CPT/ HCPCS APC OK Adj APC Rate 10021 0002 54.44 10022 0036 127.51 10040 0010 33.85 10060 0006 96.04 10061 0006 96.04 10080 0006 96.04 10081 0007 709.42 10120 0006 96.04 10140 0007 709.42 10160 0018 55.10 11000 0015 98.28 11040 0015 98.28 11041 0015 98.28 11055 0012 42.61 11056 0012 42.61 11057 0013 64.85 11100 0018 55.10 11200 0013 64.85 11400 0019 237.49 11401 0019 237.49 11402 0019 237.49 11403 0020 434.48 11420 0020 434.48 11421 0020 434.48 11422 0020 434.48 11423 0021 434.48 11440 0019 237.49 11441 0019 237.49 11442 0020 434.48 11443 0020 434.48 11600 0019 237.49 11601 0019 237.49 11602 0019 237.49 11603 0020 434.48 11620 0020 434.48 11621 0019 237.49 11622 0020 434.48 11623 0021 848.32 11640 0020 237.49 11641 0020 237.49 11642 0020 434.48 11643 0020 434.48 11720 0009 38.85 11721 0009 38.85 11730 0013 64.85 11740 0009 38.85 11750 0019 237.49 11752 0022 " 1,103.76 " 11755 0019 237.49 11760 0024 101.10 11762 0024 101.10 11765 0015 98.28 12001 0024 101.10 12002 0024 101.10 12004 0024 101.10 12011 0024 101.10 12013 0024 101.10 12014 0024 101.10 12015 0024 101.10 12031 0024 101.10 12032 0024 101.10 12041 0024 101.10 12042 0024 101.10 12051 0024 101.10 12052 0024 101.10 12053 0024 101.10 15342 0024 101.10 15850 0016 161.38 16010 0016 161.38 16025 0013 64.85 16030 0015 98.28 17000 0010 33.85 17004 0011 136.99 17106 0011 136.99 17107 0011 136.99 17108 0011 136.99 17110 0010 33.85 17111 0010 33.85 17250 0013 64.85 19000 0004 97.33 19240 0030 " 2,238.35 " 19260 0021 848.32 20000 0006 96.04 20100 0023 183.69 20101 0027 959.34 20102 0027 959.34 20103 0023 183.69 20150 0051 " 2,043.45 " 20500 0251 110.27 20520 0019 237.49 20600 0204 124.23 20605 0204 124.23 20610 0204 124.23 20612 0204 124.23 20615 0004 97.33 20982 1557 " 1,850.00 " 21356 0254 " 1,330.22 " 21390 0256 " 2,104.37 " 21406 0256 " 2,104.37 " 21407 0256 " 2,104.37 " 21470 0256 " 2,104.37 " 21550 0021 848.32 22520 0050 " 1,401.79 " 22521 0050 " 1,401.79 " 24343 0050 " 1,401.79 " 25500 0043 105.57 25530 0043 105.57 25560 0043 105.57 25652 0046 " 2,000.70 " 26720 0043 105.57 26725 0043 105.57 27524 0046 " 2,000.70 " 28124 0055 " 1,102.30 " 28190 0019 237.49 28220 0055 " 1,102.30 " 28230 0055 " 1,102.30 " 28232 0055 " 1,102.30 " 28272 0055 " 1,102.30 " 28360 0056 " 1,514.68 " 28430 0043 105.57 29044 0426 113.81 29046 0426 113.81 29305 0426 113.81 29325 0426 113.81 29345 0426 113.81 29720 0058 63.20 30020 0251 110.27 31000 0251 110.27 31002 0252 371.43 31040 0254 " 1,330.22 " 31231 0072 79.22 31502 0121 130.54 32020 0070 188.99 33208 0655 " 7,701.05 " 33210 0106 " 3,142.27 " 33215 0105 " 1,227.69 " 33226 0105 " 1,227.69 " 33234 0105 " 1,227.69 " 33235 0105 " 1,227.69 " 33241 0105 " 1,227.69 " 33244 0105 " 1,227.69 " 35180 0093 " 1,369.59 " 35184 0093 " 1,369.59 " 35190 0093 " 1,369.59 " 35201 0093 " 1,369.59 " 35206 0093 " 1,369.59 " 35226 0093 " 1,369.59 " 35231 0093 " 1,369.59 " 35236 0093 " 1,369.59 " 35256 0093 " 1,369.59 " 35261 0653 " 1,600.31 " 35266 0653 " 1,600.31 " 35286 0653 " 1,600.31 " 35321 0093 " 1,369.59 " 35458 0081 " 1,866.47 " 35459 0081 " 1,866.47 " 35460 0081 " 1,866.47 " 35470 0081 " 1,866.47 " 35471 0081 " 1,866.47 " 35472 0081 " 1,866.47 " 35473 0081 " 1,866.47 " 35474 0081 " 1,866.47 " 35475 0081 " 1,866.47 " 35476 0081 " 1,866.47 " 35484 0081 " 1,866.47 " 35485 0081 " 1,866.47 " 35490 0081 " 1,866.47 " 35491 0081 " 1,866.47 " 35492 0081 " 1,866.47 " 35493 0081 " 1,866.47 " 35494 0081 " 1,866.47 " 35495 0081 " 1,866.47 " 35903 0115 " 1,462.30 " 36420 0035 16.46 36425 0035 16.46 36550 0676 145.51 36597 0621 219.53 37201 0676 243.48 37202 0676 145.51 37203 0103 748.40 37204 0115 " 1,462.30 " 37205 0229 " 3,540.68 " 37207 0229 " 3,540.68 " 37620 0091 " 1,690.23 " 37765 0091 " 1,690.23 " 37766 0091 " 1,690.23 " 38120 0131 " 2,436.17 " 38221 0003 141.20 38720 0113 " 1,196.89 " 39400 0069 " 1,704.69 " 40702 0256 " 2,104.37 " 40806 0251 110.27 40820 0253 911.03 41100 0252 371.43 41105 0253 911.03 41108 0252 371.43 41110 0253 911.03 41115 0252 371.43 42100 0252 371.43 42104 0253 911.03 42106 0253 911.03 42225 0256 " 2,104.37 " 42227 0256 " 2,104.37 " 42800 0253 911.03 42842 0254 " 1,330.22 " 42844 0256 " 2,104.37 " 43280 0132 " 3,494.24 " 43761 0122 130.54 43830 0422 " 1,264.79 " 43831 0141 460.00 44200 0131 " 2,436.17 " 44201 0131 " 2,436.17 " 44206 0132 " 3,494.24 " 44207 0132 " 3,494.24 " 44208 0132 " 3,494.24 " 44238 0130 " 1,805.40 " 44239 0130 " 1,805.40 " 44970 0131 " 2,436.17 " 45300 0146 247.78 45303 0147 247.78 45330 0146 247.78 45520 0098 76.49 45541 0150 " 1,321.19 " 46070 0155 747.00 46083 0148 245.76 46221 0148 245.76 46320 0148 245.76 46500 0155 747.00 46934 0155 747.00 46945 0155 747.00 47382 0423 " 1,753.39 " 47562 0131 " 2,436.17 " 47563 0131 " 2,436.17 " 47564 0131 " 2,436.17 " 48511 0037 532.34 49021 0037 532.34 49041 0037 532.34 49061 0037 532.34 49200 0130 " 1,805.40 " 49323 0130 " 1,805.40 " 49423 0152 709.92 49429 0105 " 1,227.69 " 49491 0154 " 1,599.85 " 49492 0154 " 1,599.85 " 50020 0162 " 1,311.65 " 50021 0037 532.34 50080 0429 " 2,055.63 " 50081 0429 " 2,055.63 " 50391 0156 141.22 50541 0130 " 1,805.40 " 50542 0131 " 2,436.17 " 50543 0131 " 2,436.17 " 50544 0130 " 1,805.40 " 50562 0160 385.63 50590 0169 " 2,542.78 " 50945 0131 " 2,436.17 " 51000 0164 71.59 51005 0164 71.59 51700 0164 71.59 51720 0156 141.22 51725 0156 141.22 51990 0131 " 2,436.17 " 53600 0156 141.22 53601 0164 71.59 53620 0165 914.09 53621 0164 71.59 53660 0164 71.59 53661 0164 71.59 54692 0132 " 3,494.24 " 55000 0004 97.33 55450 0183 " 1,313.82 " 55860 0165 914.09 56405 0189 218.13 56420 0189 122.23 56501 0017 990.90 56605 0019 237.49 56805 0193 " 1,089.21 " 56820 0188 62.94 56821 0189 122.23 57022 0007 709.42 57061 0194 " 1,089.21 " 57100 0192 218.13 57106 0194 " 1,089.21 " 57310 0202 " 2,260.37 " 57320 0195 " 1,507.62 " 57330 0195 " 1,507.62 " 57420 0189 122.23 57421 0189 122.23 57452 0189 122.23 57454 0189 122.23 57455 0189 122.23 57456 0189 122.23 57460 0193 758.17 57461 0194 " 1,089.21 " 57500 0192 218.13 57505 0189 122.23 57510 0193 758.17 57511 0189 122.23 57555 0195 " 1,507.62 " 57800 0193 758.17 58100 0188 62.94 58301 0189 122.23 58356 0202 " 2,260.37 " 58552 0131 " 2,436.17 " 58553 0131 " 2,436.17 " 58554 0131 " 2,436.17 " 58578 0130 " 1,805.40 " 58600 0195 " 1,507.62 " 58615 0194 " 1,089.21 " 58823 0193 758.17 58920 0195 " 1,507.62 " 58925 0195 " 1,507.62 " 59000 0198 76.94 59074 0198 76.94 59150 0131 " 2,436.17 " 59151 0131 " 2,436.17 " 60001 0004 97.33 60100 0004 97.33 60210 0114 " 2,260.59 " 60212 0114 " 2,260.59 " 60220 0114 " 2,260.59 " 60225 0114 " 2,260.59 " 60240 0114 " 2,260.59 " 60252 0256 " 2,104.37 " 60260 0256 " 2,104.37 " 60500 0256 " 2,104.37 " 63030 0208 " 2,425.77 " 64612 0204 124.23 64613 0204 124.23 64614 0204 124.23 65436 0233 836.78 66761 0247 290.00 67101 0236 295.54 67105 0248 280.79 67110 0236 " 1,216.62 " 67228 0248 280.79 67500 0231 114.38 67505 0238 168.64 67515 0238 168.64 67700 0238 168.64 67710 0239 381.87 67800 0238 168.64 67801 0239 381.87 67805 0238 168.64 67810 0238 168.64 67840 0239 381.87 67850 0239 381.87 67875 0239 381.87 67930 0240 " 1,029.77 " 67938 0698 83.47 68100 0232 393.87 68110 0699 552.97 68840 0231 114.38 69420 0251 371.43 69424 0252 371.43 69433 0252 371.43 69540 0253 911.03 69610 0254 " 1,330.22 " 92018 0699 552.97 92019 0699 552.97 92953 0094 153.54 92960 0679 318.94 92980 0104 " 4,622.33 " 92982 0083 " 3,154.68 " 92986 0083 " 3,154.68 " 92990 0083 " 3,154.68 " 92997 0081 " 1,866.47 " 93303 0269 185.50 93304 0697 86.52 93307 0269 185.50 93308 0697 86.52 93312 0270 347.86 93315 0270 347.86 93350 0269 185.50 93501 0080 " 2,066.55 " 93503 0103 748.40 93505 0103 748.40 93510 0080 " 2,066.55 " 93526 0080 " 2,066.55 " 93531 0080 " 2,066.55 " 93532 0080 " 2,066.55 " 93533 0080 " 2,066.55 " 93580 0434 " 2,250.00 " 93615 0087 " 2,121.56 " 93616 0087 " 2,121.56 " 93618 0087 " 2,121.56 " 93619 0085 " 1,980.11 " 93620 0085 " 1,980.11 " 93624 0085 606.13 93650 0086 " 2,567.03 " 93651 0086 " 2,567.03 " 93652 0086 " 2,567.03 " 93660 0101 250.46 93701 0099 21.72 93741 0689 33.35 93742 0689 33.35 93743 0689 33.35 93880 0267 138.18 93922 0096 97.07 93971 0266 138.18 93976 0267 138.18