CPT Code Description
0 TOTAL BILL AMOUNT
00 VARIOUS HOSPITAL CHARGES
000 NYS SURCHARGE
0000 DELIVERY CHARGE
00000 AMBULATORY SURGICAL CARE-GENERAL
00001 PHARMACY
00002 IV SOLUTIONS
00003 MED-SUR SUPPLIE
00004 GASTR-INTS SVS
00005 RECOVERY ROOM
00006 PROPOFOL INJ 10MG/ML
00007 FENTANYL CITR .05MG/ML
00008 TREATMENT/OBSV ROOM
00009 SUPPLY / IMPLANTS
00010 SUPPLY / OTHER
00011 ROOM BOARD SEMI PRIVATE
00012 MED-SUR-GY/ 2 BED
00013 NON-STERILE SUPPLY
00014 STERILE SUPPLY
00015 CHEMISTRY
00016 IMMUNOLOGY
00017 HEMATOLOGY
00018 BACTERIOLOGY
00019 UROLOGY
00020 DIGNOSTIC RADIOLOGY
00021 CT SCAN/BODY
00022 CT SCAN/OTHER
00023 OPERATING ROOM SERVICES
00024 PHYSICAL MEDICINE
00025 PULMONARY FUNCTION
00026 EKG/ECG
00027 DRUGS/GENERIC
00080 AMBULATORY SURGICAL (PAS 35)
00081 AMBULATORY SURGICAL (PAS 1)
00100 ALL INCL R & B PLUS ANCIL
00170 IV SEDATION
00600 ANESTHESIOLOGISTS
00630 ANESTHESIA
00634 ANESTHESIA= CHEMONUCLEOLYSIS
00640 ANESTHESIA FOR MUA
00670 ANESTHESIA - SPINE
00752 ANESTHESIA
01382 ANESTHESIA
01400 ANESTHESIA
01622 ANESTHESIA ARTHROSCOPIC/SHOULDER
01630 ANESTHESIA ARTHROSCOPIC
01810 ANESTHESIA
01830-AA-P ANESTHESIA
01991 ANESTHESIA FOR NERVE BLOCKS AND INJECTIONS
01992 ANESTHESIA INJECTION- NERVE
03330 ROOT CANAL MOLAR
05/E1399PA CAR SEAT
06010 SURGICAL PLACEMENT IMPLANT
06057 CUSTOM ABUTMENT
06061 ABUTMENT SUPPORTED CROWN
07210 SURG REMOVAL ERUPTED TOOTH
12032 LAYERED RECONSTRUCTION OF WOUND DEFECT
13132 SURGERY- REPAIR PARTS OF FACE 2.6 TO 7/.5 CM
13133 SURGERY- REPAIR PARTS OF FACE 5CM
15/E1399PA BED BOARD
152 PHARMACY
15734 MUSCLE, MYOCUTANEOUS OR FASCIOCUTANEOUS FLAP; TRUNK
15820 BLEPHAROPLASTY, LOWER EYELID
15877 SUCTION ASSISTED LIPECTOMY; TRUNK
19325 MAMMAPLASTY, WITH PROSTHETIC IMPLANT
19342 DELAYED INSERTION OF BREAST PROSTHESIS FOLLOWING MASTOPEXY,MASTECTOMY OR IN RECONSTRUCTION
19371 PERIPROSTHETIC CAPSULECTOMY, BREAST
20550 TRIGGER POINT INJECTIONS X4
20552 INJECTION-TRIGGER POINT MUSCLES
20553 SINGLE OR MULTIPLE TRIGGER POINT(S), THREE OR MORE MUSCLES
20610 ARTHOCINTESIS- MAJOR JOINT OR BURSA
20924 BONE TENDON BONE ALLOGRAFT
20931 STRUCTURAL
20937 AUTOGRAFT FOR SPINE SURGERY ONLY
21220 SINUS L/RT
21248 ENDOSTEAL IMP. PLCMNT.
21461 MANDIBULAR FRACTURE
21807 GADLINIUM PER
22505 MANIPULATION UNDER ANESTHESIA
22554 ARTHRODESIS, ANTERIOR
22612 ARTHRODESIS, LUMBAR
22614 ARTHRODESIS, EACH ADDITIONAL SEGMENT
22842 POSTERIOR SEGMENTAL INSTRUMENTATION
22845 ANTERIOR INSTRUMENTATION
22851 APPLICATION INTERVERTEBRAL BISMECHANICAL DEVICE
23000 ABULATORY FACILITY USE
23105 ARTHROTOMY, GLENOHUMERAL JOINT
23120 CLAVICULECTOMY LIG REL W/WO
23130 ACROMIOPLASTY OR ACROMIONECTOMY
23405 TENOTOMY/SHOULDER, SPINE TENDON
23412 REPAIR ROTOR CUFF/ CHRONIC (OPEN)
23415 CORACOACROM LIG REL W/WO
23430 TENODESIIS/BICEPS LONG TENDON
23455 CAPSULORRHAPHY ANT; W/ LABRAL REPAIR
23466 CAPSULORRHAPHY/ SHOULDER
23700 EXAM UNDER GENERAL
239.2 BUTTOCK
24332 TENOLYSIS TRICEPS TENDON
25000 SURGERY- WRIST
25440 SURGERY-LEFT WRIST
25560 CLOSED TX. FX. RADIAL/ULNAR SHAFT W/O MANIPULATION
26541 METACARPOPHALANGEAL JOINT
26852 SURGERY WITH AUTOGRAFT
27071 PARTIAL EXCISION, DEEP (SUBFASCIAL OR INTRAMUSCULAR)
27194 CLOSED TREATMENT PELVIS WITH MANIPULATION
27275 MANIPULATION, HIP JOINT, REQUIRING GENERAL ANESTHESIA
27350 PATELLECTOMY, OR HEMIPATELLECTOMY
27425 LATERAL RETINACULAR RELEASE
27447 ARTHROPLASTY, KNEE, MEDIAL & LATERAL W OR W/OUT PATELLA RESURFACING
27570 MANIPULATION OF KNEE JOINT
27766 REPAIR ANKLE FRACTURE
29075 SHORT ARM CAST
29240 INJECTION: DURAMORPH & MARCAINE
29358 LONGLEG BRACE-APPLICATION
29705 REMOVAL OF CAST
29805 ARTHROSCOPY SHOULDER W/O BIOPSY
29807 REPAIR OF SLAP LESION
29819 ARTHROSCOPY SHOULDER-REMOVEAL LOOSE OR FOREIN BODY
29820 SYNOVECTOMY SHOULDER
29820-83 SYNOVECTOMY PARTIAL (ASSIST)
29821 SYNOVECTOMY, COMPLETE
29821-83 SYNOVECTOMY, (ASSIST)
29822 ARTHROSCOPY, SHOULDER LABR.
29822-59 AMBULATORY SURG
29823 DEBRIDEMENT
29823-83 DEBRIDEMENT (ASSIST)
29824 MUMFORD PROCEDURE
29824-83 MUMFORD PROCEDURE (ASSIST)
29825 DISTAL CLAVICULECTOMY W/ RESECTION
29826 DECOMPRESSION FOR RELEASE
29826-59 AMBULATORY SURG
29826-83 DECOMP SUBACROMIAL SPACE (ASSIST)
29827 ARTHROSCOPY, SHOULDER
29861 ARTHROSCOPY, HIP, SURGICAL; WITH REMOVAL OF LOOSE BODY
29862 ARTHROSCOPY HIP, SURGICAL WITH DEBRIDEMENT
29863 ATHROSCOPY, HIP, SURGICAL; WITH SYNOVECTOMY
29870 DIAGNOSTIC ARTHROSCOPY
29874 REMOVAL OF LOOSE BODY
29875 SYNOVECTOMY LIMITED
29876 MAJOR SYNOVECTOMY KNEE
2987659 ARTHR. KNEE SURG;SYNV. MAJO
29877 AMBULATORY SURGERY
29879 ABRASION ARTHROPLASTY KNEE
29880 ARTHROSCOPY OF THE KNEE WITH MENISCECTOMY
29881 ARTHROSCOPY, KNEE MEDIAL OR LATERAL MENISCECTOMY OR LATERAL MENISCECTOMY
29882 REP. MENIS ( MED. OR LAT.) KNEE
29883 MENISCUS REPAIR KNEE
29887 DRIILING FOR INTACT OSTEOCHONDRIA
29888 ARTHROSCOPIC AIDED ACL REPAIR/AUGMENTATION OR RECONSTRUCTION
29999 AMBULATORY SURGERY
36000 ADDITIONAL CHARGE
36415 COLLECTION OF VENOUS BLOOD BY VENIPUNCTURE
37202 TRANSCATHETER THERAPY, INFUSION
49560 HERNIA REPAIR
49568 IMPLANTATION OF MESH FOR HERNIA REPAIR
62282 INJECTION: EPIDURAL LUMBAR
62284 INJECTION FOR MYELOGRAPHY
62287 ASPIR/DECOMPRESS-NUC PULPOS-LUMBAR
62291 INJECTION FOR DISCOGRAPHY, CERVICAL OR THORACIC
62292 INJECTION= CHEMONUCLEOLYSIS
62310 CERVICAL/THORACIC EPIDURAL, SIN
62311 INJECTION/ LUMBAR SACRAL
63030 DECOMPRESSION OF NERVE ROOT
63047 LAMINECTOMY, LUMBAR
63048 LAMINECTOMY, EACH ADDITIONAL SEGMENT
63055 AMBULTORY SURGERY
63075 DISCECTOMY, ANTERIOR W/ DECOMPRESSION SINGLE INTERSPACE
63076 DISCECTOMY, ANTERIOR W/ DECOMPRESSION EACH ADDITIONAL INTERSPACE
63081 DECOMPRESSION CORD/NERVE CERVICAL SEGMENT
63707 REPAIR OF DURAL/CEREBROSPINAL FLUID LEAK
64400 AURICULOTEMPORAL BLOCK
64405 INJECTION, ANESTHETIC AGENT: GREATER OCCIPITAL NERVE
64413 NJX ANES CRV PLEXUS
64442 INJECTION OF ANESTHETIC AGENT
64450 SURGERY- OTHER PERIPHERAL NERVE OR BRANCH
64470 INJECTIN OF ANESTHETIC AGENT
64472 INJECTION ANES FACETJT;CERVICAL/THOR-EA ADD
64475 FACET BLOCK, 1ST LEVEL
64476 FACET BLOCK, 3 ADDTL LEVELS
64479 INJ. CERVICAL/THORACIC
64480 CERVICAL OR THORACIC ADDTIONAL LEVEL
64483 INJECTION OF ANESTHETIC AGENT
64484 INJECTION OF ANESTHETIC AGENT
64510 INJECTION ANES AGT; STELLATEGANG
64520 SURGERY- LUMBAR OR THORACIC
64550 NEUROSTIMULATOR (T.E.N.S.)
64622 JOINT NERVE PARAVERTEBRAL FACET
64623 LUMBER
64714 NEUROPLASTY LUMBAR PLEXUS MAJ
64718 NEUROLYSIS ULNAR NERVE @ ELBOW
64721 SURGERY-NEUROPLASTY TRANSPOSTION MEDIAN NERVE
64999 UNLISTED PROCEDURE, NERVOUS SYSTEM
66170 TRABECULECTOMY
66680 IRIDOPLASTY/ SPHINCTEROTOMY
66984 CATARACT EXTRACTION W/INTRAOCULAR LENS
66999 LIMBAL RELAXING INCISIONS
69990 MICROSURGICAL REPAIR
70100 RADIOLOGIC EXAM- MANDIBLE
70140 X-RAY-FACE
70160 X-RAY-NOSE
70220 X-RAY SINUSES MIN. 3 VIEWS/GLOBAL
70250 X-RAY-SKULL
70260 X-RAY R.E. SKULL COMPLETE
70330 RAD EXAM TEMPOROMANDIBULAR JOINT
70336 MRI-TEMPOROMANDIBULAR JOINTS
70355 PANOREX X-RAY
70360 RADIOLOGIC EXAM NECK, SOFT TISSUE
70450 CT SCAN-HEAD
70460 TOMOGRAPHY HEAD OR BRAIN W/ CONTRAST
70486 COMPUTED TOMOGRAPHY
70540 MRI OF ORBIT
70541 MRI BRAIN MRA
70544 MAGNETIC RESONANCE ANGIOGRAPHY; HEAD; WITHOUT CONTRAST
70551 MRI-BRAIN
70553 MRI BRAIN
71010 X-RAY CHEST
71020 CHEST X-RAY
71100 EX-RAY LEFT RIB
71101 X-RAY RIBS
71110 X-RAY RIBS
71111 X-RAY RIBS, BILATERAL
71120 X-RAY STERNUM
71130 X-RAY STERNUM
71250 RADIOLOGY-TOMOGRAPHY THORAX
71260 X-RAY- WITH CONTRAST
71550 MRI CHEST
72010 X-RAY SPINE
72020 RAD EXAM OF THORACIC SPINE-ROTATION
72040 X-RAY CERVICAL
72050 X-RAY - CERVICAL SPINE; 4 VIEWS
72052 X-RAY - CERVICAL SPINE
72070 X-RAY-THOR
72072 THORACIC SPINE X-RAY
72074 X-RAY THORACIC SPINE
72100 X-RAY LUMBAR
72106 MRI OF THE RIGHT HIP
72110 X-RAY LUMBAR
72114 RAD. EXAM LUMBOSACRAL-PA
72125 CT CERVICAL SPINE
72126 TOMOGRAPHY CERVICAL W/ CONTRAST
72128 CT THORACIC SPINE W/O CONTRAST
72129 X-RAY- WITH CONTRAST
72131 CT-SCAN LUMBAR SPINE
72133 CT-SCAN-LUMBAR
72141 MRI-CERVICAL SPINE
72142 MRI CERVICAL W/GADOLINIUM
72146 MRI-THORACIC SPINE
72148 MRI-LUMBAR SPINE
72149 MRI LUMBAR W/CONT.
72156 CERVICAL MRI/ CONTRAST
72158 MRI LUMBAR SPINE W/CONTAST
72170 X-RAY PELVIS
72192 RADIOLOGY PELVIS
72193 X-RAY- WITH CONTRAST
72195 MRI PELVIS SOFT TISSUE W/O CONTRAST
72196 MRI-PELVIS
72198 MRI-PELVIS
72200 RAD EXAM LUMBOSACRAL-ROTATION
72202 X-RAY SACROILIAC JOINT, 3 OR MORE VIEWS
72240 MYELOGRAPHY-CERVICAL
72259 INJECTION W/DEPOMEDROL 40M
72275 EPIDUROGRAPHY,RADIOLOGICAL
72304 THERMOPHORE
724083C PERSCRIPTIONS
724084 PERSCRIPTIONS
724085 PERSCRIPTIONS
724087 PERSCRIPTIONS
725618 PERSCRIPTIONS
73000 CLAVICLE COMPLETE
73020 X-RAY RIGHT SHOULDER
73030 X-RAY SHOULDER 2 VIEWS
73040 X-RAY SHOULDER ARTH.
73060 X-RAY HUMERUS
73070 X-RAY LEFT ELBOW
73080 X-RAY ELBOW COMPLETE
73090 X-RAY FOREARMS
73100 X-RAY
73110 COMPLETE (MINIMUM 3 VIEWS)
73120 X-RAY
73130 X-RAY- MINIMUM OF 3 VIEWS
73200 CT SCAN UPPER EXTRIMITY
73218 MRI U/E NON-JOINT
73220 MRI UPPER EXTREMITYW/CONTRAST
73221 MRI-UPPER EXTREMITY-JOINT
73221-26 REVIEW MRI OF SHOULDER
73222 MRI UPPER EXTREMITY ANY JOINT W/CONTRAST
73510 X-RAY HIP
73520 XR HIPS ( BILATEREAL)
73550 RADIOLOGIC EXAM- FEMUR
73560 X-RAY-KNEE
73564 X-RAY KNEE
73565 X-RAY BOTH KNEES
73590 X-RAY TIBIA & FIIBULA
73600 X-RAY ANKLE
73610 EX RIGHT ANKLE
73620 X-RAY FOOT
73630 EX FOOT RIGHT
73700 CT SCAN LOWER EXTR.
73718 MRI LEFT FOOT
73720 MRI OF LOWER EXTREMITY(R/KNEE)
73721 MRI-LOWER EXTREMITY-JOINT
73725 MRI- LOWER EXTREMITY
74150 RADIOLOGY ABDOMEN
74160 X-RAY- WITH CONTRAST
74170 CT ABDOMEN
74181 ABDOMEN
74185 MRI-ABDOMEN
76000 FLOUROSCOPY IHR./CHECK UNITS
76003 FLUORO GUID NEEDLE PLACEMENT
76005 RADIOLOGY, FLUOROSCOPIC-SPINE
76066 JOINT SURVEY SINGLE VIEW
76120 CINERADIOGRAPGY
76375 3-D RECONSTRUCTION OF CT SCAN
76376 CT CORONAL VIEWS, 3D RECONSTRU
76377 3-D CT SCAN
76496 UNLISTED FLUOROSCOPIC PROCEDURE (eg, DIAGNOSTIC, INTERVENTIONAL)
76498 UNLISTED MAGNETIC RESONANCE PROCEDURE (FLEXION, EXTENSION, LATERAL BENDING)
76499 MOBIL X-RAY SETUP EQUIPMENT
76514 ULTRA SOUND
76536 ULTRASOUND SOFT TISSUE ( HEAD & NECK)
76604 SPULSD THORACIC
76800 ECHOGRAPHY, SPINAL CANAL & CONTENTS
76856 ULTRASOUND PELVIC
76880 ULTRASOUND EXTREMITY
77003 FLUOROSCOPIC GUIDANCE
78300 JOINT VIBRATION ANALYSIS
78306 WHOLE BODY BONE SCAN
78320 SPECT BONE SCAN
80048 LAB/CHEMISTY
81003 LAB/UROLOGY
82810 LAB: GASES, BLOOD & 02 SATRURATION
84702 LAB: GONADOTROPIN
85024 ARTHROSCOPY/ BONE REPAIR
85025 LAB/HEMOTOLOGY
85027 LAB/HEMATOLOGY
85610 LAB/ PROTHROMBIN
85730 LAB/ THROMBOPLASTIN BLOOD/PLASMA
88302 PATHOLOGY LAB
88304 SURGICAL PATHOLOGY
88305 PATHOLOGY LAB/PA
90090T TOTAL DISC ARTHROPLASTY
90772 THERAPEUTIC OR DIAGNOSTIC INJECTION
90784 INTRAVENOUS (DIAG. INJECTION)
90801 PSYCH. DIAGNOSTIC INTERVIEW EXAM
90804 INDIVIDUAL PSYCHOTHERAPY
90805 PSYCHOTHERAPY
90806 INDIVIDUAL PSYCHOTHERAPY
90807 INDIV. PSYCHOTHERAPY 45-50 MIN
90880 HYPNOTHERAPY
90885 EVAL. MEDICAL REPORTS & ACCUMULATED DATA
90887 INTERPRETATION OF RESULTS
90901 BIOFEEDBACK
90911 BIOFEEDBACK
915105 CERVICAL PILLOW
92004 OFFICE VISIT
92015 DETERMINATION OF REFRACTIVE STATE
92060 SENSORY MOTOR EXAM (EYES)
92081 VISUAL FIELD EXAMINATION
92083 EXTENDED EXAMINATION
92225 OPHTAIMOSCOPY
92250 FUNDUS PHOTOGRAPHY W/INTERPRETATION & REPORT
92285 EXTERNAL OCULAR PHOTOGRAPHY W/INTERPRETATION & REPORT
92286 ENDOTHELIAL CELL PHOTOGRAPHY-BOTH
92531 SONTANEOUS NISTAGMUS
92532/NR POSITINAL NYSTAGMUS
92541 SPONTANEOUS RECORDING
92542 POSITIONAL NYSTAGMUS
92543 CALORIC IRRIGATION
92544 OPK NYSTAGMUS TEST
92545 TRACKING
92546 SINUSOIDAL ROTATION
92547 SUPPLEMENTAL VERT. ELECTRODES
92548 UNKNOWN TESTING
92553 AUDIOLOGIC TESTING
92557 EVALUATION COMPREHENSIVE AUDIOMETRY
92563 TONE DECAY
92567 TYMPANOMETRY ACOUSTIC
92568 ACOUSTIC REFLEX
92569 ACOUSTIC REFLEX DECAY
92585 AUDITORY EVOKED POTENTIALS
92588 COMPREHESIVE DIAGNOSTIC EVALUATION
92706 INJECTION FORAMIN, CERVICAL/THOR
93000 EKG
93005 CY ECG (ELECTOCARDIOGRAPHY)
93040 RHYTHM ECG
93041 TRACING ONLY W/O INTERPRE & REPORT
93307 ECHOCARDIOGRAPHY
93320 DOPPLER ECHOCARDIOGRAPHY, PULSED WAVE
93325 DOPPLER ECHOCARDIOGRAPHY/ COLOR FLOW, VELOCITY MAPPING
93740 TEMPERATURE GRADIENT STUDIES CERVICAL/LUMBAR
93880 PHERIPHERAL VASC LAB
93886 TRANSRANIAL DOPPLER STUDY OF THE INTRA
93925 DUPLEX SCAN OF LOWER EXTREMITY ARTERIES OR ARTERIAL BYPASS GRAFTS, COMPLETE BILATERAL STUDY
93970 DOPPLER EXTREMITY VEINS COMPLETE BIL.
93971 DOPPLER- DEEP VEIN LOWER EXTREMITY
94010 SPIROMETRY, INCLUDING RECORD
94060 BRONCHOSPASM EVALUATION
94664 MEDICINE: INHALER OR IPPB DEVICE
94799 MEDICINE- UNLISTED PULMONARY
94800 BURN
95810 POLYSOMNOGRAPHY, SLEEP STAGING
95812 ELECTROENCEPHALOGRAM (EEG) EXTENDED MONITORING; 40-60 MINUTES
95813 ELECTROENCEPHALOGRAPHY
95816 EEG, AWAKE & DROWSY
95819 EEG
95831 MANUAL MUSCLE TESTING
95832 MANUAL MUSCLE TESTING
95833 MANUAL MUSCLE TESTING
95834 MANUAL MUSCLE TESTING
95851 RANGE OF MOTION TESTING
95852 RANGE OF MOTION TESTING
95860 EMG/1 EXTREMITY
95861 EMG/2 EXTREMITY
95863 EMG/3 EXTREMITY
95864 EMG/4 EXTREMITY
95868 NEEDLE ELECTROMYOGRAPHY
95869 EMG TESTING
95870 EMG/ 1 EXTREMITY
95900 NCV - MOTOR
95903 NCV - MOTOR W/ F WAVE
95904 NCV - SENSORY
95920 MEDICINE- INTRAOPERATIVE NEURO TESTING
95925 SSEP/UPPER EXTREMITY
95926 SSEP/LOWER EXTREMITY
95927 BAER
95930 VISUAL EVOKED POTENTIAL
95934 H-REFLEX, AMPLITUDE & LATENCY STUDY, GASTROCNEMIUS/SOLEUS MUSCLE
95936 H-REFLEX, OTHER THAN GASTROCNEMIUS/SOLEUS MUSCLE
95937 NEUROMUSCULAR JUNCTION TESTING
95954 EEG PHARMACOLOGICAL OR PHYSICAL ACTIVATION
95957 ANALYSIS OF EEG
95961 FUNCT CORTIC MAP; INIT HR MD ATTEND
95962 FUNCTIONAL MAPPING
95999 NEURO TEST, UNLISTED BR 6 NERVES
96100 PSYCH. TEST
96101 PSYCHOLOICAL TEST,INTERP. & REPORT
96103 PSYCHOLOGIST'S TIME FOR WRITTING
96105 HIGHER CEREBRAL FUNCTION W/ APHASIA
96115 NEUROBAEHAVIOR TESTING
96116 NEUROBEHAVORIAL STATUS EXAM
96117 NEUROPSYCHOLOGICAL TESTING
96118 NEUROBEHAVIORAL SCREENING
97001 P/T INITIAL EVALUATION
97010 HOT OR COLD PACK TREATMENT
97014 ELECTRICAL STIMULATION
97016 VASOPNEUMATIC DEVICES
97026 INFRARED
97032 ELECTRICAL STIMULATION 15min
97035 ULTRASOUND 15min
97039 AQUA MED-II
97070 MISC. SUPPLIES
97110 THERAPUTIC EXERCISE TO DEVELOP ROM
97112 NEUROMUSCLAR REDUCTION
97116 PHYSICAL THERAPY
97124 MASSAGE
97139 AQUA-MED DRY-HYDRO THERAPY
97140 MANUEL THERAPY TECH 15min
97180 ACUPUNCTURE, ONE OR MORE NEEDLES
97504 ORTHITIC FITTING & TRAINING
97530 THERAPEUTIC ACTIVITIES, 15 MIN
97750 PHYSICAL PERFORMANCE TEST
97780 ACUPUNCTURE, ONE OR MORE NEEDLES; W/O ELECTRICAL STIMULATION
97799 UNLISTED PMR SERVICE OR PROCEDURE
97800 FUNCTIONAL CAPACITY EVALUATION
97810 ACUP W/O ELECTRIC STIMULATION
97811 ADDT'L 15 MIN W/ RE-INSERTINO
97813 ACUPUNCTURE, ONE OR MORE NEEDLES
97814 ACUPUNCTURE, ONE OR MORE NEEDLES
98929 OMT 9-10 BODY REGIONS
98941 INJECTION-SPINAL 3-4 REGIONS
98943 INJECTION-EXTRASPINAL-1 MORE REGIONS
99002 SHIP/HAND-LARGE
99024 MEDICINE-POSTOPERATIVE FOLLOW UP VIIST
99070 SUPPLIES
99070-2 HOT/COLD PACK
99070-3 THERMOPHORE
99070-5 LUMBAR CUSHION
99080 REPORT/NARRATIVE
99141 SEDATION W/WO ANALGESIA
99199 X-RAY
99201 OFFICE CONSULTATION
99202 INITIAL EVALUATION
99203 OFFICE CONSULTATION
99204 OFFICE CONSULTATION
99205 OFFICE VISIT/ EVALUATION NEW PATIENT
99211 OFFICE VISIT
99212 OFFICE VISIT
99213 OFFICE VISIT
99214 OFFICE VISIT
99215 COMPREHENSIVE FOLLOW-UP VISIT
99231 HOSPITAL CARE INPATIENT (15 MINUETES)
99232 HOSPITAL CARE INPATIENT (250 MINUETES)
99241 OFFICE CONSULTATION
99242 OFFICE CONSULTATION
99243 OFFICE CONSULTATION
99244 OFFICE CONSULTATION
99245 OFFICE CONSULTATION
99252 HOSPITAL CARE INPATIENT (40 MINUETES)
99255 HOSPITAL CARE INPATIENT (110 MINUETES)
99262 HOSPITAL CARE INPATIENT (20 MINUETES)
99273 OFFICE CONSULTATION
99281 EMERGENCY DEPARTMENT VISIT EVALUATION
99284 ER INTENSIVE
99354 PROLONGED PHYSICIAN SVC/ FIRST HOUR
99355 PROLONGED PHYSICIAN SVC/ ADDT'L 30 MIN
99356 PROLONGED PHYSICIAN SERVICES (INPATIENT)
99358 PROLONGED EVALUATION AND MANAGEMENT
99455 IMPAIRMENT
99999 MIS. SURGICAL SUPPLIES
A0100 TRANSPORTATION
A0110 TRANSPORTATION
A4207 2CC SYRINGE WITH NEEDLE
A4215 SUPPLIES
A4245 SKIN COTE
A4360 TENS UNIT/ BATTERIES
A4550 EMG/NCV SUPPLIES
A4556 ELECTRODES
A4557 TENS UNIT/ LEAD WIRES
A4558 SUPPLY, UNLISTED
A4595 SUPPLIES
A4630 BATTERIES
A4640 CERVICAL PILLOW DOUBLE LOUP
A4647 UNLISTED PROCEDURE
A6257 SUPPLIES
A9300 THERABAND
A9503 TECHNETIUM INJECTION
A9900 TENS/EMS ELECTRODES PLACEMENT BELT
A9901 DELIVERY
A9999 MASSAGER
C1713 SUPPLY/IMPLANTS
D0140 LIMITED ORAL EVALUATION-PROB
D0220 X-RAY 1st FILM
D0274 4 BITE-WING X-RAYS
D0330 PANORAMIC X-RAY
D2540 GOLD ONLAY
D2940 SEDATIVE FILLING
D5820 INTERIM PARTIAL DENTURE
D6010 ENDOSTEAL IMPLANT
D6057 CUSTOM IMPLANT ABUTMENTS
D6240 PONTIC
D6750 ABUTMENT
D7140 CUSTOME TEMP. BRIDGE
D7210 EXTRACTION OF UPPER ARCH
D9310 PROFESSIONAL CONSULT
E0100 CANE, ADJUSTABLE WITH TIPS
E01131 INSERT NTERCOSTAL CATH
E0114 CRUCTH
E01645 C.A.T. SCAN
E0184 EGG CRATE MATTRESS
E0188 SYNTHETIC SHEEPSKIN PAD
E0190 CERVICAL PILLOW
E0199 DRY PRESSURE PAD
E0200 INFRARED HEAT LAMP WO/S
E0205 INFRARED
E0210 THERMOPHORE
E0215 THERMOPHORE
E0217 WATER CIRCULATOR HEAT PAD W/ PUMP
E0218 COLD WATER CIRCULATING UNIT W/PAD
E0225 THERMOPHORE
E0230 ICE
E0236 POSTOPERATIVE CONTROLLED COLD THERAPY
E0237 WATER CIRCULATING PAD WITH PUMP
E0249 SURGICAL THERMAL PAD
E0272 EGG CRATE MATTRESS
E0273 BED BOARD
E0274 BED BOARD UNIVERSAL
E02905 CARDIAC ELECTRSHYS STUDY
E0315 BED BOARD (UNIVERSAL)
E0459 COLD PACK W/ WRAP
E0720 TENS, TWO LEAD
E0730 TENS UNIT
E0731 TENS PLACEMENT BELT
E07311 TENS ACCESSORY KIT
E0742 EMS UNIT
E0744 EMS UNIT (4LEAD)
E0745 EMS UNIT
E0747 EBI BONE GROWTH STIMULATOR
E0760 OSTEOGENESIS STIMULATOR LOW INTENSITY ULTRASOUND
E0770 E.M.S. BELT
E0855 CERVICAL SUPINE TRACTION
E0890 CERVICALTRACTION W/STAND & WEIGHT BAG
E0935 CPM UNIT
E0936 CPM FOR THE SHOULDER
E0941 GRAVITY ASST. TRACTION DEVICE
E0942 CERVICAL HEAD HALTER
E0943 CERVICAL PILLOW
E0944 EMS PLACEMENT BELT
E0945 CERVICAL HEAD HALTER
E0947 CERVICAL TRACTION UNIT
E0948 CERVICAL TRACTION UNIT W/ MECHANICAL LOAD SENSOR
E0992 SOLID SEAT INSERT
E1300 WHIRLPOOL, HYDROTHERAPY
E1310 HYDROTHERAPY WHIRLPOOL
E1399 UNSPECIFIED SURGICAL SUPPLY
E2340 THERMOPHORE
E2601 LUMBAR CUSHION
E2602 SEAT CUSHION ORTHOPEDIC
E2605 ORTHO LUMBAR CUSHION
E2611 GENERAL USE BACK CUSHION
E2619 LUMBAR CUSHION
E9999 UNSPECIFIED SURGICAL SUPPLIES
EMSKIT EMS ACCESSORY KIT
G0289 ARTHROSCOPY/CHRONDROPLASTY
J0670 MARCAINE
J0690 DRUGS/DETAIL CODE
J1020 DRUGS/DETAIL CODE
J1030 DRUG/DETAIL CODE
J1040 MEDICAL SUPPLIES
J1100 MEDICATION/DEXAMETHOSONE, UP 8MG
J2001 INJECTION, LIDOCAINE
J2250 DRUGS/DETAIL CODE
J2405 DRUGS/DETAIL CODE
J3010 FENTANYL 1MG/ 2ML
J3301 MED-SUR SUPPLY
J3420 VITAMIN B12 CYANOCOBALAMIN
J3490 MARCAINE (BUPIVICAINE)
K0089 EMS ACCESSORY KIT
K0118 E.M.S. ACCESSORY KIT
K0635 LSO S
K0636 LUMBAR ORTHOSIS CONTROL
K0638 LSO, FLEXIBLE,PROVIDES LUMBO-SACRAL SUPPORT
K0639 LUMBOSACRAL ORTHOSIS
K0642 LSO FLEXIBLE
K0647 LSO, APL CONTRL, CUSTOM FITTED
K0648 LSO, APL CONTROL, CUSTOM FITTED
L0120 CERVICAL COLLAR
L0140 CERVICAL COLLAR
L0150 CERVICAL COLLAR
L0172 CERVICAL COLLAR
L0174 TWO PIECE, CERVICAL COLLAR, SEMI-RIGID
L0190 CERVICAL PILLOW
L0205 INFRA RED HEATING LAMP
L0300 LUMBAR CUSHION
L0315 T/L/S/O BACK SUPPORT
L0317 TLSO
L0430 SPINAL ORTHOSIS, APL CONTROL CUSTOM FITTED
L0450 TLSO BACK SUPPORT
L0480 TLSO
L0500 LS SUPPORT
L0510 LUMBO-SACRAL SUPPORT
L0515 LUMBOSACRAL SUPPORT
L0520 LUMBAR SACRAL ORTHOSIS
L0540 TLSO
L0565 L.S.O.A.P.L. CONTROL CUSTOM FITTED
L0626 LSO FLEXIBLE ELASTIC
L0627 LUMBAR ORTHOSIS CNTROL
L0629 LUMBAR SUPPORT
L0630 LUMBO-SACRAL SUPPORT
L0631 LSO W/ APL, CONTROL CUSTOM FITTED
L0632 LSO APL CONTROL, CUSTOM FITTED
L0633 LUMBOSACRAL ORTHOSIS
L0635 KNIGHT SPINAL BRACE
L0637 LSO APL CONTROL CUSTOM FITTED
L0638 TRACTION UNIT-LUMBAR FRAME
L0639 LSO APL CONTROL CUSTOM FITTED
L0943 ORTHOPEDIC PILLOW
L0999 LUMBAR CUSHION
L1499 BELT
L1800 KNEE SUPPORT
L1810 KNEE SUPPORT
L1815 K.O. ELASTIC W/ CONDYLE PADS
L1820 KNEE SUPPORT
L1832 KNEE SUPPORT
L1834 KO ADJ. W/JOINT SUPPORT CUSTOM FITTED
L1844 KNEE ORTHOSIS, SINGLE UPRIGHT, THIGH AND
L1845 KO, DOUBLE UPRIGHT W/ L.R CONTROL
L1846 KO RIGIO ADJUSTAL CUSTUM FITED
L1885 KNEE BRACE ( UNLOADING)
L1906 ANKLE-FOOT ORTHOSIS
L1930 AFO, CUSTOM FITTED PLASTIC
L1960 ANKLE SUPPORT
L2425 KNEE SUPPORT
L2435 ADDITION TO KNEE JOINT, POLYCENTRIC
L3020 UNSPECIFIED CODE
L3650 SHOULDER SUPPORT
L3652 SHOULDER ORTHOSIS
L3660 SHOULDER SUPPORT
L3670 SHOULDER IMMOBILZER
L3710 ELBOW SUPPORT
L3801 WRIST BRACE
L3908 WRIST SUPPORT
L3914 WRIST-HAND-FINGER ORTHOSIS
L8499 SHIPPING
L8699 CANNULATED SCREW/ PARTIAL
M0005 CAR SEAT
M1005 ORT. CAR SEAT
M1007 SHOULDER SUPPORT
MEC3010 BED MATTRESS
Q4010 CAST SUPPLIES
Q4050 PROCEL GORTEX
Q9946 MISC-DYE
Q9952 ADDITIONAL CHARGE
S0020 INJECTION, MARCAINE
T5001 ORTHOPEDIC CAR SEAT SUPPORT
Z2304 THERMOPHORE