) TREATMENT OF NOSE FRACTURE (0.02) (103.01) TREATMENT OF NOSE FRACTURE (54.45) (190.93) TREATMENT OF NOSE FRACTURE (122.42) TREATMENT OF NOSE FRACTURE (212.80) (212.80)

16 21330 TREATMENT OF NOSE FRACTURE (177.20) (177.20) TREATMENT OF NOSE FRACTURE (158.35) (158.35) TREAT NASAL SEPTAL FRACTURE (246.84) (246.84) TREAT NASAL SEPTAL FRACTURE (77.27) (195.75) TREAT NASOETHMOID FRACTURE (333.78) (333.78) TREAT NASOETHMOID FRACTURE (256.48) (256.48) TREATMENT OF NOSE FRACTURE (100.98) (100.98) TREATMENT OF SINUS FRACTURE (423.29) (423.29) TREATMENT OF SINUS FRACTURE (385.36) (385.36) TREAT NOSE/JAW FRACTURE (51.73) (218.46) TREAT NOSE/JAW FRACTURE (172.48) (172.48) TREAT NOSE/JAW FRACTURE (301.90) (301.90) TREAT NOSE/JAW FRACTURE (47.16) (47.16) TREAT CHEEK BONE FRACTURE (96.26) (216.89) TREAT CHEEK BONE FRACTURE (107.31) (238.03) TREAT CHEEK BONE FRACTURE (85.97) (85.97) TREAT CHEEK BONE FRACTURE (134.72) (134.72) TREAT CHEEK BONE FRACTURE (26.80) (26.80) TREAT EYE SOCKET FRACTURE (66.28) (66.28) TREAT EYE SOCKET FRACTURE (11.74) (11.74) TREAT EYE SOCKET FRACTURE (80.22) (80.22) TREAT EYE SOCKET FRACTURE (114.16) (114.16) TREAT EYE SOCKET FRACTURE (176.09) (176.09) TREAT EYE SOCKET FRACTURE (68.01) (105.46) TREAT EYE SOCKET FRACTURE (52.14) (246.60) TREAT EYE SOCKET FRACTURE (36.37) (36.37) TREAT EYE SOCKET FRACTURE (44.09) (44.09) TREAT EYE SOCKET FRACTURE (70.77) (70.77) TREAT MOUTH ROOF FRACTURE (235.06) (375.15) TREAT MOUTH ROOF FRACTURE (70.09) (70.09) TREAT MOUTH ROOF FRACTURE (102.98) (102.98) TREAT CRANIOFACIAL FRACTURE (120.11) (120.11) TREAT CRANIOFACIAL FRACTURE (117.96) (117.96) TREAT CRANIOFACIAL FRACTURE (70.58) (70.58) TREAT CRANIOFACIAL FRACTURE (253.00) (253.00) TREAT CRANIOFACIAL FRACTURE (459.94) (459.94) TREAT DENTAL RIDGE FRACTURE (245.45) (356.37) TREAT DENTAL RIDGE FRACTURE (240.89) (390.70) TREAT LOWER JAW FRACTURE (288.85) (409.85) TREAT LOWER JAW FRACTURE (239.75) (367.23) TREAT LOWER JAW FRACTURE (133.70) (406.31) TREAT LOWER JAW FRACTURE (347.88) (478.96) TREAT LOWER JAW FRACTURE (141.56) (141.56) TREAT LOWER JAW FRACTURE (360.76) (1,611.09) TREAT LOWER JAW FRACTURE (387.09) (1,655.07) TREAT LOWER JAW FRACTURE (216.55) (216.55) TREAT LOWER JAW FRACTURE (263.98) (263.98)

17 21480 RESET DISLOCATED JAW (2.47) (71.25) RESET DISLOCATED JAW (322.23) (439.98) REPAIR DISLOCATED JAW (200.19) (200.19) TREAT HYOID BONE FRACTURE (333.76) (333.76) INTERDENTAL WIRING (346.82) (473.94) DRAIN NECK/CHEST LESION (47.29) (186.65) DRAIN CHEST LESION (0.74) (0.74) DRAINAGE OF BONE LESION (26.85) (26.85) BIOPSY OF NECK/CHEST (37.65) (146.76) EXC NECK LES SC 3 CM/> (22.64) (22.64) EXC NECK TUM DEEP 5 CM/> (34.26) (34.26) EXC NECK LES SC < 3 CM (57.36) (171.88) EXC NECK TUM DEEP < 5 CM (204.43) (204.43) RESECT NECK TUM < 5 CM (317.83) (317.83) RESECT NECK TUM 5 CM/> (42.86) (42.86) PARTIAL REMOVAL OF RIB (23.28) (23.28) PARTIAL REMOVAL OF RIB (226.48) (226.48) REMOVAL OF RIB REMOVAL OF RIB AND NERVES (63.54) (63.54) PARTIAL REMOVAL OF STERNUM STERNAL DEBRIDEMENT EXTENSIVE STERNUM SURGERY (79.34) (79.34) EXTENSIVE STERNUM SURGERY (89.95) (89.95) HYOID MYOTOMY & SUSPENSION (109.04) (109.04) REVISION OF NECK MUSCLE REVISION OF NECK MUSCLE/RIB REVISION OF NECK MUSCLE (72.95) (72.95) REVISION OF NECK MUSCLE RECONSTRUCTION OF STERNUM (87.81) (87.81) REPAIR STERN/NUSS W/O SCOPE REPAIR STERNUM/NUSS W/SCOPE , , REPAIR OF STERNUM SEPARATION TREATMENT OF RIB FRACTURE (36.47) (33.23) TREATMENT OF RIB FRACTURE (16.35) (16.35) TREATMENT OF RIB FRACTURE(S) TREAT STERNUM FRACTURE (36.80) (33.56) TREAT STERNUM FRACTURE NECK/CHEST SURGERY PROCEDURE BIOPSY SOFT TISSUE OF BACK (61.02) (164.74) BIOPSY SOFT TISSUE OF BACK (4.57) (100.36) EXC BACK LES SC < 3 CM (80.43) (192.78) EXC BACK LES SC 3 CM/> (26.87) (26.87) EXC BACK TUM DEEP < 5 CM (23.55) (23.55) EXC BACK TUM DEEP 5 CM/> (37.74) (37.74) RESECT BACK TUM < 5 CM RESECT BACK TUM 5 CM/> (44.55) (44.55) I&D P-SPINE C/T/CERV-THOR (189.16) (189.16)

18 22015 I&D P-SPINE L/S/LS (177.51) (177.51) REMOVE PART OF NECK VERTEBRA (236.68) (236.68) REMOVE PART THORAX VERTEBRA (214.11) (214.11) REMOVE PART LUMBAR VERTEBRA (94.39) (94.39) REMOVE EXTRA SPINE SEGMENT (2.00) (2.00) REMOVE PART OF NECK VERTEBRA (173.96) (173.96) REMOVE PART THORAX VERTEBRA (164.94) (164.94) REMOVE PART LUMBAR VERTEBRA (87.79) (87.79) REMOVE EXTRA SPINE SEGMENT CUT SPINE 3 COL THOR (379.37) (379.37) CUT SPINE 3 COL LUMB (457.74) (457.74) CUT SPINE 3 COL ADDL SEG (94.72) (94.72) REVISION OF NECK SPINE (161.42) (161.42) REVISION OF THORAX SPINE (168.46) (168.46) REVISION OF LUMBAR SPINE (152.94) (152.94) REVISE EXTRA SPINE SEGMENT REVISION OF NECK SPINE (185.76) (185.76) REVISION OF THORAX SPINE (112.29) (112.29) REVISION OF LUMBAR SPINE (148.03) (148.03) REVISE EXTRA SPINE SEGMENT (2.66) (2.66) TREAT SPINE PROCESS FRACTURE (17.54) (35.55) TREAT SPINE FRACTURE (48.25) (72.73) TREAT SPINE FRACTURE (80.29) (194.81) TREAT ODONTOID FX W/O GRAFT (203.69) (203.69) TREAT ODONTOID FX W/GRAFT (206.31) (206.31) TREAT SPINE FRACTURE (178.00) (178.00) TREAT NECK SPINE FRACTURE (117.52) (117.52) TREAT THORAX SPINE FRACTURE (163.98) (163.98) TREAT EACH ADD SPINE FX (14.04) (14.04) MANIPULATION OF SPINE PERCUT VERTEBROPLASTY THOR (6.96) (1,848.25) PERCUT VERTEBROPLASTY LUMB (13.36) (1,869.77) PERCUT VERTEBROPLASTY ADDL PERCUT KYPHOPLASTY THOR (7,498.44) PERCUT KYPHOPLASTY LUMBAR (7,460.25) PERCUT KYPHOPLASTY ADD-ON (4,752.51) IDET SINGLE LEVEL (20.90) (2,062.41) IDET 1 OR MORE LEVELS (5.17) (1,801.44) LAT THORAX SPINE FUSION (220.71) (220.71) LAT LUMBAR SPINE FUSION (221.06) (221.06) LAT THOR/LUMB ADDL SEG NECK SPINE FUSION (248.12) (248.12) NECK SPINE FUSE&REMOV BEL C ADDL NECK SPINE FUSION ARTHR NECK SPINE FUSION (1.24) (1.24) THORAX SPINE FUSION (109.76) (109.76) LUMBAR SPINE FUSION (100.86) (100.86)

19 22585 ADDITIONAL SPINAL FUSION (4.24) (4.24) SPINE & SKULL SPINAL FUSION (178.99) (178.99) NECK SPINAL FUSION (184.57) (184.57) NECK SPINE FUSION (175.71) (175.71) THORAX SPINE FUSION (144.07) (144.07) LUMBAR SPINE FUSION (188.28) (188.28) SPINE FUSION EXTRA SEGMENT (4.29) (4.29) LUMBAR SPINE FUSION (110.19) (110.19) SPINE FUSION EXTRA SEGMENT (8.01) (8.01) Lumbar spine fusion combined Spine fusion extra segment FUSION OF SPINE (108.98) (108.98) FUSION OF SPINE (76.56) (76.56) FUSION OF SPINE (77.81) (77.81) FUSION OF SPINE (93.73) (93.73) FUSION OF SPINE (110.32) (110.32) FUSION OF SPINE (96.60) (96.60) KYPHECTOMY 1-2 SEGMENTS (83.31) (83.31) KYPHECTOMY 3 OR MORE (534.90) (534.90) EXPLORATION OF SPINAL FUSION (7.91) (7.91) INSERT SPINE FIXATION DEVICE (11.17) (11.17) INSERT SPINE FIXATION DEVICE INSERT SPINE FIXATION DEVICE (10.13) (10.13) INSERT SPINE FIXATION DEVICE (4.50) (4.50) INSERT SPINE FIXATION DEVICE INSERT SPINE FIXATION DEVICE (15.70) (15.70) INSERT SPINE FIXATION DEVICE (14.21) (14.21) INSERT SPINE FIXATION DEVICE (75.37) (75.37) INSERT PELV FIXATION DEVICE REINSERT SPINAL FIXATION (44.00) (44.00) REMOVE SPINE FIXATION DEVICE (16.32) (16.32) APPLY SPINE PROSTH DEVICE (10.16) (10.16) REMOVE SPINE FIXATION DEVICE (16.57) (16.57) REMOVE SPINE FIXATION DEVICE (79.65) (79.65) CERV ARTIFIC DISKECTOMY (173.98) (173.98) LUMBAR ARTIF DISKECTOMY (394.07) (394.07) REVISE CERV ARTIFIC DISC (191.24) (191.24) REVISE LUMBAR ARTIF DISC (558.62) (558.62) REMOVE CERV ARTIF DISC (241.37) (241.37) REMOVE LUMB ARTIF DISC (558.15) (558.15) EXC ABDL TUM DEEP < 5 CM (170.95) (170.95) EXC ABDL TUM DEEP 5 CM/> (39.14) (39.14) EXC ABD LES SC < 3 CM (7.51) (123.11) EXC ABD LES SC 3 CM/> (19.85) (19.85) RESECT ABD TUM < 5 CM (72.23) (72.23) RESECT ABD TUM 5 CM/> (62.08) (62.08) REMOVAL OF CALCIUM DEPOSITS (155.29)