N.Y. Comp. Codes R. & Regs. Tit. 11 § 52.80 - State of New York Certified Surgical Fee Schedule

The following schedule of relative values for surgery, with $6 applied to each unit of value, shall constitute the State of New York Certified Surgical Fee Schedule:

INTEGUMENTARY SYSTEM

Skin, Mucous Membrane, Subcutaneous and Areolar Tissues

Value

Incision
0101 Incision and drainage of infected or noninfected sebaceous cyst ....... 2.0
(2nd lesion 50%; each additional lesion 25%)
0102 Incision and drainage of furuncle ....... 2.0
0103 Acne surgery; marsupialization, opening, or removal of multiple milia, comedones, cysts, pustules, etc. ....... 1.5
0108 Incision and drainage of carbuncle, suppurative hidradenitis and other cutaneous or subcutaneous abscesses simple ....... 2.0
0109 extensive ....... by report
0115 Drainage of pilonidal cyst ....... 2.0
0125 Drainage of onychia or paronychia ....... 2.0
0126 multiple or complicated ....... by report
0130 Incision and removal of foreign body, subcutaneous tissues, simple ....... 2.0
0131 complicated by ....... by report
0140 Drainage of hematoma, simple ....... 2.0
0141 complicated ....... by report
0145 Puncture aspiration of abscess or hematoma ....... 1.0
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
0161 for each additional 10% of body surface, add ....... 1.0
0162 Debridement of nails, any method, five or less ....... 2.0
0163 for each additional five or major portion thereof ....... 1.0
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
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.)
0175 lesion diameter up to 1/4 inch ....... 4.0
0176 lesion diameter 1/4 to 1/2 ....... 5.0
0177 lesion diameter 1/2 to 3/4 ....... 6.0
0178 lesion diameter more than 3/4 inch or complicated ....... by report
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
0189 lesion diameter 1/4 to 1/2 inch ....... 8.0
0190 lesion diameter 1/2 to 3/4 inch ....... 10.0
Face, scalp, ears, neck, hands, feet, genitalia:
0191 lesion diameter up to 1/4 inch ....... 10.0
0192 lesion diameter up to 1/2 inch ....... 15.0
0193 lesion diameter 1/2 to 3/4 inch ....... 20.0
Eyelids, nose, lips, mucous membrane:
0194 lesion diameter up to 1/4 inch ....... 15.0
0195 lesion diameter 1/4 to 1/2 inch ....... 20.0
0196 lesion diameter 1/2 to 3/4 inch ....... 25.0
0197 Lesions over 3/4 inch, complicated or unusually located ....... by report
0225 Avulsion, nail, partial, or complete, simple ....... 2.0
0228 Excision of nail or nail matrix, partial or complete, e.g., ingrown or deformed nail for permanent removal ....... 10.0
0238 Excision of pilonidal cyst or sinus ....... 30.0
Miscellaneous lesions (use appropriate procedure number and state diagnosis.)
Hemangioma (see 0175-0178, 0260-0324.)
Hidradenitis (see 0108, 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
0243 more than seven ....... 3.0
Repair-Simple
0251 Wounds, recent, up to 2 1/2 inches ....... 2.0
0252 for each additional inch add ....... 1.0

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 debridemnet and repair of complicated laceration (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
0261 eyelids, nose, ears and lips ....... 10.0
(See also 0290-0294, 2737-2746.)
(For other areas see 0175-0178, 0188-0197, 0251-0252.)
0262 1/2 inch to 1 inch, trunk ....... 7.0
0263 scalp, arms and legs ....... 10.0
0264 forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet ....... 14.0
0265 eyelids, nose, ears and lips ....... 17.0
(See also 0290-0294, 2737-2746.)
0266 1 inch to 3 inches, trunk ....... 15.0
0267 scalp, arms and legs ....... 22.0
0268 forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet ....... 30.0
0269 eyelids, none, ears and lips ....... 40.0
(See also 0290-0294, 2737-2746.)
0270 Unusual, complicated or over 3 inch linear repair ....... by report
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
0276 scalp, arms and legs ....... 30.0
0277 forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet ....... 40.0
0278 eyelids, nose, ears and lips ....... 50.0
0279 defect size between 1 square inch and 3 square inches, trunk ....... 30.0
0280 scalp, arms and legs ....... 40.0
0281 forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet ....... 50.0
0282 eyelids, nose, ears and lips ....... 60.0
0283 more than 3 square inches, unusual or complicated ....... by report
Eyelid, full thickness, excision and repair: .......
0290 by advancement flaps, up to 1/4 eyelid margin ....... 37.0
0291 over 1/4 of eyelid margin ....... 50.0
0292 by transfer flaps of tarso-conjunctivea from opposing eyelid, up to 2/3 of eyelid ....... 50.0
0293 total eyelid, one or more stages, lower lid ....... 75.0
0294 upper lid ....... 85.0
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.
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
(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
0302 each additional 16 square inches or part thereof ....... 5.0
0303 face, neck, ears, genitalia or multiple digits ....... 38.0
0304 each additional 16 square inches or part thereof ....... 7.0
0308 Full thickness, free, up to 3 square inches, including direct closure of donor site, trunk ....... 20.0
0309 scalp, arms and legs ....... 30.0
0310 forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet ....... 40.0
0311 eyelids, nose, ears and lips ....... 50.0
(For each additional 3 square inches in the above procedures, add 50% of area value.)
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 flap, direct or tubed, (including direct closure of donor site) trunk ....... 20.0
0313 scalp, arms and legs ....... 30.0
0314 forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet ....... 40.0
0315 eyelids, nose, ears and lips ....... 50.0
0316 delay, intermediate transfer or sectioning of pedicle of tubed or direct flap, trunk ....... 15.0
0317 scalp, arms and legs ....... 22.0
0318 forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet ....... 30.0
0319 eyelids, nose, ears and lips ....... 37.0
0320 excision of lesion and/or preparation of recipient site and attachment of direct or tubed pedicle flap, trunk ....... 30.0
0321 scalp, arms and legs ....... 45.0
0322 forehead, cheeks, chin, mouth, neck, axilla, genitalia, hands and feet ....... 60.0
0323 eyelids, nose, ears and lips ....... 75.0
(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
0325 Derma-fat-fascia-graft (except to breast-0484) ....... 45.0
0330 Abrasion of skin, total face, for removal of scars, tattoos, etc. primary ....... 60.0
0331 secondary, total face ....... 30.0
0333 regional ( 1/4 face, cheeks, chin, forehead or elsewhere) primary ....... 15.0
0334 secondary, regional ....... 7.5
0335 Rhytidectomy, lower eyelids ....... 60.0
0336 upper eyelids ....... 40.0
0337 forehead ....... 50.0
0338 glabellar frown ....... 40.0
0339 cheeks, chin and neck ....... 150.0
0340 Facial nerve paralysis, free fascia grafts ....... 100.0
0341 re-animation-muscle transfers ....... 120.0
(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
0352 Dressings, initial or subsequent under anesthesia, small ....... 4.0
0353 under anesthesia, large or with major debridement, per hour ....... 10.0
0354 without anesthesia, small, office or hospital ....... 2.0
0355 without anesthesia, medium (whole face or whole extremity, etc.) ....... 3.0
0356 without anesthesia, large (more than one extremity, etc.) ....... 4.0
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
(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-, Tricholoracetic acid, phenol, etc.) or cryocautery (liquid N 2, CO 2, etc.) of benign or pre-malignant lesions of skin or mucous membrane (except 0405 and 0406) with or without curettement one lesion ....... 2.0
(50% for second lesion; over two, each additional lesion 25%.)
0404 complicated lesion(s) ....... by report
flat (plane, juvenile) warts, up to fifteen ....... 2.0
(Retreatment same as routine office visit.)
0406 Electro-surgical destruction of multiple fibro-cutaneous tags, up to fifteen ....... 2.0
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
0409 each subsequent treatment, up to five sections ....... 5.0
0410 each additional section over five ....... 1.0
0411 Cryotherapy-(CO 2 slush, liquid N 2 ) ....... 1.5
0412 Electrolysis epilation, each 1/2 hour ....... 3.0

Breast

Incision
0430 Puncture aspiration of cyst ....... 2.0
0431 Mastotomy with exploration or drainage of abscess, deep ....... 10.0
Excision
0441 Biopsy of breast ....... 15.0
0444 Excision of cyst, fibro-adenoma or other benign tumor, aberrant breast tissue, duct lesion (including gynecomastia) or nipple lesion (including any other partial mastectomy) male or female, unilateral ....... 15.0
0445 bilateral ....... 25.0
0446 Excision of chest wall tumor involving ribs ....... 70.0
0447 Excision of chest wall tumor involving ribs plus plastic reconstruction ....... 100.0
0457 Complete (simple) mastectomy ....... 30.0
0470 Radical mastectomy, including breast, pectoral muscles and axillary lymph nodes ....... 70.0
0481 Mammoplasty, plastic operation on breasts, reduction or repositioning, bilateral, one stage ....... 150.0
0482 two stage ....... by report
0483 augmentation, prosthetic, unilateral ....... 75.0
0484 bilateral ....... 100.0
0485 derma-fat fascia, unilateral ....... 100.0

MUSCULOSKELETAL SYSTEM

Listed values include the application of first cast or traction device only.
Incision
0501 Aspiration or curette biopsy of bone marrow ....... 3.0
0502 Needle (trocar) biopsy vertebra ....... 10.0
0506 Incision of superficial soft tissue abscess secondary to osteomyelitis ....... 2.0
0507 deep or complicated ....... by report
0513 Sequestrectomy for osteomyelitis or bone abscess ....... by report
0516 Removal of metal band, plate, screw or nail (independent procedure) ....... 15.0
(For pins, etc., see 0598, 0599.)
OSTEOTOMY-Cutting, division or transection of bone, with or without internal fixation
0526 Clavicle ....... 40.0
0527 Humerus ....... 50.0
0529 Radius ....... 40.0
0530 Ulna ....... 40.0
0531 Femur, neck, under age 8 ....... 80.0
0532 over age 8 ....... 100.0
0533 subtrochanteric ....... 80.0
0534 supracondylar ....... 70.0
0536 Tibia ....... 55.0
0537 Smaller bones (fibula, metacarpals, metatarsals, etc.) ....... 30.0
0538 Correction of bowlegs or knock-knees, unilateral ....... 50.0
0539 bilateral ....... 75.0
(For iliac osteotomy, see 1341, 1342.)
0540 Multiple osteotomies, single bones for realignment on intrameduliary rod, Scofield type procedure, humerus ....... 50.0
0541 radius or ulna ....... 50.0
0542 femur ....... 100.0
0543 tibia ....... 75.0
Excision
0549 Biopsy bone, radius, ulna, fibula, skull, sternum ....... 10.0
0550 humerus, pelvis, femur, tibia ....... 20.0
0551 vertebra ....... 40.0
(For needle biopsy, see 0502.) (Value of biopsy done preceding definitive surgery is 50 percent of listed value.)
0552 Claviculectomy, partial ....... 35.0
0553 total ....... 65.0
0554 Astragalectomy ....... 55.0
0556 Excision of head of radius ....... 35.0
0557 Carpectomy ....... 30.0
0560 Coccygectomy ....... 30.0
0561 Patellectomy or hemipatellectomy ....... 50.0
0563 Metatarsectomy ....... 25.0
0566 Excision of chondroma, osteochondroma, or exostosis; humerus, pelvis, femur, tibia, radius, fibula, ulna ....... 40.0
0567 small bones ....... 25.0
0568 Excision of bone cyst, simple, large bones ....... 40.0
0569 small bones ....... 25.0
(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
0577 small bones ....... 25.0
0578 Excision of tumor of mandible without replacement ....... 75.0
(For replacement see 0619.)
0580 Radical resection of bones for tumor with bone graft; scapula, humerus, pelvis, femur, tibia ....... 100.0
0581 other bones ....... 65.0
Introduction
(For associated procedures, see Fractures.)
0591 Insertion of wire, pin, caliper or tongs (independent procedure) ....... 5.0
0598 Removal buried wire or pin (independent procedure) ....... 2.0
0599 Removal of caliper or tongs (independent procedure) ....... 1.0
Repair
0611 Osteoplasty; shortening of bone, femur, tibia, humerus ....... 100.0
0612 radius, ulna ....... 65.0
0613 other bones ....... 45.0
0614 lengthing of bone ....... 100.0
0616 mandible for prognathism or micrognathism, one or two stages ....... 100.0
BONE OR CARTILAGE GRAFT-Osteoperiosteal graft, periosteal graft, or cartilage graft. Includes obtaining and placing of graft. Unless otherwise indicated, values are for autogenous grafts. When non-autogenous material is used, reduce value by 5.0 units.
0617 Bone graft; femur, tibia, humerus ....... 100.0
0618 radius, ulna ....... 65.0
0619 skull or significant portion of mandible ....... 100.0
0620 other bones, including chin, nose, malar prominences ....... 45.0
0621 Cartilage graft, autogenous, to face, nose, ear or skull ....... 70.0
Spinal Fusion (For fusion of childgood scoliosis, see 0643, 0644, 0645.)
(Items 0634-0642 refer to spinal procedures at one interspace; for each additional interspace, add 10%)
0634 Spinal fusion, cervical region, posterior technique ....... 90.0
0635 anterior technique ....... 80.0
0636 thoracic region, posterior or posterior-lateral technique ....... 90.0
0637 interbody technique, anterior, lateral or posterior ....... 100.0
0638 lumbar region, posterior or posterior-laterial technique ....... 90.0
(For interbody technique, anterior see 0642.)
0639 Spinal fusion with removal of intervertebral disc, cervical region, posterior, technique ....... 120.0
0640 anterior interbody technique ....... 80.0
0641 lumbar or thoracic region, posterior, posterior-lateral, or posterior interbody technique ....... 120.0
0642 anterior interbody technique ....... 100.0
0643 Spinal fusion for scoliosis, child or young adult (less than 18 years of age), up to and including five interspaces ....... 120.0
0644 Harrington rod technique ....... 150.0
0645 Halo technique ....... 150.0
(For adult scoliotic fusion see 0634-0642.)
0647 Scapulopexy ....... 65.0
0648 Patellapexy ....... 50.0
0649 Pectus excavatum, infants, plastic repair ....... 25.0
0650 Pectus excavatum (major) plastic repair ....... 90.0
0654 Epiphyseal-diaphyseal fusion; epiphyseal arrest; epiphysiodesis or stapling; femur ....... 55.0
0655 tibia and fibula, proximal or distal ....... 55.0
0656 combined distal femur and proximal tibia and fibula (knee) ....... 75.0
0657 combined proximal and distal, tibia and fibula ....... 75.0
0658 combined distal femur and proximal and distal tibia and fibula ....... 100.0
0660 Hemi-epiphyseal arrest (e.g., for genu varus or genu valgus) distal femur ....... 45.0
(For removal and reinsertion of staples at same operation, use values listed above.)
(For removal of staples only, 50% of listed values.)
(Free 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
0687 complicated (instrumental) closed reduction ....... 10.0
0688 open reduction, uncomplicated ....... 25.0
0689 complicated with either internal and/or external skeletal fixation ....... 40.0
0690 with concomitant open reduction of fractured septum ....... 60.0
0691 Malar, simple or compound, no reduction ....... Sv. ¶
0692 closed reduction (including towel clip technique) ....... 5.0
0693 depressed, open reduction ....... 30.0
0694 complicated, depressed, open reduction with internal skeletal fixation and multiple surgical approaches ....... 65.0
0698 Maxilla, simple or compound, no reduction ....... Sv. ¶
0699 closed reduction, with wiring of teeth ....... 30.0
0701 open reduction, with wiring of teeth and/or local fixation ....... 50.0
0702 complicated, open reduction, fixation by head cap, multiple surgical approaches, internal fixation, wiring teeth, etc ....... by report
(For antral approach, see 1988.)
0703 Mandible, simple or compound, no reduction ....... Sv. ¶
0704 closed reduction and wiring of teeth ....... 30.0
0705 open reduction with or without wiring of teeth ....... 50.0
0706 skeletal pinning with external fixation ....... 40.0
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
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
0742 compound, including uncomplicated soft tissue closure ....... 20.0
0743 simple or compound, open reduction ....... 40.0
0747 Scapula, simple, no reduction ....... Sv. ¶
0748 simple or compound, open reduction ....... 55.0
0756 Sternum, simple ....... Sv. ¶
0757 compound or complicated ....... by report
0761 Ribs, simple ....... Sv. ¶
0762 compound or complicated ....... by report
Pelvis (Illum, Ischlum, Pubis)
0767 Fracture, simple, no reduction ....... Sv. ¶
0768 complicated, closed reduction ....... by report
0771 compound, open reduction ....... 75.0
0772 Acetabulum, with or without other fractures of pelvis, simple, no reduction ....... Sv. ¶
0773 central, with displacement, requiring closed reduction ....... 55.0
0775 simple or compound, open reduction ....... 75.0
Upper Extremity
0778 Humerus, surgical neck, simple, not requiring reduction ....... Sv. ¶
0780 requiring manipulative reduction ....... 30.0
0781 compound, with uncomplicated soft tissue closure ....... 35.0
0782 simple or compound, open reduction ....... 50.0
0783 shaft, simple, not requiring reduction ....... Sv. ¶
0784 simple, closed reduction ....... 25.0
0785 compound, with uncomplicated soft tissue closure ....... 30.0
0786 simple or compound, open reduction ....... 45.0
0787 simple or compound, open reduction, skeletal pinning with external fixation ....... 40.0
0788 supracondylar or dicondylar, not requiring reduction ....... Sv. ¶
0789 closed reduction ....... 25.0
0790 compound, with uncomplicated soft tissue closure ....... 30.0
0791 simple or compound, open reduction ....... 50.0
0792 medial or lateral condyle, simple, not requiring reduction ....... Sv. ¶
0793 closed reduction ....... 20.0
0794 compound, with uncomplicated soft tissue closure ....... 25.0
0795 simple or compound, open reduction ....... 40.0
0796 Elbow, proximal end of ulna with dislocation of radial head simple, (Monteggia fracture) closed reduction ....... 20.0
0797 simple or compound, open reduction (See also 1292.) ....... 55.0
0798 Radius, head, simple, no reduction ....... Sv. ¶
0799 closed reduction ....... 15.0
0800 compound, with uncomplicated soft tissue closure ....... 20.0
0801 simple or compound, open reduction or excision (See also 0556.) ....... 35.0
0802 shaft, simple, no reduction ....... Sv. ¶
0803 simple, closed reduction ....... 20.0
0804 compound, with uncomplicated soft tissue closure ....... 25.0
0805 simple or compound, open reduction ....... 40.0
0806 distal end (e.g., Colle's type), simple, no reduction ....... Sv. ¶
0807 closed reduction ....... 15.0
0808 with severe comminution and impaction, closed reduction ....... 20.0
0809 simple or compound, open reduction ....... 40.0
0810 skeletal pinning, with external fixation ....... 30.0
0811 Ulna, proximal end, olecranon process, simple, no reduction ....... Sv. ¶
0812 compound, with uncomplicated soft tissue closure ....... 25.0
0813 simple or compound, open reduction and/or resection ....... 40.0
0814 shaft, simple, no reduction ....... Sv. ¶
0815 closed reduction ....... 20.0
0816 compound, with uncomplicated soft tissue closure ....... 25.0
0817 simple or compound, open reduction ....... 40.0
0818 skeletal pinning with external fixation ....... 30.0
0820 Radius and ulna shaft, simple, no reduction ....... Sv. ¶
0821 simple, closed reduction ....... 25.0
0822 compound, with uncomplicated soft tissue closure ....... 30.0
0823 simple compound, open reduction ....... 50.0
0824 skeletal pinning with external fixation ....... 40.0
(For Colle's fracture see 0806-0810.)
0827 Carpal bones, one or more, simple reduction ....... Sv. ¶
0830 simple or compound, open reduction ....... 35.0
0840 Metacarpal, simple, no reduction ....... Sv. ¶
0842 one, simple or compound, closed reduction with uncomplicated soft tissue closure ....... 10.0
0843 more than one, simple or compound, closed reduction, with uncomplicated soft tissue closure ....... 12.5
0844 one or more, simple or compound, open reduction ....... 30.0
0848 skeletal pinning with external fixation ....... 25.0
0852 Phalanx or phalanges, finger, proximal, middle or thumb, simple, no reduction ....... Sv. ¶
0853 closed reduction ....... 7.5
0854 compound, with uncomplicated soft tissue closure ....... 10.0
0855 simple or compound, open reduction ....... 20.0
0856 Phalanx or phalanges, distal, simple, no reduction ....... Sv. ¶
0857 simple or compound, closed reduction with uncomplicated soft tissue closure ....... 5.0
0858 simple or compound, open reduction ....... 12.5
Lower Extremity
0865 Femur, neck, simple, no reduction ....... Sv. ¶
0866 with fixation or traction ....... 50.0
0867 simple or compound, open reduction ....... 80.0
0868 multiple pinning, with or without external fixation ....... 80.0
0869 treatment with replacement prosthesis ....... 80.0
0872 intertrochanteric, simple, no reduction ....... Sv. ¶
0873 with fixation or traction ....... 45.0
0874 simple or compound, open reduction ....... 80.0
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
0879 reconstruction ....... 100.0
0880 shaft, including supracondylar, simple, no reduction ....... Sv. ¶
0881 simple, closed reduction ....... 40.0
0882 compound, with uncomplicated soft tissue closure ....... 45.0
0883 simple or compound, open reduction ....... 80.0
0884 skeletal pinning with external fixation ....... 60.0
0885 distal end, medial or lateral condyle, simple, no reduction ....... Sv. ¶
0886 condyle or condyles, simple, closed reduction ....... 35.0
0887 simple or compound, open reduction ....... 60.0
0889 Patella, simple, no reduction ....... Sv. ¶
0890 compound, with uncomplicated soft tissue closure ....... 25.0
0891 simple or compound, open reduction ....... 50.0
0893 Tibia, proximal end, tibial plateaus, condyle, condyles or intercondylar spines, simple, no reduction ....... Sv. ¶
0894 closed reduction ....... 25.0
0895 compound, with uncomplicated soft tissue closure ....... 30.0
0896 simple or compound, open reduction ....... 55.0
0901 shaft, simple, no reduction ....... Sv. ¶
0902 closed reduction ....... 25.0
0903 compound, with uncomplicated soft tissue closure ....... 30.0
0904 simple or compounded, open reduction ....... 50.0
0905 simple or compound, open or "blind" insertion of intramedullary rod (e.g., Lottes nail) ....... 50.0
0907 distal end, malleolus, simple, no reduction ....... Sv. ¶
0908 simple, closed reduction ....... 15.0
0909 compound, with uncomplicated soft tissue closure ....... 20.0
0910 simple or compound, open reduction ....... 40.0
0914 Fibula, shaft, simple, no reduction ....... Sv. ¶
0915 compound, with uncomplicated soft tissue closure ....... 20.0
0916 simple or compound, open reduction ....... 30.0
0920 distal end, malleolus, simple, no reduction ....... Sv. ¶
0921 closed reduction ....... 15.0
0922 compound, with uncomplicated soft tissue closure ....... 20.0
0923 simple or compound, open reduction ....... 40.0
0925 Tibia and fibula, shafts, simple, no reduction ....... Sv. ¶
0926 closed reduction ....... 30.0
0927 compound, with uncomplicated soft tissue closure ....... 35.0
0928 simple or compound, open reduction ....... 60.0
0930 skeletal pinning with external fixation ....... 40.0
0932 Ankle, bimalleolar (including Potts) simple, no reduction ....... Sv. ¶
0933 simple, closed reduction ....... 25.0
0934 compound, with uncomplicated soft tissue closure ....... 30.0
0935 simple or compound, open reduction ....... 50.0
0937 trimalleolar, simple, no reduction ....... Sv. ¶
0938 closed reduction ....... 30.0
0940 compound, with uncomplicated soft tissue closure ....... 35.0
0941 simple or compound, open reduction ....... 60.0
0943 Tarsal (except astragalus and os calcis) one or more, simple, no reduction ....... Sv. ¶
0944 closed reduction ....... 10.0
0945 compound, with uncomplicated soft tissue closure ....... 15.0
0946 simple or compound, open reduction ....... 30.0
0954 Astragalus, simple, no reduction ....... Sv. ¶
0955 simple, closed reduction ....... 20.0
0956 compound, with uncomplicated soft tissue closure ....... 25.0
0957 simple or compound, open reduction ....... 55.0
0960 Os calcis, simple, no reduction ....... Sv. ¶
0961 closed reduction ....... 20.0
0962 compound, with uncomplicated soft tissue closure ....... 25.0
0963 simple or compound, open reduction ....... 50.0
0964 skeletal pinning with external fixation ....... 40.0
0966 Metatarsal, simple, no reduction ....... Sv. ¶
0967 closed reduction ....... 10.0
0968 compound, with uncomplicated soft tissue closure ....... 15.0
0970 simple or compound, open reduction ....... 25.0
0975 Phalanx or phalanges, great toe, simple, no reduction ....... Sv. ¶
0976 simple, closed reduction ....... 5.0
0977 simple or compound, open reduction ....... 15.0
0979 other than great toe, simple, no reduction ....... Sv. ¶
0981 closed reduction ....... 5.0
0982 simple or compound, open reduction ....... 12.5

Joints

Incision
ARTHROTOMY or capsulotomy with exploration, drainage, or removal of loose body, e.g., osteochondritis of foreign body.
1001 Shoulder ....... 50.0
1002 Elbow ....... 50.0
1003 Wrist ....... 40.0
1005 Other joints of upper extremity ....... 30.0
1006 Finger, one ....... 15.0
1007 Hip ....... 70.0
1008 Knee ....... 50.0
(For miniscectomy, see 1082.)
1010 Ankle ....... 50.0
1013 Other joints of lower extremity ....... 30.0
1020 Toe, great toe ....... 15.0
1026 other ....... 10.0
1044 Arthrocentesis; puncture for aspiration of hemarthrosis, initial ....... 3.0
1045 subsequent ....... 2.0
1046 puncture for aspiration of joint effusion (not traumatic), or injection of medication, initial or subsequent ....... 2.0
1050 Sesamoid bone, excision, one or more, unilateral ....... 15.0
Excision
ARTHRECTOMY-Excision of joint (See also Arthrodesis.)
1065 Temporomandibular joint, unilateral ....... 75.0
1074 Excision of intervertebral disc ....... 90.0
(See also 5208-5211.)
(With spinal fusion, see 0639-0642.)
(For laminectomy for spondylolisthesis, see 5225.)
1082 Meniscectomy: excision of semilunar cartilage of knee joint ....... 50.0
1085 temporomandibular joint ....... 75.0
1093 Synovectomy elbow ....... 70.0
1101 hip ....... 80.0
1102 knee ....... 70.0
1103 ankle ....... 50.0
Introduction
1131 Injection procedure for arthography ....... 3.0
Repair
ARTHROPLASTY-Plastic or reconstructive operation on joint, any type unless otherwise specified.
1141 Shoulder (See also 1200, 1201.) ....... 80.0
1142 Elbow ....... 80.0
1143 Wrist ....... 80.0
1144 Finger, one joint ....... 30.0
1148 Hip, cup ....... 100.0
1149 replacement prosthesis, primary for fracture ....... 80.0
1150 secondary reconstruction ....... 100.0
(For acetabuloplasty, either 1148 or 1150, add 25% to listed values.)
1151 Knee ....... 100.0
1152 Ankle ....... 75.0
1154 Toe, one joint ....... 20.0
1159 Metatarsal-phalangeal joint; bunion operation, Silver type ....... 20.0
1160 Keller, McBride, etc., types ....... 30.0
1162 Joplin type ....... 35.0
1163 Club foot corrective procedure, medial release, Brockman type ....... 30.0
ARTHRODESIS-Fusion of joint (For spine see 0634-0645.)
1166 Shoulder ....... 90.0
1167 Elbow ....... 70.0
1168 Wrist ....... 60.0
1170 Finger, thumb, one joint ....... 20.0
1175 Hip ....... 100.0
1176 Knee ....... 80.0
1177 Ankle ....... 70.0
1178 Toe, one or more joints ....... 15.0
1179 Hammer toe operation, one toe ( e.g., inter-phalangeal fusion, filleting, phalanectomy) ....... 20.0
1183 Tarsal joints, one or more ( e.g., Grice procedure) ....... 50.0
1184 Other joints, lower extremity ....... 40.0
1185 Foot, triple arthrodesis, unilateral under age 14 years ....... 50.0
1186 over age 14 years ....... 60.0
With tendon transplantation see 1585, 1586
Suture
CAPSULORRAPHY OR RECONSTRUCTION
1200 Shoulder, suture or repair of joint capsule for recurrent dislocation (independent procedure), Putti-Platt, Magnusen types ....... 70.0
1201 Bankart type ....... 80.0
1206 Patella (See also 0561, 1352, 1632.) ....... 60.0
1211 Knee, suture of a torn, ruptured or severed collateral ligament ....... 55.0
1212 suture of a torn, ruptured or severed cruciate ligament ....... 55.0
1213 suture of torn, ruptured or severed collateral and cruciate ligaments ....... 75.0
1214 reconstruction of a collateral or cruciate ligament ....... 65.0
1215 both collateral or cruciate ligaments ....... 85.0
1216 Ankle, reconstruction of a collateral ligament, ankle ....... 45.0
1217 both ligaments ....... 60.0
1218 Hand, reconstruction, metacarpophalangeal or interphalangeal ligaments ....... 35.0
Manipulation
Manipulation of joint under general anesthesia, including application of fixation apparatus (dislocation excluded).
(For club feet and turnbuckle casts, see section on cast.)
1221 Shoulder ....... 5.0
1222 Elbow ....... 4.0
1223 Wrist ....... 4.0
1224 Digits, one or more, under anesthesia, where no other surgical procedure is performed ....... 2.5
1226 Hip ....... 6.0
1227 Knee ....... 5.0
1228 Ankle ....... 4.0
1232 Spine ....... 6.0
Dislocations
1251 Temporomandibular, simple, closed reduction, initial ....... 5.0
1252 subsequent ....... 1.0
1255 Vertebra, cervical, simple, closed reduction, using traction ....... Sv. ¶
1256 closed reduction with anesthesia ....... 55.0
1262 thoracic, simple, closed reduction with anesthesia ....... 55.0
1264 simple or compound, open reduction ....... 100.0
1267 lumbar, simple, closed reduction with anesthesia ....... 55.0
1270 simple or compound, open reduction ....... 100.0
1273 Clavicle, sternoclavicular, simple, no reduction ....... Sv. ¶
1274 closed reduction with anesthesia ....... 10.0
1275 simple or compound, open reduction ....... 40.0
1278 acromioclavicular, simple, no reduction ....... Sv. ¶
1279 closed reduction with anesthesia ....... 10.0
1281 simple or compound, open reduction ....... 40.0
1284 Shoulder (humerus), simple, closed reduction without anesthesia ....... Sv. ¶
1285 with anesthesia ....... 5.0
1286 simple or compound, open reduction ....... 55.0
1290 Elbow, simple, closed reduction ....... 5.0
1291 compound, with uncomplicated soft tissue closure ....... 25.0
1292 simple or compound, open reduction ....... 55.0
1295 Wrist, carpal, one bone, simple, closed reduction ....... 5.0
1296 compound, with uncomplicated soft tissue closure ....... 25.0
1297 simple or compound, open reduction ....... 45.0
1298 more than one bone, simple, closed reduction ....... 7.0
1300 compound, with uncomplicated soft tissue closure ....... 25.0
1301 simple or compound, open reduction ....... 45.0
1304 Metacarpal, one bone, simple, closed reduction ....... 3.0
1305 compound, with uncomplicated soft tissue closure ....... 10.0
1306 simple or compound, open reduction ....... 20.0
1315 Finger, one, one or more joints, simple, closed reduction ....... 3.0
1316 compound, with uncomplicated soft tissue closure ....... 7.5
1317 simple or compound, open reduction ....... 15.0
1326 Thumb, simple, closed reduction ....... 4.0
1327 compound, with uncomplicated soft tissue closure ....... 10.0
1328 simple or compound, open reduction ....... 20.0
1332 Hip (femur), simple, closed reduction ....... 20.0
1334 simple or compound, open reduction ....... 60.0
1338 congenital, abduction splinting or traction in any form ....... Sv. ¶
1339 congenital, closed reduction with anesthesia ....... 20.0
1340 congenital, open reduction and replacement of femoral head in acetabulum ....... 60.0
1341 iliac or acetabular osteotomy, ( e.g., Pemberton or Salter type), under age 8 ....... 80.0
1342 over age 8 ....... 100.0
(For dislocated or slipped femoral head epiphyses, see 0877-0879.)
1344 Knee (femoral-tibial joint), simple, closed reduction ....... 20.0
1345 compound, with uncomplicated soft tissue closure ....... 25.0
1346 simple or compound, open reduction ....... 60.0
1350 Patella, simple, closed reduction ....... 3.0
1351 compound, with uncomplicated soft tissue closure ....... 15.0
1352 simple or compound, open reduction (with or without partial or total patellectomy) ....... 50.0
(See also 0561, 1206 and 1632.)
1354 Distal tibial-fibular joint (ankle mortise), open reduction and fixation ....... 45.0
1355 Ankle, simple, closed reduction ....... 10.0
1356 compound, with uncomplicated soft tissue closure ....... 25.0
1357 simple or compound, open reduction ....... 50.0
1361 Tarsal, simple, closed reduction ....... 10.0
1362 compound, with uncomplicated soft tissue closure ....... 17.5
1363 simple or compound, open reduction ....... 45.0
1371 Astragalo-tarsal, simple, closed reduction ....... 10.0
1372 compound, with uncomplicated soft tissue closure ....... 17.5
1373 simple or compound, open reduction ....... 45.0
1376 Metatarsal, one bone, simple, closed reduction ....... 7.0
1377 compound, with uncomplicated soft tissue closure ....... 12.0
1378 simple or compound, open reduction ....... 25.0
1385 Toe, one, simple, closed reduction ....... 2.0
1386 compound, with uncomplicated soft tissue closure ....... 7.0
1387 simple or compound, open reduction ....... 15.0
1391 multiple joints and/or toes, simple, closed reduction ....... 7.0
1392 compound, with uncomplicated soft tissue closure ....... 12.0
1393 simple or compound, open reduction ....... 20.0

Bursae

Incision
1401 Drainage of infected bursa ....... 3.0
1406 Removal of subdeltoid calcium deposits ....... 25.0
1410 Removal of subtrochanteric calcium deposits ....... 30.0
1413 Needle puncture of bursa, with or without aspiration, injection or irregation, initial or subsequent ....... 2.0
Excision
1430 Radical excision of bursa, hand, wrist or forearm, ( i.e., tenosynovitis fungosa, Tbc., and other granulomas) ....... 50.0
1431 Excision of bursa, olecranon ....... 20.0
1433 prepatellar ....... 20.0
1435 subacromial (subdeltoid) ....... 25.0
1436 peritrochanteric, femur ....... 30.0
(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
1456 with resection of cervical rib ....... 50.0
1458 Division of sternocleidomastoid for torticollis open operation ....... 35.0
1460 Muscle biopsy, superficial ....... 5.0
1462 deep ....... 10.0
Suture
1495 Suture of ruptured diaphragm, chronic, transabdominal ....... 70.0
1496 transthoracic or combined ....... 80.0
1497 acute, traumatic ....... by report
(For other specific muscles, see 1633, 1640, 1654.)

Tendons, Tendon Sheaths and Fascia

Incision
1511 Drainage of tendon sheath, acute suppurative tenosynovitis, one digit ....... 3.0
1514 single palmar and/or ulnar or radial bursa ....... 30.0
1515 multiple or complicated ....... by report
1517 Injection of medication, tendon sheath ....... 2.0
1519 Incision of fibrous sheath of tendon for stenosing tenosynovitis, including freeing of tendons or removal of foreign body ....... 20.0
1531 Division of iliotibial band, open operation ....... 30.0
1534 Stripping of ilium (Soutter operation) ....... 40.0
Tenotomy
1535 Tenotomy, subcutaneous, corrective, single digit ....... 5.0
1536 multiple digits ....... 7.5
1537 adductor, hip ....... 10.0
1538 open, elbow to shoulder, single ....... 20.0
1539 multiple ....... 25.0
1540 elbow to wrist, single ....... 15.0
1541 multiple ....... 25.0
1542 knee to hip, single ....... 30.0
1543 multiple ....... 40.0
1544 knee to thigh, single ....... 15.0
1545 multiple ....... 30.0
Excision
1550 Excision of lesion of tendon or fibrous sheath, or ganglion, digits only ....... 10.0
1553 in other locations ....... 15.0
(For radical excision of bursa, forearm, i.e., tenosynovitis fungosa, Tbc., and other granulomas, see 1430.)
1562 Excision of synovial cyst of popliteal space (Baker's cyst) ....... 30.0
1570 Fasciotomy, palmar plantar, subcutaneous ....... 10.0
1573 Fasciectomy, for Dupuytren's contracture, partial ....... 30.0
1574 radical, including finger extensions and vertical bands ....... 50.0
Repair
Includes necessary initial dressing (including cast and/or splint application.)
1580 Repair or suture of an extensor tendon, primary or late, hand or foot, distal to wrist or ankle ....... 12.0
1582 forearm or leg ....... 18.0
1583 Repair or suture of a flexor tendon, primary or late, finger, hand or forearm foot or leg ....... 30.0
1585 Transfer, transplant or free tendon graft, distal to elbow, or distal to knee, single ....... 40.0
1586 multiple ....... 50.0
1587 elbow to shoulder or knee to hip, single ....... 50.0
1588 multiple ....... 60.0
1589 Tenolysis, single ....... 25.0
1590 multiple (any number through same incision) ....... 30.0
1591 Lengthening or shortening of tendon ( e.g. Achilles' tendon) ....... 30.0
(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
1612 Free fascial graft for reconstruction of tendon pulley or gliding surface, etc. ....... 15.0
1616 Abdominal fascial transplants, bilateral (Lowman type procedure) ....... 75.0
(For free fascial graft to face see 0340.)
1618 Fascia lata transplants, other ....... by report
1632 Patellar (extensor mechanism) advancement, with or without patellectomy ....... 60.0
1633 Ruptured quadirceps insertion ....... 45.0
1635 Ruptured Achilles' tendon from insertion at heel ....... 45.0
1639 Ruptured long head of biceps, proximal ....... 35.0
1640 Ruptured biceps tendon from insertion at elbow ....... 45.0
1641 Flexor-plasty, elbow (e.g., Steindler type advancement or extensor release) ....... 30.0
1654 Repair ruptured supraspinatus tendon or musculotendinous cuff shoulder, acute ....... 50.0
1655 Repair of complete shoulder cuff avulsion, chronic ....... 70.0

Extremities

Incision
1681 Drainage of felon, superficial ....... 2.0
1682 in hospital ....... 5.0
(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 EXTREMITY:
1701 Interthoracoscapular ....... 100.0
1703 Disarticulation of shoulder ....... 75.0
1705 Arm through humerus ....... 40.0
1708 Forearm, through radius and ulna ....... 40.0
1709 Open (Guillotine) arm ....... 35.0
1710 secondary closure or minor scar revision ....... 5.0
1711 reamputation ....... 40.0
1713 Cineplasty, complete procedure ....... 75.0
1718 Disarticulation through wrist or amputation of hand through metacarpal bones ....... 40.0
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
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
LOWER EXTREMITY:
1745 Interpelviabdominal ....... by report
1748 Disarticulation of hip ....... 80.0
1750 Disarticulation of knee ....... 40.0
1752 Thigh, through femur, including supracondylar ....... 60.0
1760 open (Guillotine) ....... 50.0
1761 secondary closure or minor revision ....... 5.0
1763 reamputation ....... 60.0
1767 Leg, through tibia and fibula ....... 50.0
1771 open (Guillotine) ....... 40.0
1772 secondary closure or minor revision ....... 5.0
1774 re-amputation ....... 50.0
1778 Ankle (Syme, Pirogoff types), with skin-plasty and resection of nerves ....... 50.0
1782 Midtarsal ....... 35.0
1785 Foot, transmetatarsal ....... 35.0
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
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
1803 more than one ....... 15.0
Repair
1811 Freeing of web fingers, with flaps ....... 35.0
1815 with skin graft ....... 45.0
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
1841 bilateral ....... 3.5
(If over age 24 months, see casts, general.)
1842 Wedging club-foot cast single ....... 1.0
1843 bilateral ....... 1.5
(For children 10 years of age or under, reduce listed values 1851-1890 by 30%.)
1851 Molded plaster to forearm (splint) ....... 2.0
1854 Elbow to fingers (short arm) ....... 2.0
1856 Hand and wrist (gauntlet) ....... 2.0
1860 Shoulder to hand (full arm) ....... 3.0
1862 Shoulder spica ....... 6.0
1863 Thigh-foot, molded splint ....... 3.0
1864 Leg-foot, molded splint ....... 2.0
1865 Ankle (foot to midleg) (short leg) ....... 3.0
1867 Knee (foot to thigh) (long leg) ....... 4.0
1871 Ambulatory leg cast (walking boot cast) ....... 3.5
1878 Hip spica, unilateral ....... 7.0
1882 bilateral ....... 8.0
1884 Body, shoulder to hips ....... 8.0
1885 including head ....... 10.0
1886 Risser jacket, localizer, body only ....... 12.5
1887 including head ....... 15.0
1888 Turnbuckle jacket, body only for scoliosis ....... 12.5
1889 including head ....... 15.0
1890 "Halo" type fixation and cast ....... 20.0
1891 Unna boot ....... 2.0
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
1905 Drainage of septal abscess or hematoma ....... 2.5
Excision
1911 Biopsy, soft tissue, nose ....... 3.0
1916 Excision of nasal polyp(s) one or more, unilateral or bilateral, one or more stages, office ....... 7.0
1917 complicated, requiring hospitalization ....... 20.0
(For excision of nasopharyngeal fibroma, see 3006.)
1924 Excision or surgical planning of skin of nose for rhinophyma ....... 35.0
1928 Submucous resection, classic, nasal septum ....... 30.0
(For septoplasty, see 1952.)
1935 Resection of inferior turbinate (submucous), complete or partial, unilateral or bilateral (independent procedure) ....... 15.0
Endoscopy
1941 Removal of intranasal foreign body by rhinoscopy ....... 2.0
1942 by lateral rhinotomy ....... by report
Repair
See also Repair-Complex 0260-0324, and 0620, 0621.)
1950 Rhinoplasty, lateral and alar cartilages and/or elevation of nasal tip ....... 40.0
1951 complete, external parts including bony pyramid, lateral and alar cartilages, and/or elevation of nasal tip ....... 80.0
1952 including major septal repair ....... 90.0
1953 secondary minor revision ....... 15.0
(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
1959 Repair choanal altresia, intranasal ....... 10.0
1960 transpalantine ....... 60.0
1961 Lysis of synechia ....... 2.0
1962 Repair of oromaxillary fistula ....... by report
1963 with radical antrotomy ....... 50.0
1964 Repair oronasal fistula ....... 20.0
1965 Reconstruction, functional, of the internal nose ....... 40.0
Destruction
1966 Cauterization of turbinates, unilateral or bilateral (independent procedure) ....... 2.0
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
1973 posterior, with cauterzation or posterior nasal packs, with or without anterior pack, initial ....... 10.0
1974 subsequent ....... 2.0
1978 by ligation of anterior ethmoidal artery ....... 30.0

Accessory Sinuses

Incision
1981 Antrum lavage. puncture or natural ostium, unilateral ....... 2.0
1982 bilateral ....... 3.0
1983 Antroscopy ....... 4.0
1985 Antrotomy, intranasal, unilateral ....... 15.0
1986 bilateral ....... 25.0
1988 Radical (Caldwell-Luc), unilateral ....... 50.0
1989 bilateral ....... 65.0
1991 Sphenoid sinusotomy ....... 30.0
1992 Frontal sinusotomy, external, simple (trephine operation) ....... 20.0
1993 transorbital, unilateral ....... 40.0
1994 radical, obliterative ....... 60.0
1995 Combined external frontal, ethmoidal and sphenoidal sinusotomy, unilateral ....... 80.0
Excision
2006 Ethmoidectomy, intranasal or external, unilateral ....... 30.0
2017 Maxillectomy, unilateral, with or without orbital exenteration and/or lateral rhinotomy ....... 100.0
2019 Hypophisectomy, transeptal ....... 70.0
(See also 5130.)

Larynx

Incision
2041 Laryngofissure with removal of tumor or laryngocele ....... 60.0
2042 Thyrotomy, diagnostic ....... 35.0
2043 for laryngeal web, two stage, with Keel insertion, (McNaught type) ....... 90.0
2044 for laryngeal stenosis with graft or core mold, including tracheotomy ....... by report
Excision
2051 Laryngectomy, without neck dissection ....... 100.0
2054 with neck dissection ....... 140.0
2055 Hemilaryngectomy ....... 60.0
2056 Arytenoidectomy, external approach (See also 2084.) ....... 70.0
2057 Epiglottidectomy, external approach ....... 60.0
2058 endoral approach ....... 25.0
Introduction
2060 Injection procedure for bronchography, indirect method ....... 3.0
2061 with insertion of catheter, (independent procedure) ....... 4.0
2062 Endotracheal intubation, emergency procedure ....... 5.0
Endoscopy
2070 Laryngoscopy, indirect with biopsy ....... 4.0
2071 direct, diagnostic (independent procedure) ....... 10.0
2072 operative, including foreign body removal ....... 30.0
2073 with biopsy ....... 15.0
2074 including excision of tumor ....... 25.0
2075 with Lynch suspension ....... 30.0
2084 Endoscopic arytenoidectomy ....... 50.0

Trachea and Bronchi

Incision
2101 Tracheotomy (independent procedure) ....... 20.0
2102 Tracheal fenestration ....... 50.0
Endoscopy
2111 Bronchoscopy, diagnostic ....... 15.0
2113 with biopsy ....... 20.0
2117 with removal of foreign body ....... 25.0
2120 with excision of tumor ....... 25.0
2121 with therapeutic aspiration of bronchus ....... 15.0
2122 with drainage of lung abscess or cavity, initial ....... 15.0
2123 with injection of contrast media ....... 15.0
2124 subsequent ....... 10.0
2126 Catheterization for bronchospirometry (independent procedure) (exclusive of gas analysis) ....... 10.0
2127 Tracheal aspiration (independent procedure) under direct vision ....... 10.0
2128 indirect ....... 1.0
Repair
2131 Tracheoplasty: plastic operation on trachea, cervical ....... by report
2132 intrathoracic ....... by report
2133 Bronchoplasty, graft repair ....... by report
2134 excision of stenosis and anastomosis ....... by report
2135 with lobectomy and anastomosis ....... by report
Suture
2141 Tracheorrhaphy: suture of external tracheal wound or injury, depending on structure and extent of injury, cervical ....... by report
2142 intrathoracic ....... by report
2144 Closure of tracheostomy or tracheal fistula ....... 25.0
2147 Closure of tracheo-esophageal fistula ....... 90.0
2148 complicated ....... by report
Incision
2151 Thoracotomy, exploratory, including biopsy ....... 50.0
2152 including control of hemorrhage and/or repair of lung fistula ....... 75.0
2153 for postoperative complications ....... 75.0
2154 with open drainage of empyema cavity by rib resection (independent procedure) ....... 40.0
2155 with cyst removal ....... 75.0
2157 with closed drainage of empyema cavity; tube drainage with negative pressure (independent procedure), in hospital ....... 5.0
2160 with removal of intrapleural foreign body or fibrin body ....... 70.0
2161 with cardiac massage ....... by report
2163 with open intrapleural pneumonolysis (See also 2207.) ....... 75.0
2170 Pneumonotomy, with open drainage of pulmonary abscess or cyst ....... 60.0
2173 with removal of foreign body from lung ....... 75.0
2177 Decortication, pulmonary, total ....... 100.0
2180 Pneumonocentesis: puncture of lung for aspiration biopsy ....... 5.0
2183 Thoracentesis: puncture of pleural cavity for aspiration, initial or subsequent ....... 3.0
Excision
2191 Pneumonectomy, total ....... 100.0
2193 Lobectomy, total, subtotal or segmental ....... 100.0
2194 with concomitant decortication ....... 125.0
2195 Wedge resection, single or multiple ....... 80.0
2196 Pulmonary resection with concomitant thoracoplasty ....... 150.0
2197 Pleurectomy, any type (independent procedure) ....... 50.0
Endoscopy
2201 Thoracoscopy, exploratory (independent procedure) ....... 20.0
2204 with biopsy ....... 20.0
2207 Closed intrapleural pneumonolysis ....... 30.0
Surgical Collapse Therapy
Thoracoplasty
2211 Extrapleural resection of ribs, any type, first stage ....... 60.0
2212 second stage ....... 30.0
2213 third stage ....... 30.0
2217 Extrapleural pneumonolysis, including associated filling or packing procedures ....... 60.0
2218 Extraperiosteal pneumonolysis, including associated filling or packing procedures ....... 70.0
2221 Pneumothorax: intrapleural injection of air, initial ....... 5.0
2222 subsequent ....... 2.0

CARDIOVASCULAR SYSTEM

Heart and Pericardium

Values for principal surgeon only.
Incision
2301 Cardiotomy, exploratory (includes removal of foreign body) ....... 100.0
2305 Pericardiotomy with exploration, drainage or removal of foreign body ....... 100.0
2309 pericardiocentesis, initial ....... 5.0
2310 subsequent ....... 4.0
2311 Blalock-Hanlon procedure (creation of atrial-septal defect) (closed) ....... 150.0
Excision
2316 Pericardiectomy, extensive ....... 120.0
2317 Excision intracardiac tumor ....... 200.0
2319 Infundibular stenosis ....... by report
Introduction
Listed values include usual preassessment of clinical problem and recording of intracardiac pressures.
2330 Catheterization of heart, including recording of intracardiac pressures where indicated (independent procedure) right ....... 35.0
2331 left, percutaneous ....... 15.0
2332 trans-septal ....... 20.0
2333 retrograde ....... 20.0
2334 combined left and right ....... 45.0
2335 final evaluation and report only ....... 5.0
Suture
2337 Cardiorrhaphy: suture of heart wound or injury ....... 100.0
Repair
2340 Aortic valve, valvotomy (commissurotomy) (closed) ....... 150.0
2341 valvuloplasty for stenosis or insufficiency (open) ....... 200.0
2342 replacement (open) ....... 200.0
2343 Pulmonic valve, valvotomy (commissurotomy) (closed) ....... 150.0
2344 valvotomy; infundibular stenosis (open) ....... 200.0
2345 Mitral valve, valvotomy (commissurotomy) (closed) ....... 140.0
2346 valvuloplasty for stenosis or insufficiency (open) ....... 200.0
2347 replacement (open) ....... 200.0
2348 Tricuspid valve ....... by report
2349 Coronary endarterectomy, myocardial revascularization by implantation or anastomosis ....... 100.0
2350 Myocardial aneurysm ....... 200.0
2351 Atrial septal defect (secundum type; endocardial cushion defect) (open) ....... 180.0
2352 Ventricular septal defect (open) ....... 180.0
2353 Tetralogy of Fallot (with or without previous shunt) (open) ....... 200.0
2354 Aortic sinus of Valsalva fistula (open) ....... 200.0
2355 Repair anomaleus pulmonary venous connection, total (open) ....... 200.0
2356 Insert internal pacemaker with myocardial electrodes, initial ....... 100.0
2357 replacement or repair ....... 30.0
2358 Pervenous or transvenous insertion of a pacemaker and subcutaneous implantation of a battery ....... 50.0
2359 Subcutaneous implantation of a battery (used with code 2330, right heart catheterization, currently in fee schedule) ....... 18.75

Arteries and Veins

Incision
Arteriotomy - With removal of embolus:
2373 Trunk ....... 80.0
2374 Neck ....... 60.0
2375 Extremity ....... 60.0
Phlebotomy - With removal of thrombus:
2380 Trunk ....... 70.0
2381 Extremity ....... 45.0
Excision
2390 Thromboendarterectomy, abdominal aorta and iliac arteries and/or femoral arteries ....... 150.0
2392 femoral and/or popliteal arteries ....... 120.0
2394 carotid artery ....... 120.0
2400 Excision and graft or bypass graft of arch of aorta ....... by report
2404 Excision and graft, thoracic aorta ....... 150.0
2408 abdominal aorta ....... 150.0
2412 extremity ....... 120.0
2420 Excision of arteriovenous fistula (See also 2474.) ....... by report
Introduction
2441 Venopuncture, withdrawal of venous blood, intravenous injection (femoral, internal or external jugular 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 years of age ....... 3.0
2443 Exposure of and incision into vein ("cutdown") for fluid therapy or indirect transfusion, under one year of age ....... 4.0
2445 Blood transfusion, indirect method ....... 2.0
2446 replacement type, infant, initial or subsequent ....... 30.0
2448 direct method ....... 5.0
2450 "push" transfusion, given under two years of age ....... 5.0
2454 Injection of sclerosing solution into vein of leg, one ....... 1.0
2455 two or more injections, same leg ....... 2.0
Repair
2460 Repair aneurysm of aorta, lateral repair ....... 150.0
2464 dissecting ("window" operation) ....... 150.0
2466 Banding of pulmonary artery ....... 100.0
2472 Repair of aortic arch anomalies (vascular ring) ....... 120.0
2473 Repair of atrial septal defect ....... 200.0
2474 Repair of arterio-venous fistula, plastic procedure ....... by report
(For aortic anastomosis, see also 2400-2408, 2472.)
2475 Excision of coarctation of aorta with primary anastomosis (See also 2400-2408.) ....... 150.0
2478 Pulmonary-subclavian anastomosis, Potts ....... 150.0
2482 Blalock ....... 120.0
2486 Pulmonary-superiorcaval anastomosis, Glenn ....... 150.0
2487 Baffes procedure: inferior cava to left atrium-right pulmonary vein to right antrium ....... 150.0
2490 Portocaval anastomosis ....... 100.0
2496 Splenorenal anastomosis ....... 100.0
Suture
2511 Arteriorrhaphy: suture of wound or injury of artery (independent procedure), trunk ....... 60.0
2512 extremity ....... 30.0
2515 Phleborrhaphy: suture of wound or injury of vein (independent procedure), trunk ....... 60.0
2516 extremity ....... 20.0
2520 Ligation and division of ductus arteriosus ....... 100.0
2522 Ligation of carotid artery ....... 40.0
2525 Ligation and division of inferior vena cava ....... 60.0
2526 Ligation of femoral vein ....... 25.0
2530 Ligation and division of common iliac vein ....... 50.0
2558 Ligation and division of long saphenous vein at saphenofemoral junction, with or without retrograde injection or distal interruptions ....... 20.0
2561 Ligation and division and complete stripping of long or short saphenous veins, unilateral ....... 30.0
2562 bilateral ....... 50.0
2563 long and short saphenous veins, unilateral ....... 40.0
2565 bilateral ....... 60.0
2576 Ligation and division of short saphenous vein at saphenopopliteal junction (independent procedure) ....... 12.5
2581 minor varicose vein of leg, initial ....... 5.0
2585 subsequent ....... 3.0
Hemodialysis-Related Surgical Procedures
2590 Insertion of initial arterio-venous shunt (Including revisions during 21 follow-up days) ....... 50.0
2591 Revision of either arterial or venous cannula ....... 31.25
2592 Construction of arterio-venous fistula ....... 50.0

HEMIC AND LYMPHATIC SYSTEMS

Spleen

Excision
2601 Splenectomy ....... 60.0
Introduction
2610 Injection procedure for splenoportography ....... 10.0

Lymph Nodes and Lymphatic Channels

Incision
2631 Drainage of lymph node abscess or lymphadenitis, simple ....... 3.0
2632 extensive ....... by report
Excision
2641 Biopsy or excision of lymph node (independent procedure) (except 2642) ....... 5.0
2642 anterior scalene ....... 15.0
Radical Lymphadenectomy
(Radical resection of lymph nodes):
2651 Supra-hyoid, unilateral ....... 50.0
2652 bilateral ....... 60.0
2655 Cervical (complete), unilateral ....... 80.0
2658 Axilla ....... 50.0
2671 Groin, superficial ....... 50.0
2672 deep, with common iliac dissection ....... 80.0
2673 Retroperitoneal, extensive, including pelvic, aortic and renal dissection ....... 100.0
Introduction
2676 Injection procedure for lymph-angiography, unilateral ....... 10.0
2677 bilateral ....... 15.0

MEDIASTINUM

Incision
2680 Mediastinotomy with exploration or drainage, cervical approach ....... 40.0
2681 transthoracic ....... 80.0
2683 Foreign body removal, cervical approach ....... 70.0
2684 transthoracic ....... 80.0
Excision
2691 Excision of mediastinal cyst ....... 80.0
2693 Excision of mediastinal tumor ....... 100.0
2696 Ligation or repair, thoracic duct ....... 75.0

DIGESTIVE SYSTEM

Mouth

Incision
2701 Drainage of sublingual abscess ....... 2.0
2705 Drainage of Ludwig's angina ....... 8.0

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 ("lip peel") ....... 40.0
2739 Transverse wedge excision, lip ....... 25.0
2743 V-excision of large lesion of lip up to one-half lip ....... 25.0
2746 Resection of more than one-half lip without plastic closure ....... 25.0
(With plastic closure, primary or secondary see 0260-0324.)
Repair (Cheiloplasty)
2754 Plastic repair of cleft lip, primary, unilateral ....... 70.0
2758 bilateral, one stage ....... 90.0
2759 bilateral, two stages, per stage ....... 60.0
(For secondary, local revision, unilateral or bilateral see 0260-0324.)
2762 Plastic repair (secondary) of unilateral cleft lip by recreation of defect and reclosure ....... 70.0
2765 Plastic repair (secondary) of bilateral harelip by recreation of defect and reclosure-per major stage ....... 60.0
(For plastic or reconstruction operation on lip see also 0260-0324.)

Tongue

Incision (Glossotomy)
2771 Drainage of lingual abscess ....... 2.0
Excision (Glossectomy)
2781 Biopsy of tongue, anterior third ....... 3.0
2782 posterior two-thirds ....... 5.0
2785 Partial glossectomy or hemiglossectomy ....... 40.0
2787 Complete or total glossectomy ....... 70.0
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 cellulitis, intraoral ....... 2.0
2820a General anesthesia for multiple extractions in hospital

Palate and Uvula

Incision
2871 Incision and drainage of abscess of palate ....... 2.0
Excision
2881 Biopsy of palate ....... 3.0
(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
(For resection of palate with reconstruction see 0277-0283, 0312-0323.)
2887 Uvulectomy: excision of uvula ....... 3.0
Repair
2890 Palatoplasty: plastic operation for cleft palate, partial ....... 60.0
2892 complete, including alveolar ridge ....... 80.0
2895 major revision ....... 60.0
2897 secondary lengthening procedure ....... 70.0
2898 attachment pharyngeal flap ....... 60.0
2899 alveolar ridge, anterior palate defect ....... 30.0
(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
2912 Drainage of submaxillary abscess ....... 5.0
2914 Sialolithotomy, submaxillary or parotid, uncomplicated ....... 3.0
2915 Sialolithotomy, submaxillary, complicated ....... 10.0
2916 Sialolithotomy, parotid extraoral ....... 25.0
Excision
2921 Biopsy of salivary gland ....... 5.0
2927 Excision of parotid tumor or gland, superficial without nerve dissection ....... 20.0
2928 with nerve dissection ....... 60.0
2934 Excision of parotid gland, total, with dissection of facial nerve ....... 70.0
2937 with sacrifice of facial nerve ....... 60.0
2938 Excision of submaxillary tumor and/or gland ....... 40.0
Repair (Sialodochoplasty)
2941 Plastic repair of salivary duct, simple ....... 35.0
2942 complicated ....... by report
Introduction
2945 Injection procedure for sialography ....... 1.0
Suture
2951 Closure of salivary fistula ....... 40.0
Manipulation
2961 Dilation of salivary duct; ptyalectasis ....... 1.0

Pharynx, Adenoids and Tonsils

Incision
2970 Drainage of peritonsillar abscess ....... 3.0
2971 Drainage of retropharyngeal or parapharyngeal abscess, intraoral ....... 10.0
2973 external approach ....... by report
Excision
2981 Biopsy of oropharynx ....... 3.0
2982 hypopharynx ....... 5.0
2983 nasopharynx ....... 5.0
(For larynx, see 2070 or 2073.)
2984 Excision of pharyngoesophageal diverticulum, single stage ....... 50.0
2985 multiple stages ....... 60.0
2989 Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues ....... 15.0
2990 extending beneath subcutaneous tissues ....... 50.0
2992 Tonsillectomy, with or without adenoidectomy, under age 18 years ....... 15.0
2993 18 years or over ....... 20.0
2994 Adenoidectomy (independent procedure), primary or secondary ....... 10.0
3000 Excision of tonsil tag(s), hospital ....... 10.0
3002 office ....... 6.0
3004 Excision of lingual tonsil (independent procedure) ....... 10.0
3005 Excision of nasopharyngeal fibroma ....... by report
Suture
3006 Suture of wound or injury of pharynx ....... by report
Repair
3011 Pharyngoplasty: plastic or reconstructive operation on pharynx ....... by report
(For pharyngeal flap, see 2898.)

Esophagus

Incision
3031 Esophagotomy, cervical ....... 60.0
3032 for removal of foreign body, cervical ....... 60.0
3033 thoracic ....... 80.0
Excision
3043 Esophagectomy: resection of esophagus, transpleural or extrapleural (upper two-thirds) ....... 120.0
3045 Esophagogastrectomy, combined thoraco-abdominal ....... 120.0
3046 Local excision, end-to-end anastomosis ....... 90.0
Endoscopy
3051 Esophagoscopy, diagnostic ....... 15.0
3053 with insertion of radioactive substance ....... 20.0
3055 with biopsy ....... 20.0
3057 with foreign body removal ....... 25.0
3061 with dilation, direct ....... 20.0
3063 subsequent dilation ....... 15.0
(See also 3092, 3095.)
Repair
3071 Esophagoplasty: plastic repair or reconstruction of esophagus ....... by report
3072 Esophagogastrostomy (cardioplasty) ....... 80.0
3073 Esophagomyotomy (Heller type) ....... 80.0
3074 Esophagoduodenostomy (including total gastrectomy) ....... 100.0
3075 Esophagojejunostomy, including total gastrectomy ....... 100.0
3076 Esophagostomy: fistulization of esophagus, external ....... 60.0
Suture
3077 Direct ligation of esophageal varices ....... 80.0
3081 Suture of esophageal wound, injury or rupture, cervical approach ....... by report
3083 transthoracic ....... 70.0
3086 Closure of esophagostomy or other external esophageal fistula, cervical ....... 45.0
3087 thoracic ....... 70.0
Manipulation
3092 Dilation of esophagus by sound, bougie or bag, indirect, initial ....... 5.0
3095 subsequent ....... 3.0
(For direct see 3061 and 3063.)

Stomach

Incision
3101 Gastrotomy with exploration or foreign body removal ....... 50.0
3105 Pyloromyotomy: cutting of pyloric muscle (Fredet-Ramsted type operation) ....... 50.0
Excision
3111 Biopsy by laparotomy ....... 50.0
3112 Local excision of ulcer or tumor ....... 60.0
3114 Total gastrectomy ....... 100.0
3115 Subtotal or hemi-gastrectomy, without vagotomy ....... 80.0
3116 with vagotomy ....... 90.0
3117 Vagotomy and pylorplasty ....... 70.0
(See also 3131.)
Endoscopy (independent procedure)
3121 Gastroscopy, diagnostic ....... 15.0
3123 with biopsy ....... 15.0
Suture
3131 Pyloroplasty ....... 50.0
3133 Gastroduodenostomy ....... 60.0
3135 Gastrojejunostomy ....... 60.0
3136 with vagotomy ....... 75.0
3137 Gastrostomy ....... 40.0
3141 Gastrorrhaphy: suture of perforated duodenal or gastric ulcer, wound or injury ....... 50.0
3144 Revision of gastroduodenal anatomosis (gastroduodenostomy) with reconstruction, without vagotomy ....... 90.0
3145 with vagotomy ....... 100.0
3146 Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, without vagotomy ....... 90.0
3147 with vagotomy ....... 100.0
3153 Closure of gastrostomy, surgical ....... 40.0

Intestines (Except Rectum)

Incision
3161 Enterotomy with exploration or foreign body removal, small bowel ....... 60.0
3162 large bowel ....... 65.0
3166 Exteriorization of intestine (Mikulicz resection of colon, with or without crushing of spur) ....... 70.0
Excision
3171 Excision of one or more lesions of small or large bowel not requiring anastomosis, exteriorization or fistulization, single enterotomy ....... 60.0
3172 multiple enterotomies ....... 70.0
3174 Enterectomy: resection of small intestine with anastomosis ....... 70.0
3176 with enterostomy ....... 70.0
3178 Colectomy, partial resection of large intestine in two stages, including first stage colostomy or cecostomy ....... 100.0
3179 Colectomy, partial, with anastomosis with or without concomitant proximal colostomy ....... 80.0
3180 total, with ileostomy or ilioproctostomy ....... 110.0
3181 with proctectomy and ileostomy ....... 120.0
3191 Enteroenterostomy; anastomosis of intestine ....... 60.0
ENTEROSTOMY - External fistulization of intestines (independent procedure):
3193 small bowel (ileostomy or jejunostomy) ....... 50.0
3195 large bowel, (colostomy or cecostomy) ....... 50.0
3197 small or large bowel, for ulcerative colitis ....... 75.0
3200 Reduction of volvulus, intussusception, internal hernia, by laparotomy ....... 60.0
3203 Revision of colostomy, simple, (release of superficial scar) ....... 5.0
3204 complicated (reconstruction in depth) ....... 25.0
Destruction
3211 Enterolysis (freeing of intestinal adhesion) ....... 40.0
3212 with acute bowel obstruction ....... 60.0
3213 Intestinal plication (Noble type) ....... 60.0
Suture
3220 Suture of intestine (enterorrhaphy), large or small, for perforated ulcer, wound, injury or rupture, single ....... 60.0
3221 multiple ....... by report
3222 Suture of intestine with colostomy ....... 70.0
3225 Closure of enterostomy, large or small intestine ....... 40.0
3227 Closure of fecal fistula ....... by report

Meckel's Diverticulum and the Mesentery

Excision
3231 Excision of Meckel's diverticulum (diverticulectomy) ....... 50.0
3235 Excision of lesion of mesentery ....... 50.0
(With bowel resection, see 3174.)
Suture
3241 Suture of mesentery ....... 40.0

Appendix

Incision
3251 Incision and drainage of appendicular abscess, transabdominal ....... 30.0
Excision
3261 Appendectomy ....... 40.0

Rectum

Incision
3282 Transrectal drainage of pelvic abscess ....... 15.0
3283 Incision and drainage of deep supralevator, pelvirectal or retrorectal abscess ....... 20.0
(See also 3357, 3358.)
Excision
3291 Complete proctectomy, combined abdomino-perineal, one or two stages ....... 100.0
3292 Complete proctectomy for congenital megacolon (Swenson type procedure) ....... 100.0
3294 Excision of rextal procidentia, with anastomosis, perineal approach ....... 60.0
3295 abdominal and perineal approach ....... 100.0
3296 Division of stricture in rectum ....... 20.0
3298 Perineal excision of primary or recurrent malignant tumor (Kraske type) ....... 80.0
3299 Local excision of extensive villous papilloma of rectum ....... 40.0
Endoscopy (independent procedure)
3310 Proctosigmoidoscopy, diagnostic, initial ....... 3.0
3311 subsequent ....... 2.0
3312 with biopsy, initial ....... 5.0
3313 subsequent for same lesion ....... 3.0
3314 with removal of papilloma or polyp, initial ....... 7.0
3315 subsequent for same lesion ....... 5.0
3316 with removal of multiple papillomas or polyps ....... 9.0
3317 complicated ....... by report
3318 Endoscopic control of hemmorrhage ....... by report
3319 Endoscopic removal of foreign body, anus or rectum ....... by report
Repair
3320 Proctoplasty, for stenosis ....... 40.0
3321 for prolapse of mucous membrane ....... 40.0
3322 Perirectal injection of sclerosing solution for prolapse, in hospital ....... 10.0
3323 Proctopexy for prolapse, abdominal approach ....... 60.0
3325 Proctopexy combined with sigmoid resection, abdominal approach ....... 90.0
Suture
3331 Closure of rectovesical fistula ....... 60.0
(See also 3965.)
3333 Closure of rectourethral fistula ....... 70.0
(See also 4026.)
3335 Closure of rectovaginal fistula ....... 60.0
(When a colostomy is part of the above procedures, add 10 units.)
Manipulation
3341 Reduction of procidentia (independent procedure) ....... 2.0

Anus

Incision
3351 Fistulotomy or fistulectomy, subcutaneous ....... 10.0
3352 submuscular ....... 40.0
3353 complex or multiple ....... by report
3354 second stage ....... 10.0
3355 Remove seton, office ....... 2.0
3356 Incision and drainage of ischiorectal abscess (independent procedure) ....... 10.0
3357 Incision and drainage, perianal abscess (See also 3283.) ....... 2.0
3358 Incision and drainage of ischiorectal abscess with fistulotomy or fistulectomy, submuscular (See also 3283.) ....... 40.0
3364 Sphincterotomy, anal: division of anal sphincter (independent procedure) ....... 5.0
Excision
3371 Fissurectomy, with or without sphincterotomy ....... 20.0
3372 Cryptectomy, single, office ....... 5.0
3373 multiple, hospital procedure ....... 30.0
3374 Papillectomy or excision of single tab (independent procedure), office ....... 3.0
3375 Excision of external hemorrhoidal tags and/or multple papillae, office ....... 5.0
3377 Hemorrhoidectomy, external, complete ....... 20.0
3380 internal and external ....... 30.0
3381 radical (Buie or amputative type) ....... 40.0
3382 Fistulotomy or fistulectomy, submuscular, and hemorrhoidectomy ....... 40.0
3386 Fissurectomy and hemorrhoidectomy ....... 30.0
3392 Enucleation or excision of external thrombotic hemorrhoid ....... 3.0
Introduction
3401 Hemorrhoids, injection of sclerosing solution ....... 2.0
Endoscopy (independent procedure)
3411 Anoscopy, diagnostic with or without biopsy ....... 1.0
(For with removal of foreign body see 3319.)
(For control of hemorrhage, endoscopic, see 3318.)
Repair
3420 Anoplasty: plastic operation for stricture ....... 40.0
3421 infant, minor thin septum ....... 5.0
3422 Construction of anus for congenital absence, perineal approach ....... 50.0
3423 combined abdominal and perineal approach ....... 80.0
3425 Sphincteroplasty, anal, for incontinence ....... 40.0
3426 muscle transplant ....... by report
3427 Thiersch procedure for incontinence and/or prolapse ....... 25.0
Destruction
3433 Condyloma, single or multiple, internal and external, in hospital ....... 20.0
3434 external, electrodesiccation, initial ....... 3.0
3435 subsequent ....... 2.0

Liver

Incision
3456 Aspiration biopsy of liver ....... 5.0
Excision
3464 Hepatectomy, partial: resection of liver ....... 80.0
Repair
3471 Marsupialization of cyst or abscess of liver ....... 70.0
Suture
3481 Hepatorrhaphy: suture of liver wound or injury ....... 60.0

Biliary Tract

Incision
3491 Hepaticotomy or hepaticostomy with exploration, drainage or removal of calculus ....... 70.0
3495 Choledochotomy or choledochostomy with exploration, drainage or removal of calculus, with or without cholecystotomy ....... 70.0
3500 Duodenocholedochotomy: transduodenal choledocholithotomy ....... 80.0
3501 Transduodenal sphincterotomy ....... 80.0
3504 Cholecystotomy or cholecystostomy with exploration, drainage or removal of calculus ....... 50.0
Introduction
3509 Injection procedure for percutaneous trans-hepatic cholangiography (independent procedure) ....... 10.0
Excision
3515 Cholecystectomy ....... 60.0
3517 with open exploration of common duct ....... 70.0
Repair
3518 Exploration for congenital atresia of bile ducts ....... 50.0
3519 Direct anastomosis of gallbladder and gastrointestinal tract ....... 65.0
3520 Roux-en-y anastomosis of gallbladder and gastrointestinal tract ....... 65.0
3521 Direct anastomosis of extrahepatic biliary ducts and gastrointestinal tract ....... 75.0
3522 Roux-en-y anastomosis of extrahepatic biliary ducts and gastrointestinal tract ....... 85.0
3523 Plastic reconstruction of extrahepatic biliary ducts with end-to-end anastomosis ....... 80.0

Pancreas

Incision
3541 Abdominal drainage of pancreatitis ....... 50.0
3544 Removal of calculus ....... 70.0
Excision
3550 Pancreatectomy, subtotal ....... 80.0
3551 subtotal (Whipple type) ....... 140.0
3552 ....... 140.0
3553 Pancreatico-jejunostomy ....... 80.0
Repair
3565 Marsupialization of cyst of pancreas ....... 60.0
3566 Internal direct anastomosis of cyst to gastrointestinal tract ....... 70.0
3567 Rouxeny internal anastomosis, cyst to gastrointestinal tract ....... 80.0

Abdomen, Peritoneum and Omentum

Incision
3571 Exploratory laparotomy: exploratory celiotomy ....... 40.0
3573 Drainage of peritoneal abscess or localized peritonitis exclusive of appendicular abscess ....... 40.0
3575 Subdiaphragmatic or subphrenic abscess ....... 50.0
3578 Retroperitoneal abscess ....... 40.0
3588 Peritoneocentesis: abdominal paracentesis, initial ....... 4.0
3590 subsequent ....... 3.0
Excision
3591 Trans-peritoneal excision of intra-abdominal or retroperitoneal tumors or cysts ....... 70.0
Endoscopy
3595 Peritoneoscopy ....... 15.0
Introduction
3611 Pneumoperitoneum: intraperitoneal injection of air, initial ....... 4.0
3612 subsequent ....... 2.0
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:
3631 Inguinal, unilateral ....... 35.0
3633 with orchiectomy ....... 40.0
3634 with excision of hydrocele ....... 40.0
3635 recurrent ....... 40.0
3646 Femoral, unilateral ....... 35.0
3651 recurrent ....... 45.0
3661 Ventral, incisional ....... 45.0
3662 recurrent ....... 50.0
3663 Epigastric ....... 35.0
3664 recurrent ....... 45.0
3665 Umbilical, under age five years ....... 30.0
3666 over age five years ....... 35.0
3667 Omphalocele, in newborn, one stage ....... 40.0
3668 Gross type procedure, first stage ....... 50.0
3669 second stage ....... 50.0
(For diaphragmatic hernia, see 1495, 1496.)
Suture
3734 Secondary suture of abdominal wall for evisceration or disruption ....... 20.0
(For suture of ruptured diaphragm, see 1495, 1496.)

URINARY SYSTEM

Kidney

Incision
3802 Drainage of perirenal abscess (independent procedure) ....... 50.0
3808 Nephrotomy with drainage: nephrostomy ....... 80.0
3811 Nephrolithotomy, removal of calculus ....... 80.0
3812 large (staghorn) calculus ....... 90.0
3813 Division or transection of aberrant renal vessels (independent procedure) ....... 70.0
3815 Pyelotomy with exploration ....... 70.0
3816 Pyelotomy with drainage, pyelostomy ....... 70.0
3817 Pyelotomy with removal of calculus; pyelolithotomy; pelviolithotomy ....... 70.0
Excision
3820 Renal biopsy, trochar or needle ....... 5.0
3821 Nephrectomy, including partial ureterectomy ....... 80.0
3822 with total ureterectomy through same or separate incision ....... 100.0
3824 Heminephrectomy ....... 100.0
3827 Excision of cyst of kidney ....... 70.0
3829 Aspiration or injection of renal cyst or renal pelvis ....... 5.0
Introduction
(For perirenal insufflation, unilateral or bilateral, see 3614.)
Repair
3831 Pyeloplasty: plastic operation on renal pelvis with or without plastic operation on ureter or nephropexy ....... 80.0
3835 Nephropexy: fixation or suspension of kidney (independent procedure) ....... 70.0
Suture
3841 Nephrorrhaphy: suture of kidney wound or injury ....... 80.0
3845 Closure of nephrostomy, pyelostomy or other renal fistula (e.g., renocolic fistula) ....... 80.0
3846 Symphysiotomy for horseshoe kidney ....... 100.0
Transplant
3850 Kidney transplant ....... 125.0

Ureter

Incision
3851 Ureterotomy with exploration or drainage (independent procedure) ....... 70.0
3857 Ureterolithotomy, upper three quarters of ureter ....... 70.0
3858 lower one quarter ....... 80.0
Excision
3861 Ureterectomy, with bladder cuff (independent procedure) ....... 80.0
Repair
3871 Ureteroplasty: plastic operation on ureter (stricture) ....... 80.0
3872 Ureterolysis, with or without repositioning of ureter, unilateral ....... 70.0
3873 bilateral ....... 90.0
3874 Ureteropyelostomy: anastomosis of ureter and renal pelvis ....... 80.0
3875 Ureteroureterostomy ....... 80.0
3876 Ureteroneocystostomy: anastomosis of ureter to bladder, unilateral ....... 80.0
3877 bilateral ....... 100.0
3880 Ureteroenterostomy: anastomosis of ureter to intestine, unilateral ....... 80.0
3881 bilateral ....... 100.0
3884 Ureterostomy: transplantation of ureter to skin, unilateral ....... 70.0
3885 bilateral ....... 90.0
Suture
3891 Ureterorrhaphy: suture of ureter (independent procedure) ....... 80.0
3895 Closure of fistula of ureter ....... by report

Bladder

Incision
3900 Aspiration of bladder by needle or trochar ....... 5.0
3902 with insertion of suprapubic catheter ....... 10.0
3904 Cystotomy or cystostomy with fulguration ....... 60.0
3905 Cystotomy with drainage; cystostomy ....... 50.0
3907 Cystotomy with removal of calculus (cystolithotomy) without vesical neck resection ....... 50.0
3908 Drainage of perivesical or prevesical space abscess ....... 50.0
Excision
3911 Cystectomy, partial ....... 70.0
3912 with re-implantation of ureter into bladder (ureteroneocystostomy) ....... 80.0
3913 complete ....... 100.0
3914 radical with ureteral transplants ....... 120.0
3915 with ureteral-ileo conduit ....... 140.0
3918 Transurethral resection, vesical neck, female or child (See also 4321.) ....... 50.0
3919 Cystotomy for excision of vesical neck (independent procedure) ....... 60.0
3920 Excision of bladder diverticulum (independent procedure) ....... 70.0
3922 Excision of bladder tumor (See also 3904.) ....... 60.0
3924 Transurethral resection of bladder tumors, large (For small tumors, see 3936, 3937.) ....... 60.0
Introduction
3926 Bladder irrigation, simple, lavage and/or instillation ....... 1.0
3927 Injection procedure for cystography or urethro-cystography ....... 1.0
Cystoscopy (independent procedure):
3930 Diagnostic, office, initial ....... 5.0
3931 subsequent within 30 days ....... 3.0
3932 with ureteral catheterization ....... 8.0
3933 hospital ....... 8.0
3934 with ureteral catheterization ....... 15.0
(For Howard or Stamey type renal function test see 3948.)
3935 With biopsy ....... 10.0
3936 With fulguration or treatment of minor (less than 0.5 cm.) lesion, with or without biopsy ....... 10.0
3937 With fulguration of small bladder tumors (0.5 cm. to 2 cm.) (For larger tumors, see 3924.) ....... 25.0
3938 With subsequent fulguration of bladder tumor ....... 10.0
3939 With insertion of radioactive substance, with or without biopsy or fulguration ....... 30.0
3940 With dilatation of bladder for interstitial cystitis, general anesthesia ....... 15.0
3942 With ureteral meatotomy ....... 20.0
3943 With resection of fulguration of ureterocele ....... 20.0
3944 With removal of foreign body from urethra or bladder ....... 20.0
3945 With removal of calculus from ureter ....... 30.0
3946 With manipulation of ureteral calculus, primary ....... 20.0
3947 subsequent ....... 10.0
3948 Differential quantitative and chemical renal function test (e.g., Howard or Stamey type) .......
Destruction
3951 Litholaplaxy: crushing of calculus in bladder and removal of fragments ....... 50.0
Repair
3952 Cystoplasty; plastic operation on bladder (anterior Y-plasty, vesical fundus resection, etc.) any procedure ....... 80.0
Suture
3961 Cystorrhaphy: suture of bladder wound, injury or rupture ....... 60.0
3963 Closure of cycstostomy (independent procedure) ....... 30.0
3965 Closure of vesicovaginal, vesicouterine, or vesicoenteric fistula (See also 3331.) ....... 60.0

Urethra

Incision
3971 Urethrotomy, external (independent procedure) anterior ....... 10.0
3973 perineal, external ....... 25.0
3977 Meatotomy: cutting of meatus (independent procedure) ....... 3.0
3978 Drainage of deep periurethral abscess, hospital ....... 10.0
3979 Drainage of simple perineal urinary extravasation (independent procedure), uncomplicated ....... 15.0
3980 complicated, with or without diversion of urinary stream ....... 50.0
(See also 3908.)
Excision
(For excision or fulguration of urethral caruncle, see 4437.)
3987 Excision or fulguration of carcinoma of urethra ....... by report
3991 Excision or diverticulum of urethra (independent procedure) ....... 50.0
3994 Excision of fulguration of urethral polyps, distal 3/4 inch of urethra ....... 5.0
(For posterior urethra, see 4006.)
Endoscopy
4000 Urethroscopy, diagnostic ....... 5.0
4001 with removal of calculus or foreign body ....... 20.0
4004 with internal urethrotomy ....... 20.0
4006 with fulguration of posterior urethra ....... 10.0
4008 subsequent, within 30 days ....... 5.0
Repair
4011 Urethroplasty: plastic operation on urethra (except 4132 and 4135) ....... by report
Suture
4021 Urethrorrhaphy: suture of urethral wound or injury ....... by report
4023 Closure of urethrostomy or fistula of urethra (independent procedure) ....... 30.0
4025 Closure of urethrovaginal fistula ....... 50.0
4026 Closure of urethrorectal fistula (See also 3333.) ....... 70.0
Manipulation
4031 Dilation of urethral stricture by passage of sound, initial, male ....... 3.0
4032 subsequent within 30 days ....... 1.5
4033 Dilation of urethral stricture by passage of filiform and follower, male ....... 5.0
4034 subsequent within 30 days ....... 2.5
4035 Passage of filiform and follower for acute vesical retention, male ....... 5.0
4036 Dilation of female urethra including suppository and/or installation ....... 2.0
4037 subsequent within 30 days ....... 1.0

MALE GENITAL SYSTEM

Penis

Incision
4101 Dorsal or lateral "slit" of prepuce (independent procedure) ....... 3.0
Excision
4111 Biopsy of penis (independent procedure) ....... 3.0
4114 Amputation of penis, partial ....... 40.0
4115 complete ....... 60.0
4116 radical ....... 100.0
(For local excision of lesion of penis, see Integumentary System.)
4122 Circumcision, clamp procedure, newborn ....... 3.0
4123 except newborn ....... 5.0
4124 surgical excision other than clamp or dorsal slit, any age (except newborn) ....... 10.0
(For excision or fulguration of warts, see 0403, 0405.)
Repair
4131 Plastic operation on penis for hypospadias, straightening of chordee ....... 30.0
(For urethroplasty for hypospadias, see 0260 to 0324.)
4134 Plastic operation on penis for injury ....... by report
4135 Plastic operation on penis for epispadias with exstrophy of bladder ....... by report
4136 Plastic operation for penile epispadias distal to external sphincter ....... 50.0

Testis

Excision
4140 Biopsy, needle (independent procedure) ....... 2.0
4141 incisional (independent procedure) ....... 10.0
4143 Orchiectomy, simple unilateral ....... 20.0
4144 bilateral ....... 30.0
4145 with superficial inguinal node dissection, unilateral ....... 50.0
(For radical retroperitoneal node dissection, see 2673.)
Repair
4152 Reduction of torsion of testis by surgical means ....... 30.0
4153 with fixation of contralateral testis ....... 45.0
4154 Fixation of contralateral testis (independent procedure) ....... 20.0
4156 Orchiopexy, any type, with or without hernia repair ....... 50.0
4157 second stage (Torek type) ....... 10.0
(For orchiectomy with repair of hernia, see 3633.)

Epididymis

Incision
4161 Drainage of abscess of epididymis ....... 3.0
Excision
4171 Biopsy of epididymis, needle ....... 2.0
4172 Exploration of epididymis with or without biopsy ....... 10.0
4174 Excision of spermatocele with or without epididymectomy ....... 30.0
4176 Epididymectomy, unilateral ....... 30.0
Repair
4181 Epididymovasostomy (anastomosis of epididymis to vas deferens), unilateral ....... 40.0
4182 bilateral ....... 50.0

Tunica Vaginalis

Incision
4191 Puncture aspiration of hydrocele with or without injection of medication ....... 2.0
4200 Repair of hydrocele (Bottle type) ....... 20.0
4201 Excision of hydrocele, unilateral ....... 30.0
4202 with hernia repair ....... 40.0
Scrotum
Incision
4211 Drainage of scrotal abscess ....... 2.0
4215 Removal of foreign body in scrotum ....... by report
Excision
(For local excision of lesion of skin of scrotum, see 0175-0197, 0260-0270.)
4224 Resection of scrotum ....... by report
4227 Scrotoplasty; plastic operation on scrotum ....... by report

Vas Deferens

Incision
4231 Vasotomy: incision or transection of vas, unilateral or bilateral (independent procedure) ....... 15.0
Excision
4241 Vasectomy, unilateral or bilateral (independent procedure) ....... 15.0
Repair
4251 Vasovasostomy unilateral ....... 30.0
4252 bilateral ....... 40.0
Suture
4261 Ligation (percutaneous of vas deferens (independent procedure) ....... 5.0

Spermatic Cord

Excision
4271 Excision of hydrocele of spermatic cord (independent procedure), unilateral ....... 30.0
4275 Excision of varicocele (independent procedure), unilateral ....... 30.0
4278 with hernia repair ....... 40.0
Seminal Vesicles
Incision
4281 Vesiculotomy, unilateral ....... by report
Excision
4291 Vesiculectomy ....... 80.0

Prostate

Incision
4300 Biopsy, prostate, needle, single or multiple ....... 5.0
4301 incisional, perineal approach ....... 30.0
4302 transrectal ....... 20.0
4303 Prostatotomy: external drainage of prostatic abscess ....... 30.0
4304 Prostatolithotomy: removal of prostatic calculus (independent procedure) ....... 70.0
Excision
4311 Prostatectomy, perineal, subtotal ....... 80.0
4313 radical ....... 100.0
4316 suprapubic, one or two stages ....... 80.0
4318 retropubic ....... 80.0
4319 radical ....... 100.0
Endoscopy
4321 Transurethral resection of prostate, including control of postoperative bleeding, complete (See also 3918.) ....... 80.0

FEMALE GENITAL SYSTEM

Vulva and Introitus

Incision
4403 Incision and drainage, abscess of vulva ....... 5.0
4405 Incision and drainage of Bartholin's gland abscess, unilateral ....... 5.0
Excision
4421 Biopsy of vulva (independent procedure) ....... 3.0
(For local excision or fulguration of lesion(s) of external genitalia, see 0175-0197, 0260-0324, 0401-0406.)
4423 Vulvectomy, complete, bilateral ....... 55.0
4424 partial, less than 80% of vulvar area ....... 40.0
4425 radical, including unilateral regional lymph nodes ....... 100.0
4426 including bilateral regional lymph nodes ....... 150.0
4428 Clitoridotomy: circumcision, female ....... 7.5
4429 Clitoridectomy ....... 10.0
4431 Hymenectomy, partial excision of hymen ....... 10.0
4433 Excision of Bartholin's gland or cyst ....... 20.0
4434 Marsupialization or cautery destruction of Bartholin's gland or cyst ....... 15.0
4436 Excision or fulguration of Skene's glands ....... 7.0
4437 Excision or fulguration of urethral caruncle ....... 7.0
(For excision of urethral diverticulum see 3991.)
(For excision or fulguration of urethral carcinoma see 3987.)
Repair
4441 Episioplasty: plastic repair of vulva (non-obstetrical) ....... 20.0
4443 Plastic operation on urethral sphincter, vaginal approach ....... 30.0
4445 Plastic repair of urethra for mucosal prolapse (independent procedure) ....... by report
4447 Plastic repair of urethrocele (independent procedure) ....... 30.0
Suture
(For eposiorrhaphy or episioperineorrhaphy: for recent injury of vulva and/or perineum [nonobstetrical], see 4480.)

Vagina

Incision
4461 Colpotomy with exploration or drainage of pelvic abscess ....... 15.0
4462 Colpocentesis (independent procedure) ....... 4.0
4463 Puncture and aspiration of cul de sac ....... 3.0
4471 Biopsy of vaginal mucosa (independent procedure) ....... 3.0
(For excision and/or fulguration of local lesion(s) see 0175-0197, 0401-0406.)
4473 Colpocleisis, complete obliteration of vagina ....... 50.0
4475 Le Fort type ....... 35.0
4477 Excision of vaginal septum ....... by report
Introduction
4478 Irrigation and/or application of any medicament for treatment of bacterial, parasitic or fungoid disease ....... 1.0
Repair
4479 Colporrhaphy: suture of injury of vagina (nonobstetrical) ....... by report
4480 Colpoperineorrhaphy: suture of injury of vagina and/or perineum (nonobstetrical) ....... by report
4481 Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele (independent procedure) ....... 35.0
4484 Posterior colporrhaphy, repair of rectocele (independent procedure) ....... 30.0
4485 with perineoplasty or perineorrhaphy ....... 35.0
4488 Combined anterior-posterior colporrhaphy ....... 50.0
4492 Urethral suspension, abdominal approach (Marshall-Marchetti type) ....... 40.0
4493 Repair of enterocele (independent procedure) abdominal approach ....... 45.0
4494 vaginal approach ....... 45.0
4495 Colpopexy, abdominal approach ....... 45.0
4497 Construction of artificial vagina (vaginal atresia or absence) with or without graft ....... by report
(For closure of vaginal fistulae, see 3335, 3965, 4025.)
Manipulation
4511 Dilation of vagina under anesthesia ....... 2.0
4512 Pelvic examination under anesthesia ....... 2.0
Endoscopy
4521 Culdoscopy (independent procedure) ....... 15.0

Oviduct

Incision
4531 Transection of Fallopian tube, unilateral or bilateral, abdominal or vaginal approach ....... 40.0
4532 post-partum, during same hospitalization ....... 30.0
Excision
4541 Salpingectomy, complete or partial, unilateral or bilateral (independent procedure) ....... 45.0
4545 Salpingo-oophorectomy, complete or partial, unilateral or bilateral (independent procedure) ....... 45.0
4551 Salpingoplasty, unilateral or bilateral (independent procedure) ....... 50.0

Oviduct

Incision
4561 Drainage of ovarian cyst, vaginal approach, unilateral or bilateral ....... 25.0
4562 abdominal approach, unilateral or bilateral ....... 40.0
4564 Drainage of ovarian abscess, vaginal approach ....... 20.0
4565 abdominal approach ....... 40.0
Excision
4566 Biopsy of ovary, unilateral or bilateral (independent procedure) ....... 45.0
4568 Partial oophorectomy, bilateral or unilateral ....... 45.0

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
4572 Cauterization of cervix, office ....... 3.0
4573 Biopsy of cervix, circumferential (cone) with or without dilation and curettage, with or without Sturmdorff type repair ....... 20.0
4575 Trachelectomy: cervicectomy: amputation of cervix (independent procedure) ....... 20.0
4577 total excision of cervical stump, with or without pelvic floor repair, abdominal approach ....... 50.0
4578 vaginal approach ....... 60.0
Introduction
*4581 Insertion of any hemostatic agent for control of hemorrhage (independent procedure) ....... 3.0
(For insertion of any radioactive material, see 7615.)
4583 Insertion of intracervical or intrauterine device ....... 3.0
Repair
4585 Tracheloplasty: surgical repair of incompetent cervix, loop type ....... 8.0
4586 Shirodkar type ....... 20.0
4587 Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach ....... by report
Manipulation
4588 Dilation of cervical canal, instrumental (independent procedure) ....... 3.0
4589 Dilation and curettement of cervical canal ....... 15.0

Corpus Uteri

Excision
4610 Endometrial biopsy (independent procedure) ....... 3.0
4612 Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical) ....... 15.0
4613 Myomectomy: excision of fibroid tumor of uterus (independent procedure, nonobstetrical) ....... 50.0
4614 Total hysterectomy (corpus and cervix) with or without tubes, and/or ovaries, one or both ....... 60.0
4618 Supracervical hysterectomy: subtotal hysterectomy, with or without tubes, and/or ovaries, one or both ....... 55.0
4620 Radical hysterectomy for cancer including regional lymph nodes ....... 100.0
4626 plus removal of bladder and ureteral transplantations and/or abdominoperineal resection of rectum and colon and colostomy or any combination thereof ....... by report
4631 Vaginal hysterectomy ....... 60.0
4632 with plastic repair of vagina, anterior and/or posterior colporrhaphy ....... 70.0
4634 with repair of enterocele ....... 75.0
Introduction
*4675 Insufflation of uterus and tubes with air or CO 2 ....... *3.0
*4676 Injection procedure for hystero-salpingography ....... *3.0
Repair
4683 Uterine suspension with or without shortening of round ligaments (independent procedure) ....... 40.0
4684 with presacral sympathectomy ....... 45.0
4685 with interposition operation, with or without pelvic floor repair ....... 50.0
4690 with shortening of endopelvic fascia: parametrial fixation with or without pelvic floor repair (Manchester type) ....... 50.0
4692 with shortening of sacro-uterine ligaments ....... 50.0
4694 Hysterosalpingostomy: anastomosis of tubes of uterus ....... 50.0
4695 Hysterorrhaphy: repair of ruptured uterus (nonobstetrical) ....... 40.0

Perineum

Excision
4710 Biopsy of perineum (independent procedure) ....... 3.0
(For excision of local lesion see 0175-0178, 0260-0324.)
Incision
*4720 Incision and drainage of perineal abscess (nonobstetrical) ....... *3.0
Repair
4731 Perincoplasty: repair of perineum (independent procedure) ....... 15.0
4735 third degree laceration, old (independent procedure) ....... 40.0
(Also see 4441, 4480.)
4742 Perineorrhaphy, postpartum, by other than delivering physician ....... 20.0
4745 Repair of perineal fistula ....... 25.0
(For repair of recent injury of perineum, nonobstetrical, see 4480.)

MATERNITY

(Fees for all maternity procedures include prenatal and postpartum care unless otherwise specified.)
Incision
4801 Classic cesarean section ....... 50.0
4802 Low cervical (lower uterine segment) cesarean section ....... 50.0
4803 Cesarean section and hysterectomy, total or subtotal ....... 60.0
4804 Extraperitoneal cesarean section ....... 60.0
Excision
4809 Hysterotomy induced abortion ....... 50.0
4811 Ectopic pregnancy, tubal, requiring salpingectomy and/or oophorectomy, abdominal or vaginal approach ....... 50.0
4812 ovarian, requiring oophorectomy ....... by report
4815 Hysterotomy, abdominal, for removal of hydatidiform mole ....... 45.0
Manipulation
4821 Total obstetrical care including antepartum care, obstetrical delivery and postpartum care (with or without low forceps, and/or episiotomy) ....... 35.0
4822 Obstetrical delivery (with or without low forceps, and/or episiotomy) and including hospital postpartum care ....... 20.0
4823 Antepartum care only (independent procedure) ....... Sv.!
4824 Postpartum care only (independent procedure) ....... Sv.!
4841 Amniocentesis, diagnostic ....... 5.0
4842 Amniocentesis with hypertonic solution including terminal curettage, induced abortion ....... 40.0
4843 Dilation and curettage, and/or suction, induced abortion ....... 20.0
4850 Abortion, first trimester, completed medically ....... Sv.!
4851 (incomplete) completed surgically, (dilataion and curettage) ....... 15.0
4853 second trimester, completed medically ....... Sv.!
4854 (incomplete) completed surgically, (dilatation and curettage) ....... 15.0
4856 missed, first or second trimester, completed medically or surgically ....... by report
4858 incomplete, septic, requiring dilatation and curettage and additional care ....... by report
4870 Dilatation and curettage of uterus for postpartum bleeding ....... 15.0

ENDOCRINE SYSTEM

Thyroid Gland

Incision
4904 Incision and drainage of thyroglossal cyst (infected) ....... 3.0
Excision
4911 Local excision of small cyst or adenoma of thyroid ....... 40.0
4912 Total thyroid lobectomy, unilateral ....... 50.0
4914 Thyroidectomy, total or complete ....... 70.0
4917 subtotal or partial ....... 60.0
4924 total or subtotal for malignancy with radical neck dissection ....... 100.0
4925 total or subtotal for malignancy with limited neck dissection ....... 80.0
4937 secondary, unilateral ....... 60.0
4938 bilateral ....... 70.0
4941 Excision of thyroglossal duct, cyst or sinus ....... 45.0
Parathyroid, Thymus, Pituitary, Pineal, Adrenal Glands and Carotid Body
(For hypophysectomy, see 2019 and 5130.)
Excision
4971 Parathyroidectomy or exploration of parathyroid ....... 70.0
4972 with mediastinal exploration with or without splitting of sternum ....... 90.0
4985 Adrenalectomy, transabdominal, lumbar or dorsal, unilateral ....... 80.0
4986 bilateral, one stage ....... 100.0
4987 two stages ....... 120.0
4989 Biopsy adrenal, unilateral ....... 60.0
4990 bilateral ....... 70.0
4993 Excision of carotid body tumor, with excision of carotid artery ....... 100.0
4994 without excision of carotid artery ....... 70.0

NERVOUS SYSTEM

Skull, Meninges and Brain

CRANIOTOMY FOLLOWING TRAUMA:
Incision
5001 Burr holes, unilateral, exploratory for subdural puncture, not followed by surgery ....... 30.0
5002 multiple, bilateral, not followed by surgery ....... 50.0
5003 Evacuation of hematoma, subdural, extradural, or intracerebral by burr holes only ....... 90.0
5004 requiring craniotomy ....... 100.0
5012 Removal of foreign body from brain ....... 100.0
Excision
5015 Removal of brain scar ....... by report
Repair
5018 Elevation of depressed skull fracture, simple ....... 75.0
5020 with debridement of brain and repair of dura ....... 100.0
5022 Cranioplasty for skull defect, bone, metal or plastic ....... 100.0
5024 Repair of dura by graft, including repair for cerebrospinal rhinorrhea ....... 100.0
CRANIOTOMY FOR NON-TRAUMATIC CAUSES:
Incision
5101 Burr holes, exploratory or ventricular puncture, not followed by surgery ....... 30.0
5102 Ventricular puncture through previous burr holes or fontanelle ....... 5.0
5106 Craniotomy for drainage of brain abscess ....... 75.0
5108 Subsequent tapping (aspiration) abscess in operating room ....... 10.0
5110 at bedside ....... 5.0
5112 Suboccipital craniectomy for tractotomy or section of 5th, 8th, 9th or other cranial nerves ....... 125.0
5113 Intratemporal (mastoid) craniectomy for decompression, neurolysis or excision of acoustic nerve tumor ....... 100.0
5114 Craniotomy for surgery of sensory root of grasserian ganglion ....... 100.0
5116 Craniotomy for lobotomy, unilateral ....... 40.0
5117 bilateral ....... 60.0
5119 Craniotomy for orbital decompression, unilateral ....... 100.0
5121 Cisternal puncture (independent procedure) ....... 3.0
5122 Subdural tap through fontanelle (infant) ....... 3.0
Excision
(For trans-septal hypophysectomy see 2019.)
5130 Osteoplastic craniotomy for excision of brain tumor, abscess, or cyst, supratentorial ....... 125.0
5132 Suboccipital craniectomy for brain tumor ....... 150.0
5134 Osteoplastic craniotomy for arteriovenous malformation ....... by report
5136 Osteoplastic craniotomy for obliteration of aneurysm ....... 150.0
5140 Craniotomy for pallidectomy, any method, including localizing techniques, single or multiple stages ....... 100.0
5144 for topectomy ....... 100.0
5146 for excision of choroid plexus ....... 50.0
5148 Craniectomy for osteomyelitis of skull ....... by report
Introduction
5152 Burr holes with ventriculography, not followed by surgery ....... 30.0
5153 followed by surgery ....... 20.0
5154 Ventriculography through fontanelle or previous burr holes ....... 10.0
5155 Ventricular puncture with introduction of dye and recovery by spinal puncture ....... 12.0
5159 Injection procedure for pneumoencephalography ....... 10.0
Repair
5160 Ventriculocisternostomy ....... 100.0
5162 Repair of encephalocele ....... by report
5166 Ventriculoauricular shunt ....... 100.0
5167 replacement or irrigation of obstructed valve ....... 90.0
5168 replacement or irrigation of ventricular catheter ....... 30.0
5169 removal of shunt in toto without replacement ....... 30.0
5170 Ventriculo-auricular-peritoneal-pleural-uretera l shunt ....... 100.0
5171 co-surgeon ....... 80.0
5174 Craniectomy for craniostenosis, single suture ....... 75.0
5175 multiple sutures ....... 100.0

Spine and Spinal Cord

Incision
5190 Laminectomy for decompression of the spinal cord and nerve roots (See also 5208-5210, 5225.) ....... 100.0
5192 Cordotomy, cervico-dorsal ....... 100.0
5194 Rhizotomy ....... 75.0
5198 Spinal puncture, lumbar, simple (independent procedure) ....... 2.0
5199 diagnostic, initial, with study of hydrodynamics ....... 4.0
(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
5208 Laminotomy for removal of intervertebral discs, cervical ....... 90.0
5209 thoracic ....... 90.0
5210 lumbar ....... 90.0
5211 Excision of intervertebral discs, anterior approach, cervical ....... 80.0
(See also 0634-0642.)
Introduction
5214 Injection procedure for myelography ....... 10.0
5216 for discography ....... 10.0
Repair
5225 Laminectomy for spondylolisthesis (See also 5190.) ....... 100.0
5227 Repair of meningocele ....... 75.0
5229 Repair of meningomyelocele ....... 90.0
5231 Lumbar subarachnoid-peritoneal-ureteral shunt ....... 80.0
5232 co-surgeon ....... 75.0
5233 Application crutchfield tongs or other skeletal traction device ....... 5.0

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
5255 Transection, spinal nerve ....... 40.0
5257 Transection, occipital nerve ....... 40.0
Excision
(For excision of tender scar, skin and subcutaneous tissues with or without tiny neuroma, see 0175, 0178, 0265, 0266.)
5273 Excision of surgically identifiable neuroma of cutaneous nerve ....... 8.0
5274 digital nerve, one or both, same digit ....... 10.0
5275 hand or foot, one (add 10 percent each additional) ....... 15.0
5276 arm or leg ....... 25.0
5277 Avulsion infraorbital nerve ....... 20.0
5280 Stoefel's neurectomy ....... 40.0
5282 Obturator neurectomy ....... 40.0
Introduction
5290 Alcohol injection, subarachnoid ....... 5.0
5294 2nd or 3rd branch of trigeminal nerve ....... 7.5
5295 under x-ray control (excluding x-ray charge) ....... 10.0
Nerve Block
5298 Paravertebral block, lumbar or thoracic ....... 5.0
5300 Sympathetic block (cervical) ....... 5.0
5302 Stellate ganglion ....... 5.0
5311 Brachial plexus block ....... 5.0
5312 Intercostal nerves ....... 3.0
5313 Lumbar, sacral and coccygeal nerves ....... 5.0
5314 Pudendal nerve ....... 5.0
5315 Splanchnic nerves ....... 5.0
5316 Ilioinguinal and iliohypogastric nerves ....... 5.0
5317 Sciatic nerve ....... 3.0
5318 Phrenic nerve ....... 3.0
5319 Other peripheral nerves ....... 3.0
Repair
NEURORRHAPHY-suture of nerve.
Primary
5320 Digital, one (add 25 percent each additional nerve) ....... 15.0
5822 Hand or foot (except motor thenar or ulnar motor) ....... 20.0
5323 Motor thenar or ulnar motor ....... 30.0
5325 Arm or leg (except sciatic) ....... 40.0
5326 Sciatic ....... by report
5328 Brachial or lumbar plexus ....... by report
5330 Cranial, extra-cranial ....... 75.0
(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
5337 hand or foot ....... 20.0
5339 arm or leg (except sciatic) ....... 40.0
5340 sciatic ....... by report
5341 brachial or lumbar plexus ....... by report
5343 cranial, extra-cranial ....... 75.0
(For facial nerve, see 6002, 6003.)
5345 Transplantation ulnar nerve, elbow (independent procedure) (includes neurolysis) ....... 25.0
5347 Median nerve decompression at carpal tunnel, simple ....... 30.0
(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

Vegetative Nervous System

Excision
SYMPATHECTOMIES:
5371 Cervical, unilateral ....... 60.0
5372 bilateral ....... 80.0
5375 Cervico-thoracic (Smithwicke type, supra- and infra-diaphragmatic), unilateral ....... 70.0
5376 bilateral, concomitant or delayed ....... 100.0
5381 Lumbar, unilateral ....... 55.0
5382 bilateral ....... 75.0
5385 Splanchnicectomy (Peet type) unilateral ....... 65.0
5386 bilateral ....... 80.0
5390 Presacral neurectomy, hypogastric plexus ....... 50.0
Eyeball
Incision
5420 Goniotomy ....... 50.0
Excision
5421 Enucleation of eyeball with or without sphere implant ....... 40.0
5422 with integrated implant ....... 50.0
5424 Secondary implantation of integrated implant ....... 60.0
5427 Evisceration of eyeball ....... 40.0
5428 with implantation in scleral shell ....... 50.0
5431 Suture of eyeball for wound or injury ....... by report

Cornea

Incision
5441 Keratotomy, any type ....... 10.0
5443 Paracentesis of cornea ....... 10.0
5445 Removal of foreign body from surface of cornea ....... 2.0
5448 under slit lamp ....... 3.0
Excision
5451 Keratectomy, partial ....... 30.0
5452 complete ....... 40.0
5457 Pterygium ....... 25.0
Introduction
5461 Tattoo of cornea, mechanical or chemical ....... 30.0
5465 Curettage and cauterization of corneal ulcer ....... 5.0
5466 Iontophoresis of corneal ulcer ....... 5.0
Repair
5471 Keratoplasty, (corneal transplant) lamellar ....... 100.0
5472 partial or complete, penetrating ....... 110.0
Suture
5481 Suture of perforated cornea ....... by report

Scelera

Incision
5491 Sclerotomy, operative incision, with removal of intraocular foreign body (with or without magnet) ....... 50.0
5492 with removal of foreign body from anterior chamber (with or without magnet) ....... 50.0
5495 Sclerotomy, posterior ....... 30.0
5496 Aspiration of anterior chamber, diagnostic ....... 4.0
Excision
5501 Sclerectomy for glaucoma, with scissors, punch or trephination ....... 60.0
5503 Scleral resection ....... 100.0
Introduction
5511 Irrigation and/or air injection into anterior chamber ....... 15.0
Suture
5521 Suture of sclera for wound or injury ....... by report

Iris and Ciliary Body

Incision
5531 Iridotomy ....... 20.0
5532 with transfixion of iris; iris bombe ....... 20.0
5534 Iridotomy-performed with photocoagulator ....... 10.0
Excision
5541 Excision of lesion of iris ....... 60.0
5542 and/or ciliary body (iridocylectomy) ....... 80.0
5544 Iridectomy; basal, optical or preliminary ....... 50.0
5546 peripheral ....... 50.0
Repair
5552 Iridodialysis ....... 40.0
5561 Repair of prolapsed iris with suture of perforated sclera or cornea ....... by report
Manipulation
5571 Iridenclesis or comparable procedure ....... 50.0
Destruction
5580 Diathermy of the ciliary body; cyclodiathermy ....... 30.0
5582 Cyclodialysis ....... 50.0

Crystalline Lens

Incision
5601 Discission (needling of lens), initial ....... 20.0
5602 subsequent ....... 10.0
5603 Aspiration of lens material for congenital cataract, one or more stages ....... 60.0
Excision
5611 Extraction of lens, intracapsular, extracapsular or linear, unilateral ....... 80.0
5616 Removal of dislocated lens ....... 80.0

Crystalline Lens

Introduction
5622 Transplantation of vitreous ....... 50.0

Retina

Repair
5630 Reattachment of retina, electrocoagulation, scleral resection, buckling or partial tubing ....... 100.0
5631 encircling tube, initial ....... 100.0
5632 subsequent ....... by report
5633 Removal of encirclng tube ....... 40.0
5634 Reattachment of retina, light coagulation of retinal break(s), one or more stages during same period of hospitalization ....... 40.0
5635 with drainage of subretinal fluid ....... 50.0
5636 Light coagulation of retina for tumor, Eales disease, etc., initial ....... 40.0
5637 subsequent ....... 20.0

Retina

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
5647 Muscle transplant (Hummelscheim type, etc. ....... 70.0

Orbit

Incision
5651 Orbitomy with exploration ....... 60.0
5652 with drainage of intraorbital abscess ....... 60.0
5653 with removal of intraorbital foreign body ....... 60.0
5662 Excision of benign lesion of orbit, requiring bone flap ....... 90.0
5664 Exenteration or evisceration of orbital contents with or without graft ....... 60.0
5665 including orbital bone ....... by report
Introduction
5671 Orbital injection of alcohol for hemorrhagic glaucoma or intractable pain ....... 10.0
Repair
(For plastic repair of orbit, see 0260-0324, 0619-0621.)

Eyelids

Incision
5691 Blepharotomy with drainage of abscess of eyelid ....... 2.0
5692 with drainage of Meibomian glands; hordeolum (stye) ....... 2.0
Excision
(For blepharectomy, see 0175-0197, 0260-0324,)
5702 Excision or incision of Meibomian gland (chalazion), single ....... 5.0
5703 multiple, same lid ....... 6.0
5704 multiple, different lids ....... 7.0
(For excision of lesion of eyelid, malignant, see 0194-0197, 0260-0324.)
5712 Epilation, electrolysis ....... 4.0
(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
5728 fascia sling method ....... 40.0
5729 lid suture method ....... 25.0
5730 Cautery puncture for entropion or ectropion ....... 5.0
5731 Ectropion repair ( e.g., Kuhnt-Szymanowski type) ....... 40.0
5732 Entropion repair ( e.g., Wheeler type) ....... 40.0
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
5742 embedded in conjunctiva ....... 2.0
5743 Suture of conjunctiva ....... 5.0
Excision
5751 Biopsy of conjunctiva ....... 5.0
5753 Excision of lesion of conjunctiva, e.g., cyst ....... 5.0
(For epithelioma, see 0175-0196, 0261-0269.)
For nevus see 0175-0196, 0261-0269.)
Repair
5760 Conjunctivoplasty, free graft using conjunctiva ....... 50.0
5762 using buccal mucous membrane ....... 60.0
5774 Flap operation of corneal ulcer ....... 20.0
5775 Flap operation: "flapping" of conjunctiva for perforating injuries or operative wound ....... 20.0
(For repair of symblepharon without graft, see 0175-0178, 0260-0276.)

Lacrimal Tract

Incision
5801 Drainage of lacrimal gland (abscess) ....... 10.0
5803 Drainage of lacrimal sac, (dacryocystotomy or dacryocystostomy) ....... 7.5
Excision
5811 Excision of lacrimal gland (dacryoadenectomy) ....... 50.0
5813 Excision of lacrimal sac (dacryocystectomy) ....... 50.0
5815 Excision of lacrimal gland tumor ....... 60.0
Introduction
5821 Catheterization of nasolacrimal duct with implantation of tube or stent ....... 10.0
5823 Injection procedure for dacryocystography ....... 3.0
Repair
5831 Plastic operation on canaliculi ....... by report
5833 Dacryocystorrhinostomy: fistulization of lacrimal sac into nasal cavity, with or without anterior ethmoidectomy ....... 70.0
5835 Closure of punctum by cautery ....... 4.0
Manipulation
5841 Dilation of punctum ....... 2.0
5843 Probing of nasolocrimal duct ....... 3.0
5846 Probing and/or irrigation of canaliculus ....... *2.0

EAR

External Ear

Incision
5901 Drainage of abscess or hematoma of auricle, simple ....... 2.0
5902 complicated, including suppurative chondritis ....... by report
5905 Drainage of abscess of external auditory canal ....... 2.0
Excision
5911 Biopsy of ear ....... 3.0
(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
5917 Complete amputation, auricle ....... 20.0
5920 Excision; osteoma, external canal, simple ....... 5.0
5923 Excision of exostosis of external auditory canal, endaural or post-aural approach, complicated ....... 50.0
5924 Radical excision of malignant lesion of external auditory canal ....... by report
5926 with neck dissection ....... by report
Endoscopy
5931 Otoscopy with removal of foreign body in external auditory canal ....... 2.0
Repair
(Otolasty: plastic operation on ear, see 0260-0324.)
(Reconstruction of ear with graft of skin plus cartilage, bone or other implant, see 0260-0324, 0620 and 0621.)
5947 Otoplasty, of cartilage ("lop-ear"), with or without reduction in size, unilateral ....... 50.0
5948 bilateral ....... 70.0
5949 Reconstruct external auditory canal for congenital astresia, single stage ....... 100.0
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
Incision
5961 Myringotomy; tympanotomy; plicotomy, with or without Eustachian inflation and/or aspiration ....... 3.0
5962 Tympanotomy, diagnostic, exploratory for middle ear exposure ....... 50.0
5963 with insertion of tube for serous otitis media, unilateral ....... 5.0
5964 with insertion of collar button tube for muco-serous otitis media, unilateral or bilateral ....... 25.0
5968 Tympanolysis, transtympanic ....... 80.0
Excision
5971 Mastoidectomy, simple ....... 50.0
5972 Mastoidectomy, modified radical or radical, without skin graft ....... 80.0
5975 with skin graft ....... 90.0
5980 Petrous apicectomy including radical mastoidectomy ....... by report
5982 Removal of middle ear polyp ....... 10.0
Repair
5990 Revision of radical mastoidectomy, with or without skin graft ....... 90.0
5991 Patching tympanic membrane, with or without cauterization ....... 2.0
5992 Myringoplasty, uncomplicated ....... 80.0
5993 Tympanoplasty without mastoidectomy (may include change in contours of external auditory canal and be combined with middle ear, including ossicular chain construction and/or attic surgery), post auricular or endaural approach ....... 100.0
5994 Typanoplasty with mastoidectomy ....... 120.0
5996 Incudo-stapedial arthrodesis, with or without graft ....... 70.0
5997 Stapes mobilization, primary or secondary ....... 70.0
5998 Stapedectomy with insertion of prosthetic stapes with fenestration of the oval window ....... 100.0
5999 Mastoid obliteration ....... 80.0
Suture
6001 Closure of fistula, mastoid (independent procedure) ....... 25.0
6002 Decompression, intratemporal, facial nerve, with or without neurolysis ....... 100.0
(See also 5330.)
6003 Suture and/or graft, facial nerve, intratemporal ....... 120.0

Internal Ear

Incision
6011 Labyrinthotomy, any type ....... 100.0
6012 Fenestration of semicircular canal ....... 100.0
6014 Revision of fenestration operation ....... 60.0
Excision
6021 Labyrinthectomy ....... 100.0

Footnotes

* Value is to be calculated as the sum of the various services rendered (e.g., hospital visit, application of cast or splint, detention with patient, office visit, etc.).

Notes

N.Y. Comp. Codes R. & Regs. Tit. 11 § 52.80

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