N.Y. Comp. Codes R. & Regs. tit. 18 § 533.5

Current through Register Vol. 46, No. 45, November 2, 2024

Section 533.5 - Anesthesia and surgery

All fees billed must be in accordance with the provisions of Part 505 of this Subchapter.

(a)Anesthesia.

(1) The conversion factor for the anesthesia services and procedures listed in this section shall be $5.

(2) Anesthesia values.

(i) The total values for anesthesia services include pre- and post-operative visits, the administration of the anesthesia and the administration of fluids and/or blood incident to the anesthesia or surgery.

(ii) Calculated values for anesthesia services shall be used only when the anesthesia is personally administered by a licensed physician who remains in constant attendance during the procedure for the sole purpose of rendering such anesthesia services.

(iii) For anesthesia procedures, the same item number as the related surgical procedure shall be used with the suffix "a" added.

(iv) When hypothermia and/or pump oxygenator are employed in conjunction with an anesthesia, the anesthesia "basic" value shall be 20 units instead of the "basic" value presently listed and the suffix "y" shall be substituted for "a".

(v) If the general or regional anesthetic is administered by the attending surgeon, the value shall be 50 percent of the calculated value and the suffix "p" shall be substituted for "a".

(vi) In procedures where no value is listed, the basic portion of the calculated value shall be the same as listed for a comparable procedure.

(vii) Necessary drugs and materials provided by the physician anesthetist may be charged for separately.

(viii) Where unusual detention with the patient is essential for the safety and welfare of such patient, the necessary time shall be valued on the same basis as indicated below for anesthesia time.

(ix) No fee shall be allowed for local infiltration or digital block anesthesia administered by the operating surgeon.

(3) Calculation of total anesthesia values.

Calculation of total anesthesia value shall be determined by adding the listed basic value and time units. The time units shall be computed by allowing one unit for each 15 minutes of anesthesia time. Anesthesia time shall start with the beginning of the administration of the anesthetic agents and shall end when the physician anesthetist is no longer in personal attendance.

(b)Surgery.

(1) The conversion factor for the surgical services and procedures listed in this section shall be $4.

(2) The values hereinafter listed for surgical procedures include the surgery and follow-up care for the period indicated. In cases in which follow-up care beyond the required period is necessary, reimbursement shall be available for additional payments made by the social services district to the physician on a fee-for-service basis.

(3) Where an asterisk (*) precedes a procedure number and its listed value, reimbursement shall be determined on the basis of the following factors:

(i) the listed value is for the surgical procedure only;

(ii) reimbursement for all post-operative care shall be available for payments made to the physician on a fee-for-service basis;

(iii) when such procedure requires admission to a hospital, an additional two units shall be added to its listed value in lieu of any hospital visit fee;

(iv) when such procedure is carired out at the time of the initial visit, one additional unit shall be added to the value of the procedure in lieu of any office visit fee.

(4) When the notation "Sv" follows a listed surgical procedure, the maximum reimbursable allowance therefor shall be the sum of the values of the various respective services rendered, such as for a hospital visit, application of cast or splint, detention with the patient, or office visit, multiplied by the respective appropriate conversion factor.

(5) In the event of complications or other circumstances requiring additional and unusual services concurrent with the procedure or during the established period of follow-up care, reimbursement shall be available for payment to a physician on a fee-for-service basis in addition to the reimbursement for the procedure.

(6)

(i) When multiple or bilateral surgical procedures are performed at the same operative session, the total value shall be the value of the major procedure plus 50 percent of the value of the lesser procedure(s) after the conversion factor ($4) has been applied to all fee items, unless otherwise specified.

(ii) When an incidental procedure, such as an incidental appendectomy, lysis of adhesions, excision of a previous scar, or puncture of an ovary cyst, is performed through the same incision, the value of such procedure shall be that of the major procedure only, unless otherwise specified.

(7) When the skills of two surgeons are required in the management of a specific surgical procedure, by prior agreement, the total value may be apportioned in relation to the responsibility and work done, provided the patient is made aware of the fee distribution according to medical ethics. The value of such procedure may be increased by 25 percent.

(8) When an additional surgical procedure is carried out within the established period of follow-up care for a previous surgery, the follow-up periods for each shall be deemed to run concurrently.

(9) When the value of a surgical procedure is to be determined "by report", the social services district shall require the physician to submit the following information:

(i) postoperative diagnosis;

(ii) size, location and number of lesions on procedures where appropriate;

(iii) major surgical procedure and supplementary procedures;

(iv) where possible, a list of similar procedures, by item number, as set forth in this section;

(v) an estimate of the follow-up period;

(vi) operative time;

(vii) such other information as may be required.

(10) In the case of a kidney transplant, procedure item 3850, if the recipient of a kidney transplant is eligible for medical assistance, all costs attributable to medical services provided to a live donor of a kidney shall be reimbursable. If, however, the recipient of a kidney transplant is not eligible for medical assistance, payments for neither the transplant nor the costs incured for the live donor shall be reimbursable even though the live donor may be eligible for medical assistance.

(11) Surgical fees.

The maximum reimbursable allowance for the numbered and described items of surgical procedures listed in this section shall be computed on the basis of the respective listed value multiplied by the conversion factor of $4.

(12) The maximum reimbursable allowance to an individual physician for a single operation shall be $800.

(c)Maximum reimbursable anesthesia and surgery fee schedules:

SURGICAL ASSISTANTS

6993	Assist at surgery, 20% of listed unit value(s) of surgical procedure(s)-

Integumitary System

Skin, Mucous Membrane, Subcutaneous and Areolar Tissues

Unitr or Dollar Value	Follow-up Days	Anes.§
Incision
*0101	Incision and drainage of infected or non-infected sebaceous cyst ........................	*2.0	0	3.0+T
(2nd lesion 50%; each additional lesion 25%)
*0102	Incision and drainage of furuncle.....................................	*2.0	0	3.0+T
*0103	Acne surgery; marsupialization, opening, or removal of multiple milia, comedones, cysts, pustules, etc............................................	*1.5	0	3.0+T
*0108	Incision and drainage of carbuncle, suppurative hidradenitis and other cutaneous or subcutaneous abscesses, simple.................................	*2.0	0	3.0+T
0109	extensive................................	by report	3.0+T
*0115	Drainage of pilonidal cyst....................................	*2.0	0	3.0+T
*0125	Drainage of onychia or paronychia..............................	*2.0	0	3.0+T
0126	multiple or complicated	by report	3.0+T
*0130	Incision and removal of foreign body, subcutaneous tissues, simple....................	*2.0	0	3.0+T
0131	complicated...........................	by report	0	3.0+T
*0140	Drainage of hematoma simple.....................................	*2.0	0	3.0+T
0141	complicated...............................	by report	0	3.0+T
*0145	Puncture aspiration of abscess or hematoma ...........................................	*1.0	0	3.0+T
Excision
Debridement (for abrasions and burns see 0164, 0330-0334, 0351-0356.)
*0160	Debridement of extensively eczematized or infected skin up to 10% of the body surface	*2.0	0	3.0+T
*0161	for each additional 10% of body surface, add	*1.0	0	3.0+T
*0162	Debridement of nails, any method, five or less	*2.0	0	3.0+T
*0163	for each additional five or major portion thereof	*1.0	0	3.0+T
0164	Debridement of abrasions	by report
Excision and Simple Closure-(Not reconstructive surgery; for reconstructive surgery see "Repair-Complex.")
(For electro-surgical methods see 0401, et seq.)
0171	Biopsy; excision of skin, subcutaneous tissue or mucous membrane for biopsy (including simple closure) independent procedure)	3.0	15	3.0+T
Excision (including simple closure) of BENIGN cicatricial, fibrous, inflammatory, congenital, cystic, etc., lesions of skin, subcutaneous tissue or mucous membrane; one (see appropriate size below.)
(For multiple lesions see Surgical Rule 9.)
0175	lesion diameter up to 1/4 inch	4.0	30	3.0+T
0176	lesion diameter 1/4 to 1/2 inch	5.0	30	3.0+T
0177	lesion diameter 1/2 to 3/4 inch	6.0	30	3.0+T
0178	lesion diameter more than 3/4 inch or complicated	by report	3.0+T
Excision (including simple closure) or treatment by any other method (except radiation) of MALIGNANT lesions of skin or mucous membrane (except melanoma) to include local anesthesia.
Trunk, arms or legs:
0188	lesion diameter up to 1/4 inch	6.0	90	3.0+T
0189	lesion diameter 1/4 to 1/2 inch	8.0	90	3.0+T
0190	lesion diameter 1/2 to 3/4 inch	10.0	90	3.0+T
Face, scalp, ears, neck, hands, feet, genitalia:
0191	lesion diameter up to 1/4 inch	10.0	90	3.0+T
0192	lesion diameter up to 1/2 inch	15.0	90	3.0+T
0193	lesion diameter 1/2 to 3/4 inch	20.0	90	3.0+T
Eyelids, nose, lips, mucous membrane:
0194	lesion diameter up to 1/4 inch	15.0	90	3.0+T
0195	lesion diameter 1/4 to 1/2 inch	20.0	90	3.0+T
0196	lesion diameter 1/2 to 3/4 inch	25.0	90	3.0+T
0197	Lesions over 3/4 inch, complicated or unusually located	by report	3.0+T
0225	Avulsion, nail, partial, or complete, simple	*2.0	0	3.0+T
0228	Excision of nail or nail matrix, partial or complete, e.g., ingrown or deformed nail for permanent removal	10.0	30	3.0+T
0238	Excision of pilonidal cyst or sinus	30.0	60	3.0+T
Miscellaneous lesions (use appropriate procedure number and state diagnosis.)
Hermangioma (see 0175-0178, 0260-0324.)
Hidradenitis (see 0106, 0175-0178, 0260-0324.)
Lipoma (see 0175-0178, 0260-0324.)
Lymph node dissection (see 2651-2672.)
Melanoma (see 0188-0197, 0260-0324.)
Ulcer-vascular or inflammatory (see 0175-0178, 0260-0324.)
Introduction
*0242	Injection, intralesional (up to and including seven lesions)	*2.0	0	3.0+T
*0243	more than seven	*3.0	0	3.0+T
Repair-Simple
*0251	Wounds, recent, up to 2 1/2 inches	*2.0	0	3.0+T
*0252	for each additional inch add	*1.0	0	3.0+T
(For multiple wounds, see Surgical Rule 9.)
REPAIR-COMPLEX (e.g., reconstructive surgery, complicated wound closure, skin grafts, etc.).
The following values (0260-0324) are to be applied in situations requiring unusual and time-consuming techniques of repair to obtain the maximum functional and cosmetic result. Unless otherwise noted, the stated values include the creation of the defect and necessary preparation for repair, or the debridement and repair of complicated lacerations (excluding 0251, 0252.)
Excision and/or repair by direct closure of lesion or laceration resulting in a LINEAR REPAIR:
0260	up to 1/2 inch, forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet	8.0	30	3.0+T
0261	eyelids, nose, ears and lips (See also 0290-0294, 2737-2746.)	10.0	30	3.0+T
(For other areas see 0175-0178, 0188-0197, 0251-0252.)
0262	1/2 inch to 1 inch, trunk	7.0	30	3.0+T
0263	scalp, arms and legs	10.0	30	3.0+T
0264	forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet	14.0	30	3.0+T
0265	eyelids, nose, ears and lips	17.0	30	3.0+T
(See also 0290-0294, 2737-2746.)
0266	1 inch to 3 inches, trunk	15.0	30	3.0+T
0267	scalp, arms and legs	22.0	30	3.0+T
0268	forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet	30.0	30	3.0+T
0269	eyelids, nose, ears and lips (See also 0290-0294, 2737-2746.)	40.0	30	3.0+T
0270	Unusual, complicated or over 3 inch linear repair	by report	3.0+T
Excision and/or repair by adjacent tissue transfer or rearrangement (e.g., Z-plasty, rotation flap, advanced flap, double pedicle flap, etc.):
0275	for defect up to 1 square inch, trunk	20.0	60	3.0+T
0276	scalp, arms and legs	30.0	60	3.0+T
0277	forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet	40.0	60	3.0+T
0278	eyelids, nose, ears and lips	50.0	60	3.0+T
0279	defect size between 1 square inch and 3 square inches, trunk	30.0	60	3.0+T
0280	scalp, arms and legs	40.0	60	3.0+T
0281	forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet	50.0	60	3.0+T
0282	eyelids, nose, ears and lips	60.0	60	3.0+T
0283	more than 3 square inches, unusual or complicated	by report	3.0+T
Eyelid, full thickness, excision and repair:
0290	by advancement flaps, up to 1/4 eyelid margin	37.0	60	3.0+T
0291	over 1/4 of eyelid margin	50.0	60	3.0+T
0292	by transfer flaps of tarsoconjunctivea from opposing eyelid, up to 2/3 of eyelid	50.0	60	3.0+T
0293	total eyelid, one or more stages, lower lid	75.0	60	3.0+T
0294	upper lid	85.0	60	3.0+T
SKIN GRAFTS-The value is to be determined on the basis of size and location of defect (recipient area) and type of graft. Unless otherwise noted, these values include creation and/or surgical preparation of the defect, obtaining and placing of the graft, and the care of the donor site. For repair of the donor site requiring skin graft or local flaps, see section 533.5(b)(6)(i).
*0300	Pinch, split or full thickness skin to cover small ulcer, tip of digit or other minimal open area (except on face, use 0301-0304) up to defect size 3/4 inch diameter	*5.0	0
(Values for items 0301-0304 include simple debridement of granulations or recent avulsions. When the recipient area for grafting is created by surgical excision of essentially intact skin, scar or other lesion (including subcutaneous tissue) add 50% to the calculated value for the graft. This includes primary or delayed application of the graft.)
0301	Split skin graft, up to 16 square inches (except 0300), trunk, scalp, arms, legs, hands and feet (except multiple digits)	25.0	45
0302	each additional 16 square inches or part thereof	5.0	45
0303	face, neck, ears, genitalia or multiple digits	38.0	45
0304	each additional 16 square inches or part thereof	7.0	45
0308	Full thickness, free, up to 3 square inches, including direct closure of donor site, trunk	20.0	45
0309	scalp, arms and legs	30.0	45
0310	forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet	40.0	45
0311	eyelids, nose, ears and lips	50.0	45
(For each additional 3 square inches in the above procedures, add 50% of area value.)
(For repair of donor site requiring skin graft or local flaps, see section 533.5(b)(6)(i)).
Values for following items (0312-0323) do NOT include extensive immobilizing; for plaster casts see 1851-1890 for values for these services.
0312	Pedicle flap, direct or tubed, (including direct closure of donor site) trunk	20.0	45
0313	scalp, arms and legs	30.0	45
0314	forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet	40.0	45
0315	eyelids, nose, ears and lips	50.0	45
(For repair of donor site requiring skin graft or local flaps, see section 533.5(b)(6)(i)).
0316	delay, intermediate transfer or sectioning of pedicle of tubed or direct flap, trunk	15.0	45
0317	scalp, arms and legs	22.0	45
0318	forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet	30.0	45
0319	eyelids, nose, ears and lips	37.0	45
0320	excision of lesion and/or preparation of recipient site and attachment of direct or tubed pedicle flap, trunk	30.0	45
0321	scalp, arms and legs	45.0	45
0322	forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet	60.0	45
0323	eyelids, nose, ears and lips	75.0	45
(Revision, defatting or rearranging of transferred pedicle or flap skin graft, see 0260-0283 inclusive.)
0324	Composite graft (full thickness of external ear or nasal ala)	25.0	45	3.0+T
0325	Derma-fat-fascia-graft (except to breast-0484)	45.0	60	3.0+T
0330	Abrasion of skin, total face, for removal of scars, tattoos, etc., primary	60.0	90	3.0+T
0331	secondary, total face	30.0	45	3.0+T
0333	regional ( 1/4 face, cheeks, chin, forehead or elsewhere) primary	15.0	60	3.0+T
0334	secondary, regional	7.5	30	3.0+T
0335	Rhytidectomy, lower eyelids	60.0	30	3.0+T
0336	upper eyelids	40.0	30	3.0+T
0337	forehead	50.0	30	3.0+T
0338	glabellar frown	40.0	30	3.0+T
0339	cheeks, chin and neck	150.0	45	4.0+T
0340	Facial nerve paralysis, free fascia grafts	100.0	100	4.0+T
0341	reanimation-muscle transfers	120.0	120	4.0+T
(For nerve transfers, decompression or suture, see 5350, 6002, 6003.)
BURNS-List percentage of body surface involved and depth of burn. Does not include skin grafts.
*0351	Initial treatment, first degree, where no more than local treatment necessary	*1.5	0
*0352	Dressings, initial or subsequent under anesthesia, small	*4.0	0	3.0+T
*0353	under anesthesia, large or with major debridement, per hour	*10.0	0	3.0+T
*0354	without anesthesia, small, office or hospital	*2.0	0
*0355	without anesthesia, medium (whole face or whole extremity, etc.)	*3.0	0
*0356	without anesthesia, large (more than one extremity, etc.)	*4.0	0
Destruction
*0401	Electro-surgical destruction with or without surgical curettement of facial nevi, leukoplakia, actinic or senile keratoses, or keratoacanthomas, to include local anesthesia, one lesion	*3.0	0	3.0+T
(50% for each additional lesion up to a total of three; over three, each additional lesion 25%.)
0402	complicated lesion(s)	by report
*0403	Electro-surgical destruction (except 0401 and 0402) or chemocautery (Mono-, Bi-, Trichloracetic acid, phenol, etc.) or cryocautery (liquid N2, CO2, etc.) of benign or premalignant lesions of skin or mucous membrane (except 0405 and 0406) with or without curettement, one lesion	*2.0	0
(50% for second lesion; over two, each additional lesion 25%.)
0404	complicated lesion(s)	by report
*0405	flat (plane, juvenile) warts, up to fifteen	*2.0	0
(Retreatment same as routine office visit.)
*0406	Electro-surgical destruction of multiple fibro-cutaneous tags, up to fifteen	*2.0	0
0408	Chemosurgery, (Mohs type technique), malignancies of skin, includes removal of growth and microscopic delineation of margins and base, first stage -fulguration and application of chemicals	20.0	30
0409	each subsequent treatment, up to five sections	5.0	30
0410	each additional section over five	1.0	30
*0411	Cryotherapy-(CO2 slush, liquid N2)	*1.5	0
*0412	Electrolysis epilation, each 1/2 hour	*3.0	0
(For actinotherapy and galvanic iontophoresis, see 9425-9427.)
Breast
Incision
*0430	Puncture aspiration of cyst	*2.0	0
0431	Mastotomy with exploration or drainage of abscess, deep	10.0	14	3.0+T
Excision
0441	Biopsy of breast	15.0	30	3.0+T
0444	Excision of cyst, fibro-adenoma or other benign tumor, aberrant breast tissue, duct lesion (including gyneco-mastia) or nipple lesion (including any other partial mastectomy) male or female, unilateral	15.0	30	3.0+T
0445	bilateral	25.0	30	3.0+T
0446	Excision of chest wall tumor involving ribs	70.0	60	9.0+T
0447	Excision of chest wall tumor involving ribs plus plastic reconstruction	100.0	60	9.0+T
0457	Complete (simple) mastectomy	30.0	45	3.0+T
0470	Radical mastectomy, including breast, pectoral muscles and axillary lymph nodes	70.0	60	3.0+T
0481	Mammoplasty, plastic operation on breasts, reduction or repositioning, bilateral, one stage	150.0	90	3.0+T
0482	two stage	by report	3.0+T
0483	augmentation, prosthetic, unilateral	75.0	90	3.0+T
0484	bilateral	100.0	90	3.0+T
0485	derma-fat fascia, unilateral	100.0	90	3.0+T
MUSCULOSKELETAL SYSTEM
Listed values include the application of first cast or traction device only. Values for major replacement casts and traction devices necessarily applied during listed period of aftercare to be added.
Incision
0501	Aspiration or curette biopsy of bone marrow	3.0	7	3.0+T
(For sternal or iliac puncture, see L116)
0502	Needle (Trocar) biopsy, vertebra	10.0	7	4.0+T
*0506	Incision of superficial soft tissue abscess secondary to osteomyelitis	*2.0	0	3.0+T
0507	deep or complicated	by report	3.0+T
0513	Sequestrectomy for osteomyelitis or bone abscess	by report	30	3.0+T
0516	Removal of metal band, plate, screw or nail (independent procedure)	15.0	15	3.0+T
(For pins, etc., see 0596, 0599.)
OSTEOTOMY-Cutting, division or transection of bone, with or without internal fixation.
0526	Clavicle	40.0	90	3.0+T
0527	Humerus	50.0	150	3.0+T
0529	Radius	40.0	120	3.0+T
0530	Ulna	40.0	120	3.0+T
0531	Femur, neck, under age 8	80.0	180	3.0+T
0532	over age 8	100.0	180	3.0+T
0533	subtrochanteric	80.0	180	3.0+T
0534	supracondylar	70.0	180	3.0+T
0536	Tibia	55.0	150	3.0+T
0537	Smaller bones (fibula, metacarpals, metatarsals, etc.)	30.0	120	3.0+T
0538	Correction of bowlegs or knock-knees, unilateral	50.0	150	3.0+T
0539	bilateral	75.0	150	3.0+T
(For iliac osteotomy, see 1341, 1342.)
0540	Multiple osteotomies, single bones for realignment on intrameduallary rod, Scofield type procedure, humerous.	50.00	150	3.0+T
0541	radius or ulna	50.0	120	3.0+T
0542	femur	100.0	180	3.0+T
0543	tibia	75.0	150	3.0+T
Excision
0549	Biopsy bone, radius, ulna, fibula, skull, sternum	10.0	15	3.0+T
0550	humerus, pelvis, femur, tibia	20.0	15	3.0+T
0551	vertebra	40.0	45	3.0+T
(For needle biopsy, see 0502.)
(Value of biopsy done preceding definitive surgery is 50 percent of listed value.)
0552	Claviculectomy, partial	35.0	60	3.0+T
0553	total	65.0	60	3.0+T
0554	Astragalectomy	55.0	120	3.0+T
0556	Excision of head of radius	35.0	90	3.0+T
0557	Carpectomy	30.0	90	3.0+T
0560	Coccygectomy	30.0	90	4.0+T
0561	Patelectomy or hemipatellectomy	50.0	120	3.0+T
0563	Metatarsectomy	25.0	60	3.0+T
0566	Excision of chondroma, osteochondroma, or exostosis; humerus, pelvis, femur, tibia, radius, fibula, ulna	40.0	150	3.0+T
0567	small bones	25.00	90	3.0+T
0568	Excision of bone cyst, simple, large bones	40.0	120	3.0+T
0569	small bones	25.00	90	3.0+T
(With autogenous bone graft, add 10.0 units to 0568, 0569.)
0576	Partial ostectomy; partial excision of bone, craterization, guttering or saucerization of bone; diaphysectomy; humerus, pelvis, femur, tibia, fibula, radius, ulna	50.0	150	3.0+T
0577	small bones	25.0	90	3.0+T
0578	Excision of tumor of mandible without replacement	75.00	90	6.0+T
(For replacement see 0619.)
0580	Radical resection of bones for tumor with bone graft; scapula, humerus, pelvis, femur, tibia	100.0	120	5.0+T
0581	other bones	65.0	90	3.0+T
Introduction
(For associated procedures, see Fractures.)
(For injection procedure for intraosseus venography, see radiology.)
*0591	Insertion of wire, pin, caliper or tongs (independent procedure)	*5.0	0	3.0+T
*0598	Removal buried wire or pin (independent procedure)	*2.0	0	3.0+T
*0599	Removal of caliper or tongs (independent procedure)	*1.0	0	3.0+T
Repair
0611	Osteoplasty; shortening of bone, femur, tibia, humerus	100.0	180	3.0+T
0612	radius, ulna	65.0	120	3.0+T
0613	other bones	45.0	90	3.0+T
0614	lengthening of bone	100.0	365	3.0+T
0616	mandible for prognathism or micrognathism, one or two stages	100.0	90	5.0+T
BONE OR CARTILAGE GRAFT-Osteoperiosteal graft, periosteal graft, or cartilage graft. Includes otbaining and placing of graft. Unless otherwise indicated, values are for autogenous graft. When non-autogenous material is used, reduce value by 5.0 units.
0617	Bone graft; femur, tibia, humerus	100.0	180	3.0+T
0618	radius, ulna	65.0	150	3.0+T
0619	skull or significant portion of mandible	100.0	180	7.0+T
0620	other bones, including chin, nose, malar prominences	45.0	120	3.0+T
0621	Cartilage graft, autogenous, to face, nose, ear or skull	70.0	120	7.0+T
Spinal Fusion (For fusion of childhood scoliosis, see 0643, 0644, 0645.)
(Items 0634-0642 refer to spinal procedures at one interspace; for each additional interspace, add 10%.) (If two surgeons are involved, see sections 533.3(c) and 533.5(b)(7).)
0634	Spinal fusion, cervical region, posterior technique	90.0	180	7.0+T
0635	anterior technique	80.0	180	7.0+T
0636	thoracic region, posterior or posterior-lateral technique	90.0	180	7.0+T
0637	interbody technique, anterior, lateral or posterior	100.0	270	7.0+T
0638	lumbar region, posterior or posterior-lateral technique	90.0	270	7.0+T
(For interbody technique, anterior see 0642.)
0639	Spinal fusion with removal of intervertebral disc, cervical region, posterior, technique	120.0	180	7.0+T
0640	anterior interbody technique	80.00	180	7.0+T
0641	lumbar or thoracic region, posterior, posterior-lateral, or posterior interbody technique	120.0	270	7.0+T
0642	anterior interbody technique	100.0	270	7.0+T
0643	Spinal fusion for scoliosis, child or young adult (less than 18 years of age), up to and including five interspaces	120.0	270	7.0+T
0644	Harrington rod technique	150.0	270	7.0+T
0645	Halo technique	150.0	270	9.0+T
(For adult scoliotic fusion see 0634-0642.)
0647	Scapulopexy	65.0	90	6.0+T
0648	Patellapexy	50.0	90	3.0+T
0649	Pectus excavatum, infants, plastic repair	25.0	60	3.0+T
0650	Pectus excavatum (major) plastic repair	90.0	90	9.0+T
0654	Epiphyseal-diaphyseal fusion; epiphyseal arrest; epiphysiodesis or stapling; femur	55.0	90	3.0+T
0655	tibia and fibula, proximal or distal	55.0	90	3.0+T
0656	combined distal femur and proximal tibia and fibula (knee)	75.0	90	3.0+T
0657	combined proximal and distal, tibia and fibula	75.0	90	3.0+T
0658	combined distal femur and proximal and distal tibia and fibula	100.0	120	3.0+T
0660	Hemi-epiphyseal arrest (e.g. for genu varus or genu valgus) distal femur	45.0	180	3.0+T
(For removal and reinsertion of staples at same operation, use values listed above.)
(For removal of staples only, 50% of listed values.)
(Freeing of bone adhesions, callus or synostosis, independent procedure, see Ostectomy.)
FRACTURES
Skull
0681	Skull, non-operative	Sv. ¶
(Depressed with operation, see 5018, 5020.)
Facial Bones
0685	Nasal, simple or compound, no reduction	Sv. ¶
*0686	uncomplicated (digital) closed reduction	*5.0	0
0687	complicated (instrumental) closed reduction	10.0	30	4.0+T
0688	open reduction, uncomplicated	25.0	30	4.0+T
0689	complicated with either internal and/or external skeletal fixation	40.0	45	4.0+T
0690	with concomitant open reduction of fractured septum	60.0	45
0691	Malar, simple or compound, no reduction	Sv. ¶
*0692	closed reduction (including towel clip technique)	*5.0	0	4.0+T
0693	depressed, open reduction	30.0	60	4.0+T
0694	complicated, depressed, open reduction with internal skeletal fixation and multiple surgical approaches	65.0	90	5.0+T
0698	Maxilla, simple or compound, no reduction	Sv. ¶
0699	closed reduction, with wiring of teeth	30.0	90	4.0+T
0701	open reduction, with wiring of teeth and/or local fixation	50.0	90	4.0+T
0702	complicated, open reduction, fixation by head cap, multiple surgical approaches, internal fixation, wiring teeth, etc.	by report	90	6.0+T
(For antral approach, see 1988.)
0703	Mandible, simple or compound, no reduction	Sv. ¶
0704	closed reduction and wiring of teeth	30.0	90	4.0+T
0705	open reduction with or without wiring of teeth	50.0	90	4.0+T
0706	skeletal pinning with external fixation	40.0	90	4.0+T
Spine and Trunk
0720	Vertebral process, one or more	Sv. ¶
0721	Vertebral body, one or more not requiring reduction	Sv. ¶
0722	requiring reduction	30.0	180	3.0+T
0732	Sacrum, simple, not requiring reduction	Sv. ¶
0733	compound or complex	by report
0735	Coccyx, simple, not requiring reduction	Sv. ¶
0736	compound or complicated	by report
0740	Clavicle, simple, no reduction	Sv. ¶
0741	simple, closed reduction	15.0	90	3.0+T
0742	compound, including uncomplicated soft tissue closure	20.0	90	3.0+T
0743	simple or compound, open reduction	40.0	120	3.0+T
0747	Scapula, simple, no reduction	Sv. ¶
0748	simple or compound, open reduction	55.0	90	3.0+T
0756	Sternum, simple	Sv. ¶
0757	compound or complicated	by report	3.0+T
0761	Ribs, simple	Sv. ¶
0762	compound or complicated	by report	3.0+T
Pelvis (Ilium, Ischium, Pubis)
0767	Fracture, simple, no reduction	Sv. ¶
0768	complicated, closed reduction	by report	3.0+T
0771	compound, open reduction	75.0	120	3.0+T
0772	Acetabulum, with or without other fractures of pelvis, simple, no reduction	Sv. ¶
0773	central, with displacement, requiring closed reduction	55.0	180	3.0+T
0775	simple or compound, open reduction	75.0	180	3.0+T
Upper Extremity
0778	Humerus, surgical neck, simple, not requiring reduction	Sv. ¶
0780	requiring manipulative reduction	30.0	120	3.0+T
0781	compound, with uncomplicated soft tissue closure	35.0	120	3.0+T
0782	simple or compound, open reduction	50.0	120	3.0+T
0783	shaft, simple, not requiring reduction	Sv. ¶
0784	simple, closed reduction	25.0	120	3.0+T
0785	compound, with uncomplicated soft tissue closure	30.0	120	3.0+T
0786	simple or compound, open reduction	45.0	120	3.0+T
0787	simple or compound, open reduction, skeletal pinning with external fixation	40.0	120	3.0+T
0788	supracondylar or dicondylar, nor requiring reduction	Sv. ¶
0789	closed reduction	25.0	120	3.0+T
0790	compound with uncomplicated soft tissue closure	30.0	120	3.0+T
0791	simple or compound, open reduction	50.0	120	3.0+T
0792	medial or lateral condyle, simple not requiring reduction	Sv. ¶
0793	closed reduction	20.0	120	3.0+T
0794	compound with uncomplicated soft tissue closure	25.0	120	3.0+T
0795	simple or compound, open reduction	40.0	120	3.0+T
0796	Elbow, proximal end of ulna with dislocation of radial head, simple, (Monteggia, fracture) closed reduction	20.0	90	3.0+T
0797	simple or compound, open reduction	55.0	120	3.0+T
(see also 1292.)
0798	Radius, head, simple, no reduction	Sv. ¶
0799	closed reduction	15.0	60	3.0+T
0800	compound with uncomplicated soft tissue closure	20.0	60	3.0+T
0801	simple or compound, open reduction or excision (See also 0556.)	35.0	90	3.0+T
0802	shaft, simple, no reduction	Sv. ¶
0803	simple, closed reduction	20.0	120	3.0+T
0804	compound, with uncomplicated soft tissue closure	25.0	120	3.0+T
0805	simple or compound, open reduction	40.0	150	3.0+T
0806	distal end (e.g. Colle's type), simple, no reduction	Sv. ¶
0807	closed reduction	15.0	120	3.0+T
0808	with severe comminution and impaction, closed reduction	20.0	120	3.0+T
0809	simple or compound, open reduction	40.0	120	3.0+T
0810	skeletal pinning, with external fixation	30.0	120	3.0+T
0811	Ulna, proximal end, olecranon process, simple, no reduction	Sv. ¶
0812	compound with uncomplicated soft tissue closure	25.0	120	3.0+T
0813	simple or compound, open reduction and/or resection	40.0	120	3.0+T
0814	shaft, simple, no reduction	Sv. ¶
0815	closed reduction	20.0	120	3.0+T
0816	compound, with uncomplicated soft tissue closure	25.0	120	3.0+T
0817	simple or compound, open reduction	40.0	120	3.0+T
0818	skeletal pinning with external fixation	30.0	120	3.0+T
0820	Radius and ulna shaft, simple, no reduction	Sv. ¶
0821	simple, closed reduction	25.0	120	3.0+T
0822	compound, with uncomplicated soft tissue closure	30.0	120	3.0+T
0823	simple or compound, open reduction	50.0	150	3.0+T
0824	skeletal pinning with eterxnal fixation	40.0	150	3.0+T
(For Colle's fracture see 0806-0810.)
0827	Carpal bones, one or more, simple reduction	Sv. ¶
0830	simple or compound, open reduction	35.0	120	3.0+T
0840	Metacarpal, simple, no reduction	Sv. ¶
0842	one, simple or compound, closed reduction with uncomplicated soft tissue closure	10.0	45	3.0+T
0843	more than one, simple or compound, closed reduction, with uncomplicated soft tissue closure	12.5	60	3.0+T
0844	one or more, simple or compound, open reduction	30.0	90	3.0+T
0848	skeletal pinning with external fixation	25.0	90	3.0+T
0852	Phalanx or phalanges, finger, proximal, middle or thumb, simple, no reduction	Sv. ¶
0853	closed reduction	7.5	45	3.0+T
0854	compound, with uncomplicated soft tissue closure	10.0	45	3.0+T
0855	simple or compound, open reduction	20.0	60	3.0+T
0856	Phalanx or phalanges, distal, simple, no reduction	Sv. ¶
0857	simple or compound, closed reduction with uncomplicated soft tissue closure	5.0	30	3.0+T
0858	simple or compound, open reduction	12.5	45	3.0+T
LOWER EXTREMITY
0865	Femur, neck, simple, no reduction	Sv. ¶
0866	with fixation or traction	50.0	180	3.0+T
0867	simple or compound, open reduction	80.0	180	5.0+T
0868	multiple pinning, with or without external fixation	80.0	180	5.0+T
0869	treatment with replacement prosthesis	80.0	180	6.0+T
0872	intertrochanteric, simple, no reduction	Sv. ¶
0873	with fixation or traction	45.0	180	3.0+T
0874	simple or compound, open reduction	80.0	180	5.0+T
0877	slipped epiphysis, no reduction, treatment by traction, bed rest or cast application	Sv. ¶
0878	open reduction, single or multiple pinning or bone graft	80.0	180	5.0+T
0879	reconstruction	100.0	180	5.0+T
0880	shaft, including supracondylar, simple, no reduction	Sv. ¶
0881	simple, closed reduction	40.0	180	3.0+T
0882	compound, with uncomplicated soft tissue closure	45.0	180	3.0+T
0883	simple or compound, open reduction	80.0	180	3.0+T
0884	skeletal pinning with external fixation	60.0	180	3.0+T
0885	distal end, medial or lateral condyle, simple, no reduction	Sv. ¶
0886	condyle or condyles, simple, closed reduction	35.0	120	3.0+T
0887	simple or compound, open reduction	60.0	150	3.0+T
0889	Patella, simple, no reduction	Sv. ¶
0890	compound, with uncomplicated soft tissue closure	25.0	120	3.0+T
0891	simple or compound, open reduction	50.0	120	3.0+T
0893	Tibia, proximal end, tibial plateaus, condyle, condyles or intercondylar spines, simple, no reduction	Sv. ¶
0894	close reduction	25.0	120	3.0+T
0895	compound with uncomplicated soft tissue closure	30.0	120	3.0+T
0896	simple or compound, open reduction	55.0	150	3.0+T
0901	shaft, simple, no reduction	Sv. ¶
0902	closed reduction	25.0	180	3.0+T
0903	compound with uncomplicated soft tissue closure	30.0	180	3.0+T
0904	simple or compound, open reduction	50.0	180	3.0+T
0905	simple or compound, open or "lind"insertion of intramedullary rod (e.g. Lottes nail)	50.0	180	3.0+T
0907	distal end, malleolus, simple, no reduction	Sv. ¶
0908	simple, closed reduction	15.0	120	3.0+T
0909	compound with uncomplicated soft tissue closure	20.0	120	3.0+T
0910	simple or compound, open reduction	40.0	120	3.0+T
0914	Fibula, shaft, simple, no reduction	Sv. ¶
0915	compound, with uncomplicated soft tissue closure	20.0	60	3.0+T
0916	simple or compound, open reduction	30.0	60	3.0+T
0920	distal end, malleolus, simple, no reduction	Sv. ¶
0921	closed reduction	15.0	75	3.0+T
0922	compound with uncomplicated soft tissue closure	20.0	120	3.0+T
0923	simple or compound, open reduction	40.0	120	3.0+T
0925	Tibia and fibula, shafts, simple, no reduction	Sv. ¶
0926	closed reduction	30.0	180	3.0+T
0927	compound with uncomplicated soft tissue closure	35.0	180	3.0+T
0928	simple or compound, open reduction	60.0	180	3.0+T
0930	skeletal pinning with external fixation	40.0	180	3.0+T
0932	Ankle, bimalleolar (including Potts) simple, no reduction	Sv. ¶
0933	simple, closed reduction	25.0	150	3.0+T
0934	compound with uncomplicated soft tissue closure	30.0	150	3.0+T
0935	simple or compound, open reduction	50.0	150	3.0+T
0937	trimalleolar, simple, no reduction	Sv. ¶
0938	closed reduction	30.0	150	3.0+T
0940	compound with uncomplicated soft tissue closure	35.0	150	3.0+T
0941	simple or compound, open reduction	60.0	150	3.0+T
0943	Tarsal (except astragalus and os calcis) one or more, simple, no reduction	Sv. ¶
0944	closed reduction	10.0	90	3.0+T
0945	compound with uncomplicated soft tissue closure	15.0	90	3.0+T
0946	simple or compound, open reduction	30.0	90	3.0+T
0954	Astragalus, simple, no reduction	Sv. ¶
0955	simple, closed reduction	20.0	120	3.0+T
0956	compound with uncomplicated soft tissue closure	25.0	120	3.0+T
0957	simple or compound, open reduction	55.0	120	3.0+T
0960	Os calcis, simple, no reduction	Sv. ¶
0961	closed reduction	20.0	120	3.0+T
0962	compound, with uncomplicated soft tissue closure	25.0	270	3.0+T
0963	simple or compound, open reduction	50.0	270	3.0+T
0964	skeletal pinning with external fixation	40.0	270	3.0+T
0966	Metatarsal, simple, no reduction	Sv. ¶
0967	closed reduction	10.0	90	3.0+T
0968	compound with uncomplicated soft tissue closure	15.0	90	3.0+T
0970	simple or compound, open reduction	25.0	90	3.0+T
0975	Phalanx or phalanges, great toe, simple, no reduction	Sv. ¶
0976	simple, closed reduction	5.0	60	3.0+T
0977	simple or compound, open reduction	15.0	60	3.0+T
0979	other than great toe, simple, no reduction	Sv. ¶
0981	closed reduction	5.0	60	3.0+T
0982	simple or compound, open reduction	12.5	60	3.0+T
Joints
Incision
ARTHROTOMY or capsulotomy with exploration, drainage, or removal of loose body, e.g., osteochondritis or foreign body.
1001	Shoulder	50.0	90	3.0+T
1002	Elbow	50.0	60	3.0+T
1003	Wrist	40.0	60	3.0+T
1005	Other joints of upper extremity	30.0	60	3.0+T
1006	Finger, one	15.0	60	3.0+T
1007	Hip	70.0	90	3.0+T
1008	Knee	50.0	90	3.0+T
(For meniscectomy, see 1082.)
1010	Ankle	50.0	90	3.0+T
1013	Other joints of lower extremity	30.0	90	3.0+T
1020	Toe great toe	15.0	60	3.0+T
1026	other	10.0	60	3.0+T
*1044	Arthrocentesis; puncture for aspiration of hemarthrosis, initial	*3.0	0	3.0+T
*1045	subsequent	*2.0	0	3.0+T
*1046	puncture for aspiration of joint effusion (not traumatic), or injection of medication, initial or subsequent	*2.0	0	3.0+T
1050	Sesamoid bone, excision, one or more, unilateral	15.0	60	3.0+T
Excision
ARTHRECTOMY-Excision of joint (See also Arthrodesis.)
1065	Temporomandibular Joint, unilateral	75.0	90	5.0+T
1074	Excision of intervertebral disc	90.0	90	7.0+T
(See also 5208-5211.)
(With spinal fusion, see 0639-0642.)
(For laminectomy for spondylolisthesis, see 5225.)
1082	Menisectomy: excision of semilunar cartilage of knee joint	50.0	90	3.0+T
1085	temporomandibular joint	75.0	90	5.0+T
1093	Synovectomy elbow	70.0	120	3.0+T
1101	hip	80.0	120	4.0+T
1102	knee	70.0	120	3.0+T
1103	ankle	50.0	120	3.0+T
Introduction
*1131	Injection procedure for arthrography	*3.0	0	3.0+T
Repair
ARTHROPLASTY-Plastic or reconstructive operation on Joint, any type unless otherwise specified.
1141	Shoulder (See also 1200, 1201.)	80.0	120	3.0+T
1142	Elbow	80.0	120	3.0+T
1143	Wrist	80.0	120	3.0+T
1144	Finger, one joint	30.0	90	3.0+T
1148	Hip, cup	100.0	270	5.0+T
1149	replacement prosthesis, primary for fracture	80.0	270	5.0+T
1150	secondary reconstruction	100.0	270	5.0+T
(For acetabuloplasty, either 1148 or 1150, add 25% to listed values.)
1151	Knee	100.0	270	3.0+T
1152	Ankle	75.0	180	3.0+T
1154	Toe, one joint	20.0	60	3.0+T
1159	Metatarsal-phalangeal joint; bunion operation, Silver type	20.0	60	3.0+T
1160	Keller, McBride, etc., types	30.0	120	3.0+T
1162	Joplin type	35.0	150	3.0+T
1163	Club foot corrective procedure, medial release, Brockman type	30.0	120	3.0+T
ARTHRODESIS- Fusion of joint (For spine see 0634-0645.)
1166	Shoulder	90.0	150	3.0+T
1167	Elbow	70.0	150	3.0+T
1168	Wrist	60.0	120	3.0+T
1170	Finger, thumb, one joint	20.0	120	3.0+T
1175	Hip	100.0	365	5.0+T
1176	Knee	80.0	180	3.0+T
1177	Ankle	70.0	180	3.0+T
1178	Toe, one or more joints	15.0	120	3.0+T
1179	Hammer toe operation, one toe (e.g., inter-phalangeal fusion, filleting, phalangectomy)	20.0	120	3.0+T
(More than one toe, see section 533.5(b)(6)(i).)
1183	Tarsal joints, one or more (e.g. Grice procedure)	50.0	120	3.0+T
1184	Other joints, lower extremity	40.0	120	3.0+T
1185	Foot, triple arthrodesis, unilateral under age 14 years	50.0	180	3.0+T
1186	over age 14 years	60.0	180	3.0+T
(With tendon transplantation see 1585, 1586, and see section 533.5(b)(6)(i).)
Suture
CAPSULORRAPHY OR RECONSTRUCTION
1200	Shoulder, suture or repair of joint capsule for recurrent dislocation (independent procedure), Putti-Platt, Mag-nusen types	70.0	90	3.0+T
1201	Bankart type	80.0	90	3.0+T
1206	Patella (See also 0561, 1352, 1632.)	60.0	120	3.0+T
1211	Knee, suture of a torn, ruptured or severed collateral ligament	55.0	120	3.0+T
1212	suture of a torn, ruptured, or severed cruciate ligament	55.0	120	3.0+T
1213	suture of torn, ruptured or severed collateral and cruciate ligaments	75.0	180	3.0+T
1214	reconstruction of a collateral or cruiate ligament	65.0	180	3.0+T
1215	both collateral or cruciate ligaments	85.0	180	3.0+T
1216	Ankle, reconstruction of a collateral ligament, ankle	45.0	180	3.0+T
1217	both ligaments	60.0	180	3.0+T
1218	Hand, reconstruction, metacarpophalangeal or interphalangeal ligaments	35.0	90	3.0+T
Manipulation
Manipulation of joint under general anesthesia, including application of fixation apparatus (dislocation excluded).
(For club feet and turnbuckle casts, see section on casts.)
*1221	Shoulder	*5.0	0	3.0+T
*1222	Elbow	*4.0	0	3.0+T
*1223	Wrist	*4.0	0	3.0+T
*1224	Digits, one or more, under anesthesia, where no other surgical procedure is performed	*2.5	0	3.0+T
*1226	Hip	*6.0	0	3.0+T
*1227	Knee	*5.0	0	3.0+T
*1228	Ankle	*4.0	0	3.0+T
*1232	Spine	6.0	0	3.0+T
Dislocations
*1251	Temporomandibular, simple closed reduction, initial	*5.0	0	3.0+T
*1252	subsequent	*1.0	0
1255	Vertebra, cervical, simple, closed reduction, using traction	Sv. ¶
1256	closed reduction with anesthesia	55.0	180	3.0+T
1262	thoracic, simple, closed reduction with anesthesia....	55.0	180	3.0+T
1264	simple or compound, open reduction	100.0	180	6.0+T
1267	lumbar, simple, closed reduction with anesthesia	55.0	180	3.0+T
1270	simple or compound, open reduction	100.0	180	6.0+T
1273	Clavicle, sternoclavicular, simple, no reduction	Sv. ¶
1274	closed reduction with anesthesia	10.0	45	3.0+T
1275	simple or compound, open reduction	40.0	120	3.0+T
1278	acromioclavicular, simple, no reduction	Sv. ¶
1279	closed reduction with anesthesia	10.0	45	3.0+T
1281	simple or compound, open reduction	40.0	120	3.0+T
1284	Shoulder (humerus), simple, closed reduction, without anesthesia	Sv. ¶
*1285	with anesthesia	*5.0	0	3.0+T
1286	simple or compound, open reduction	55.0	120	3.0+T
*1290	Elbow, simple, closed reduction	*5.0	0	3.0+T
1291	compound with uncomplicated soft tissue closure	25.0	120	3.0+T
1292	simple or compound, open reduction	55.0	120	3.0+T
*1295	Wrist, carpal, one bone, simple, closed reduction	*5.0	0	3.0+T
1296	compound, with uncomplicated soft tissue closure	25.0	120	3.0+T
1297	simple or compound, open reduction	45.0	120	3.0+T
*1298	more than one bone, simple, closed reduction	*7.0	0	3.0+T
1300	compound, with uncomplicated soft tissue closure	25.0	120	3.0+T
1301	simple or compound. open reduction	45.0	120	3.0+T
*1304	Metacarpal, one bone, simple, closed reduction	*3.0	0	3.0+T
1305	compound with uncomplicated soft tissue closure	10.0	90	3.0+T
1306	simple or compound, open reduction	20.0	90	3.0+T
*1315	Finger, one, one or more joints, simple, closed reduction	*3.0	0	3.0+T
1316	compound, with uncomplicated soft tissue closure	7.5	75	3.0+T
1317	simple or compound. open reduction	15.0	75	3.0+T
*1326	Thumb, simple, closed reduction	*4.0	0	3.0+T
1327	compound with uncomplicated soft tissue closure	10.0	75	3.0+T
1328	simple or compound, open reduction	20.0	75	3.0+T
1332	Hip (femur), simple, closed reduction	20.0	180	3.0+T
1334	simple or compound. open reduction	60.0	180	5.0+T
1338	congenital, abduction splinting or traction in any form	Sv. ¶
1339	congenital, closed reduction with anesthesia	20.0	45	3.0+T
1340	congenital, open reduction and replacement of fe-moral head in acetabulum	60.0	180	4.0+T
1341	iliac or acetabular osteotomy, (e.g., Pemberton or Salter type), under age 8	80.0	180	4.0+T
1342	over age 8	100.0	180	5.0+T
(For dislocated or slipped femoral head epiphyses, see 0877-0879.)
1344	Knee (femoral-tibial joint), simple, closed reduction	20.0	90	3.0+T
1345	compound with uncomplicated soft tissue closure	25.0	120	3.0+T
1346	simple or compound, open reduction	60.0	120	3.0+T
*1350	Patella, simple, closed reduction	*3.0	0
1351	compound with uncomplicated soft tissue closure	15.0	120	3.0+T
1352	simple or compound, open reduction (with or without partial or total patellectomy)	50.0	120	3.0+T
(See also 0561, 1206 and 1632.)
1354	Distal tibial-fibular joint (ankle mortise), open reduction and fixation	45.0	90	3.0+T
1355	Ankle, simple, closed reduction	10.0	90	3.0+T
1356	compound, with uncomplicated soft tissue closure	25.0	90	3.0+T
1357	simple or compound, open reduction	50.0	90	3.0+T
1361	Tarsal, simple, closed reduction	10.0	90	3.0+T
1362	compound, with uncomplicated soft tissue closure	17.5	90	3.0+T
1363	simple or compound, open reduction	45.0	120	3.0+T
1371	Astragalo-tarsal, simple, closed reduction	10.0	90	3.0+T
1372	compound with uncomplicated soft tissue closure	17.5	180	3.0+T
1373	simple or compound, open reduction	45.0	180	3.0+T
1376	Metatarsal, one bone, simple, closed reduction	7.0	45	3.0+T
1377	compound with uncomplicated soft tissue closure	12.0	60	3.0+T
1378	simple or compound, open reduction	25.0	60	3.0+T
*1385	Toe, one, simple, closed reduction	*2.0	0
1386	compound with uncomplicated soft tissue closure	7.0	15	3.0+T
1387	simple or compound, open reduction	15.0	45	3.0+T
1391	multiple joints and/or toes, simple, closed reduction	7.0	30	3.0+T
1392	compound with uncomplicated soft tissue closure	12.0	45	3.0+T
1393	simple or compound, open reduction	20.0	45	3.0+T
Bursae
Incision
*1401	Drainage of infected bursa	*3.0	0	3.0+T
1406	Removal of subdeltoid calcium deposits	25.0	60	3.0+T
1410	Removal of subtrochanteric calcium deposits	30.0	60	3.0+T
*1413	Needle puncture of bursa, with or without aspiration, injection or irrigation, initial or subsequent	*2.0	0
Excision
1430	Radical excision of bursa, hand, wrist or forearm, (i.e., tenosynovitis fungosa, Tbc., and other granulomas)	50.0	60	3.0+T
1431	Excision of bursa, olecranon	20.0	60	3.0+T
1433	prepatellar	20.0	60	3.0+T
1435	subacromial (subdeltoid)	25.0	90	3.0+T
1436	peritrochanteric, femur	30.0	90	3.0+T
(For popliteal see 1562.)
Muscles
Incision
1450	Removal of foreign body in muscle, with anesthesia	by report
1454	Division of scalenus anticus, without resection of cervical rib	35.0	60	3.0+T
1456	with resection of cervical rib	50.0	60	5.0+T
1458	Division of sternocleidomastoid for torticollis, open operation	35.0	60	3.0+T
1460	Muscle biopsy, superficial	5.0	15	3.0+T
1462	deep	10.0	15	3.0+T
Suture
1495	Suture of ruptured diaphragm, chronic, transabdominal	70.0	60	5.0+T
1496	transthoracic or combined	80.0	60	11.0+T
1497	acute, traumatic	by report	60	13.0+T
(For other specific muscles, see 1683, 1640, 1654.)
Tendons, Tendon Sheaths and Fascia
Incision
*1511	Drainage of tendon sheath, acute suppurative tenosynovitis, one digit	*3.0	0	3.0+T
1514	single palmar and/or ulnar or radial bursa	30.0	60	3.0+T
1515	multiple or complicated	by report	60	3.0+T
*1517	Injection of medication, tendon sheath	*2.0	0
1519	Incision of fibrous sheath of tendon for stenosing tenosynovitis, including freeing of tendons or removal of foreign body	20.0	30	3.0+T
1531	Division of iliotibial band, open operation	30.0	45	3.0+T
1534	Stripping of ilium (Soutter operation)	40.0	90	3.0+T
Tenotomy
*1535	Tenotomy, subcutaneous, corrective, single digit	*5.0	0	3.0+T
*1536	multiple digits	*7.5	0	3.0+T
1537	adductor, hip	10.0	15	3.0+T
1538	open, elbow to shoulder, single	20.0	30	3.0+T
1539	multiple	25.0	30	3.0+T
1540	elbow to wrist, single	15.0	30	3.0+T
1541	multiple	25.0	30	3.0+T
1542	knee to hip, single	30.0	45	3.0+T
1543	multiple	40.0	45	3.0+T
1544	knee to thigh, single	15.0	45	3.0+T
1545	multiple	30.0	45	3.0+T
Exclusion
1550	Excision of lesion of tendon or fibrous sheath, or ganglion, digits only	10.0	30	3.0+T
1553	in other locations	15.0	30	3.0+T
(For radical excision of bursa, forearm, i.e., tenosynovitis fungosa, Tbc., and other granuiomas, see 1430.)
1562	Excision of synovial cyst of popliteal space (Baker's cyst)	30.0	60	5.0+T
1570	Fasciotomy, palmar or plantar, subcutaneous	10.0	60	3.0+T
1573	Fasciectomy, for Dupuytren's contracture, partial	30.0	60	3.0+T
1574	radical, including finger extensions and vertical bands	50.0	90	3.0+T
Repair
Includes necessary initial dressing (including cast and/or splint application).
(For multiple structures unless otherwise specified see 1593 or section 533.5(a)(6)(i).)
1580	Repair or suture of an extensor tendon, primary or late, hand or foot, distal to wrist or ankle	12.0	60	3.0+T
1582	forearm or leg	18.0	60	3.0+T
1583	Repair or suture of a flexor tendon, primary or late, finger, hand or forearm, foot or leg	30.0	120	3.0+T
1585	Transfer, transplant or free tendon graft, distal to elbow, or distal to knee, single	40.0	120	3.0+T
1586	multiple	50.0	120	3.0+T
1587	elbow to shoulder or knee to hip, single	50.0	120	3.0+T
1588	multiple	60.0	120	3.0+T
1589	Tenolysis, single	25.0	60	3.0+T
1590	multiple (any number through same incision)	30.0	60	3.0+T
1591	Lengthening or shortening of tendon, (e.g. Achilles' tendon)	30.0	60	3.0+T
(Retrieve or reroute tendon through separate incision, add 25 percent of appropriate fee.)
1593	Multiple tendons and/or other structures through same incision or wound	by report	3.0+T
1612	Free fascial graft for reconstruction of tendon pulley or gliding surface, etc	15.0	90	3.0+T
1616	Abdominal fascial transplants, bilateral (Lowman type procedure)	75.0	90	3.0+T
(For free fascial graft to face see 0340.)
1618	Fascia lata transplants, other	by report	3.0+T
1632	Patellar (extensor mechanism) advancement, with or without patellectomy	60.0	90	3.0+T
1633	Rutured quadriceps insertion	45.0	90	3.0+T
1635	Ruptured Achilles tendon from insertion at heel	45.0	120	3.0+T
1639	Ruptured long head of biceps, proximal	35.0	90	3.0+T
1640	Ruptured biceps tendon from insertion at elbow	45.0	90	3.0+T
1641	Flexor-plasty, elbow (e.g. (e.g. Steindler type advancement or extensor release)	30.0	90	3.0+T
1654	Repair ruptured supraspinatus tendon or musculotendinous cuff shoulder, acute	50.0	120	3.0+T
1655	Repair of complete shoulder cuff avulsion, chronic	70.0	150	3.0+T
EXTREMITIES
Incision
*1681	Drainage of felon, superficial	*2.0	0	3.0+T
*1682	in hospital	*5.0	0	3.0+T
(For drainage of single or multiple infected spaces of hand, lumbrical, hypothenar, thenar, middle palmar, etc. with or without tendon sheath involvement, see 1514, 1515.)
Amputation
UPPER EXTREMITIY:
1701	Interthoracoscapular	100.0	90	11.0+T
1703	Disarticulation of shoulder	75.0	90	5.0+T
1705	Arm through humerus	40.0	90	3.0+T
1708	Forearm, through radius and ulna	40.0	90	3.0+T
1709	Open (Guillotine) arm	35.0	90	3.0+T
*1710	secondary closure or minor scar revision	*5.0	0	3.0+T
1711	re-amputation	40.0	90	3.0+T
1713	Cineplasty, complete procedure	75.0	150	3.0+T
1718	Disarticulation through wrist or amputation of hand through metacarpal bones	40.0	90	3.0+T
1725	Metacarpal, with finger or thumb, one, with or without split or Wolff graft, or skin-plasty and/or tenodesis, with or without resection of digital nerves	30.0	60	3.0+T
1737	Digit (finger or thumb), any joint or phalanx, one, with or without split or Wolff graft, or skin-plasty and/or tenodesis, with or without resection of digital nerves	15.0	45	3.0+T
LOWER EXTREMITY:
1745	Interpelviabdominal	by report	11.0+T
1748	Disarticulation of hip	80.0	180	8.0+T
1750	Disarticulation of knee	40.0	120	3.0+T
1752	Thigh, through femur, including supracondylar	60.0	120	3.0+T
1760	open (Guillotine)	50.0	180	3.0+T
*1761	secondary closure or minor revision	*5.0	0	3.0+T
1763	reamputation	60.0	120	3.0+T
1767	Leg, through tibia and fibula	50.0	90	3.0+T
1771	open (Guillotine)	40.0	120	3.0+T
*1772	secondary closure or minor revision	*5.0	0	3.0+T
1774	reamputation	50.0	90	3.0+T
1778	Ankle (Syme, Pirogoff types), with skin-plasty and resection of nerves	50.0	90	3.0+T
1782	Midtarsal	35.0	90	3.0+T
1785	Foot, transmetatarsal	35.0	90	3.0+T
1788	Metatarsal with toe, with or without split or Wolff graft, or skin-plasty and/or tenodesis, with or without resection of digital nerves	25.0	90	3.0+T
1802	Toe, one, with or without split or Wolff graft, or skin-plasty and/or tenodesis, with or without resection of digital nerves	10.0	45	3.0+T
1803	more than one	15.0	60	3.0+T
Repair
1811	Freeing of web fingers, with flaps	35.0	60	3.0+T
1815	with skin graft	45.0	60	3.0+T
1816	complex	by report
Plaster Casts (Independent Procedure Only)
(Excluding Cost of Materials)
1840	Club-foot cast with molding or manipulation, long or short leg, under age of 24 months, single	2.0	2	3.0+T
1841	bilateral	3.5	2	3.0+T
(If over age 24 months, see casts, general.)
1842	Wedging club-foot cast single	1.0	2	3.0+T
1843	bilateral	1.5	2	3.0+T
(For children 10 years of age or under, reduce listed values 1851-1890 by 30%.)
1851	Molded plaster to forearm (splint)	2.0	2	3.0+T
1854	Elbow to fingers (short arm)	2.0	2	3.0+T
1856	Hand and wrist (gauntlet)	2.0	2	3.0+T
1860	Shoulder to hand (full arm)	3.0	2	3.0+T
1862	Shoulder spica	6.0	2	3.0+T
1863	Thigh-foot, molded splint	3.0	2	3.0+T
1864	Leg-foot, molded splint	2.0	2	3.0+T
1865	Ankle (foot to midleg) (short leg)	3.0	2	3.0+T
1867	Knee (foot to thigh) (long leg)	4.0	2	3.0+T
1871	Ambulatory leg cast (walking boot cast)	3.5	2	3.0+T
1878	Hip spica, unilateral	7.0	2	3.0+T
1882	bilateral	8.0	2	3.0+T
1884	Body, sboulder to hips	8.0	2	3.0+T
1885	including head	10.0	2	3.0+T
1886	Risser jacket, localizer, body only	12.5	2	3.0+T
1887	including head	15.0	2	3.0+T
1888	Turnbuckle jacket, body only, for scoliosis	12.5	2	3.0+T
1889	including head	15.0	2	3.0+T
1890	"alo"type fixation and cast	20.0	2	3.0+T
1891	Unna boot	2.0	2
1892	Wedging cast, any age (except 1842-1843)	1.0	3.0+T
1894	Windowing a cast	1.0	3.0+T
1895	Removal or bivalving of cast applied by another physician small, (e.g., gauntlet, boot, body, full arm)	1.5
1896	large, (e.g., long leg, shoulder or hip spica, Minerva, Calot jacket, turnbuckle, etc.)	2.0
1897	Repair of spica, body cast or jacket	3.0
(For change of cast, unit value will be that of application only.)
RESPIRATORY SYSTEM
Nose
Incision
*1901	Drainage of nasal abscess or hematoma	*2.0	0	3.0+T
*1905	Drainage of septal abscess or hematoma	*2.5	0	3.0+T
Excision
1911	Biopsy, soft tissue, nose	3.0	7	3.0+T
1916	Excision of nasal polyp(s) one or more, unilateral or bilateral, one or more stages, office	7.0	15	3.0+T
1917	complicated, requiring hospitalization	20.0	30	3.0+T
(For excision of nasopharyngeal fibroma, see 3005.)
1924	Excision or surgical planing of skin of nose for rhinophyma	35.0	60	3.0+T
1928	Submucous resection, classic, nasal septum	30.0	90	3.0+T
(For septoplasty, see 1952.)
1935	Resection of inferior turbinate (submucous) complete or partial, unilateral or bilateral (independent procedure)	15.0	90	3.0+T
Endoscopy
*1941	Removal of intranasal foreign body by rhinoscopy	*2.0	0	3.0+T
1942	by lateral rhinotomy	by report	3.0+T
Repair
(See also Repair-Complex 0260-0324, and 0620, 0621.)
1950	Rhinoplasty, lateral and alar cartilages and/or elevation of nasal tip	40.0	180	3.0+T
1951	complete, external parts including bony pyramid, lateral and alar cartilages, and/or elevation of nasal tip	80.0	180	3.0+T
1952	including major septal repair	90.0	180	3.0+T
1953	secondary minor revision	15.0	45	3.0+T
(For total or major partial reconstruction, see 0260-0324, 0620, 0621.)
(For nasal bridge collapse, bone or cartilage graft, see 0620, 0621.)
1954	Septoplasty, (not 1928) independent procedure	40.0	90	3.0+T
1959	Repair, choanal atresia, intranasal	10.0	60	3.0+T
1960	transpalatine	60.0	365	3.0+T
*1961	Lysis of synechia	*2.0	0	3.0+T
1962	Repair of oromaxillary fistula	by report	3.0+T
1963	with radical antrotomy	50.0	90	3.0+T
1964	Repair oronasal fistula	20.0	30	3.0+T
1965	Reconstruction, functional, of the internal nose	40.0	90	3.0+T
Destruction
*1966	Cauterization of turbinates, unilateral or bilateral (independent procedure)	*2.0	0
Manipulation
(For reduction of fracture, see 0685-0690.)
*1971	Nasal hemorrhage, anterior, control of, unilateral or bilateral, with or without cauterization or anterior packs	*2.0	0
*1973	posterior, with cauterization or posterior nasal packs, with or without anterior pack, initial	*10.0	0	3.0+T
*1974	subsequent	*2.0	0	3.0+T
1978	by ligation of anterior ethmoidal artery	30.0	30	3.0+T
ACCESSORY SINUSES
Incision
*1981	Antrum lavage, puncture or natural ostium, unilateral	*2.0	0	3.0+T
*1982	bilateral	*3.0	0	3.0+T
1983	Antroscopy	*4.0	0	3.0+T
1985	Antrotomy, intranasal, unilateral	15.0	90	3.0+T
1986	bilateral	25.0	90	3.0+T
1988	Radical (Caldwell-Luc), unilateral	50.0	90	3.0+T
1989	bilateral	65.0	90	3.0+T
1991	Sphenoid sinusotomy	30.0	90	3.0+T
1992	Frontal sinusotomy, external, simple (trephine operation)	20.0	30	3.0+T
1993	transorbital, unilateral	40.0	180	3.0+T
1994	radical, obliterative	60.0	180	3.0+T
1995	Combined external frontal, ethmoidal and sphenoidal sinusotomy, unilateral	80.0	180	3.0+T
Excision
2006	Ethmoidectomy, intranasal or external, unilateral	30.0	90	3.0+T
2017	Maxillectomy, unilateral, with or without orbital exenteration and/or lateral rhinotomy	100.0	365	3.0+T
2019	Hypophysectomy, transeptal	70.0	90	4.0+T
(See also 5130.)
LARYNX
Incision
2041	Laryngofissure with removal of tumor or laryngocele	60.0	365	6.0+T
2042	Thyrotomy, diagnostic	35.0	60	6.0+T
2043	for laryngeal web, two stage, with Keel insertion, (McNaught type)	90.0	365	6.0+T
2044	for laryngeal stenosis with graft or core mold, including tracheotomy	by report	6.0+T
Excision
2051	Laryngectomy, without neck dissection	100.0	365	6.0+T
2054	with neck dissection	140.0	365	6.0+T
2055	Hemilaryngectomy	60.0	365	6.0+T
2056	Arytenoidectomy, external approach (See also 2084.)	70.0	180	6.0+T
2057	Epiglottidectomy, external approach	60.0	365	6.0+T
2058	endoral approach	25.0	90	4.0+T
Introduction
*2060	Injection procedure for bronchography, indirect method	*3.0	0	4.0+T
*2061	with insertion of catheter, (independent procedure)	*4.0	0	4.0+T
*2062	Endotracheal intubation, emergency procedure	*5.0	0
Endoscopy
2070	Laryngoscopy, indirect with biopsy	4.0	7
2071	direct, diagnostic (independent procedure)	10.0	30	4.0+T
2072	operative, including foreign body removal	30.0	30	4.0+T
2073	with biopsy	15.0	30	4.0+T
2074	including excision of tumor	25.0	180	4.0+T
2075	with Lynch suspension	30.0	180	4.0+T
2084	Endoscopic arytenoidectomy	50.0	180	4.0+T
TRACHEA AND BRONCHI
Incision
2101	Tracheotomy (independent procedure)	20.0	15	4.0+T
2102	Tracheal fenestration	50.0	180	4.0+T
Endoscopy
2111	Bronchoscopy, diagnostic	15.0	30	4.0+T
2113	with biopsy	20.0	30	4.0+T
2117	with removal of foreign body	25.0	30	4.0+T
2120	with excision of tumor	25.0	30	4.0+T
2121	with therapeutic aspiration of bronchus	15.0	30	4.0+T
2122	with drainage of lung abscess or cavity, initial	15.0	30	4.0+T
2123	with injection of contrast media	15.0	30	4.0+T
2124	subsequent	10.0	30	4.0+T
2126	Catheterization for bronchospirometry (independent procedure) (exclusive of gas analysis) (See also 9201- 9206.)	10.0	30	4.0+T
2127	Tracheal aspiration (independent procedure) under direct vision	10.0	30	4.0+T
*2128	indirect	*1.0	0
Repair
2131	Tracheoplasty: plastic operation on trachea. cervical	by report	6.0+T
2132	intrathoracic	by report	11.0+T
2133	Bronchoplasty, graft repair	by report	11.0+T
2134	excision of stenosis and anastomosis	by report	11.0+T
2135	with lobectomy and anastomosis	by report	11.0+T
Suture
2141	Tracheorrhaphy: suture of external tracheal wound or injury, depending on structure and extent of injury, cervial	by report	5.0+T
2142	intrathoracic	by report	11.0+T
2144	Closure of tracheostomy or tracheal fistula	25.0	30	4.0+T
2147	Closure of traeheo-esophageal fistula	90.0	90	11.0+T
2148	complicated	by report	90	11.0+T
Incision
2151	Thoracotomy, exploratory, including biopsy	50.0	90	11.0+T
2152	including control of hemorrhage and/or repair of lung fistula	75.0	90	11.0+T
2153	for post-operative complications	75.0	90	11.0+T
2154	with open drainage of empyema cavity by rib resection (independent procedure)	40.0	90	11.0+T
2155	with cyst removal	75.0	90	11.0+T
*2157	with closed drainage of empyema cavity; tube drainage with negative pressure (independent procedure), in hospital	*5.0	0	3.0+T
2160	with removal of intra-pleural foreign body or fibrin body	70.0	90	11.0+T
2161	with cardiac massage	by report	12.0+T
2163	with open intrapleural pneumonolysis (See also 2207.)	75.0	90	11.0+T
2170	Pneumonotomy, with open drainage of pulmonary abscess or cyst	60.0	120	11.0+T
2173	with removal of foreign body from lung	75.0	90	11.0+T
2177	Decortication, pulmonary, total	100.0	90	11.0+T
*2180	Pneumonocentesis: puncture of lung for aspiration biopsy	*5.0	0
*2183	Thoracentesis: puncture of pleural cavity for aspiration, initial or subsequent	*3.0	0
Excision
2191	Pneumonectomy, total	100.0	90	11.0+T
2193	Lobectomy, total, subtotal or segmental	100.0	90	11.0+T
2194	with concomitant decortication	125.0	90	11.0+T
2195	Wedge resection, single or multiple	80.0	90	11.0+T
2196	Pulmonary resection with concomitant thoracoplasty	150.0	180	11.0+T
2197	Pleurectomy, any type (independent procedure)	50.0	90	11.0+T
Endoscopy
2201	Thoracoscopy, exploratory (independent procedure)	20.0	30	4.0+T
2204	with biopsy	20.0	30	4.0+T
2207	Closed intrapleural pneumonolysis	30.0	30	4.0+T
Surgical Collapse Therapy
Thoracoplasty
2211	Extrapleural resection of ribs, any type, first stage	60.0	90	6.0+T
2212	second stage	30.0	90	5.0+T
2213	third stage	30.0	90	5.0+T
2217	Extrapleural pneumonolysis, including associated filling or packing procedures	60.0	90	6.0+T
2218	Extraperiosteal pneumonolysis, including associated filling or packing procedures	70.0	90	6.0+T
*2221	Pneumothorax: intrapleural injection of air, initial	*5.0	0
*2222	subsequent	*2.0	0
CARDIOVASCULAR SYSTEM
Heart and Pericardium
Values for principal surgeon only. For monitoring, operation of pump and other nonsurgical services, see 9195, 9196, etc.
Incision
2301	Cardiotomy, exploratory (includes removal of foreign body)	100.0	90	15.0+T
2305	Periocardiotomy with exploration, drainage or removal of foreign body	100.0	90	13.0+T
*2309	Pericardiocentesis, initial	*5.0	0
*2310	subsequent	*4.0	0
2311	Blalock-Hanlon procedure (creation of atrial-septal defect) (closed)	150.0	90	15.0+T
Excision
2316	Pericardiectomy, extensive	120.0	90	15.0+T
2317	Excision intracardiac tumor	200.0	90	15.0+T
2319	Infundibular stenosis	by report	15.0+T
Introduction
Listed values include usual preassessment of clinical problem and recording of intracardiac pressures. (For consultation services, see 9028-9031.)
2330	Catheterization of heart, including recording of intracardiac pressures where indicated (independent procedure) right	35.0	7
2331	left, percutaneous	15.0	7
2332	trans-septal	20.0	7
2333	retrograde	20.0	7
2334	combined left and right	45.0	7
2335	final evaluation and report only	5.0
(For injection procedures see radiology.)
Suture
2337	Cardiorrhaphy: suture of heart wound or injury	100.0	90	15.0+T
Repair
2340	Aortic valve, valvotomy (commissurotomy (closed)	150.0	90	15.0+T
2341	valvuloplasty for stenosis or insufficiency (open)	200.0	90	15.0+T
2342	replacement (open)	200.0	90	15.0+T
2343	Pulmonic valve, valvotomy (commissurotomy) (closed)	150.0	90	15.0+T
2344	valvotomy; infundibular stenosis (open)	200.0	90	15.0+T
2345	Mitral valve, valvotomy (commissurotomy) (closed)	140.0	90	15.0+T
2346	valvuloplasty for stenosis or insufficiency (open)	200.0	90	15.0+T
2347	replacement (open)	200.0	90	15.0+T
2348	Tricuspid valve	by report	90	15.0+T
2349	Coronary endarterectomy, myocardial revascularization by implantation or anastomosis	100.0	90	15.0+T
2350	Myocardial aneurysm	200.0	90	15.0+T
2351	Atrial septal defect (secundum type; endocardial cushion defect) (open)	180.0	90	15.0+T
2352	Ventricular septal defect (open)	180.0	90	15.0+T
2353	Tetralogy of Fallot (with or without previous shunt) (open)	200.0	90	15.0+T
2354	Aortic sinus of Valsalva fistula (open)	200.0	90	15.0+T
2355	Repair anomalous pulmonary venous connection, total (open)	200.0	90	15.0+T
2356	Insert internal pacemaker with myocardial electrodes, initial	100.0	90	15.0T
2357	replacement or repair	30.0	30	3.0+T
2358	Pervenous or transvenous insertion of a pacemaker and subcutaneous implantation of a battery	50.0	30	3.0+T
2359	Subcutaneous implantation of a battery (used with code 2330, right heart catheterization, currently in fee schedule)	18.75	7	3.0+T
Arteries and Veins
Incision
ARTERIOTOMY-With removal of embolus:
2373	Trunk	80.0	60	6.0+T
2374	Neck	60.0	60	6.0+T
2375	Extremity	60.0	60	5.0+T
PHLEBOTOMY-With removal of thrombus:
2380	Trunk	70.0	60	5.0+T
2381	Extremity	45.0	60	4.0+T
Excision
2390	Thromboendarterectomy, abdominal aorta and iliac arteries and/or femoral arteries	150.0	90	13.0+T
2392	femoral and/or popliteal arteries	120.0	90	5.0+T
2394	carotid artery	120.0	90	6.0+T
2400	Excision and graft or bypass graft of arch of aorta	by report	90	15.0+T
2404	Excision and graft, thoracic aorta	150.0	90	15.0+T
2408	abdominal aorta	150.0	90	13.0+T
2412	extremity	120.0	90	5.0+T
2420	Excision of arteriovenous fistula (See also 2474.)	by report
Introduction
(For injection procedures see radiology.)
2441	Venopuncture, withdrawal of venous blood, intravenous injection (femoral, internal or external juglar or sagittal sinus) for diagnostic study or introduction of intravenous therapy, up to three years of age	2.0
2442	scalp vein, for fluid therapy or indirect transfusion, up to three year of age	3.0
2443	Exposure of and incision into vein ("utdown" for fluid therapy or indirect transfusion, under one year of age	4.0
2444	over one year of age	3.0
2445	Blood transfusion, indirect method	2.0	0
2446	replacement type, infant, initial or subsequent	30.0	15
2448	direct method	5.0	7
2450	"ush"transfusion, given under two years of age	5.0	0
*2454	Injection of sclerosing solution into vein of leg, one	*1.0	0
*2455	two or more injections, same leg	*2.0	0
Repair
2460	Repair aneurysm of aorta, lateral repair	150.0	90	13.0+T
2464	dissecting ("indow"operation)	150.0	90	13.0+T
2466	Banding of pulmonary artery	100.0	90	13.0+T
2472	Repair of aortic arch anomalies (vascular ring)	120.0	90	15.0+T
2473	Repair of atrial septal defect	200.0	90	15.0+T
2474	Repair arterio-venous fistula, plastic procedure	by report
2475	Excision of corarctation of aorta with primary anastomosis (See also 2400-2408.)	150.0	90	15.0+T
(For aortic anastomosis, see also 2400-2408, 2472.)
2478	Pulmonary-subclavian anastomosis, Potts	150.0	90	15.0+T
2482	Blalock	120.0	90	15.0+T
2486	Pulmonary-superiorcaval anastomosis, Glenn	150.0	90	15.0+T
2487	Baffes procedure: inferior cava to left atrium-right pulmonary vein to right antrium	150.0	90	15.0+T
2490	Portocaval anastomosis	100.0	90	9.0+T
2496	Splenorenal anastomosis	100.0	90	9.0+T
Suture
Abdominal
2511	Arteriorrhaphy: suture of wound or injury of artery	6.0+T
(independent procedure), trunk	or Thoracic
60.0	60	12.0+T
2512	extremity	60.0	60	4.0+T
Abdominal
2515	Phleborrhaphy: suture of wound or injury of vein	4.0+T
(independent procedure), trunk	or Thoracic
60.0	60	12.0+T
2516	extremity,	60.0	60	4.0+T
2520	Ligation and division of ductus arteriosus	100.0	90	13.0+T
2522	Ligation of carotid artery	40.00	30	4.0+T
2525	Ligation and division of inferior vena cava	60.0	90	5.0+T
2526	Ligation of femoral vein	25.0	30	3.0+T
2530	Ligation and division of common iliac vein	50.0	90	3.0+T
2558	Ligation and division of long saphenous vein at saph-enofemoral junction, with or without retrograde injection or distal interruptions	20.0	30	3.0+T
2561	Ligation and division and complete stripping of long or short saphenous veins, unilateral	30.0	30	3.0+T
2562	bilateral	50.0	30	3.0+T
2563	long and short saphanous veins, unilateral	40.0	30	3.0+T
2565	bilateral	60.0	30	3.0+T
2576	Ligation and division of short saphenous vein at saphenopopliteal junction (independent procedure)	12.5	30	3.0+T
2581	minor varicose vein of leg, initial	5.0	15
2585	subsequent	3.0	15
HEMODIALYSIS-RELATED SURGICAL PROCEDURES
2590	Insertion of initial arteriovenous shunt (Including revisions during 21 follow-up days)	50.0	21	by report
2591	Revision of either arterial or venous cannula	31.25	21	by report
2592	Construction of arterio-venous fistula	50.0	21	by report
HEMIC AND LYMPHATIC SYSTEMS
Spleen
Excision
2601	Splenectomy	60.0	45	6.0+T
Introduction
2610	Injection procedure for splenoportography	10.0	7	3.0+T
Lymph Nodes and Lymphatic Channels
Incision
*2631	Drainage of lymph node abscess or lymphadenitis, simple	*3.0	0
2632	extensive	by report	3.0+T
Excision
2641	Biopsy or excision of lymph node (independent procedure) (except 2642)	5.0	30	3.0+T
2642	anterior scalene	15.0	30	3.0+T
RADICAL LYMPHADENECTOMY
(Radical resection of lymph nodes):
2651	Supra-hyoid, unilateral	50.0	60	4.0+T
2652	bilateral	60.0	60	4.0+T
2655	Cervical (complete), unilateral	80.0	60	4.0+T
2658	Axilla	50.0	60	3.0+T
2671	Groin, superficial	50.0	60	3.0+T
2672	deep, with common iliac dissection	80.0	60	3.0+T
2673	Retroperitoneal, extensive, including pelvic, aortic and renal dissection	100.0	90	5.0+T
Introduction
2676	Injection procedure for lymphangiography, unilateral	10.0	14
2677	bilateral	15.0	14
MEDIASTINUM
Incision
2680	Mediastinotomy with exploration or drainage, cervical approach	40.0	90	12.0+T
2681	transthoracic	80.0	90	12.0+T
2683	Foreign body removal, cervical approach	70.0	90	12.0+T
2684	transthoracic	80.0	90	12.0+T
Excision
2691	Excision of mediastinal cyst	80.0	90	12.0+T
2693	Excision of mediastinal tumor	100.0	90	12.0+T
2696	Ligation or repair, thoracic duct	75.0	90	12.0+T
DIGESTIVE SYSTEM
Mouth
Incision
*2701	Drainage of sublingual abscess	*2.0	0	3.0+T
2705	Drainage of Ludwig's angina	8.0	7	4.0+T
LIPS
Excision
(For excision of mucocele see 0175-0178 or 0260-0269.)
(For excision of small lesion of lip see 0175-0178 or 0260-0269.)
2737	Vermilionectomy ("ip peel"	40.0	120	3.0+T
2739	Transverse wedge excision, lip	25.0	120	3.0+T
2743	V-excision of large lesion of lip up to one-half lip	25.0	120	3.0+T
2746	Resection of more than one-half lip without plastic closure	25.0	120	3.0+T
(With plastic closure, primary or secondary see 0260-0324.)
Repair (Cheiloplasty)
2754	Plastic repair of cleft lip, primary, unilateral	70.0	90	6.0+T
2758	bilateral, one stage	90.0	90	6.0+T
2759	bilateral, two stages, per stage	60.0	90	6.0+T
(For secondary, local revision, unilateral or bilateral see 0260-03234.)
2762	Plastic repair (secondary) of unilateral cleft lip by recreation of defect and reclosure	70.0	90	6.0+T
2765	Plastic repair (secondary) of bilateral harelip by recreation of defect and reclosure-per major stage	60.0	90	6.0+T
(For plastic or reconstruction operation on lip see also 0260-0324.)
TONGUE
Incision (Glossotomy)
*2771	Drainage of lingual abscess	*2.0	0	3.0+T
Excision (Glossectomy)
2781	Biopsy of tongue, anterior third	3.0	30	3.0+T
2782	posterior two-thirds	5.0	30	3.0+T
2785	Partial glossectomy or hemiglossectomy	40.0	120	6.0+T
2787	Complete or total glossectomy	70.0	120	6.0+T
Repair (Glossoplasty)
(For plastic repair of tongue see 0260-0324.)
Suture (Glossorrhaphy)
(For suture of injury see 0251, 0260-0270.)
TEETH AND GUMS
Incision
*2815	Drainage of alveolar abscess, acute with cellulitus, intraoral	*2.0	0	3.0+T
2820a	General anesthesia for multiple extractions in hospital	3.0+T
PALATE AND UVULA
Incision
*2871	Incision and drainage of abscess of palate	*2.0	0	3.0+T
Excision
2881	Biopsy of palate	3.0	30	3.0+T
(For excision of local lesion of palate see 0175-0196, 0260-0270.)
(For graft or flap closure see 0275-0283, 0300-0304.)
2885	Resection of palate or extensive excision of lesion of palate	40.0	90	6.0+T
(For resection of palate with reconstruction see 0277- 0283, 0312-0323.)
2887	Uvulectomy: excision of uvula	3.0	30	3.0+T
Repair
2890	Palatoplasty: plastic operation for cleft palate, partial	60.0	90	6.0+T
2890	complete, including alveolar ridge	80.0	90	6.0+T
2895	major revision	60.0	90	6.0+T
2897	secondary lengthening procedure	70.0	90	6.0+T
2898	attachment pharyngeal flap	60.0	90	6.0+T
2899	alveolar ridge, anterior palate defect	30.0	90	6.0+T
(For secondary minor revision see 0260-0270, 0277-0283.)
Suture
(For suture of palate injury see 0260-0270, 0277-0283.)
Salivary Glands and Ducts
Incision
*2911	Drainage of parotid abscess	*5.0	0	3.0+T
*2912	Drainage of submaxillary abscess	*5.0	0	3.0+T
*2914	Sialolithotomy, submaxillary or parotid, uncomplicated	*3.0	0	3.0+T
2915	Sialolithotomy, submaxillary, complicated	10.0	30	3.0+T
2916	Sialolithotomy, parotid, extraoral	25.0	30	3.0+T
Excision
2921	Biopsy of salivary gland	5.0	30	3.0+T
2927	Excision of parotid tumor or gland, superficial, without nerve dissection	20.0	60	3.0+T
2928	with nerve dissection	60.0	60	3.0+T
2934	Excision of parotid gland, total, with dissection of facial nerve	70.0	60	3.0+T
2937	with sacrifice of facial nerve	60.0	60	3.0+T
2938	Excision of submaxillary tumor and/or gland	40.0	60	3.0+T
Repair (Slalodochoplasty)
2941	Plastic repair of salivary duct, simple	35.0	60	3.0+T
2942	complicated	by report	3.0+T
Introduction
*2945	Injection procedure for sialography	*1.0	0	3.0+T
Suture
2951	Closure of salivary fistula	40.0	60	3.0+T

Unit or Dollar Value	Follow-up Days	Anes.§
Manipulation
*2961	Dilation of salivary duct; ptyalectasis	*1.0	0
Pharynx, Adenoids and Tonsils
Incision
*2970	Drainage of peritonsillar abscess	*3.0	0	4.0+T
2971	Drainage of retropharyngeal or parapharyngeal abscess, intraoral	10.0	15	4.0+T
2973	external approach	by report	4.0+T
Excision
2981	Biopsy of oropharynx	3.0	15	3.0+T
2982	hypopharynx	5.0	15	3.0+T
2983	nasopharynx	5.0	15	3.0+T
(For larynx, see 2070 or 2073.)
2984	Excision of pharyngoesophageal diverticulum, single stage	50.0	60	3.0+T
2985	multiple stages	60.0	60	4.0+T
2989	Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues	15.0	30	3.0+T
2990	extending beneath subcutaneous tissues	50.0	30	3.0+T
2992	Tonsillectomy, with or without adenoidectomy, under age 18 years	15.0	30	3.0+T
2993	18 years or over	20.0	30	3.0+T
2994	Adenoidectomy (independent procedure), primary or secondary	10.0	30	3.0+T
3000	Excision of tonsil tag(s), hospital	10.0	30	3.0+T
3002	office	6.0	30	3.0+T
3004	Excision of lingual tonsil (independent procedure)	10.0	30	3.0+T
3005	Excision of nasopharyngeal fibroma	by report	3.0+T
Suture
3006	Suture of wound or injury of pharynx	by report	3.0+T
Repair
3011	Pharyngoplasty: plastic or reconstructive operation on pharynx	by report	4.0+T
(For pharyngeal flap, see 2898.)
Esophagus
Incision
3031	Esophagotomy, cervical	60.0	90	6.0+T
3032	for removal of foreign body, cervical	60.0	90	6.0+T
3033	thoracic	80.0	90	12.0+T
Excision
3043	Esophagectomy: resection of esophagus, transpleural or extrapleural (upper two-thirds)	120.0	90	12.0+T
3045	Esophagogastrectomy, combined thoraco-abdominal	120.0	90	12.0+T
3046	Local excision, end-to-end anastomosis	90.0	90	12.0+T
Endoscopy
3051	Esophagoscopy, diagnostic	15.0	15	4.0+T
3053	with insertion of radioactive substance	20.0	30	4.0+T
3055	with biopsy	20.0	15	4.0+T
3057	with foreign body removal	25.0	15	4.0+T
3061	with dilation, direct	20.0	15	4.0+T
3063	subsequent dilation	15.0	15	4.0+T
(See also 3092, 3095.)
Repair
3071	Esophagoplasty: plastic repair or reconstruction of esophagus	by report	12.0+T
3072	Esophagogastrostomy (cardioplasty)	80.0	90	12.0+T
3073	Esophagomyotomy (Heller type)	80.0	90	12.0+T
3074	Esophagoduodenostomy (including total gastrectomy)	100.0	90	11.0+T
3075	Esophagojejunostomy, including total gastrectomy	100.0	90	11.0+T
3076	Esophagostomy; fistulization of esophagus, external	60.0	90	6.0+T
Suture
3077	Direct ligation of esophageal varices	80.0	90	12.0+T
3081	Suture of esophageal wound, injury or rupture, cervical approach	by report	7.0+T
3083	transthoracic	70.0	90	12.0+T
3086	Closure of esophagostomy or other external esophageal fistula, cervical	45.0	90	7.0+T
3087	thoracic	70.0	90	12.0+T
Manipulation
*3092	Dilation of esophagus by sound, bougie or bag, indirect, initial	*5.0	0
*3095	subsequent	*3.0	0
(For direct see 3061 and 3063.)
STOMACH
Incision
3101	Gastrotomy with exploration or foreign body removal	50.0	45	5.0+T
3105	Pyloromyotomy: cutting of pyloric muscle (Fredet-Ramstedt type operation)	50.0	45	6.0+T
Excision
3111	Biopsy by laparotomy	50.0	45	5.0+T
3112	Local excision of ulcer or tumor	60.0	45	5.0+T
3114	Total gastrectomy	100.0	90	6.0+T
3115	Subtotal or hemi-gastrectomy, without vagotomy	80.0	60	6.0+T
3116	with vagotomy	90.0	60	6.0+T
3117	Vagotomy and pyloroplasty	70.0	60	6.0+T
(See also 3131.)
Endoscopy (independent procedure)
3121	Gastroscopy, diagnostic	15.0	7	4.0+T
3123	with biopsy	15.0	7	4.0+T
Suture
3131	Pyloroplasty	50.0	45	5.0+T
3133	Gastroduodenostomy	60.0	45	5.0+T
3135	Gastrojejunostomy	60.0	45	5.0+T
3136	with vagotomy	75.0	45	6.0+T
3137	Gastrostomy	40.0	45	5.0+T
3141	Gastrorrhaphy: suture of perforated duodeal or gutric ulcer, wound or injury	50.0	45	6.0+T
3144	Revision of gastroduodenal anastomosis (gastroduodenostomy) with reconstruction without vagotomy	90.0	60	6.0+T
3145	with vagotomy	100.0	60	6.0+T
3146	Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, without vagatomy	90.0	60	6.0+T
3147	with vagotomy	100.0	60	6.0+T
3153	Closure of gastrostomy, surgical	40.0	45	5.0+T
INTESTINES (EXCEPT RECTUM)
Incision
3161	Enterotomy with exploration or foreign body removal, small bowel	60.0	60	4.0+T
3162	large bowel	65.0	60	4.0+T
3166	Exteriorization of intestine (Mikulicz resection of colon, with or without crushing of spur)	70.0	60	4.0+T
Excision
3171	Excision of one or more lesions of small or large bowel not requiring anastomosis, exteriorization or fistulization, single enterotomy	60.0	60	4.0+T
3172	multiple enterotomies	70.0	60	4.0+T
3174	Enterectomy: resection of small intestine with anastomosis	70.0	60	4.0+T
3176	with enterostomy	70.0	60	4.0+T
3178	Colectomy, partial resection of large intestine in two stages, including first stage colostomy or cecostomy	100.0	90	5.0+T
3179	Colectomy, partial, with anastomosis, with or without concomitant proximal colostomy	80.0	90	5.0+T
3180	total, with ileostomy or ilioproctostomy	110.0	90	6.0+T
3181	with proctectomy and ileostomy	120.0	90	6.0+T
3191	Enteroenterostomy; anastomosis of intestine	60.0	90	5.0+T
ENTEROSTOMY-External fistulization of intestines (independent procedure):
3193	small bowel (ileostomy or jejunostomy)	50.0	90	4.0+T
3195	large bowel (colostomy or cecostomy)	50.0	90	4.0+T
3197	small or large bowel, for ulcerative colitis	75.0	90	6.0+T
3200	Reduction of volvulus, intussusception, internal hernia, by laparotomy	60.0	90	5.0+T
3203	Revision of colostomy, simple, (release of superficial scar)	5.0	90
3204	complicated (reconstruction in depth)	25.0	60	4.0+T
Destruction
3211	Enterolysis (freeing of intestinal adhesion)	40.0	45	4.0+T
3212	with acute bowel obstruction	60.0	45	5.0+T
3213	Intestinal plication (Noble type)	60.0	90	4.0+T
Suture
3220	Suture of intestine (enterorrhaphy), large or small, for perforated ulcer, wound, injury or rupture, single	60.0	45	5.0+T
3221	multiple	by report	6.0+T
3222	Suture of intestine with colostomy	70.0	90	5.0+T
3225	Closure of enterostomy large or small intestine	40.0	90	5.0+T
3227	Closure of fecal fistula	by report	5.0+T
Meckel's Diverticulum and the Mesentery
Excision
3231	Excision of Meckel's diverticulum (diverticulectomy)	50.0	45	4.0+T
3235	Excision of lesion of mesentery	50.0	45	4.0+T
(With bowel resection, see 3174.)
Suture
3241	Suture of mesentery	40.0	45	4.0+T
Appendix
Incision
3251	Incision and drainage of appendicular abscess, trans-abdominal	30.0	45	4.0+T
Excision
3261	Appendectomy	40.0	45	4.0+T
Rectum
Incision
3282	Transrectal drainage of pelvic abscess	15.0	15	3.0+T
3283	Incision and drainage of deep supralevator, pelvirectal or retrorectal abscess	20.0	30	3.0+T
(See also 3357, 3358.)
Excision
3291	Complete proctectomy, combined abdomino-perineal, one or two stages	100.0	90	6.0+T
3292	Complete proctectomy for congenital megacolon (Swenson type procedure)	100.0	90	7.0+T
3294	Excision of rectal procidentia, with anastomosis, perineal approach	60.0	90	4.0+T
3295	abdominal and perineal approach	100.0	90	6.0+T
3296	Division of stricture in rectum	20.0	90	4.0+T
3298	Perineal excision of primary or recurrent malignant tumor (Kraske type)	80.0	90	4.0+T
3299	Local excision of extensive villous papilloma of rectum	40.0	90	4.0+T
Endoscopy (Independent procedure)
3310	Proctosigmoidoscopy, diagnostic, initial	3.0	15	3.0+T
3311	subsequent	2.0	15	3.0+T
3312	with biopsy, initial	5.0	15	3.0+T
3313	subsequent for same lesion	3.0	15	3.0+T
3314	with removal of papilloma or polyp, initial	7.0	15	3.0+T
3315	subsequent for same lesion	5.0	15	3.0+T
3316	with removal of multiple papillomas or polyps	9.0	15	3.0+T
3317	complicated	by report	3.0+T
3318	Endoscopic control of hemorrhage	by report	3.0+T
3319	Endoscopic removal of foreign body, anus or rectum	by report	3.0+T
Repair
3320	Proctoplasty, for stenosis	40.0	90	3.0+T
3321	for prolapse of mucous membrane	40.0	90	3.0+T
3322	Perirectal injection of sclerosing solution for prolapse, in hospital	10.0	30
3323	Proctopexy for prolapse, abdominal approach	60.0	90	5.0+T
3325	Proctopexy combined with sigmoid resection, abdominal approach	90.0	90	5.0+T
Suture
3331	Closure of rectovesical fistula	60.0	90	5.0+T
(See also 3965.)
3333	Closure of rectourethral fistula	70.0	90	5.0+T
(See also 4026.)
3335	Closure of rectovaginal fistula	60.0	90	5.0+T
(When a colostomy is part of the above procedures, add 10 units.)
Manipulation
*3341	Reduction of procidentia (independent procedure)	*2.0	0
Anus
Incision
3351	Fistulotomy or fistulectomy, subcutaneous	10.0	30	3.0+T
3352	submuscular	40.0	90	3.0+T
3353	complex or multiple	by report	3.0+T
3354	second stage	10.0	60	3.0+T
3355	Remove seton, office	2.0	15
3356	Incision and drainage of ischiorectal abscess (independent procedure)	10.0	15	3.0+T
*3357	Incision and drainage, perianal abscess (See also 3283.)	*2.0	0	3.0+T
3358	Incision and drainage of ischiorectal abscess with fistulotomy or fistulectomy, submuscular (See also 3283.)	40.0	90	3.0+T
*3364	Sphincterotomy, anal: division of anal sphincter (indedependent procedure)	*5.0	0	3.0+T
Excision
3371	Fissurectomy, with or without sphincterotomy	20.0	90	3.0+T
3372	Cryptectomy, single, office	5.0	30
3373	multiple, hospital procedure	30.0	90	3.0+T
3374	Papillectomy or excision of single tab (independent procedure), office	3.0	15
3375	Excision of external hemorrhoidal tags and/or multiple papillae, office	5.0	15
3377	Hemorrhoidectomy, external, complete	20.0	90	3.0+T
3380	internal and external	30.0	90	3.0+T
3381	radical (Buie or amputative type)	40.0	90	3.0+T
3382	Fistulotomy or fistulectomy, submuscular, and hemorrhoidectomy	40.0	90	3.0+T
3386	Fissurectomy and hemorrhoidectomy	30.0	90	3.0+T
*3392	Enucleation or excision of external thrombotic hemorrhoid	*3.0	0	3.0+T
Introduction
*3401	Hemorrhoids, injection of sclerosing solution	*2.0	0	3.0+T
Endoscopy (independent procedure)
*3411	Anoscopy, diagnostic with or without biopsy	*1.0	0
(For with removal of foreign body, see 3319.)
(For control of hemorrhage, endoscopic, see 3318.)
Repair
3420	Anoplasty: plastic operation for stricture	40.0	90	5.0+T
3421	infant, minor thin septum	5.0	30	3.0+T
3422	Construction of anus for congenital absence, perineal approach	50.0	90	5.0+T
3423	combined abdominal and perineal approach	80.0	90	7.0+T
3425	Sphincteroplasty, anal, for incontinence	40.0	90	4.0+T
3426	muscle transplant	by report	4.0+T
3427	Theiersch procedure for incontinence and/or prolapse	25.0	30	4.0+T
Destruction
3433	Condyloma, single or multiple, internal and external, in hospital	20.0	30	3.0+T
*3434	external, electrodesiccation, initial	*3.0	0
*3435	subsequent	*2.0	0
LIVER
Incision
*3456	Aspiration biopsy of liver	*5.0	0	3.0+T
Excision
3464	Hepatectomy, partial: resection of liver	80.0	45	9.0+T
Repair
3471	Marsupialization of cyst or abscess of liver	70.0	60	6.0+T
Suture
3481	Hepatorrhaphy: suture of liver wound or injury	60.0	45	9.0+T
BILIARY TRACT
Incision
3491	Hepaticotomy or hepaticostomy with exploration, drainage or removal of calculus	70.0	45	6.0+T
3495	Choledochotomy or choledochostomy with exploration, drainage or removal of calculus, with or without cholecystotomy	70.0	45	6.0+T
3500	Duodenocholedochotomy: transduodenal choledocholithomy	80.0	60	6.0+T
3501	Transduodenal spincterotomy	80.0	60	6.0+T
3504	Cholecystotomy or cholecystostomy with exploration, drainage or removal of calculus	50.0	45	5.0+T
Introduction
3509	Injection procedure for percutaneous trans-hepatic cholangiography (independent procedure)	10.0	7	3.0+T
Excision
3515	Cholecystectomy	60.0	45	5.0+T
3517	with open exploration of common duct	70.0	45	5.0+T
Repair
3518	Exploration for congenital atresia of bile ducts	50.0	60	7.0+T
3519	Direct anastomosis of gallbladder and gastrointestinal tract	60.0	60	5.0+T
3520	Roux-en-y anastomosis of gallbladder and gastro-intestinal tract	65.0	60	5.0+T
3521	Direct anastomosis of extrahepatic biliary ducts and gastrointestinal tract	75.0	90	5.0+T
3522	Roux-en-y anastomosis of extrahepatic biliary ducts and gastrointestinal tract	85.0	90	5.0+T
3523	Plastic reconstruction of extrahepatic biliary ducts with end-to-end anastomosis	80.0	90	5.0+T
PANCREAS
Incision
3541	Abdominal drainage of pancreatitis	50.0	60	6.0+T
3544	Removal of calculus	70.0	60	6.0+T
Excision
3550	Pancreatectomy, subtotal	80.0	90	6.0+T
3551	subtotal (Whipple type)	140.0	90	6.0+T
3552	total	140.0	90	6.0+T
3553	Pancreatico-jejunostomy	80.0	90	6.0+T
Repair
3565	Marsupialization of cyst of pancreas	60.0	60	6.0+T
3566	Internal direct anastomosis of cyst to gastrointestinal tract	70.0	60	6.0+T
3567	Roux-en-y internal anastomosis, cyst to gastro-intestinal tract	80.0	60	6.0+T
ABDOMEN, PERITONEUM AND OMENTUM
Incision
3571	Exploratory laparotomy: exploratory celiotomy	40.0	45	4.0+T
3573	Drainage of peritoneal abscess or localized peritonitis exclusive of appendicular abscess	40.0	45	4.0+T
3575	Subdiaphragmatic or subphrenic abscess	50.0	45	5.0+T
3578	Retroperitoneal abscess	40.0	45	5.0+T
*3588	Peritoneocentesis: abdominal paracentesis, initial	*4.0	0
*3590	subsequent	*3.0	0
Excision
3591	Trans-peritoneal excision of intra-abdominal or retroperitoneal tumors or cysts	70.0	60	5.0+T
Endoscopy
3595	Peritoneoscopy	15.0	15
Introduction
*3611	Pneumoperitoneum: intraperitoneal injection of air, initial	*4.0	0
*3612	subsequent	*2.0	0
*3614	Injection procedure for retroperitoneal pneumography, unilateral or bilateral (independent procedure)	*5.0
*3615	Injection procedure for pelvic pneumography (independent procedure)	*4.0
(See also 4462.)
Repair
Hernioplasty, Herniorrhaphy, Herniotomy:
(For bilateral herniorrhaphy see Rule 11.)
3631	Inguinal, unilateral	35.0	45	3.0+T
3633	with orchiectomy	40.0	45	3.0+T
3634	with excision of hydrocele	40.0	45	3.0+T
3635	recurrent	40.0	45	3.0+T
3646	Femoral, unilateral	35.0	45	3.0+T
3651	recurrent	45.0	45	3.0+T
3661	Ventral, incisional	45.0	45	3.0+T
3662	recurrent	50.0	45	3.0+T
3663	Epigastric	35.0	45	3.0+T
3664	recurrent	45.0	45	3.0+T
3665	Umbilical, under age five years	30.0	45	3.0+T
3666	over age five years	35.0	45	3.0+T
3667	Omphalocele, in newborn, one stage	40.0	60	6.0+T
3668	Gross type procedure, first stage	50.0	60	6.0+T
3669	second stage	50.0	60	6.0+T
(For diaphragmatic hernia, see 1495, 1496.)
Suture
3734	Secondary suture of abdominal wall for evisceration or disruption	20.0	30	4.0+T
(For suture of ruptured diaphragm, see 1495, 1496.)
URINARY SYSTEM
Kidney
Incision
3802	Drainage of perirenal abscess (independent procedure)	50.0	90	5.0+T
3808	Nephrotomy with drainage; nephrostomy	80.0	90	5.0+T
3811	Nephrolithotomy, removal of calculus	80.0	90	5.0+T
3812	large (staghorn) calculus	90.0	90	5.0+T
3813	Division or transection of aberrant renal vessels (indedependent procedure)	70.0	90	5.0+T
Pyelotomy with exploration	70.0	90	5.0+T
3816	Pyelotomy with drainage, pyelostomy	70.0	90	5.0+T
3817	Pyelotomy with removal of calculus; pyelolithotomy; pelviolithotomy	70.0	90	5.0+T
Excision
*3820	Renal biopsy, trochar or needle	*5.0	0
3821	Nephrectomy, including partial ureterectomy	80.0	90	5.0+T
3822	with total ureterectomy through same or separate incision	100.0	90	5.0+T
3824	Heminephrectomy	100.0	90	5.0+T
3827	Excision of cyst of kidney	70.0	90	5.0+T
*3829	Aspiration or injection of renal cyst or renal pelvis	*5.0	0
Introduction
(For perirenal insufflation, unilateral or bilateral, see 3614.)
Repair
3831	Pycloplasty: plastic operation on renal pelvis with or without plastic operation on ureter or nephropexy	80.0	90	5.0+T
3835	Nephropexy: fixation or suspension of kidney (independent procedure)	70.0	90	5.0+T
Suture
3841	Nephrorrhaphy: suture of kidney wound or injury	80.0	90	8.0+T
3845	Closure of nephrostomy, pyelostomy or other renal fistula (e.g., renocolic fistula)	80.0	90	5.0+T
3846	Symphysiotomy for horseshoe kidney	100.0	90	6.0+T
Transplant
3850	Kidney transplant	125.0	90	5.0+T
URETER
Incision
3851	Ureterotomy with exploration or drainage (independent procedure)	70.0	90	5.0+T
3857	Ureterolithotomy, upper three quarters of ureter	70.0	90	5.0+T
3858	lower one quarter	80.0	90	5.0+T
Excision
3861	Ureterectomy, with bladder cuff (independent procedure)	80.0	90	5.0+T
Repair
3871	Ureteroplasty: plastic operation on ureter (stricture)	80.0	90	5.0+T
3872	Ureterolysis, with or without repositioning of ureter, unilateral	70.0	90	5.0+T
3873	bilateral	90.0	90	5.0+T
3874	Ureteropyclostomy: anastomosis of ureter and renal pelvis	80.0	90	5.0+T
3875	Ureteroureterostomy	80.0	90	5.0+T
3876	Ureteroneocystostomy: anastomosis of ureter to bladder, unilateral	80.0	90	5.0+T
3877	bilateral	100.0	90	5.0+T
3880	Ureteroenterostomy: anastomosis of ureter to intestine, unilateral	80.0	90	5.0+T
3881	bilateral	100.0	90	5.0+T
3884	Ureterostomy: transplantation of ureter to skin, unilateral	70.0	90	5.0+T
3885	bilateral	90.0	90	5.0+T
Suture
3891	Ureterorrhaphy: suture of ureter (independent procedure)	80.0	90	5.0+T
3895	Closure of fistula of ureter	by report	5.0+T
BLADDER
Incision
*3900	Aspiration of bladder by needle or trochar	*5.0	0
3902	with insertion of suprapubic catheter	10.0	30
3904	Cystotomy or cystostomy with fulguration	60.0	90	5.0+T
3906	Cystotomy with drainage; cystostomy	50.0	90	5.0+T
3907	Cystotomy with removal of calculus (cystolithotomy) without vesical neck resection	50.0	90	5.0+T
3908	Drainage of perivesical or prevesical space abscess	50.0	90	5.0+T
Excision
3911	Cystectomy, partial	70.0	90	6.0+T
3912	with re-implantation of ureter into bladder (ureteroneocystostomy)	80.0	90	6.0+T
3913	complete	100.0	90	6.0+T
3914	radical with ureteral transplants	120.0	180	7.0+T
3915	with ureteral-ileo conduit	140.0	180	7.0+T
3918	Transurethral resection, vesical neck, female or child (See also 4321.)	50.0	90	4.0+T
3919	Cystotomy for excision of vesical neck (independent procedure)	60.0	90	5.0+T
3920	Excision of bladder diverticulum (independent procedure)	70.0	90	5.0+T
3922	Excision of bladder tumor (See also 3904.)	60.0	90	5.0+T
3924	Transurethral resection of bladder tumors, large (For small tumors, see 3936, 3937.)	60.0	90	5.0+T
Introduction
*3926	Bladder irrigation, simple, lavage and/or instillation	*1.0	0
*3927	Injection procedure for cystography or urethro-cystography	*1.0	0
CYSTOSCOPY (independent procedure):
3930	Diagnostic, office, initial	5.0	7
3931	subsequent within 30 days	3.0	7
3932	with ureteral catheterization	8.0	7
3933	hospital	8.0	7	3.0+T
3934	with ureteral catheterization	15.0	7	3.0+T
(For Howard or Stamey type renal function test see 3948.)
3935	With biopsy	10.0	7
3936	With fulguration or treatment of minor (less than 0.5 cm.) lesion, with or without biopsy	10.0	7
3937	With fulguration of small bladder tumors (0.5 cm. to 2 cm.) (For larger tumors, see 3924.)	25.0	30	3.0+T
3938	With subsequent fulguration of bladder tumor	10.0	7	3.0+T
3939	With insertion of radioactive substance, with or without biopsy or fulguration	30.0	30	3.0+T
3940	With dilation of bladder, for interstitial cystitis, general anesthesia	15.0	30	3.0+T
3942	With ureteral meatotomy	20.0	30	3.0+T
3943	With resection or fulguration of ureterocele	20.0	30	3.0+T
3944	With removal of foreign body from urethra or bladder	20.0	30	3.0+T
3945	With removal of calculus from ureter	30.0	30	3.0+T
3946	With manipulation of ureteral calculus, primary	20.0	7	3.0+T
3947	subsequent	10.0	7	3.0+T
3948	Differential quantitative and chemical renal function test (e.g., Howard or Stamey type), see 3932 or 3934, and add detention time beyond that required for usual catheterization, see 9071.
Destruction
3951	Litholapaxy: crushing of calculus in bladder and removal of fragments	50.0	90	3.0+T
Repair
3952	Cystoplasty: plastic operation on bladder (anterior Y-plasty, vesical fundus resection, etc.) any procedure	80.0	90	5.0+T
Suture
3961	Cystorrhaphy: suture of bladder wound, injury or rupture	60.0	90	6.0+T
3963	Closure of cystostomy (independent procedure)	30.0	90	3.0+T
3965	Closure of vesicovaginal, vesicouterine, or vesicoenteric fistula (See also 3331.)	60.0	90	5.0+T
Urethra
Incision
3971	Urethotomy, external (independent procedure) anterior	10.0	15	3.0+T
3973	perineal, external	25.0	15	3.0+T
3977	Meatotomy: cutting of meatus (independent procedure)	3.0	7	3.0+T
3978	Drainage of deep periurethral abscess, hospital	10.0	30	3.0+T
3979	Drainage of simple perineal urinary extravasation (independent procedure), uncomplicated	15.0	15	3.0+T
3980	complicated, with or without diversion of urinary stream	50.0	60	5.0+T
(See also 3908.)
Excision
(For excision or fulguration of urethral caruncle, see 4437.)
3987	Excision or fulguration of carcinoma of urethra	by report	3.0+T
3991	Excision of diverticulum of urethra (independent procedure)	50.0	60	3.0+T
3994	Excision or fulguration of urethral polyps, distal 3/4 inch of urethra	5.0	15	3.0+T
(For posterior urethra, see 4006.)
Endoscopy
4000	Urethroscopy, diagnostic	5.0	15	3.0+T
4001	with removal of calculus or foreign body	20.0	45	3.0+T
4004	with internal urethrotomy	20.0	45	3.0+T
4006	with fulguration of posterior urethra	10.0	15	3.0+T
4008	subsequent, within 30 days	5.0	15	3.0+T
Repair
4011	Urethroplasty: plastic operation on urethra (except 4132 and 4135)	by report	3.0+T
Suture
4021	Urethrorrhaphy: suture of urethral wound or injury	by report	4.0+T
4023	Closure of urethrostomy or fistual of urethra (independent procedure)	30.0	60	4.0+T
4025	Closure of urethrovaginal fistula	50.0	60	4.0+T
4026	Closure of urethrorectal fistula (See also 3333.)	70.0	90	5.0+T
Manipulation
*4031	Dilation of urethral stricture by passage of sound, initial, male	*3.0	0
*4032	subsequent within 30 days	*1.5	0
*4033	Dilation of urethral stricture by passage of filiform and follower, male	*5.0	0
*4034	subsequent within 30 days	*2.5	0
*4035	Passage of filiform and follower for acute vesical retention, male	*5.0	0
*4036	Dilation of female urethra including suppository and/or installation	*2.0	0
*4037	subsequent within 30 days	*1.0	0
MALE GENITAL SYSTEM
PENIS
Incision
*4101	Dorsal or lateral "slit"of prepuce (independent procedure)	*3.0	0
Excision
4111	Biopsy of penis (independent procedure)	3.0	15
4114	Amputation of penis, partial	40.0	60	3.0+T
4115	complete	60.0	60	3.0+T
4116	radical	100.0	90	4.0+T
(For local excision of lesion of penis, see Integumentary System.)
4122	Circumcision, clamp procedure, newborn	3.0	15
4123	except newborn	5.0	15	3.0+T
4124	surgical excision other than clamp or dorsal slit, any age (except newborn)	10.0	30	3.0+T
(For excision or fulguration of warts, see 0403, 0405.)
Repair
4131	Plastic operation on penis for hypospadias, straightening of chordee	30.0	30	3.0+T
(For urethroplasty for hypospadias, see 0260 to 0324.)
4134	Plastic operation on penis for injury	by report	4.0+T
4135	Plastic operation on penis for epispadias with extrophy of bladder	by report	4.0+T
4136	Plastic operation for penile epispadias distal to external sphincter	50.0	30	4.0+T
TESTIS
Excision
4140	Biopsy, needle (independent procedure)	2.0	15
4141	incisional (independent procedure)	10.0	15	3.0+T
4143	Orchiectomy, simple unilateral	20.0	30	3.0+T
4144	bilateral	30.0	30	3.0+T
4145	with superficial inguinal node dissection, unilateral	50.0	90	3.0+T
(For radical retroperitoneal node dissection, see 2673.)
Repair
4152	Reduction of torsion of testis by surgical means	30.0	30	3.0+T
4153	with fixation of contralateral testis	45.0	30	3.0+T
4154	Fixation of contralateral testis (independent procedure)	20.0	30	3.0+T
4156	Orchiopexy, any type, with or without hernia repair	50.0	60	3.0+T
4157	second stage (Torek type)	10.0	30	3.0+T
(For orchiectomy with repair of hernia, see 3633.)
EPIDIDYMIS
Incision
*4161	Drainage of abscess of epididymis	*3.0	0	3.0+T
Excision
4171	Biopsy of epididymis, needle	2.0	15	3.0+T
4172	Exploration of epididymis with or without biopsy	10.0	30	3.0+T
4174	Excision of spermatocele with or without epididymectomy	30.0	90	3.0+T
4176	Epididymectomy, unilateral	30.0	90	3.0+T
Repair
4181	Epididymovasostomy (anastomosis of epididymis to vas deferens), unilateral	40.0	90	3.0+T
4182	bilateral	50.0	90	3.0+T
TUNICA VAGINALIS
Incision
*4191	Puncture aspiration of hydrocele with or without injection of medication	*2.0	0
4200	Repair of hydrocele (Bottle type)	20.0	90	3.0+T
4201	Excision of hydrocele, unilateral	30.0	90	3.0+T
4202	with hernia repair	40.0	45	3.0+T
SCROTUM
Incision
*4211	Drainage of scrotal abscess	*2.0	0	3.0+T
4215	Removal of foreign body in scrotum	by report	3.0+T
Excision
(For local excision of lesion of skin of scrotum, see 0175-0197, 0260-0270.)
4224	Resection of scrotum	by report	3.0+T
4227	Scrotoplasty; plastic operation on scrotum	by report	3.0+T
Vas Deferens
Incision
4231	Vasotomy: incision or transection of vas, unilateral or bilateral (independent procedure)	15.0	30	3.0+T
Excision
4241	Vasectomy, unilateral or bilateral (independent procedure)	15.0	30	3.0+T
Repair
4251	Vasovasostomy, unilateral	30.0	30	3.0+T
4252	bilateral	40.0	30	3.0+T
Suture
4261	Ligation (percutaneous) of vas deferens (independent procedure)	5.0	30	3.0+T
Spermatic Cord
Excision
4271	Excision of hydrocele of spermatic cord (independent procedure), unilateral	30.0	90	3.0+T
4275	Excision of varicocele (independent procedure), unilateral	30.0	45	3.0+T
4278	with hernia repair	40.0	45	3.0+T
Seminal Vesicles
Incision
4281	Vesiculotomy, unilateral	by report
Excision
4291	Vesiculectomy	80.0	90	3.0+T
Prostate
Incision
4300	Biopsy, prostate, needle, single or multiple	5.0	15
4301	incisional, perineal approach	30.0	30	4.0+T
4302	transrectal	20.0	30	3.0+T
4303	Prostatotomy: external drainage of prostatic abscess	30.0	60	4.0+T
4304	Prostatolithotomy: removal of prostatic calculus (independent procedure)	70.0	60	4.0+T
Excision
4311	Prostatectomy, perineal, subtotal	80.0	90	6.0+T
4313	radical	100.0	90	6.0+T
4316	suprapubic, one or two stages	80.0	90	5.0+T
4318	retropubic	80.0	90	5.0+T
4319	radical	100.0	90	6.0+T
Endoscopy
4321	Transurethral resection of prostate, including control of postoperative bleeding, complete (See also 3918.)	80.0	90	5.0+T
FEMALE GENITAL SYSTEM Vulva and Introitus
Incision
4403	Incision and drainage, abscess of vulva	5.0	15	3.0+T
4405	Incision and drainage of Bartholin's gland abscess, unilateral	5.0	15	3.0+T
Excision
4421	Biopsy of vulva (independent procedure)	3.0	15	3.0+T
(For local excision or fulgration of lesion(s) of external genitalia, see 0175-0197, 0260-0324, 0401-0406.)
4423	Vulvectomy, complete, bilateral	55.0	60	3.0+T
4424	partial, less than 80% of vulvar area	40.0	60	3.0+T
4425	radical, including unilateral regional lymph nodes	100.0	90	5.0+T
4426	including bilateral regional lymph nodes	150.0	90	5.0+T
4428	Clitoridotomy: circumcision, female	7.5	30	3.0+T
4429	Clitoridectomy	10.0	30	3.0+T
4431	Hymenectomy, partial excision of hymen	10.0	30	3.0+T
4433	Excision of Bartholin's gland or cyst	20.0	30	3.0+T
4434	Marsupialization or cautery destruction of Bartholin's gland or cyst	15.0	30	3.0+T
4436	Excision or fulguration of Skene's glands	7.0	30	3.0+T
4437	Excision or fulguration of unrethral caruncle	7.0	30	3.0+T
(For excision of unrethral diverticulum see 3991.)
(For excision or fulguration of unrethal carcinoma see 3987.)
Repair
4441	Episioplasty: plastic repair of vulva (non obstetrical)	20.0	30	3.0+T
4443	Plastic operation on unrethral sphincter, vaginal approach	30.0	60	3.0+T
4445	Plastic repair of urethra for mucosal prolapse (independent procedure)	by report	60	3.0+T
4447	Plastic repair of unrethocele (independent procedure)..	30.0	60	3.0+T
Suture
(For episiorrhaphy or episiperineorrhapy: for recent injury of vulva and/or perineum (nonobstetrical), see 4480.)
Vagina
Incision
4461	Colpotomy with exploration or drainage of pelvic abscess	15.0	30	3.0+T
*4462	Colpocentsis (independent procedure)	*4.0	0	3.0+T
*4463	Puncture and aspiration of cul de sac	*3.0	0	3.0+T
4471	Biopsy of vaginal mucosa (independent procedure)	3.0	15	3.0+T
(For excision and/or fulguration of local lesion(s) see 0175-0197, 0401-0406.)
4473	Colpocleisis, complete obliteration of vagina	50.0	60	3.0+T
4475	Le Fort type	35.0	60	3.0+T
4477	Excision of vaginal septum	by report	30	3.0+T
Introduction
*4478	Irrigation and/or application of any medicament for treatment of bacterial, parasitic or fungoid disease...	*1.0	0
Repair
4479	Colporrhaphy: suture of injury of vagina (non-obsterical)	by report	60	3.0+T
4480	Colpoperineorrhaphy: suture of injury of vagina and/or perineum (nonobstetrical)	by report	60	3.0+T
4481	Anterior colporrhaphy, repair of cystocele with or without repair of urethocele (independent procedure)	35.0	60	3.0+T
4484	Posterior colporrhaphy, repair of rectocele (independent procedure)	30.0	60	3.0+T
4485	with perineoplasty or perineorrhaphy	35.0	60	3.0+T
4488	Combined anterior-posterior colporrhaphy	50.0	60	3.0+T
4492	Urethral suspension, abdominal approach (Marshall-Marchetti type)	40.0	45	4.0+T
4493	Repair of enterocele (independent procedure) abdominal approach	45.0	60	4.0+T
4494	vaginal approach	45.0	60	4.0+T
4495	Colpopexy, abdominal approach	45.0	60	4.0+T
4497	Construction of artificial vagina (vaginal atresia or absence) with or without graft	by report	60	3.0+T
(For closure of vaginal fistulae, see 3335, 3965, 4025.)
Manipulation
*4511	Dilation of vagina under anesthesia	*2.0	0	3.0+T
*4512	Pelvic examination under anesthesia	*2.0	0	3.0+T
Endoscopy
4521	Culdoscopy (independent procedure)	15.0	15	3.0+T
Oviduct
Incision
4531	Transection of Fallopian tube, unilateral or bilateral, abdominal or vaginal approach	40.0	45	4.0+T
4532	post-partum, during same hospitalization	30.0	45	4.0+T
Excision
4541	Salpingectomy, complete or partial, unilateral or bi-lateral (independent procedure)	45.0	45	4.0+T
4545	Salpingo-oophorectomy, complete or partial, unilateral or bilateral (independent procedure)	45.0	45	4.0+T
4551	Salpingoplasty, unilateral or bilateral (independent procedure)	50.0	45	4.0+T
Ovary
Incision
4561	Drainage of ovarian cyst, vaginal approach, unilateral or bilateral	25.0	60	4.0+T
4562	abdominal approach, unilateral or bilateral	40.0	60	4.0+T
4564	Drainage of ovarian abscess, vaginal approach	20.0	60	4.0+T
4565	abdominal approach	40.0	60	4.0+T
Excision
4566	Biopsy of ovary, unilateral or bilateral (independent procedure)	45.0	60	4.0+T
4568	Partial oophorectomy, bilateral or unilateral	45.0	60	4.0+T
Cervix Uteri
Excision
(For radical surgical procedures, see 4620, 4626.)
4571	Biopsy or local excision of lesion, with or without fulguration, quadrant biopsy (independent procedure)	3.0	15	3.0+T
*4572	Cauterization of cervix, office	*3.0	0
4573	Biopsy of cervix, circumferential (cone) with or without dilation and curettage, with or without Sturmdorff type repair	20.0	45	3.0+T
4574	Cryocautery of the cervix	5.0	0
4575	Trachelectomy: cervicectomy: amputation of cervix (independent procedure)	20.0	45	3.0+T
4577	total excision of cervical stump, with or without pelvic floor repair, abdominal approach	50.0	45	4.0+T
4578	vaginal approach	60.0	45	3.0+T
Introduction
*4581	Insertion of any hemostatic agent for control of hemorrhage (independent procedure)	*3.0	0	3.0+T
(For Insertion of any radioactive materials, see 7615.)
*4583	Insertion of intracervical or intrauterine device	*3.0	0	3.0+T
Repair
*4585	Tracheloplasty: surgical repair of incompetent cervix, loop type	*8.0	0	3.0+T
4586	Shirodkar type	20.0	45	3.0+T
4587	Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach	by report	60	3.0+T
Manipulation
*4588	Dilation of cervical canal, instrumental (independent procedure)	*3.0	0	3.0+T
4589	Dilation and curettement of cervical canal	15.0	15	3.0+T
Corpus Uteri
Excision
4610	Endometrial biopsy (independent procedure)	3.0	15	3.0+T
4612	Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical)	15.0	15	3.0+T
4613	Myomectomy: excision of fibroid tumor of uterus (independent procedure, nonobstetrical)	50.0	45	4.0+T
4614	Total hysterectomy (corpus and cervix) with or without tubes, and/or ovaries, one or both	60.0	45	4.0+T
4618	Supracervical hysterectomy: subtotal hysterectomy, with or without tubes, and/or ovaries, one or both	55.0	45	4.0+T
4620	Radical hysterectomy for cancer including regional lymph nodes	100.0	90	6.0+T
4626	plus removal of bladder and ureteral transplantations and/or abdomino-perineal resection of rectum and colon and colostomy or any combination thereof	by report	90	7.0+T
4631	Vaginal hysterectomy	60.0	45	4.0 +T
4632	with plastic repair of vagina, anterior and/or posterior coloporrhaphy	70.0	45	4.0+T
4634	with repair of enterocele	75.0	45	4.0+T
Introduction
(For insertion of radioactive substance into corpus with or without dilation and curettage, see 7615.)
*4675	Insuffiation of uterus and tubes with air or CO2	*3.0	0	3.0+T
*4676	Injection procedure for hystero-salpingography	*3.0	0	3.0+T
Repair
4683	Uterine suspension with or without shortening of round ligaments (independent procedure)	40.0	45	4.0+T
4684	with presacral sympathectomy	45.0	45	4.0+T
4685	with interposition operation, with or without pelvic floor repair	50.0	45	4.0+T
4690	with shortening of endopelvic fascia: parametrial fixation with or without pelvic floor repair (Manchester type)	50.0	45	4.0+T
4692	with shortening of sacro-uterine ligaments	50.0	45	4.0+T
4694	Hysterosalpingostomy: anastomosic of tubes of uterus..	50.0	45	4.0+T
4695	Hysterorrhaphy: repair of ruptured uterus (non-obstetrical)	40.0	45	4.0+T
Perineum
Excision
4710	Biopsy of perineum (independent procedure)	3.0	15	3.0+T
(For excision of local lesion see 0175-0178, 0260-0324.)
Incision
*4720	Incision and drainage of perineal abscess (non-obsterical)	*3.0	0	3.0+T
Repair
4731	Perineoplasty: repair of perineum (independent procedure)	15.0	45	3.0+T
4735	third degree laceration, old (independent procedure)..	40.0	45	3.0+T
(Also see 4441, 4480.)
4742	Perineorrhaphy, postpartum, by other than delivering physician	20.0	45	3.0+T
4745	Repair of perineal fistula	25.0	45	3.0+T
(For repair of recent injury of perineum, non-obstetrical, see 4480.)
MATERNITY
Nonspecialist in Obstetrics
(For medical or surgical complications during maternity care, see section 533.5(a) (2) (vii). Fees for all maternity procedures include prenatal and postpartum care unless otherwise specified.)
Incision
4801	Classic cesarean section	50.0	45	5.0+T
4802	Low cervical (lower uterine segment) cesarean section..	50.0	45	5.0+T
4803	Cesarean section and hysterectomy, total or subtotal	60.0	45	5.0+T
4804	Extraperitoneal cesarean section	60.0	45	5.0+T
Excision
4809	Hysterotomy induced abortion	50.0	45	5.0+T
4811	Ectopic pregnancy, tubal, requiring salpingectomy and/or oophorectorny, abdominal or vaginal approach	50.0	60	5.0+T
4812	ovarian, requiring oophorectomy	by report	60	5.0+T
4815	Hysterotomy, abdominal, for removal of hydatidiform mole	45.0	90	5.0+T
Manipulation
(For value of anesthesia service rendered by attending physician, see Anesthesia sections 533.5(a)(2)(v) and 533.5(a)(2)(ix))
4821	Total obstetrical care including antepartum care, obstetrical delivery and postpartum care (with or without low forceps, and/or episiotomy)	35.0	45	3.0+T
4822	Obstetrical delivery (with or without low forceps, and/or episiotomy) and including hospital postpartum care	20.0	45	3.0+T
4823	Antepartum care only (independent procedure)	Sv[Phi]
4824	Postpartum care only (independent procedure)	Sv[Phi]
4843	Dilation and curettage, and/or suction, induced abortion	20.0	45	3.0+T
4850	Abortion, first trimester, completed medically	Sv[Phi]
4851	(incomplete) completed surgically, (dilatation and curettage)	15.0	45	3.0+T
4853	second trimester, completed medically	Sv[Phi]
4854	(incomplete) completed surgically, (dilatation and curettage)	15.0	45	3.0+T
4856	missed, first or second trimester, completed medically or surgically	by report	45	3.0+T
4858	incomplete, septic, requiring dilatation and curettage and additional care	by report	45	3.0+T
4870	Dilatation and curettage of uterus for postpartum bleeding	15.0	45	3.0+T
MATERNITY
Specialist in Obstetrics
(For medical or surgical complications during maternity care, see Surgery Rule 6. Fees for all maternity procedures include prenatal and postpartum care unless otherwise specified.)
Incision (Obstetrician)
4805	Classic caesarean section	68.75	45	5.0+T
4806	Low cervical (lower uterine segment) caesarean section	68.75	45	5.0+T
4807	Caesarean section & hysterectomy, total or subtotal	81.25	45	5.0+T
4808	Extraperitoneal caesarean section	75.0	45	5.0+T
Excision (Obstetrician)
4810	Hysterotomy, induced abortion	68.75	45	5.0+T
4811	Ectopic pregnancy, tubal, requiring salpingectomy and/or oophorectomy, abdominal or vaginal approach	50.0	60	5.0+T
4812	ovarian, requiring oophorectomy	by report	60	5.0+T
4815	Hysterotomy, abdominal, for removal of hydatidiform mole	45.0	90	5.0+T
Manipulation (Obstetrician)
4825	Total obstetrical care (with or without low forceps, and/or episiotomy)	50.0	45	3.0+T
4826	Obstetrical delivery (with or without low forcepts, and/or episiotomy) & including hospital postpartum care (excludes prenatal care)	27.5	45	3.0+T
4827	Antepartum care only (independent procedure)	Sv[Phi]
4828	Postpartum care only (independent procedure)	Sv[Phi]
4830	Abortion, first trimester, completed medically	Sv[Phi]
4831	(incomplete) completed surgically, (dilatation and curettage)	18.75	45	3.0+T
4833	second trimester, completed medically	Sv[Phi]
4834	(incomplete) completed surgically, (dilatation and curettage)	18.75	45	3.0+T
4836	missed, first or second trimester, completed medically or surgically	by report	45	3.0+T
4838	incomplete, septic, requiring dilatation and curettage and additional care	by report	45	3.0+T
4841	Amniocentesis, diagnostic	5.0	7	3.0+T
4842	Amniocentesis with hypertonic solution including terminal curettage, induced abortion	40.0	45	4.0+T
4844	Dilatation and curettage, and/or suction, induced abortion	25.0	45	3.0+T
4845	Dilatation and curettage of uterus for postpartum bleeding	18.75	45	3.0+T
(For medical complications of pregnancies, e.g. toxemia, cardiac, neurological, etc., or problems requiring additional and unusual services, see Medicine or other appropriate sections of these studies.)
ENDOCRINE SYSTEM
Thyroid Gland
Incision
*4904	Incision and drainage of thyroglossal cyst (infected)	*3.0	0	3.0+T
Excision
4911	Local excision of small cyst or adenoma of thyroid	40.0	45	5.0+T
4912	Total thyroid lobectomy, unilateral	50.00	45	5.0+T
4914	Thyroidectomy, total or complete	70.0	45	5.0+T
4917	subtotal or partial	60.0	45	5.0+T
4924	total or subtotal for malignancy with radical neck dissection	100.0	45	6.0+T
4925	total or subtotal for malignancy with limited neck dissection	80.0	45	5.0+T
4937	secondary, unilateral	60.0	45	5.0+T
4938	bilateral	70.0	45	5.0+T
4941	Excision of thyroglossal duct, cyst or sinus	45.0	45	4.0+T
Parathyroid, Thymus, Pituitary, Pineal Adrenal Glands and Carotid Body
(For hypophysectomy, see 2019 and 5130.)
Excision
4971	Parathyroidectomy or exploration of parathyroid	70.0	45	5.0+T
4972	with mediastinal exploration with or without splitting of sternum	90.0	60	12.0+T
4985	Adrenalectomy, transabdominal, lumbar or dorsal, unilateral	80.0	90	9.0+T
4986	bilateral, one stage	100.0	90	9.0+T
4987	two stages	120.0	90	9.0+T
4989	Biopsy adrenal, unilateral	60.0	45	9.0+T
4990	bilateral	70.0	45	9.0+T
4993	Excision of carotid body tumor, with excision of carotid artery	100.0	60	8.0+T
4994	without excision of carotid artery	70.0	60	8.0+T
NERVOUS SYSTEM
Skull, Meninges and Brain
CRANIOTOMY FOLLOWING TRAUMA:
Incision
5001	Burr holes, unilateral, exploratory for subdural puncture, not followed by surgery	30.0	60	8.0+T
5002	multiple, bilateral, not followed by surgery	50.0	60	8.0+T
5003	Evacuation of hematoma, subdural, extradural, or introcerebral by burr holes only	90.0	60	9.0+T
5004	requiring craniotomy	100.0	60	9.0+T
5012	Removal of foreign body from brain	100.0	60	9.0+T
Excision
5015	Removal of brain scar	by report	9.0+T
Repair
5018	Elevation of depressed skull fracture, simple	75.0	60	9.0+T
5020	with debridement of brain and repair of dura	100.0	60	9.0+T
5022	Cranioplasty for skull defect, bone, metal or plastic	100.0	60	9.0+Y
5024	Repair of dura by graft, including repair for cerebrospinal rhinorrhea	100.0	60	9.0+T
CRANIOTOMY FOR NONTRAUMATIC CAUSES:
Incision
5101	Burr holes, exploratory or ventricular puncture, not followed by surgery	30.0	30	7.0+T
5102	Ventricular puncture through previous burr holes or fontanelle	5.0	7
5106	Craniotomy for drainage of brain abscess	75.0	90	11.0+T
5108	Subsequent tapping (aspiration) abscess in operating room	10.0	7	4.0+T
5110	at bedside	5.0	7
5112	Suboccipital craniectomy for tractotomy or section of 5th, 8th, 9th or other cranial nerves	125.0	90	9.0+T
5113	Intratemporal (mastoid) craniectomy for decompression, neurolysis or excision of acoustic nerve tumor	100.0	90	9.0+T
5114	Craniotomy for surgery of sensory root of gasserian ganglion	100.0	90	9.0+T
5116	Craniotomy for lobotomy, unilateral	40.0	90	9.0+T
5117	bilateral	60.0	90	9.0+T
5119	Craniotomy for orbital decompression, unilateral	100.0	90	9.0+T
*5121	Cisternal puncture (independent procedure)	*3.0	0
*5122	Subdural tap through fontanelle (infant)	*3.0	0
Excision
(For trans-septal hypophsectomy see 2019.)
5130	Osteoplastic craniotomy for excision of brain tumor, abscess, or cyst, supratentorial	125.0	90	9.0+T
5132	Suboccipital craniectomy for brain tumor	150.0	90	11.0+T
5134	Osteoplastic craniotomy for arteriovenous malformation	by report	11.0+T
5136	Osteoplastic craniotomy for obliteration of aneurysm	150.0	90	11.0+T
5140	Craniotomy for pallidectomy, any method, including localizing techniques, single or multiple stages	100.0	90	9.0+T
5144	for topectomy	100.0	90	11.0+T
5146	for excision of choroid plexus	50.0	90	11.0+T
5148	Craniectomy for osteomyelitis of skull	by report	8.0+T
Introduction
(For cerebral angiography, see radiology.)
5152	Burr holes with ventriculography, not followed by surgery	30.0	30	7.0+T
5153	followed by surgery	20.0	30
5154	Ventriculography through fontanelle or previous burr holes	10.0	7	7.0+T
5155	Ventricular puncture with introduction of dye and recovery by spinal puncture	12.0	7	7.0+T
5159	Injection procedure for pneumo-encephalography	10.0	7	5.0+T
Repair
5160	Ventriculocisternostomy	100.0	90	11.0+T
5162	Repair of encephalocele	by report	9.0+T
5166	Ventriculoauricular shunt	100.0	90	11.0+T
5167	replacement or irrigation of obstructed valve	90.0	90	11.0+T
5168	replacement or irrigation of ventricular catheter	30.0	30	5.0+T
5169	removal of shunt in toto without replacement	30.0	30	11.0+T
5170	Ventriculo-auricular-peritoneal-pleural-ureteral shunt	100.0	90	11.0+T
5171	co-surgeon	80.0	90
5174	Craniectomy for crantostenosis, single suture	75.0	90	9.0+T
5175	multiple sutures	100.0	90	9.0+T
Spine and Spinal Cord
Incision
5190	Laminectomy for decompression of the spinal cord and nerve roots (See also 5208-5210, 5225.)	100.0	90	7.0+T
5192	Cordotomy, cervico-dorsal	100.0	90	8.0+T
5194	Rhizotomy	75.0	60	8.0+T
*5198	Spinal puncture, lumbar, simple (independent procedure)	*2.0	0
*5199	diagnostic, initial, with study of hydrodynamics	*4.0	0
(Add one unit to value assigned to 5198 and 5199 if patient is under 4 years.)
Excision
5206	Laminectomy for lesion of spinal cord or meninges	100.0	90	7.0+T
5208	Laminotomy for removal of intervertebral discs, cervical	90.0	90	8.0+T
5209	thoracic	90.0	90	7.0+T
5210	lumbar	90.0	90	7.0+T
5211	Excision of intervertebral discs, anterior approach, cervical	80.0	90	7.0+T
(Also see 0634-0642.)
Introduction
5214	Injection procedure for myelography	10.0	7	3.0+T
5216	for discography	10.0	7	3.0+T
Repair
5225	Laminectomy for spondylolisthesis (See also 5190)	100.0	90	7.0+T
5227	Repair of meningocele	75.0	90	9.0+T
5229	Repair of meningomyelocele	90.0	90	9.0+T
5231	Lumbar subarachnoid-peritoneal-ureteral shunt	80.0	90	9.0+T
5232	co-surgeon	75.0	90
*5233	Application crutchfield tongs or other skeletal traction device	*5.0	0
Peripheral Nerves, Other Extracranial nerves, and Ganglia
Incision
(For transection of trigeminal or glossopharyngeal nerves, see 5112, 5114.)
5252	Phrenic nerve transection or avulsion	15.0	30	3.0+T
5255	Transection, spinal nerve	40.0	60	3.0+T
5257	Transection occipital nerve	40.0	60	4.0+T
Excision
(For excision of tender scar, skin and subcutaneous tissues with or without tiny neuroma, see 0175, 0178, 0265, 0266.)
5273	Excision of surgical identifiable neuroma of cutaneous nerve	8.0	60	3.0+T
5274	digital nerve, one or both, same digit	10.0	60	3.0+T
5275	hand or foot, one (add 10 percent each additional)	15.0	60	3.0+T
5276	arm or leg	25.0	60	3.0+T
5277	Avulsion infraorbital nerve	20.0	60	3.0+T
5280	Stoefel's neurectomy	40.0	60	3.0+T
5282	Obturator neurectomy	40.0	60	3.0+T
Introduction
*5290	Alcohol injection, subarachnoid	*5.0	0
5294	2nd or 3rd branch of trigeminal nerve	7.5	30
5295	under x-ray control (excluding x-ray charge)	10.0	30
Nerve Block
5298	Paravertebral block, lumbar or thoracic	5.0	7
5300	Sympathetic block (cervical)	5.0	7
5302	Stellate ganglion	5.0	7
5311	Brachial plexus block	5.0	7
5312	Intercostal nerves	3.0	7
5313	Lumbar, sacral and coccygeal nerves	5.0	7
5314	Pudendal nerve	5.0	7
5315	Splanchnic nerves	5.0	7
5316	Ilioinguinal and iliohypogastric nerves	5.0	7
5317	Sciatic nerve	3.0	7
5318	Phrenic nerve	3.0	7
5319	Other peripheral nerves	3.0	7
Repair
NEURORRHAPHY - suture of nerve.
Primary
5320	Digital, one (add 25% each additional nerve)	15.0	90	3.0+T
5322	Hand or foot (except motor thenar or ulnar motor)	20.0	90	3.0+T
5323	Motor thenar or ulnar motor	30.0	90	3.0+T
5325	Arm or leg (except sciatic)	40.0	90	3.0+T
5326	Sciatic	by report	3.0+T
5328	Brachial or lumbar plexus	by report	3.0+T
5330	Cranial, extra-cranial	75.0	90	5.0+T
(For facial nerve, see 6002, 6003.)
Secondary or delayed anastomosis or reanastomosis including local advancement to overcome gap. (Add 25 percent to primary repair.)
Secondary or delayed anastomosis involving additional procedures such as nerve graft and/or rerouting of nerve to overcome gap	by report
(See 6003 for facial nerve.)
NEUROPLASTIES; plastic procedure on intact nerve.
5335	Freeing nerve from scar, including internal and external lysis and transposition away from scarred area, digital, one or both	15.0	90	3.0+T
5337	hand or foot	20.0	90	3.0+T
5339	arm or leg (except sciatic)	40.0	90	3.0+T
5340	sciatic	by report
5341	brachial or lumbar plexus	by report
5343	cranial, extra-cranial	75.0	90	5.0+T
(For facial nerve, see 6002, 6003.)
5345	Transplantation ulnar nerve, elbow (independent procedure) (includes neurolysis)	25.0	90	3.0+T
5347	Median nerve decompression at carpal tunnel, simple	30.0	45	3.0+T
(If complex, see also 1550, 1553.)
NEURO-ANASTOMOSIS to establish other than normal anatomical continuity.
5350	Spinal accessory-facial, hypoglossal-facial, spinal accessory-hypoglossal, etc	75.0	90	6.0+T
Vegetative Nervous System
Excision
Sympathectomies:
5371	Cervical, unilateral	60.0	60	6.0+T
5372	bilateral	80.0	60	6.0+T
5375	Cervico-thoracic (Smithwicke type, supra- and infra-diaphragmatic), unilateral	70.0	60	6.0+T
5376	bilateral, concomitant or delaved	100.0	60	8.0+T
5381	Lumbar, unilateral	55.0	60	4.0+T
5382	bilateral	75.0	60	6.0+T
5385	Splanchnicectomy (Peet Type) unilateral	65.0	60	5.0+T
5386	bilateral	80.0	60	8.0+T
5390	Presacral neurectomy, hypogastric plexus	50.0	60	4.0+T
EYE
Diagnostic and Manipulative Procedures
5400	Eye examination to include refraction, ophthalmoscopy, tonometry, gross visual field and muscle balance examination and medical diagnosis	$20.00
5401	with complete visual fields included	$28.00
*5402	Gonioscopy, diagnostic, adult	*2.0	0	3.0+T
5403	infant	4.0	7	3.0+T
*5404	Refraction without cycloplegic or mydriatic	*$12.00	0
*5405	with cycloplegic or mydriatic, including post-cycle-plegic visit	*$16.00	0
5406	Orthoptic evaluation	2.0	0
5407	training each 30 minutes	1.0	0
*5408	Visual fields, complete	*2.0	0
*5409	Tonography (recording tonometer method or perilimbal suction device)	*2.0	0
*5410	Provocative test(s) for glaucoma including water drinking and/or mydriatic	*2.0
5411	Funduscopic under anesthesia	4.0	7	3.0+T
5412	Fitting contact lenses	Sv[Phi]
Ophthalmologist
Office Visits
5414	**External eye examination (medical treatment of minor external eye diseases, e.g., conjunctivitis, chalazion, hordeolum, blepharitis)	$10.00
5416	Follow-up visit to external eye examination	$7.20
**Not to be added to codes 5400 or 5401.
Hospital Visits
5417	Initial visit	2.5
5418	Follow-up visit, including treatment	1.5
Eyeball
Incision
5420	Goniotomy	50.0	30	4.0+T
Excision
5421	Enucleation of eyeball with or without sphere implant	40.0	30	4.0+T
5422	with integrated implant	50.0	30	4.0+T
5424	Secondary implantation of integrated implant	60.0	30	4.0+T
5427	Evisceration of eyeball	40.0	30	4.0+T
5428	with implantation in scleral shell	50.0	30	4.0+T
5431	Suture of eyeball for wound or injury	by report	4.0+T
Cornea
Incision
5441	Keratotomy, any type	10.0	14	4.0+T
5443	Paracentesis of cornea	10.0	14	4.0+T
*5445	Removal of foreign body from surface of cornea	*2.0	0
*5448	under slit lamp	*3.0	0
Excision
5451	Keratectomy, partial	30.0	30	6.0+T
5452	complete	40.0	30	6.0+T
5457	Pterygium	25.0	30	4.0+T
Introduction
5461	Tattoo of cornea, mechanical or chemical	30.0	30	4.0+T
*5465	Curettage and cauterization of corneal ulcer	*5.0	0
*5466	Iontophoresis of corneal ulcer	*5.0	0
Repair
5471	Keratoplasty, (corneal transplant) lamellar	100.0	90	8.0+T
5472	partial or complete, penetrating	110.0	90	8.0+T
Suture
5481	Suture of perforated cornea	by report	6.0+T
Sclera
Incision
5491	Sclerotomy, operative incision, with removal of intraocular foreign body (with or without magnet)	50.0	45	6.0+T
5492	with removal of foreign body from anterior chamber (with or without magnet)	50.0	45	6.0+T
5495	Sclerotomy, posterior	30.0	15	4.0+T
*5496	Aspiration of anterior chamber, diagnostic	*4.0	0
Excision
5501	Sclerectomy for glaucoma, with scissors, punch or trephination	60.0	45	6.0+T
5503	Scleral resection	100.0	90	6.0+T
Introduction
5511	Irrigation and/or air injection into anterior chamber	15.0	15	4.0+T
Suture
5521	Suture of sclera for wound or injury	by report	8.0+T
Iris and Ciliary Body
Incision
5531	Iridotomy	20.0	30	4.0+T
5532	with transfixion of iris; iris bombe	20.0	30	4.0+T
5534	Iridotomy-performed with photocoagulator	10.0	30	4.0+T
Excision
5541	Excision of lesion of iris	60.0	45	4.0+T
5542	and/or ciliary body (iridocyclectomy)	80.0	45	4.0+T
5544	Iridectomy; basal, optical or preliminary	50.0	45	4.0+T
5546	peripheral	50.0	45	4.0+T
Repair
5552	Iridodialysis	40.0	45	4.0+T
5561	Repair of prolapsed iris with suture of perforated sclera or cornea	by report	8.0+T
Manipulation
5571	Iridencleisis or comparable procedure	50.0	45	4.0+T
Destruction
5580	Diathermy of the ciliary body; cyclodiathermy	30.0	30	4.0+T
5582	Cyclodialysis	50.0	45	4.0+T
Crystalline Lens
Incision
5601	Discission (needling of lens), initial	20.0	45	4.0+T
5602	subsequent	10.0	45	4.0+T
5603	Aspiration of lens material for congenital cataract, one or more stages	60.0	30	4.0+T
Excision
5611	Extraction of lens, intracapsular, extracapsular or linear, unilateral	80.0	90	8.0+T
5616	Removal of dislocated lens	80.0	90	8.0+T
Vitreous
Introduction
5622	Transplantation of vitreous	50.0	60	8.0+T
Retina
Repair
5630	Reattachment of retina, electrocoagulation, scleral resection, buckling or partial tubing	100.0	90	7.0+T
5631	encircling tube, initial	100.0	90	7.0+T
5632	subsequent	by report	30	7.0+T
5633	Removal of encircling tube	40.0	30	4.0+T
5634	Reattachnent of retina, light coagulation of retinal break(s), one or more stages during same period of hospitalization	40.0	30	7.0+T
5635	with drainage of subretinal fluid	50.0	60	7.0+T
5636	Light coagulation of retina for tumor, Eales disease, etc., initial	40.0	30	4.0+T
5637	subsequent	20.0	30	4.0+T
Examination
5638	Comprehensive retinal examination prior to or in anticipation of surgery, to include the following	10.0	0
1. Code 5400 - Eye examination to include refraction, opthalmoscopy, tonometry, gross visual field and muscle balance examination and medical diagnosis.
2. Complete visual fields and records.
3. Study of the vitreous cavities and the fundi of both eyes including contact lens examination and binocular indirect ophthalmoscopy.
4. Gonioscopy.
5. Complete retinal drawings of both eyes.
Ocular Muscles
Incision, Excision and Repair
5641	Any type of muscle operation involving one or more muscles in one or both eyes done in one stage	60.0	30	4.0+T
5647	Muscle transplant (Hummelscheim type, etc.)	70.0	30	4.0+T
Orbit
Incision
5651	Orbitotomy with exploration	60.0	30	7.0+T
5652	with drainage of intraorbital abscess	60.0	30	7.0+T
5653	with removal of intraorbital foreign body	60.0	30	7.0+T
5662	Excision of benign lesion of orbit, requiring bone flap	90.0	30	7.0+T
5864	Exenteration or evisceration of orbital contents with or without graft	60.0	60	7.0+T
5665	including orbital bone	by report
Introduction
5671	Orbital injection of alcohol for hemorrhagic glaucoma or intractable pain	10.0	15
Repair
(For plastic repair of orbit, see 0260-0324, 0619-0621.)
Eyelids
Incision
*5691	Blepharotomy with drainage of abscess of eyelid	*2.0	0
*5692	with drainage of Meibomian glands; hordeolum (stye)	*2.0	0
Excision
(For blepharectomy, see 0175-0197, 0260-0324.)
5702	Excision or incision of Meibomian gland (chalazion), single	5.0	15	3.0+T
5703	multiple, same lid	6.0	15	3.0+T
5704	multiple, different lids	7.0	15	3.0+T
(For excision of lesion of eyelid, malignant, see 0194-0197, 0260-0324.)
5712	Epilation, electrolysis	4.0	15	3.0+T
(For excision of xantholasma, 0175-0178, 0260-0324.)
Repair
(Blepharoplasty; plastic repair of eyelid with or without graft, any type, see 0251, 0252, 0260-0324.)
(Canthoplasty: plastic repair of canthus, see 0251, 0252, 0260-0324.)
(Plastic restoration of eyebrow, by graft, see 0308-0324.)
(Tarsoplasty: plastic repair of tarsal cartilage, see 0261-0275.)
(Reposition of ciliary base, see 0260-0324.)
5727	Blepharoptosis repair, superior rectus, levator, or frontalis methods, unilateral	60.0	60	4.0+T
5728	fascia sling method	40.0	60	4.0+T
5729	lid suture method	25.0	60	3.0+T
5730	Cautery puncture for entropion or ectropian	5.0	15
5731	Ectropion repair (e.g., Kuhnt-Szymanowski type)	40.0	30	4.0+T
5732	Entropion repair (e.g., Wheeler type)	40.0	30	4.0+T
Suture
(Blepharorrhaphy: suture of eyelid, see 0251, 0261-0269.)
(Tarsorrhaphy: suture of tarsal cartilage see 0251, 0261-0269.)
(Canthorrhaphy: suture of palpebral fissure of canthus, see 0251, 0261-0269.)
Conjunctiva
Incision
*5741	Removal of foreign body from surface of conjunctiva	*1.0	0
*5742	embedded in conjunctiva	*2.0	0
5743	Suture of conjunctiva	5.0	15	4.0+T
Excision
5751	Biopsy of conjunctiva	5.0	15	4.0+T
5753	Excision of lesion of conjunctiva, e.g., cyst	5.0	15	4.0+T
(For epithelioma, see 0175-0196, 0261-0269.)
(For nevus, see 0175-0196, 0261-0269.)
Repair
5760	Conjunctivoplasty, free graft using conjunctiva	50.0	30	5.0+T
5762	using buccal mucous membrane	60.0	30	5.0+T
5774	Flap operation of corneal ulcer	20.0	30	4.0+T
5775	Flap operation: "flapping"of conjunctiva for perforating injuries or operative wound	20.0	30	5.0+T
(For repair of symblepharon without graft see 0175-0178, 0260-0276.)
Lacrimal Tract
Incision
5801	Drainage of lacrimal gland (abscess)	10.0	15	4.0+T
5803	Drainage of lacrimal sac, dacryocystotomy or dacryo-cystostomy)	7.5	15	4.0+T
Excision
5811	Excision of lacrimal gland (dacryoadenectomy)	50.0	45	4.0+T
5813	Excision of lacrimal sac (dacryocystectomy)	50.0	45	4.0+T
5815	Excision of lacrimal gland tumor	60.0	45	4.0+T
Introduction
5821	Catheterization of nasolacrimal duct with implantation of tube or stent	10.0	15	3.0+T
*5823	Injection procedure for dacryocystography	*3.0	0
Repair
5831	Plastic operation on canaliculi	by report	4.0+T
5833	Dacryocystorrhinostomy: fistulization of lacrimal sac into nasal cavity, with or without anterior ethmoliidectomy	70.0	60	5.0+T
5835	Closure of punctum by cautery	4.0	15	3.0+T
Manipulation
*5841	Dilation of punctum	*2.0	0	3.0+T
*5843	Probing of nasolacrimal duct	*3.0	0	3.0+T
*5846	Probing and/or irrigation of canaliculus	*2.0	0	3.0+T
EAR
External Ear
(For audiometric, vestibular and speech tests, see 9340-9342.)
Incision
*5901	Drainage of abscess or hematoma of auricle, simple	*2.0	0	3.0+T
5902	complicated, including suppurative chondritis	by report	3.0+T
*5905	Drainage of abscess of external auditory canal	*2.0	0	3.0+T
Excision
5911	Biopsy of ear	3.0	15
(For local destruction or excision of lesion of ear, see 0175-0197.)
(For plastic closure, see 0260-0324.)
5916	Excision ear, partial, simple repair	10.0	30	3.0+T
5917	Complete amputation, auricle	20.0	90	3.0+T
*5920	Excision osteoma, external canal, simple	*5.0	0
5923	Excision of exostois of external auditory canal, end-aural or post-aural approach, complicated	50.0	90	3.0+T
5924	Radical excision of malignant lesion of external auditory canal	by report	4.0+T
5926	with neck dissection	by report	6.0+T
Endoscopy
*5931	Otoscopy with removal foreign body in external auditory canal	*2.0	0	3.0+T
Repair
(Otoplasty: plastic operation on ear, see 0260-0324.)
(Reconstruction of ear with graft of skin plus cartilage, bone or other implant, see 0260-0324, 0620, 0621.)
5947	Otoplasty, of cartilage ("lop-ear")with or without reduction in size, unilateral	50.0	180	3.0+T
5948	bilateral	70.0	180	3.0+T
5949	Reconstruct external auditory canal for congenital atresia, single stage	100.0	180	3.0+T
Suture
(For suture of wound or injury of ear, see 0251, 0252, 0260-0270.)
Middle Ear
Introduction
5955	Eustachian tube catheterization and insufflation, unilateral or bilateral	1.5	0
Incision
*5961	Myringotomy; tympanotomy; plicotomy, with or without Eustachian inflation and/or aspiration	*3.0	0	3.0+T
5962	Tympanotomy, diagnostic, exploratory for middle ear exposure	50.0	30	3.0+T
5963	with insertion of tube for serous otitis media, unilateral	5.0	7	3.0+T
5964	with insertion of collar-button tube for muco-serous otitis media, unilateral or bilateral	25.0	45	3.0+T
5968	Tympanolysis, transtympanic	80.0	180	3.0+T
Excision
5971	Mastoidectomy, simple	50.0	180	4.0+T
5972	Mastoidectomy, modified radical or radical, without skin graft	80.0	180	4.0+T
5975	with skin graft	90.0	180	4.0+T
5980	Petrous apicectomy, including radical mastoidectomy	by report	4.0+T
5982	Removal of middle ear polyp	10.0	30	3.0+T
Repair
5990	Revision of radical mastoidectomy, with or without skin graft	90.0	180	4.0+T
*5991	Patching tympanic membrane, with or without cauterization	*2.0	0
5992	Myringoplasty, uncomplicated	80.0	180	4.0+T
5993	Tympanoplasty without mastoidectomy (may include change in contours of external auditory canal and be combined with middle ear, including ossicular chain constuction and/or attic surgery), post-auricular or endaural approach	100.0	180	4.0+T
5994	Tympanoplasty with mastoidectomy	120.0	180	4.0+T
5996	Incudo-stapedial arthrodesis, with or without graft	70.0	90	4.0+T
5997	Stapes mobiliation, primary or secondary	70.0	90	4.0+T
5998	Stapedectomy with insertion of prosthetic stapes with fenestration of the oval window	100.0	90	4.0+T
5999	Mastoid obliteration	80.0	90	4.0+T
Suture
6001	Closure of fistula, mastoid (independent procedure)	25.0	60	4.0+T
6002	Decompression, intratemporal, facial nerve, with or without neurolysis	100.0	180	9.0+T
(see also 5330)
6003	Suture and/or graft, facial nerve, intratemporal	120.0	180	9.0+T
Internal Ear
Incision
6011	Labyrinthotomy, any type	100.0	180	6.0+T
6012	Fenestration of semicircular canal	100.0	180	6.0+T
6014	Revision of fenestration operation	60.0	180	6.0+T
Excision
6021	Labyrinthectomy	100.0	180	6.0+T

N.Y. Comp. Codes R. & Regs. Tit. 18 § 533.5